WorldWideScience

Sample records for cardiovascular prevention programs

  1. Development of an interprofessional program for cardiovascular prevention in primary care: A participatory research approach

    Directory of Open Access Journals (Sweden)

    Lyne Lalonde

    2014-02-01

    Full Text Available Background: The chronic care model provides a framework for improving the management of chronic diseases. Participatory research could be useful in developing a chronic care model–based program of interventions, but no one has as yet offered a description of precisely how to apply the approach. Objectives: An innovative, structured, multi-step participatory process was applied to select and develop (1 chronic care model–based interventions program to improve cardiovascular disease prevention that can be adapted to a particular regional context and (2 a set of indicators to monitor its implementation. Methods: Primary care clinicians (n = 16, administrative staff (n = 2, patients and family members (n = 4, decision makers (n = 5, researchers, and a research coordinator (n = 7 took part in the process. Additional primary care actors (n = 26 validated the program. Results: The program targets multimorbid patients at high or moderate risk of cardiovascular disease with uncontrolled hypertension, dyslipidemia or diabetes. It comprises interprofessional follow-up coordinated by case-management nurses, in which motivated patients are referred in a timely fashion to appropriate clinical and community resources. The program is supported by clinical tools and includes training in motivational interviewing. A set of 89 process and clinical indicators were defined. Conclusion: Through a participatory process, a contextualized interventions program to optimize cardiovascular disease prevention and a set of quality indicators to monitor its implementation were developed. Similar approach might be used to develop other health programs in primary care if program developers are open to building on community strengths and priorities.

  2. Implementation of a Cardiovascular Disease Prevention Program among School-Aged Children: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Lavon Young

    2006-09-01

    Full Text Available The objective of this study was to test students’ knowledge of cardiovascular disease information and to determine if a carefully structured training program administered to high school students would increase their knowledge about cardiovascular disease and risk factors that are preventable. A pilot study was conducted during which fifty high school students from nine counties in the State of Mississippi were measured for their knowledge of hypertension both at baseline and after the completion of an intervention training activity. There were significant gains in knowledge between the pre-test and the post-test that the students completed. The gains in knowledge indicate that elimination of risk factors is possible if all health care and school-based prevention programs are implemented to positively impact changes in eating and physical activity behaviors. Students’ involvement in such activities could translate into significant changes in risk factors at these ages and throughout their lifetime. It is widely accepted that these behavioral changes, if sustained into adulthood, could have the potential to influence cardiovascular risk reduction.

  3. Cardiovascular disease prevention in a health insurance program in rural Nigeria

    NARCIS (Netherlands)

    Hendriks, M.E.

    2014-01-01

    Cardiovascular diseases (CVD) are a leading cause of death and disability in sub-Saharan Africa. Treatment of cardiovascular risk factors, such as hypertension and diabetes, greatly reduces the risk of CVD. However, this treatment is often not available or not accessible for patients in sub-Saharan

  4. Closing the gap-cardiovascular risk and primary prevention: results from the American College of Physicians quality improvement program.

    Science.gov (United States)

    Snow, Vincenza; Reynolds, Cara Egan; Bennett, Lia; Weiss, Kevin B; Snooks, Qianna; Qaseem, Amir

    2010-01-01

    The objective was to study the impact of a practice-based quality improvement program on practice teams' care for patients who have increased risk of cardiovascular disease. A total of 54 team members from 18 internal medicine practices participated in an educational program that used a pre-post intervention study design and focused on measures related to cardiovascular risk factors. The program involved live instruction, faculty-led conference calls, practice data collection, and progress reports detailing practices' improvement strategies. Data on 817 patients were reported. Practices showed significant improvement in counseling for diet (70% to 78%), exercise (67% to 74%), and weight loss (64% to 72%). Use of aspirin (53% to 64%) and statins (83% to 89%) also showed significant improvement. Administration of flu vaccine increased significantly from 51% to 54%. Improvements in patient counseling and medication management, if sustained, should lead to fewer cardiovascular events. However, program duration did not allow the capture of outcomes measures improvement.

  5. Cardiovascular Prevention of Cognitive Decline

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Monsuez

    2011-01-01

    Full Text Available Midlife cardiovascular risk factors, including diabetes, hypertension, dyslipemia, and an unhealthy lifestyle, have been linked to subsequent incidence, delay of onset, and progression rate of Alzheimer disease and vascular dementia. Conversely, optimal treatment of cardiovascular risk factors prevents and slows down age-related cognitive disorders. The impact of antihypertensive therapy on cognitive outcome in patients with hypertension was assessed in large trials which demonstrated a reduction in progression of MRI white matter hyperintensities, in cognitive decline and in incidence of dementia. Large-scale database correlated statin use and reduction in the incidence of dementia, mainly in patients with documented atherosclerosis, but clinical trials failed to reach similar conclusions. Whether a multitargeted intervention would substantially improve protection, quality of life, and reduce medical cost expenditures in patients with lower risk profile has not been ascertained. This would require appropriately designed trials targeting large populations and focusing on cognitive decline as a primary outcome endpoint.

  6. Preventive Effects of Catechins on Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Xiao-Qiang Chen

    2016-12-01

    Full Text Available Catechins are polyphenolic phytochemicals with many important physiological activities that play a multifaceted health care function in the human body, especially in the prevention of cardiovascular disease. In this paper, various experimental and clinical studies have revealed the role of catechins in the prevention and treatment of cardiovascular disorders, and we review the preventive effects of catechins on cardiovascular disease from the following aspects: Regulating lipid metabolism, regulating blood lipid metabolism, vascular endothelial protection, and reducing blood pressure.

  7. [Exercise and cardiac rehabilitation in secondary cardiovascular prevention].

    Science.gov (United States)

    Acevedo, Mónica; Krämer, Verónica; Bustamante, María José; Yáñez, Fernando; Guidi, Dominique; Corbalán, Ramón; Godoy, Iván; Vergara, Ismael; Jalil, Jorge; Fernández, Marcelo

    2013-10-01

    Exercise and cardiac rehabilitation are indications with type I A evidence in most secondary cardiovascular prevention guidelines. Rehabilitation programs not only include exercise but also provide integral care and education about cardiovascular risk factors. However there is a paucity of such programs in Chile. Moreover there is a lack of awareness about the benefits of exercise and there is lack of knowledge about the details of exercise prescription in secondary prevention. Therefore, the divulgation of this knowledge is of utmost importance.

  8. Cardiovascular disease: primary prevention, disease modulation and regenerative therapy.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2012-10-01

    Cardiovascular primary prevention and regeneration programs are the contemporary frontiers in functional metabolic vascular medicine. This novel science perspective harnesses our inherent ability to modulate the interface between specialized gene receptors and bioavailable nutrients in what is labeled as the nutrient-gene interaction. By mimicking a natural process through the conveyance of highly absorbable receptor specific nutrients, it is feasible to accelerate cell repair and optimize mitochondrial function, thereby achieving cardiovascular cure. We performed a comprehensive review of PubMed, EMBASE and Cochrane Review databases for articles relating to cardiovascular regenerative medicine, nutrigenomics and primary prevention, with the aim of harmonizing their roles within contemporary clinical practice. We searched in particular for large-scale randomized controlled trials on contemporary cardiovascular pharmacotherapies and their specific adverse effects on metabolic pathways which feature prominently in cardiovascular regenerative programs, such as nitric oxide and glucose metabolism. Scientific research on \\'cardiovascular-free\\' centenarians delineated that low sugar and low insulin are consistent findings. As we age, our insulin level increases. Those who can decelerate the rapidity of this process are prompting their cardiovascular rejuvenation. It is beginning to dawn on some clinicians that contemporary treatments are not only failing to impact on our most prevalent diseases, but they may be causing more damage than good. Primary prevention programs are crucial elements for a better outcome. Cardiovascular primary prevention and regeneration programs have enhanced clinical efficacy and quality of life and complement our conventional endovascular practice.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Time Trends in Incidence and Mortality of Acute Myocardial Infarction, and All-Cause Mortality following a Cardiovascular Prevention Program in Sweden.

    Directory of Open Access Journals (Sweden)

    Gunilla Journath

    Full Text Available In 1988, a cardiovascular prevention program which combined an individual and a population-based strategy was launched within primary health-care in Sollentuna, a municipality in Stockholm County. The aim of this study was to investigate time trends in the incidence of and mortality from acute myocardial infarction and all-cause mortality in Sollentuna compared with the rest of Stockholm County during a period of two decades following the implementation of a cardiovascular prevention program.The average population in Sollentuna was 56,589 (49% men and in Stockholm County (Sollentuna included 1,795,504 (49% men during the study period of 1987-2010. Cases of hospitalized acute myocardial infarction and death were obtained for the population of Sollentuna and the rest of Stockholm County using national registries of hospital discharges and deaths. Acute myocardial infarction incidence and mortality were estimated using the average population of Sollentuna and Stockholm in 1987-2010.During the observation period, the incidence of acute myocardial infarction decreased more in Sollentuna compared with the rest of Stockholm County in women (-22% vs. -7%; for difference in slope <0.05. There was a trend towards a greater decline in Sollentuna compared to the rest of Stockholm County in the incidence of acute myocardial infarction (in men, acute myocardial mortality, and all-cause mortality but the differences were not significant.During a period of steep decline in acute myocardial infarction incidence and mortality in Stockholm County the municipality of Sollentuna showed a stronger trend in women possibly compatible with favorable influence of a cardiovascular prevention program.ClinicalTrials.gov NCT02212145.

  11. [New indications for the prevention of cardiovascular diseases].

    Science.gov (United States)

    Tenconi, Maria Teresa

    2008-01-01

    Cardiovascular diseases represent the first cause of death and disability in Italy. The main reversible risk factors are high levels of LDL-cholesterol, hypertension, tobacco-smoking, diabetes and/or metabolic syndrome and poor physical activity (at leisure). The prevalence of these risk factors is high in adult Italian population. Cardiovascular diseases prevention should start early in life, with health promotion programs aimed at the acquisition of a healthy lifestyle in communities such as schools and worksites. Besides the "cardiovascular risk score" should be used by general practitioners in order to screen adult population and to lower risk factors levels.

  12. Prevention of cardiovascular disease in women.

    Science.gov (United States)

    Bavry, Anthony A; Limacher, Marian C

    2014-11-01

    Cardiovascular disease is the leading cause of death among women. In fact, the cardiovascular disease mortality rate among women exceeds the rate in men. Unfortunately, many minority women are still unaware of the importance of this disease. All women, including those with no history of cardiovascular disease, should have an accurate estimate of the probability of a cardiovascular disease event (death, myocardial infarction, or stroke) usually within the next decade. Such an estimate will help determine if women are candidates for preventive measures and specific therapies such as aspirin. Data from the Framingham Heart Study were used to construct a risk score, which is now widely used; however, other risk scores are available. To prevent cardiovascular disease, women should refrain from smoking, maintain a healthy weight, eat a heart-healthy diet, be physically active, and have normal blood pressure and cholesterol levels. Aspirin can be considered for primary prevention, with expected benefit to prevent ischemic stroke; however, this needs to be balanced against potential bleeding risk. Hormone therapy is no longer recommended due to an increase in adverse events (most consistently seen as increased ischemic stroke risk). Folic acid is also no longer recommended due to lack of benefit.

  13. Influenza vaccines for preventing cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Christine Clar

    Full Text Available ABSTRACTBACKGROUND: This is an update of the original review published in 2008. The risk of adverse cardiovascular outcomes is increased with influenza-like infection, and vaccination against influenza may improve cardiovascular outcomes.OBJECTIVES: To assess the potential benefits of influenza vaccination for primary and secondary prevention of cardiovascular disease.METHODS:Search methods:We searched the following electronic databases on 18 October 2013: The Cochrane Library (including Cochrane Central Register of Controlled Trials (CENTRAL, Database of Abstracts of Reviews of Effects (DARE, Economic Evaluation Database (EED and Health Technology Assessment database (HTA, MEDLINE, EMBASE, Science Citation Index Expanded, Conference Proceedings Citation Index - Science and ongoing trials registers (www.controlled-trials.com/ and www.clinicaltrials.gov. We examined reference lists of relevant primary studies and systematic reviews. We performed a limited PubMed search on 20 February 2015, just before publication.Selection criteria:Randomised controlled trials (RCTs of influenza vaccination compared with placebo or no treatment in participants with or without cardiovascular disease, assessing cardiovascular death or non-fatal cardiovascular events.Data collection and analysis:We used standard methodological procedures as expected by The Cochrane Collaboration. We carried out meta-analyses only for cardiovascular death, as other outcomes were reported too infrequently. We expressed effect sizes as risk ratios (RRs, and we used random-effects models.MAIN RESULTS: We included eight trials of influenza vaccination compared with placebo or no vaccination, with 12,029 participants receiving at least one vaccination or control treatment. We included six new studies (n = 11,251, in addition to the two included in the previous version of the review. Four of these trials (n = 10,347 focused on prevention of influenza in the general or elderly population

  14. [Cardiovascular disease prevention and life style modifications].

    Science.gov (United States)

    Baudet, M; Daugareil, C; Ferrieres, J

    2012-04-01

    Cardiovascular diseases are mainly caused by atherosclerosis, the development of which is highly dependent on our Western lifestyle. Slowing this pathology depends on the reduction of risk factors such as hypercholesterolemia, high blood pressure, smoking, lack of physical activity, excess weight and diabetes. Drug treatment exists and is very effective, but too often they treat the immediate abnormality such as diabetes, high blood pressure and hypercholesterolemia and not the underlying causes: poor eating habits, lack of physical activity and excess weight. These have a negative impact on endothelial function, oxidative stress, and can trigger inflammation, arrythmias and thrombosis. Cardiovascular prevention must therefore target sedentary lifestyle, excess weight, and favor low-calorie, low-salt food and Mediterranean diet. The way this diet works begins to be understood and goes beyond simple cardiovascular prevention. Therapeutic education holds a growing and complementary role in the Public Health system which should call upon the strengths of all healthcare professionals.

  15. [Trends and current questions of cardiovascular prevention in primary health care].

    Science.gov (United States)

    Ilyés, István; Jancsó, Zoltán; Simay, Attila

    2012-09-30

    Although an impressive progress has been achieved in the treatment of cardiovascular diseases, they are at the top of the mortality statistics in Hungary. Prevention of these diseases is an essential task of the primary health care. Cardiovascular prevention is carried out at primary, secondary and tertiary levels using risk group and population preventive strategies. The two main tasks of primary cardiovascular prevention are health promotion and cardiovascular disease prevention, and its main programs are ensuring healthy nutrition, improving physical training and accomplishing an anti-smoking program. The essential form of secondary prevention is the screening activity of the primary health care. The majority of cardiovascular risk factors can be discovered during the doctor-patient consultation, but laboratory screening is needed for assessing metabolic risks. The official screening rules of the cardiovascular risk factors and diseases are based on diagnostic criteria of the metabolic syndrome; however, nowadays revealing of global cardiometabolic risks is also necessary. In patients without cardiovascular diseases but with risk factors, a cardiovascular risk estimation has to be performed. In primary care, there is a possibility for long term follow-up and continuous care of patients with chronic diseases, which is the main form of the tertiary prevention. In patients with cardiovascular diseases, ranking to cardiovascular risk groups is a very important task since target values of continuous care depend on which risk group they belong to. The methods used during continuous care are lifestyle therapy, specific pharmacotherapy and organ protection with drugs. Combined health education and counselling is the next element of the primary health care prevention; it is a tool that helps primary, secondary and tertiary prevention. Changes needed for improving cardiovascular prevention in primary care are the following: appropriate evaluation of primary prevention

  16. South American Guidelines for Cardiovascular Disease Prevention and Rehabilitation

    Directory of Open Access Journals (Sweden)

    AH Herdy

    2014-08-01

    Full Text Available In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR. In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline and adapt it to the national reality. The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World Health Organization (WHO, which is the reduction of worldwide cardiovascular mortality by 25% until 2025. The study group's priorities are the following: • Emphasize the important role of CVDPR as an instrument of secondary prevention with significant impact on cardiovascular morbidity and mortality; • Join efforts for the knowledge on CVDPR, its dissemination, and adoption in most cardiovascular centers and institutes in South America, prioritizing the adoption of cardiovascular prevention methods that are comprehensive, practical, simple and which have a good cost/benefit ratio; • Improve the education of health professionals and patients with education programs on the importance of CVDPR services, which are directly targeted at the health system, clinical staff, patients, and community leaders, with the aim of decreasing the barriers to CVDPR implementation.

  17. Impact of nutrition since early life on cardiovascular prevention.

    Science.gov (United States)

    Guardamagna, Ornella; Abello, Francesca; Cagliero, Paola; Lughetti, Lorenzo

    2012-12-21

    The cardiovascular disease represents the leading cause of morbidity and mortality in Western countries and it is related to the atherosclerotic process. Cardiovascular disease risk factors, such as dyslipidemia, hypertension, insulin resistance, obesity, accelerate the atherosclerotic process which begins in childhood and progresses throughout the life span. The cardiovascular disease risk factor detection and management through prevention delays the atherosclerotic progression towards clinical cardiovascular disease. Dietary habits, from prenatal nutrition, breastfeeding, complementary feeding to childhood and adolescence nutrition play a basic role for this topic.The metabolic and neuroendocrine environment of the fetus is fundamental in the body's "metabolic programming". Further several studies have demonstrated the beneficial effects of breastfeeding on cardiovascular risk factors reduction. Moreover the introduction of complementary foods represents another important step, with particular regard to protein intake. An adequate distribution between macronutrients (lipids, proteins and carbohydrates) is required for correct growth development from infancy throughout adolescence and for prevention of several cardiovascular disease risk determinants in adulthood.The purpose of this review is to examine the impact of nutrition since early life on disease.

  18. [Cacoa and dark chocolate in cardiovascular prevention?].

    Science.gov (United States)

    Belz, G G; Mohr-Kahaly, S

    2011-12-01

    It has been shown that the consumption of cocoa has a positive influence on a number of cardiovascular surrogate parameters such as arterial vasodilatation and a moderate decrease in blood pressure in humans. In the blood, a decrease in platelet aggregation and an increase in angiogenetic progenitor cells was noted. Furthermore, anti-inflammatory effects, an amelioration of the lipid profile and glucose metabolism was described. An increase of endothelial NO production following the ingestion of the antioxidant cocoa flavanols catechin and epicatechin seems to be the leading mechanism causing these effects. In animal studies of myocardial reperfusion, a decrease in infarct size was noted. In several prospective cohort studies from Europe and the United States, a 50 % reduction of mortality mostly due to a reduction of myocardial infarction was published. Consumption up to about 25 g daily of a flavanol rich dark chocolate (ca. 85 % cocoa content) can be recommended for cardiovascular prevention. In this moderate dosage, the potentially harmful effects due to weight gain and cadmium intake will be minimal. However, controlled randomized trials with well defined clinical endpoints are needed to prove the positive effects described so far. At this point, in time based on the information described in this article, a moderate consumption of flavanol rich cocoa products seems to be effective in the prevention of coronary artery disease and myocardial infarction.

  19. Impact of nutrition since early life on cardiovascular prevention.

    OpenAIRE

    2012-01-01

    Abstract The cardiovascular disease represents the leading cause of morbidity and mortality in Western countries and it is related to the atherosclerotic process. Cardiovascular disease risk factors, such as dyslipidemia, hypertension, insulin resistance, obesity, accelerate the atherosclerotic process which begins in childhood and progresses throughout the life span. The cardiovascular disease risk factor detection and management through prevention delays the atherosclerotic progression towa...

  20. Nutrigenomic programming of cardiovascular and metabolic diseases.

    Science.gov (United States)

    Ozanne, Susan

    2014-10-01

    Over twenty five years ago epidemiological studies revealed that there was a relationship between patterns of early growth and subsequent risk of diseases such as type 2 diabetes, cardiovascular disease and the metabolic syndrome. Studies of identical twins, individuals who were in utero during periods of famine, discordant siblings and animal models have provided strong evidence that the early environment plays an important role in mediating these relationships. Early nutrition is one such important environmental factor. The concept of early life programming is therefore widely accepted and the underlying mechanisms starting to emerge. These include: (1) Permanent structural changes in an organ due to exposure to suboptimal levels of essential hormones or nutrients during a critical period of development leading to permanent changes in tissue function (2) Persistent epigenetic changes such as DNA methylation and histone modifications and miRNAs leading to changes in gene expression. (3) Permanent effects on regulation of cellular ageing through increases in oxidative stress and mitochondrial dysfunction leading to DNA damage and telomere shortening. Further understanding of these processes will enable the development of preventative and intervention strategies to combat the burden of common diseases such as type 2 diabetes and cardiovascular disease.

  1. Eating Disorder Prevention Programming.

    Science.gov (United States)

    Sapia, Jennifer L.

    This paper provides information for school psychologists regarding the necessity and benefits of school-based prevention programming for students at risk for developing eating disorders (i.e., females). School-based programming is a cost-effective means of reaching the largest number of individuals at once and identifying those individuals…

  2. BIOACTIVE SUBSTANCES WITH PREVENTIVE EFFECT IN CARDIOVASCULAR DISEASES.

    Science.gov (United States)

    Mulero, Juana; Abellán, José; Zafrilla, Pilar; Amores, Diego; Hernández Sánchez, Pilar

    2015-10-01

    The effect of diet on cardiovascular disease prevention has been widely studied for many years. Numerous studies have confirmed that diets rich in fruits and vegetables (Mediterranean diet) are beneficial to the cardiovascular system and various bioactive food components have preventive effect on chronic diseases such as cardiovascular disease. In this paper we review the effect of bioactive substances included in the group of flavonoids (catechins and proanthocyanidins, anthocyanins and isoflavones), stilbenes such as resveratrol, bioactive peptides, plant sterols and polyunsaturated fatty acids omega- 3 on the cardiovascular system.

  3. Epidemiology and prevention of cardiovascular disease: Quo vadis?

    Science.gov (United States)

    De Backer, Guy

    2017-05-01

    With observational epidemiological studies it has been possible in the 1950-60 s to identify what has been called cardiovascular risk factors. The multifactorial origin of atherothrombotic cardiovascular disease has been elucidated and in multifactorial intervention trials it was demonstrated that lifestyle changes related to smoking, diet and exercise can prevent the incidence of premature cardiovascular events. The application of that knowledge at the level of the community has resulted in a reversal of the cardiovascular disease epidemic. More investment is needed in the prevention of the development of cardiovascular risk from childhood onwards. More studies are needed to examine the long-term effects of low-intensity exposure to environmental factors on the cardiovascular system using the most appropriate study design and biosensors. More epidemiological studies are needed to evaluate societal changes on cardiovascular disease. Given the actual knowledge on how to prevent cardiovascular disease there is a need for a shift from aetiological epidemiological research into preventive research.

  4. Prevention of Cardiovascular Diseases in Deprived Neighbourhoods

    OpenAIRE

    El Fakiri, Fatima

    2008-01-01

    textabstractWorldwide, cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality even though mortality rates in the industrialised countries have declined over the past decades. Recent WHO reports show that an estimated 17 million people die every year of CVD, particularly from myocardial infarction and strokes [1]. In Western countries, such as the Netherlands, discrepancies in cardiovascular morbidity and mortality according to ethnicity and socio-economic status sti...

  5. Multifactorial Prevention of Cardiovascular Disease in Patients with Hypertension : the Cardiovascular Polypill

    NARCIS (Netherlands)

    Lafeber, M; Spiering, W; Visseren, F L J; Grobbee, D E

    2016-01-01

    Hypertension is a major, if not the most important, contributor to the disease burden and premature death globally which is largely related to cardiovascular disease. In both the primary and the secondary preventions of cardiovascular disease, blood pressure (BP) targets are often not achieved which

  6. The Role of Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease.

    Science.gov (United States)

    Claas, Steven A; Arnett, Donna K

    2016-06-01

    Whereas primary prevention seeks to forestall development of disease in individuals with elevated risk, primordial prevention seeks to preempt the development of risk factors. Health behaviors-characterized as "lifestyle" factors-are key interventional targets in primordial prevention of cardiovascular disease. Appropriate dietary intake, including limiting salt and saturated fat consumption, can reduce the risk of developing hypertension and dyslipidemias. Regular physical activity is associated with lower blood pressure and healthier lipid profiles. Diet and exercise are critical to maintaining weight conducive to cardiovascular health. Behavioral factors such as stress management, sleep duration, portion control, and meal timing may play a role in weight management and offer additional routes of intervention. Any smoking elevates cardiovascular risk. Although lifestyle modification programs can be instrumental in reaching public health goals, maintaining cardiovascular health should not be a matter solely of willpower. Ideally, structural and social forces should make healthy lifestyles the default option.

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

    Science.gov (United States)

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

    2016-12-01

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

  8. The Challenge of Preventing Cardiovascular Disease in Tunisia

    Directory of Open Access Journals (Sweden)

    Hassen Ghannem, MD, MSc

    2005-12-01

    Full Text Available Chronic disease, and particularly cardiovascular disease (CVD, is the major cause of death in most developed countries, despite the downward trend observed during the last three decades. Although CVD is emerging in developing countries, little is known there about comprehensive preventive measures for controlling its expansion.The health care system in Tunisia faces the challenge of increasing rates of CVD risk factors. Epidemiologic studies show high levels of CVD risk factors among Tunisian adults and children. Evidence shows that several risk factors and conditions are commonly associated with major chronic diseases. Integrated actions against selected risk factors (i.e., smoking, physical inactivity, and unhealthy diet, implemented within the social context, can lead to the reduction of major chronic diseases. These interventions should take place early in childhood.In Tunisia, a much-needed community-based intervention program to control CVD is being planned. This program will promote healthy living, smoke-free air, healthy nutrition, regular physical activity, and supportive living and working environments. Its ultimate goal is to reduce the burden of CVD and its related behaviors. A description of this program and how it will be implemented and assessed in the region of Sousse, Tunisia, is presented.

  9. Endocannabinoids and cardiovascular prevention: real progress?

    Directory of Open Access Journals (Sweden)

    Livio Dei Cas

    2009-08-01

    Full Text Available ABSTRACT: The prevalence of obesity continues to increase and represents one of the principal causes of cardiovascular morbidity and mortality. After the discovery of a specific receptor of the psychoactive principle of marijuana, the cannabinoid receptors and their endogenous ligands, several studies have demonstrated the role of this system in the control of food intake and energy balance and its overactivity in obesity. Recent studies with the CB1 receptor antagonist rimonabant have demonstrated favorable effects such as a reduction in body weight and waist circumference and an improvement in metabolic factors (cholesterol, triglycerides, glycemia etc. Therefore, the antagonism of the endocannabinoid (EC system, if recent data can be confirmed, could be a new treatment target for high risk overweight or obese patients. Obesity is a growing problem that has epidemic proportions worldwide and is associated with an increased risk of premature death (1-3. Individuals with a central deposition of fats have elevated cardiovascular morbidity and mortality (including stroke, heart failure and myocardial infarction and, because of a growing prevalence not only in adults but also in adolescents, it was reclassified in AHA guidelines as a “major modifiable risk factor” for coronary heart disease (4, 5. Although first choice therapy in obesity is based on correcting lifestyle (diet and physical activity in patients with abdominal obesity and high cardiovascular risk and diabetes, often it is necessary to use drugs which reduce the risks. The EC system represents a new target for weight control and the improvement of lipid and glycemic metabolism (6, 7. (Heart International 2007; 3: 27-34

  10. Nutritional Recommendations for Cardiovascular Disease Prevention

    Directory of Open Access Journals (Sweden)

    Yaakov Henkin

    2013-09-01

    Full Text Available Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD. This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.

  11. Primary prevention of cardiovascular disease with hormone replacement therapy

    DEFF Research Database (Denmark)

    Schierbeck, L

    2015-01-01

    Many peri- and postmenopausal women suffer from a reduced quality of life due to menopausal symptoms and preventable diseases. The importance of cardiovascular disease in women must be emphasized, as it is the leading cause of mortality and morbidity in women. It is well known that female hormones...... contribute to the later onset of cardiovascular disease in women. The effect of estrogens has for decades been understood from observational studies of postmenopausal women treated with hormone replacement therapy (HRT). Later, treatment with HRT was disregarded due to the fear of side......-effects and an ambiguity of the cardiovascular advantages. Accumulating knowledge from the large number of trials and studies has elucidated the cause for the disparity in results. In this paper, the beneficial effects of HRT, with emphasis on cardiovascular disease are explained, and the relative and absolute risks...

  12. Physician Performance Assessment: Prevention of Cardiovascular Disease

    Science.gov (United States)

    Lipner, Rebecca S.; Weng, Weifeng; Caverzagie, Kelly J.; Hess, Brian J.

    2013-01-01

    Given the rising burden of healthcare costs, both patients and healthcare purchasers are interested in discerning which physicians deliver quality care. We proposed a methodology to assess physician clinical performance in preventive cardiology care, and determined a benchmark for minimally acceptable performance. We used data on eight…

  13. Delinquency Prevention Works. Program Summary.

    Science.gov (United States)

    Bilchik, Shay

    The Office of Juvenile Justice and Delinquency Prevention (OJJDP) compiled this summary in order to assist states and jurisdictions in their delinquency prevention efforts. The summary provides a synthesis of current information on a broad range of programs and strategies which seek to prevent delinquency. The theory of risk-focused prevention is…

  14. Cardiovascular prevention: lifestyle and statins--competitors or companions?

    Science.gov (United States)

    Opie, L H; Dalby, A J

    2014-03-01

    Favourable lifestyles promote cardiovascular protection. Exercise can induce beneficial changes in the genome that decrease low-density lipoprotein cholesterol (LDL-C) and increase anti-inflammatory markers. The Mediterranean dietary pattern, fortified by nuts, while not reducing weight, reduces mortality. Lifestyle changes combined with statin therapy provide potent protection against coronary heart disease, especially when used for secondary prevention after cardiovascular events. Decisions regarding the initiation of statin therapy for primary prevention are more difficult, requiring consideration of both the LDL-C level and the degree of cardiovascular risk for dyslipidaemic patients. Combining intensive exercise and statin therapy substantially reduces the mortality risk, and thus is potentially the ideal risk-reducing combination.

  15. Primary Prevention of Atherosclerotic Cardiovascular Disease in Women.

    Science.gov (United States)

    McKibben, Rebeccah A; Al Rifai, Mahmoud; Mathews, Lena M; Michos, Erin D

    2016-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality among women. Despite improvements in cardiovascular disease prevention efforts, there remain gaps in cardiovascular disease awareness among women, as well as age and racial disparities in ASCVD outcomes for women. Disparity also exists in the impact the traditional risk factors confer on ASCVD risk between women and men, with smoking and diabetes both resulting in stronger relative risks in women compared to men. Additionally there are risk factors that are unique to women (such as pregnancy-related factors) or that disproportionally affect women (such as auto-immune disease) where preventive efforts should be targeted. Risk assessment and management must also be sex-specific to effectively reduce cardiovascular disease and improve outcomes among women. Evidence supports the use of statin therapy for primary prevention in women at higher ASCVD risk. However, some pause should be given to prescribing aspirin therapy in women without known ASCVD, with most evidence supporting the use of aspirin for women≥65 years not at increased risk for bleeding. This review article will summarize (1) traditional and non-traditional assessments of ASCVD risk and (2) lifestyle and pharmacologic therapies for the primary prevention of ASCVD in women.

  16. Telmisartan: a review of its use in cardiovascular disease prevention.

    Science.gov (United States)

    Frampton, James E

    2011-04-16

    Telmisartan (Micardis®, Pritor®), a well established angiotensin type 1 receptor antagonist, is indicated in the EU for the reduction of cardiovascular morbidity in patients with manifest atherothrombotic cardiovascular disease (CVD) or type 2 diabetes mellitus with documented target organ damage, as well as for the treatment of hypertension. In the pivotal ONTARGET trial, which enrolled ACE inhibitor-tolerant patients at high vascular risk, telmisartan 80 mg once daily added to existing, proven therapy was noninferior to ramipril 10 mg once daily (the gold standard cardioprotective ACE inhibitor) in terms of CVD prevention. Moreover, telmisartan was better tolerated than ramipril, as reflected in, for example, lower incidences of permanent treatment discontinuations due to cough and angioedema. The placebo-controlled TRANSCEND and PRoFESS studies provided supporting evidence for the (time-dependent) effectiveness of telmisartan in preventing cardiovascular events, although the drug appeared to have neither a beneficial nor a harmful impact on cardiovascular mortality. The TRANSCEND trial also demonstrated that telmisartan was well tolerated in ACE inhibitor-intolerant patients at high vascular risk. On the basis of these findings, telmisartan can be considered an effective treatment option for CVD prevention in patients at high vascular risk. Consideration may be given to prescribing the drug as an alternative to ramipril in patients who are able to tolerate ACE inhibitors and, potentially, instead of ramipril in patients who are unable to tolerate ACE inhibitors.

  17. Cardiovascular disease prevention in women: a rapidly evolving scenario.

    Science.gov (United States)

    Stranges, S; Guallar, E

    2012-12-01

    The past decade has witnessed a long overdue recognition of the importance of CVD in women, accompanied by an increasing awareness of gender differences in risk factors, natural history, preventive strategies, treatment, and prognosis of CVD. Reflecting the disease burden and the specific aspects of CVD in women, the American Heart Association has developed women-specific evidence-based guidelines and consensus documents for CVD prevention. The most recent update of these guidelines, published in 2011, is a milestone in the field and shows the rapidly evolving scenario of CVD prevention in women. We discuss some novel aspects of the 2011 update. The new guidelines change the focus from evidence-based to effectiveness-based, with consideration of both benefits and harms/costs of preventive interventions. The guidelines also introduce "ideal cardiovascular health" as the lowest category of risk, which implies the need of communitywide preventive, educational and policy initiatives to promote healthy lifestyles in the general population. Furthermore, the guidelines emphasize long-term overall CVD risk rather than short-term coronary risk. We also address several barriers and open questions in the evaluation and implementation of these guidelines, including how to increase the small proportion of women with ideal cardiovascular health; how to increase implementation and compliance with the recommendations; how to provide effectiveness-based recommendations for lifetime prevention goals based on short-term trials; how to obtain the best possible evidence in women; how to identify subgroups of women with different cardiovascular risk profiles or who may require tailored preventive strategies; and how to adapt current guidelines to international settings, particularly to low- and middle-income countries.

  18. Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer

    Science.gov (United States)

    Understanding Task Force Recommendations Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer The U.S. Preventive Services Task Force (Task ...

  19. Framingham Risk Score underestimates cardiovascular disease risk in severe psoriatic patients: implications in cardiovascular risk factors management and primary prevention of cardiovascular disease.

    Science.gov (United States)

    Torres, Tiago; Sales, Rita; Vasconcelos, Carlos; Martins da Silva, Berta; Selores, Manuela

    2013-11-01

    Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors and premature atherosclerosis, as a consequence of its systemic inflammation. Recently, it has been estimated that severe psoriasis may confer an increased 6.2% on long-term risk of cardiovascular disease based on Framingham Risk Score, which can have practical implications in the treatment of cardiovascular risk factors and primary prevention of cardiovascular disease, as treatment guidelines account for the risk of cardiovascular disease in treatment goals. The aim of this study was to analyze the influence of the attributable risk of severe psoriasis on long-term risk of cardiovascular disease and its implication on the correct treatment of cardiovascular risk factors and primary prevention of cardiovascular disease on a real-world cohort of patients. One hundred severe psoriasis patients without psoriatic arthritis or previous cardiovascular disease were evaluated and it was found that more than half of the patients were reclassified to a higher cardiovascular risk category with important clinical implications on the correct management of their cardiovascular risk factors and primary prevention of cardiovascular disease, as a considerable proportion of patients with hypertension, hypercholesterolemia and coronary heart disease equivalent risk were not being correctly managed.

  20. Cardiovascular prevention: components, levels, early origins, and metrics.

    Science.gov (United States)

    Kones, Richard; Rumana, Umme

    2014-08-01

    This article presents core epidemiological studies that establish the basis for cardiovascular prevention strategies. The results of the classic INTERHEART and INTERSTROKE studies that delineated population-attributed risk for myocardial infarction and stroke are described. Differences in the levels or types of prevention-primordial, primary, and secondary-lead to the concept that risk occurs on a continuum throughout life with great variability, beginning in infancy. Any meaningful and sustained reduction in cardiovascular risk must begin in childhood, as habits formed early in life have an impact for decades. Although it is never too late to improve unhealthy habits, interventions early in life are more likely to be effective in preventing disease from developing, in delaying manifestations, or in reversing pathology through evidence-based therapies that are applied later. There is compelling evidence that coronary atherosclerosis, heart disease related to diabetes, and hypertension begin with endothelial activation. Oxidative stress and reduced nitric oxide availability are also among the earliest of events, from which a self-amplifying web of events proceed. The American Heart Association, even prior to its now-validated and classic definition of risk metrics, developed a strategic plan to improve health habits in the population and at the community level for promoting and monitoring behavior change and patients' self-reported health status. Other initiatives for improving cardiovascular health are in place as well. Despite improvements in treatment of risk factors, there has been minimal, if any, success in reversing the dual epidemics of obesity and diabetes. These 2 factors continue to drive the high burden of cardiovascular risk, and now lead current public health issues. Because treatment alone cannot fully address this tsunami of risk, it has been suggested that all physicians assume an unprecedented and aggressive role as advocates for behavior change to

  1. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea.

    Science.gov (United States)

    McEvoy, R Doug; Antic, Nick A; Heeley, Emma; Luo, Yuanming; Ou, Qiong; Zhang, Xilong; Mediano, Olga; Chen, Rui; Drager, Luciano F; Liu, Zhihong; Chen, Guofang; Du, Baoliang; McArdle, Nigel; Mukherjee, Sutapa; Tripathi, Manjari; Billot, Laurent; Li, Qiang; Lorenzi-Filho, Geraldo; Barbe, Ferran; Redline, Susan; Wang, Jiguang; Arima, Hisatomi; Neal, Bruce; White, David P; Grunstein, Ron R; Zhong, Nanshan; Anderson, Craig S

    2016-09-01

    Background Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. Methods After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group). The primary composite end point was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for unstable angina, heart failure, or transient ischemic attack. Secondary end points included other cardiovascular outcomes, health-related quality of life, snoring symptoms, daytime sleepiness, and mood. Results Most of the participants were men who had moderate-to-severe obstructive sleep apnea and minimal sleepiness. In the CPAP group, the mean duration of adherence to CPAP therapy was 3.3 hours per night, and the mean apnea-hypopnea index (the number of apnea or hypopnea events per hour of recording) decreased from 29.0 events per hour at baseline to 3.7 events per hour during follow-up. After a mean follow-up of 3.7 years, a primary end-point event had occurred in 229 participants in the CPAP group (17.0%) and in 207 participants in the usual-care group (15.4%) (hazard ratio with CPAP, 1.10; 95% confidence interval, 0.91 to 1.32; P=0.34). No significant effect on any individual or other composite cardiovascular end point was observed. CPAP significantly reduced snoring and daytime sleepiness and improved health-related quality of life and mood. Conclusions Therapy with CPAP plus usual care, as compared with usual care alone, did not prevent cardiovascular events in patients with moderate-to-severe obstructive sleep apnea and established cardiovascular disease. (Funded by the National Health and

  2. Prevention and management of work-related cardiovascular disorders

    Directory of Open Access Journals (Sweden)

    Akizumi Tsutsumi

    2015-02-01

    Full Text Available Cardiovascular disorders (CVDs constitute a major burden for health of working populations throughout the world with as much as 50% of all causes of death and at least 25% of work disability. There are some changes in CVD risk factors among occupational classes. This is mainly due to the new types of work-related causes of morbidity associated with the recent developments in global work life, particularly in the industrialized countries. Meanwhile, in the developing countries or those in transition (e.g., in Eastern Europe, CVD mortality is increasing due to major socioeconomic changes, the demographic transition and rapid industrialisation and urbanisation, all leading to growing challenges to cardiovascular health. Better control of known risk factors (i.e., smoking, obesity, physical inactivity, high cholesterol, high blood pressure, and high blood glucose is effective to prevent CVD incidence. But the expected improvement has not been achieved. The obstacles of achieving such impact are due to lack of awareness, lack of policies and their implementation into practice and shortage of infrastructures and human resources. These are needed for wide-scale and long-term programme implementation. Considering the WHO Global Strategy on Occupational Health for All, the WHO Global Action Plan on Workers’ Health, the WHO Programme on Prevention of Non-communicable Diseases and the ILO Decent Work agenda, the 6th ICOH International Conference on Work Environment and Cardiovascular Diseases adopted the Tokyo Declaration.

  3. Understanding cardiovascular risk in hemophilia: A step towards prevention and management.

    Science.gov (United States)

    Sousos, Nikolaos; Gavriilaki, Eleni; Vakalopoulou, Sofia; Garipidou, Vasileia

    2016-04-01

    Advances in hemophilia care have led to increased life expectancy and new challenges in the management of the aging hemophilia population, including cardiovascular risk. Despite the deep knowledge into cardiovascular disease in terms of pathophysiology, risk prediction, prevention, early detection and management gained over the last decades, studies in hemophiliacs are scarce and mainly descriptive. As a growing amount of evidence points towards a similar or increased prevalence of traditional cardiovascular risk factors in hemophilia compared to the general population, the role of non-traditional, disease-related and treatment-related cardiovascular risk factors remains under investigation. Better understanding of cardiovascular risk in hemophilia is mandatory for proper cardiovascular risk prevention and management. Therefore, this review aims to summarize current knowledge on cardiovascular risk in hemophilia patients focusing on a) cardiovascular risk factors (traditional, non-traditional, disease-related and treatment-related), b) cardiovascular morbidity and mortality and c) cardiovascular prevention and management.

  4. THE PREVENTION PROGRAMS OF PHYSICAL REHABILITATION FOR CHERNOBYL DISASTER SURVIVORS

    Directory of Open Access Journals (Sweden)

    Korobeynikov G.V.

    2013-01-01

    Full Text Available The purpose of the study: approbation of the prevention program of physical rehabilitation for Chernobyl disaster survivors in lifestyle aspects. Sixty persons who were disaster survivors and workers of Chernobyl Nuclear Power Plant aged 32-60 have rehabilitation during 21 days. The complex of training prevention programs of physical and psycho-emotional rehabilitation methods was elaborated. The study of efficacy of training prevention programs among Chernobyl disaster survivors. The results showed the improvement of psycho-emotional status and normalization of cardiovascular vegetative regulation after training prevention programs in Chernobyl disasters survivors. The studies show that the preventive programs for Chernobyl disaster survivors in lifestyle aspects had the high effect. This displays the decrease of tempo of aging and the improving of physical and psychological health status of Chernobyl disaster survivors during preventive course.

  5. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Brenda W. Campbell Jenkins

    2015-12-01

    Full Text Available The Jackson Heart Study (JHS is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC has initiated the Daniel Hale Williams Scholar (DHWS program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1 an enrichment curriculum; (2 a learning community; (3 quarterly seminars; and (4 a Summer Institute. Students attend enrichment activities comprising: (1 Applied Biostatistics; (2 Cardiovascular Disease Epidemiology; (3 Social Epidemiology; (4 Emerging Topics; and (5 Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  6. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study.

    Science.gov (United States)

    Campbell Jenkins, Brenda W; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle

    2015-12-22

    The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  7. Bicycling to Work and Primordial Prevention of Cardiovascular Risk

    DEFF Research Database (Denmark)

    Grøntved, Anders; Koivula, Robert W; Johansson, Ingegerd

    2016-01-01

    BACKGROUND: Bicycling to work may be a viable approach for achieving physical activity that provides cardiovascular health benefits. In this study we investigated the relationship of bicycling to work with incidence of obesity, hypertension, hypertriglyceridemia, and impaired glucose tolerance...... across a decade of follow-up in middle-aged men and women. METHODS AND RESULTS: We followed 23 732 Swedish men and women with a mean age of 43.5 years at baseline who attended a health examination twice during a 10-year period (1990-2011). In multivariable adjusted models we calculated the odds......% CI 0.74-0.91) compared with participants not cycling to work at both times points or who switched from cycling to other modes of transport during follow-up. CONCLUSIONS: These data suggest that commuting by bicycle to work is an important strategy for primordial prevention of clinical cardiovascular...

  8. [Cardiovascular disease prevention and health promotion in the French speaking community of Belgium].

    Science.gov (United States)

    Coppieters, Y; Béduwé, C; Collignon, J L; Hubens, V; Levêque, A

    2010-01-01

    Cardiovascular diseases remain the first cause of mortality in Belgium and are a priority for the Five-year program of health promotion in the French speaking Community. It is declined in operational programs by priority thematics, including the heart health. With this framework, it appeared necessary to operationalize cardiovascular priorities. A process of systemic and participative planning was set up in order to seek operational strategies and actions, and to cover the whole population and actors concerned with these health problems. The various cardiovascular risk factors, which potentiate one another, are approached together and in a global way. Upstream to the risk factors, social health determinants play an important role in cardiovascular diseases and others diseases like cancers. Tracking cardiovascular risk factors among people 30 to 75 years is also proposed. It makes it possible to identify people at risk and to put forward individual and adapted measures. The plan integrates actions of health promotion (acting on the health determinants and factors which influence them) as well as actions aiming at improving tracking and the accompaniment of the patients in secondary and tertiary prevention. Actions on health determinants and the factors influencing them present moreover the advantage of being often common to many chronic diseases.

  9. Impact of nutrition since early life on cardiovascular prevention

    Science.gov (United States)

    2012-01-01

    The cardiovascular disease represents the leading cause of morbidity and mortality in Western countries and it is related to the atherosclerotic process. Cardiovascular disease risk factors, such as dyslipidemia, hypertension, insulin resistance, obesity, accelerate the atherosclerotic process which begins in childhood and progresses throughout the life span. The cardiovascular disease risk factor detection and management through prevention delays the atherosclerotic progression towards clinical cardiovascular disease. Dietary habits, from prenatal nutrition, breastfeeding, complementary feeding to childhood and adolescence nutrition play a basic role for this topic. The metabolic and neuroendocrine environment of the fetus is fundamental in the body’s “metabolic programming”. Further several studies have demonstrated the beneficial effects of breastfeeding on cardiovascular risk factors reduction. Moreover the introduction of complementary foods represents another important step, with particular regard to protein intake. An adequate distribution between macronutrients (lipids, proteins and carbohydrates) is required for correct growth development from infancy throughout adolescence and for prevention of several cardiovascular disease risk determinants in adulthood. The purpose of this review is to examine the impact of nutrition since early life on disease. La malattia cardiovascolare rappresenta la principale causa di morbilità e mortalità dei paesi occidentali ed è correlata a degenerazione vascolare aterosclerotica. I fattori di rischio cardiovascolari quali dislipidemia, ipertensione, insulino resistenza e obesità accelerano tale processo il cui esordio è noto sin dell’età pediatrica ed evolve nel corso della vita. L’individuazione e la cura dei fattori di rischio cardiovascolari mediante la prevenzione dei fattori causali ritardano la progressione dell’aterosclerosi e l’insorgenza dei sintomi cardiovascolari. La nutrizione svolge un ruolo

  10. Impact of nutrition since early life on cardiovascular prevention

    Directory of Open Access Journals (Sweden)

    Guardamagna Ornella

    2012-12-01

    Full Text Available Abstract The cardiovascular disease represents the leading cause of morbidity and mortality in Western countries and it is related to the atherosclerotic process. Cardiovascular disease risk factors, such as dyslipidemia, hypertension, insulin resistance, obesity, accelerate the atherosclerotic process which begins in childhood and progresses throughout the life span. The cardiovascular disease risk factor detection and management through prevention delays the atherosclerotic progression towards clinical cardiovascular disease. Dietary habits, from prenatal nutrition, breastfeeding, complementary feeding to childhood and adolescence nutrition play a basic role for this topic. The metabolic and neuroendocrine environment of the fetus is fundamental in the body’s “metabolic programming”. Further several studies have demonstrated the beneficial effects of breastfeeding on cardiovascular risk factors reduction. Moreover the introduction of complementary foods represents another important step, with particular regard to protein intake. An adequate distribution between macronutrients (lipids, proteins and carbohydrates is required for correct growth development from infancy throughout adolescence and for prevention of several cardiovascular disease risk determinants in adulthood. The purpose of this review is to examine the impact of nutrition since early life on disease. La malattia cardiovascolare rappresenta la principale causa di morbilità e mortalità dei paesi occidentali ed è correlata a degenerazione vascolare aterosclerotica. I fattori di rischio cardiovascolari quali dislipidemia, ipertensione, insulino resistenza e obesità accelerano tale processo il cui esordio è noto sin dell’età pediatrica ed evolve nel corso della vita. L’individuazione e la cura dei fattori di rischio cardiovascolari mediante la prevenzione dei fattori causali ritardano la progressione dell’aterosclerosi e l’insorgenza dei sintomi cardiovascolari. La

  11. [Cardiovascular Prevention: Acceptance of Enhanced Occupational Health Care].

    Science.gov (United States)

    Bleckwenn, M; Theisel, N; Mücke, M; Steudel, H

    2016-06-17

    Background: To date, prevention efforts of company medical officers and general practitioners are largely independent of each other. In a comprehensive model of healthcare management including both sets of doctors, the company doctor should determine the risk of cardiovascular disease in the employees of the company. In case increased risk is detected, there should be exchange of information between the 2 professional groups so that common preventive interventions can be decided upon. Aim: The aim of this pilot study was to determine how well cardiovascular risk assessment is accepted by employees of a midsize company and where prevention is needed. Materials and Methods: In a company with 660 employees, risk analysis was conducted among staff in the context of regular preventive measures. In addition to risk factors, primary care, agreement with an interdisciplinary exchange of information and motivation for health promotion activities were investigated. Results: 204 employees (4 females only) were examined. The average age of the participants was 42.9±10.3 years. In 27% (n=55), an increased overall risk was present. Employees with risk requiring medical intervention were under the care of primary care physician and most of them (70%) agreed to the transfer of information to these physicians. In the survey itself, employees showed sufficient motivation (VAS 6.4±2.8) for workplace health promotion. Conclusion: The examined company agreed to implementing further health promoting activities. Due to demographic changes, new concepts for effective prevention are needed. The high acceptance of the proposed prevention framework should motivate implementation of this concept. As a next step, studies must be conducted to examine the effectiveness of screening for risk carried out by company medical officers.

  12. Improving cardiovascular disease prevention and management in Africa: issues to consider for the 21st century.

    Science.gov (United States)

    Madu, Ernest C; Richardson, Kelly D; Ozigbo, Obinna H; Baugh, Dainia S

    2003-01-01

    There is substantial evidence that cardiovascular diseases, and their associated risk factors, are becoming an increasing threat to the health of a large portion of the populace in many areas of Africa, particularly sub-Saharan Africa. If not adequately addressed, this epidemic will place an even greater burden on the poor economies and weak public health infrastructures of this continent. Important strategies for curtailing this epidemic will include primordial, primary, and secondary prevention, population-based prevention programs, improved research and surveillance, and increased governmental accountability for the adequate appropriation of public health.

  13. Troponin in Cardiovascular Disease Prevention: Updates and Future Direction.

    Science.gov (United States)

    Hoff, Jason; Wehner, William; Nambi, Vijay

    2016-03-01

    Cardiac troponin has been well described as the preferred biomarker for diagnosis of myocardial infarction due to the high sensitivity and specificity for myocardial injury. Numerous other conditions apart from acute coronary syndrome can also lead to small elevations in troponin levels. However, the use of cTn as prognostic biomarker for the primary assessment of cardiovascular risk in asymptomatic patient has only recently been described. And with the development of newer generations of high-sensitivity cardiac troponin assays that can detect 10-fold lower concentrations of troponin, the potential value cTn in the prevention and management of asymptomatic cardiovascular disease has come to the fore. This review provides an overview of the transition of cardiac troponin as a marker of acute myocardial injury to one that detects sub-clinical injury. Evidence continues to show that high-sensitivity troponin is emerging as one of the most powerful prognostic biomarkers for the assessment of cardiovascular risk in the general population.

  14. Special Diabetes Program for Indians: Retention in Cardiovascular Risk Reduction

    Science.gov (United States)

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

    2011-01-01

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

  15. Tradeoffs in cardiovascular disease prevention, treatment, and research.

    Science.gov (United States)

    Miller, George; Daly, Matthew; Roehrig, Charles

    2013-06-01

    It is widely believed that the US health care system needs to transition from a culture of reactive treatment of disease to one of proactive prevention. As a tool for understanding the appropriate allocation of spending to prevention versus treatment (including research into improved prevention and treatment), a simple Markov model is used to represent the flow of individuals among states of health, where the transition rates are governed by the magnitude of appropriately-lagged expenditures in each of these categories. The model estimates the discounted cost and discounted effectiveness (measured in quality adjusted life years or QALYs) associated with a given spending mix, and it allows computing the marginal cost-effectiveness associated with additional spending in a category. We apply the model to explore interactions of alternative investments in cardiovascular disease (CVD) and to identify an optimal spending mix. Under the assumptions of our model structure, we find that the marginal cost-effectiveness of prevention of CVD varies with changes in spending on treatment (and vice versa), and that the optimal mix of CVD spending (i.e., the spending mix that maximizes the overall QALYs achieved) would, indeed, shift spending from treatment to prevention.

  16. Gender differences in developmental programming of cardiovascular diseases.

    Science.gov (United States)

    Dasinger, John Henry; Alexander, Barbara T

    2016-03-01

    Hypertension is a risk factor for cardiovascular disease, the leading cause of death worldwide. Although multiple factors contribute to the pathogenesis of hypertension, studies by Dr David Barker reporting an inverse relationship between birth weight and blood pressure led to the hypothesis that slow growth during fetal life increased blood pressure and the risk for cardiovascular disease in later life. It is now recognized that growth during infancy and childhood, in addition to exposure to adverse influences during fetal life, contributes to the developmental programming of increased cardiovascular risk. Numerous epidemiological studies support the link between influences during early life and later cardiovascular health; experimental models provide proof of principle and indicate that numerous mechanisms contribute to the developmental origins of chronic disease. Sex has an impact on the severity of cardiovascular risk in experimental models of developmental insult. Yet, few studies examine the influence of sex on blood pressure and cardiovascular health in low-birth weight men and women. Fewer still assess the impact of ageing on sex differences in programmed cardiovascular risk. Thus, the aim of the present review is to highlight current data about sex differences in the developmental programming of blood pressure and cardiovascular disease.

  17. Aspirin for primary prevention of cardiovascular disease and cancer. A benefit and harm analysis

    NARCIS (Netherlands)

    Stegeman, Inge; Bossuyt, Patrick M.; Yu, Tsung; Boyd, Cynthia; Puhan, Milo A.

    2015-01-01

    Background Aspirin is widely used for prevention of cardiovascular disease. In recent years randomized trials also suggested a preventive effect for various types of cancer. We aimed to assess, in a quantitative way, benefits and harms of aspirin for primary prevention of both cardiovascular disease

  18. [Physical activity in the prevention and treatment of cardiovascular diseases].

    Science.gov (United States)

    Mirat, Jure

    2007-01-01

    Cardiovascular diseases represent the leading health problem of the modern age. They are the first cause of mortality in developed as well as in transition countries. Physical activity has a beneficial impact on the cardiovascular system, both directly by improving endothelial function and indirectly by normalizing risk factors of atherosclerosis, such as dyslipidemia, high blood pressure, obesity and by positive effects on coagulation mechanism. The impact of physical activity on the cardiovascular system is manifested by immediate changes in hemodynamics, blood pressure and heart rate during physical training. After some time, consequences of continuous training are manifested as a decrease in the basal heart rate, blood pressure and heart rate responsiveness to physical activity stress, which indicates good conditioning i.e. increased physical capacity. Prospective epidemiological studies have shown that sedentary style of life has a twice-higher risk of sudden death and cardiovascular mortality. Physical activity should be permanent to have positive effects on the cardiovascular system; it means 4 to 5 times weekly depending on duration and intensity of exercises. In case of exercises 60-75% of the maximum, duration should be 30 to 45 minutes. Evidence based data show a 20-25 % lower mortality rate after myocardial infarction in the patients submitted to rehabilitation program of physical exercises. Physical activity in patients with coronary artery disease must be individualized, quantified and under control. In subjects with impaired function of the heart muscle, physical activity is limited with characteristic symptoms - dyspnea and stenocardia. These patients are classified into groups with mild, moderate and high risk, and based on this the allowed intensity of their physical activity is assessed, as well as the grade of its control. Physical exercises must be without range of tolerance and must not exceed this limit of symptoms. The aim of physical

  19. Primary prevention of diabetes mellitus type 2 and cardiovascular diseases using a cognitive behavior program aimed at lifestyle changes in people at risk: Design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chinapaw Marijke J

    2008-06-01

    Full Text Available Abstract Background The number of people with cardiovascular disease (CVD and diabetes mellitus type 2 (T2DM is growing rapidly. To a large extend, this increase is due to lifestyle-dependent risk factors, such as overweight, reduced physical activity, and an unhealthy diet. Changing these risk factors has the potential to postpone or prevent the development of T2DM and CVD. It is hypothesized that a cognitive behavioral program (CBP, focused in particular on motivation and self-management in persons who are at high risk for CVD and/or T2DM, will improve their lifestyle behavior and, as a result, will reduce their risk of developing T2DM and CVD. Methods 12,000 inhabitants, 30-50 years of age living in several municipalities in the semi-rural region of West-Friesland will receive an invitation from their general practitioner (n = 13 to measure their own waist circumference with a tape measure. People with abdominal obesity (male waist ≥ 102 cm, female waist ≥ 88 cm will be invited to participate in the second step of the screening which includes blood pressure, a blood sample and anthropometric measurements. T2DM and CVD risk scores will then be calculated according to the ARIC and the SCORE formulae, respectively. People with a score that indicates a high risk of developing T2DM and/or CVD will then be randomly assigned to the intervention group (n = 300 or the control group (n = 300. Participants in the intervention group will follow a CBP aimed at modifying their dietary behavior, physical activity, and smoking behavior. The counseling methods that will be used are motivational interviewing (MI and problem solving treatment (PST, which focus in particular on intrinsic motivation for change and self-management of problems of the participants. The CBP will be provided by trained nurse practitioners in the participant's general practice, and will consists of a maximum of six individual sessions of 30 minutes, followed by 3-monthly booster

  20. Personal health technology: A new era in cardiovascular disease prevention.

    Science.gov (United States)

    Franklin, Nina C; Lavie, Carl J; Arena, Ross A

    2015-03-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide yet the majority of related risk factors are largely preventable (primary prevention [PP]) and effectively treatable (secondary prevention [SP]) with healthy lifestyle behaviors. The use of information and communication technology (ICT) offers a unique approach to personal health and CVD prevention, as these mediums are relatively affordable, approachable, and accessible. The purpose of this review is to provide an overview of ICT-driven personal health technologies and their potential role in promoting and supporting self-care behaviors for PP and SP of CVD. In this review, we focus on technological interventions that have been successful at supporting positive behavior change in order to determine which tools, resources, and methods are most appropriate for delivering interventions geared towards CVD prevention. We conducted a literature search from a range of sources including scholarly, peer-reviewed journal articles indexed in PubMed and CINAHL, gray literature, and reputable websites and other Internet-based media. A synthesis of existing literature indicates that the overall efficacy of ICT-driven personal health technologies is largely determined by: 1) the educational resources provided and the extent to which the relayed information is customized or individually tailored; and 2) the degree of self-monitoring and levels of personalized feedback or other interactions (e.g. interpersonal communications). We conclude that virtually all the technological tools and resources identified (e.g. Internet-based communications including websites, weblogs and wikis, mobile devices and applications, social media, and wearable monitors) can be strategically leveraged to enhance self-care behaviors for CVD risk reduction and SP but further research is needed to evaluate their efficacy, cost-effectiveness, and long-term maintainability.

  1. Heterozygous familial hypercholesterolaemia in childhood: cardiovascular risk prevention.

    Science.gov (United States)

    van der Graaf, A; Kastelein, J J P; Wiegman, A

    2009-12-01

    Children with familial hypercholesterolaemia (FH) have severely increased low-density lipoprotein cholesterol (LDL-C) levels that strongly predispose to premature cardiovascular disease (CVD) later in life. Early identification makes it possible to start lipid-lowering therapy at young age to prevent CVD. The atherosclerotic process can be inhibited by potent lipid-lowering therapy. The cornerstone of lipid-lowering therapy is a healthy lifestyle, but most of the time this is insufficient to reach adequate LDL-C goals. Subsequently, pharmacological therapy is initiated with increasing frequency. In the past decade numerous studies have assessed the efficacy and safety of statins in children with FH. Those studies demonstrate that statins are well tolerated, safe and effective. Therefore, these agents have a pivotal role in the treatment of children with FH.

  2. Pollution Prevention Program: Technology summary

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    The Department of Energy (DOE) has established a national Research, Development, Demonstration, Testing, and Evaluation (RDDT&E) Program for pollution prevention and waste minimization at its production plants During FY89/90 the Office of Environmental Restoration and Waste Management (EM), through the Office of Technology Development (OTD), established comprehensive, pollution prevention technical support programs to demonstrate new, environmentally-conscious technology for production processes. The RDDT&E program now entails collaborative efforts across DOE. The Pollution Prevention Program is currently supporting three major activities: The DOE/US Air Force Memorandum of Understanding Program is a collaborative effort to utilize the combined resources of DOE and the Department of Defense, eliminate duplication of effort in developing technologies, and to facilitate technology solutions aimed at reducing waste through process modification, material substitution or recycling. The Waste Component Recycle, Treatment and Disposal Integrated Demonstration (WeDID) will develop recycle, treatment, and disposal processes and associated technologies for use in the dismantlement of non-nuclear weapons components, to support US arms treaties and policies. This program will focus on meeting all security and regulatory requirements (with additional benefit to the commercial electronics industry). The Environmentally Conscious Manufacturing Integrated Demonstration (ECMID) will effectively implement ECM technologies that address both the needs of the DOE Complex and US electronics industry, and encourage strong interaction between DOE and US industry. The ECMID will also develop life cycle analysis tools that will aid decisionmakers in selecting the optimum process based on the tradeoffs between cost an environmental impact.

  3. Cardiovascular disease prevention in low resource settings: lessons from the Heartfile experience in Pakistan.

    Science.gov (United States)

    Nishtar, Sania

    2003-01-01

    This paper outlines activities of the Heartfile Program in Pakistan (http://heartfile.org). The program focuses on cardiovascular disease prevention and health promotion, and includes several initiatives that encompass building policy, reorienting health services, and developing community interventions that utilize the print and electronic media and outreach at the grass-root level to incorporate social marketing approaches. Initiated by the nonprofit private sector, the program now links with major public sector primary healthcare programs, and is currently spearheading formulation of the National Action Plan on Noncommunicable Disease Prevention and Control in Pakistan. In addition, the program is being refined, validated, and packaged as a replicable model for other developing countries and in low resource settings, utilizing appropriate principles of franchising with inbuilt components sensitive to cultural and social adaptations. A review of the planning process, implementation strategy, and fund-raising experience is presented. Strategies unique to low resource settings, such as the development of cost- and time-efficient strategic alliances and partnerships, have also been highlighted. In addition, specific caveats are identified as being helpful to private sector development of chronic disease prevention programs in resource-constrained settings, and a road map to a sustainable public-private sector partnership is provided.

  4. Design for Heart Disease Prevention Programs.

    Science.gov (United States)

    New York State Education Dept., Albany. Bureau of Continuing Education Curriculum Development.

    In this teaching and curriculum guide for community health education, a design is suggested for a course that could help prevent premature deaths due to heart disease. The course communicates facts regarding the causes of cardiovascular diseases, and outlines opportunities for attaining the degree of physical conditioning essential to prevention.…

  5. A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Daniele Franchi

    2011-02-01

    Full Text Available Daniele Franchi1,2, Davide Cini1, Giorgio Iervasi11Istituto di Fisiologia Clinica, CNR, Pisa, Italy; 2Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, ItalyBackground: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient's data collection represents a critical issue.Design: A new multipurpose computer-based program has been developed in order to:1 easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2 to design a web-based computerized tool for prospective collection of structured data; 3 to support the doctor in the decision-making process for patients at risk according to recent international guidelines.Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient's data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient's goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report.Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [± SD] the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values.Conclusion: The web-based system proposed here may represent a feasible and

  6. Combination pharmacotherapy to prevent cardiovascular disease: present status and challenges.

    Science.gov (United States)

    Yusuf, Salim; Attaran, Amir; Bosch, Jackie; Joseph, Philip; Lonn, Eva; McCready, Tara; Mente, Andrew; Nieuwlaat, Robby; Pais, Prem; Rodgers, Anthony; Schwalm, J-D; Smith, Richard; Teo, Koon; Xavier, Denis

    2014-02-01

    Combination pills containing aspirin, multiple blood pressure (BP) lowering drugs, and a statin have demonstrated safety, substantial risk factor reductions, and improved medication adherence in the prevention of cardiovascular disease (CVD). The individual medications in combination pills are already recommended for use together in secondary CVD prevention. Therefore, current information on their pharmacokinetics, impact on the risk factors, and tolerability should be sufficient to persuade regulators and clinicians to use fixed-dose combination pills in high-risk individuals, such as in secondary prevention. Long-term use of these medicines, in a polypill or otherwise, is expected to reduce CVD risk by at least 50-60% in such groups. This risk reduction needs confirmation in prospective randomized trials for populations for whom concomitant use of the medications is not currently recommended (e.g. primary prevention). Given their additive benefits, the combined estimated relative risk reduction (RRR) in CVD from both lifestyle modification and a combination pill is expected to be 70-80%. The first of several barriers to the widespread use of combination therapy in CVD prevention is physician reluctance to use combination pills. This reluctance may originate from the belief that lifestyle modification should take precedence, and that medications should be introduced one drug at a time, instead of regarding combination pills and lifestyle modification as complementary and additive. Second, widespread availability of combination pills is also impeded by the reluctance of large pharmaceutical companies to invest in development of novel co-formulations of generic (or 'mature') drugs. A business model based on 'mass approaches' to drug production, packaging, marketing, and distribution could make the combination pill available at an affordable price, while at the same time providing a viable profit for the manufacturers. A third barrier is regulatory approval for novel

  7. [Longitudinal studies in the prevention of cardiovascular diseases].

    Science.gov (United States)

    Balaguer Vintró, Ignacio

    2004-01-01

    Longitudinal studies of well defined cohorts have contributed to the identification of risk factors of coronary heart disease and other clinical complications of atherosclerosis. After commenting on the conclusions of experimental atherosclerosis and risk factors suggested by the study of a series of myocardial infarction in young adults and their matched controls, we discuss the methodology, management and results of longitudinal studies carried out in the United States since 1949: Twin Cities, Framingham, Pooling Project, Western Collaborative, Puerto Rico Evans County, NI-IION-SAN, San Francisco, Harvard, Bogalusa and CARDIA. Special attention is given to the hypothesis proposed at the beginning of the Framingham Study and the obstacles and changes to continue the project after the first twenty-four years. We also expose the Seven Countries Study, designed and managed by Ancel Keys, as the first study performed with centralized methodology in various countries, and the studies in various European countries: Whitehall, Manresa, Paris, British Regional, Northwick Park, Caerphilly, Speedwell and PROCAM. We analyse the role of the longitudinal studies in the methodology of later studies: sons and daughters of the Framingham participants, longitudinal studies based on questionnaires, studies of the other risk factors, prevalence of risk factors in retrospective studies, trials of primary prevention (MRFIT, WHO European Collaborative Trial and Gotenburg Study) and the participation of the trained teams in the MONICA Project. We present the issues still under debate in connection with the methodology and results of the longitudinal studies: problems in the periodic examination of the participants in the epidemiologic studies, changes in definition of the new cases of acute cardiovascular events, use and selection of risk functions based on coronary charts to calculate the individual risk and cardiovascular risk factors as yet unknown.

  8. The impact of obesity on cardiovascular structure and function: the fetal programming era

    Directory of Open Access Journals (Sweden)

    St-Pierre J

    2012-03-01

    Full Text Available Julie St-Pierre1, Luigi Bouchard2,3, Paul Poirier41Department of Pediatrics, Chicoutimi Hospital, Saguenay, QC, Canada; 2Department of Biochemistry, Université de Sherbrooke, Sherbrooke, QC, Canada; 3ECOGENE-21 and Lipid Clinic, Chicoutimi Hospital, Saguenay, QC, Canada; 4Quebec Heart and Lungs Institute, Université Laval, Quebec, QC, CanadaAbstract: The burden of obesity is now well established as a precursor of cardiovascular disease and other disorders. Although better clinical guidelines exist to prevent and treat obesity, the prevalence of obesity among children and adolescents is increasing alarmingly. Primary prevention remains the gold standard to significantly reduce the public health concerns associated with obesity. Traditional cardiovascular disease risk factors (such as dyslipidemia, hypertension, type 2 diabetes for cardiovascular disease among children and adolescents are known. The scope of this review is thus to discuss new and emerging obesity and associated-disease risk factors. Evaluation of the coronary plaque formation, diastolic dysfunction, carotid intima-media thickness and heart rate variability represent interesting tools with clinical relevance. Beyond these new cardiovascular disease risk factors, recent evidence suggests that a detrimental fetal environment, associated with for example, maternal obesity, insulin resistance, and physical inactivity, imprints fetal metabolic programming via epigenetic mechanisms that predisposes the newborn to obesity and cardiovascular disease later in life. This information may impact on the future management of maternal health, as well as for those high-risk children.Keywords: cardiovascular disease, pediatrics, risk factors

  9. Meditation as primary intervention strategy in prevention of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Yadneshwar Khobragade

    2016-01-01

    Full Text Available Heart diseases especially Hypertension, Coronary Artery Diseases (CAD and stroke are the leading causes of death all over the world. Hostility, anxiety, depression and increased reactivity to mental stress have been strongly associated with hypertension and CAD. Mental stress or anxiety causes increased sympathetic activation and poor vagus nerve control over heart. Imbalance between sympathetic and parasympathetic nervous system leads to vasospasm and has been associated with Hypertension, Coronary Artery Disease and Myocardial Infarction. Psychosocial stress has also been found to be responsible for imbalance in autonomic nervous system, causing sympathetic dominance over parasympathetic leading to acute coronary events. Meditation is a process of self-contemplation and purification of mind. Practitioner of meditation brings about desirable changes in their behaviour and lifestyle. During Meditation sympathetic activity is reduced and there is parasympathetic dominance over sympathetic. During meditation and after meditation person feels calm, quiet and relaxed. Meditation causes decrease in metabolic rate. The blood pressure may come to normal or falls, pulse rate comes to normal or low, vascular spasm if any, is reduced and myocardial perfusion increase. Thus meditation helps in preventing hypertension, coronary artery disease and other cardiac events. This may be beneficial before a person gets coronary event and post-myocardial infarction. In view of the beneficial effects of meditation, it may be introduced as primary intervention strategy in preventing Cardio-vascular Diseases. We did this review study to find out: (1 Can meditation bring about desirable changes in human mind and body in post-intervention group compared to control group? (2 Its effectiveness in prevention of heart diseases like hypertension, coronary events and post-MI complications. This review included all randomised controlled trials on patients above 18 years, both

  10. Educators' views of eating disorder prevention programs.

    Science.gov (United States)

    Varnado-Sullivan, Paula J; Parr, Francoise; O'Grady, Megan A; Savoy, Sarah

    2013-06-01

    Further understanding of educators' views of eating disorder prevention can further engage them in this effort. No previous studies of educators have used acceptability methodology or compared eating disorder prevention to other prevention efforts. Educators (n = 135) rated the acceptability of five sample programs and provided their opinions about eating disorder and other prevention programs. The results indicated primarily psychoeducational and general well-being programs were most acceptable. Educators-specified trained professionals should implement programs during school hours to male and female junior high students. Although eating disorder prevention was perceived as important, it was not rated as vital as other programs, such as substance abuse prevention.

  11. Divergence of mechanistic pathways mediating cardiovascular aging and developmental programming of cardiovascular disease.

    Science.gov (United States)

    Allison, Beth J; Kaandorp, Joepe J; Kane, Andrew D; Camm, Emily J; Lusby, Ciara; Cross, Christine M; Nevin-Dolan, Rhianon; Thakor, Avnesh S; Derks, Jan B; Tarry-Adkins, Jane L; Ozanne, Susan E; Giussani, Dino A

    2016-05-01

    Aging and developmental programming are both associated with oxidative stress and endothelial dysfunction, suggesting common mechanistic origins. However, their interrelationship has been little explored. In a rodent model of programmed cardiovascular dysfunction we determined endothelial function and vascular telomere length in young (4 mo) and aged (15 mo) adult offspring of normoxic or hypoxic pregnancy with or without maternal antioxidant treatment. We show loss of endothelial function [maximal arterial relaxation to acetylcholine (71 ± 3 vs. 55 ± 3%) and increased vascular short telomere abundance (4.2-1.3 kb) 43.0 ± 1.5 vs. 55.1 ± 3.8%) in aged vs. young offspring of normoxic pregnancy (P programming of cardiovascular disease, and aging being decelerated by antioxidants even prior to birth.-Allison, B. J., Kaandorp, J. J., Kane, A. D., Camm, E. J., Lusby, C., Cross, C. M., Nevin-Dolan, R., Thakor, A. S., Derks, J. B., Tarry-Adkins, J. L., Ozanne, S. E., Giussani, D. A. Divergence of mechanistic pathways mediating cardiovascular aging and developmental programming of cardiovascular disease.

  12. Epigenetics in the development, modification, and prevention of cardiovascular disease.

    Science.gov (United States)

    Whayne, Thomas F

    2015-04-01

    Epigenetics has major relevance to all disease processes; cardiovascular (CV) disease and its related conditions are no exception. Epigenetics is defined as the study of heritable alterations in gene expression, or cellular phenotype, and goes far beyond a pure genetic approach. A more precise definition is that epigenetics represents all the meiotically and mitotically inherited changes in gene expression that are not encoded on the deoxyribonucleic acid (DNA) sequence itself. Major epigenetic mechanisms are modifications of histone proteins in chromatin and DNA methylation (which does not alter the DNA sequence). There is increasing evidence for the involvement of epigenetics in human disease such as cancer, inflammatory disease and CV disease. Other chronic diseases are also susceptible to epigenetic modification such as metabolic diseases including obesity, metabolic syndrome, and diabetes mellitus. There is much evidence for the modification of epigenetics by nutrition and exercise. Through these modifications, there is infinite potential for benefit for the fetus, the newborn, and the individual as well as population effects. Association with CV disease, including coronary heart disease and peripheral vascular disease, is evident through epigenetic relationships and modification by major CV risk factors such as tobacco abuse. Aging itself may be altered by epigenetic modification. Knowledge of epigenetics and its relevance to the development, modification, and prevention of CV disease is in a very preliminary stage but has an infinite future.

  13. Marine microalgae used as food supplements and their implication in preventing cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Mimouni Virginie

    2015-07-01

    Full Text Available Marine microalgae are photosynthetic microorganisms producing numerous bioactive molecules of interest for health and disease care such as lipids rich in omega-3 fatty acids -as eicosapentaenoic acid (EPA, 20:5 n-3 and docosahexaenoic acid (DHA, 22:6 n-3- and carotenoids (e.g., β-carotene, fucoxanthin, astaxanthin. It has already been shown that these molecules, individually used, are benefic in the prevention of diseases such as those associated with the cardiovascular risks, but also in some carcinomas. When these molecules are combined, synergistic effects may be observed. Microalgae, as a dietary supplement, can be used to study these synergistic effects in animal models in which dyslipidemia can be induced by a nutrition treatment. Different marine microalgae of interest are studied in this context to determine their potential effect as an alternative source to marine omega-3 rich fish oils, actually widely used for human health. Actually, the pharmaceutical and nutrition industries are developing health research programs involving microalgae, trying to limit the dramatic reduction of fish stocks and the associated pollution in the marine environment. The aim of this review is threefold: (1 to present research on lipids, particularly long chain polyunsaturated fatty acids, as components of marine microalgae used as food supplements; (2 to present the health benefits of some microalgae or their extracts, in particular in the prevention of cardiovascular diseases and (3 to highlight the role of Odontella aurita, a marine microalga rich in EPA used as food supplement with the aim of preventing cardiovascular diseases.

  14. Reducing salt intake to prevent hypertension and cardiovascular disease.

    Science.gov (United States)

    He, Feng J; Campbell, Norm R C; MacGregor, Graham A

    2012-10-01

    There is compelling evidence that dietary salt intake is the major cause of raised blood pressure (BP) and that a reduction in salt intake from the current level of ≈ 9 - 12 g/day in most countries to the recommended level of effect and there needs to be ongoing consideration of lower targets for population salt intake. Cohort studies and outcome trials have demonstrated that a lower salt intake is related to a reduced risk of cardiovascular disease. Salt reduction is one of the most cost-effective measures to improve public health worldwide. In the Americas, a salt intake of > 9 g/day is highly prevalent. Sources of salt in the diet vary hugely among countries; in developed countries, 75% of salt comes from processed foods, whereas in developing countries such as parts of Brazil, 70% comes from salt added during cooking or at the table. To reduce population salt intake, the food industry needs to implement a gradual and sustained reduction in the amount of salt added to foods in developed countries. In developing countries, a public health campaign plays a more important role in encouraging consumers to use less salt coupled with widespread replacement of salt with substitutes that are low in sodium and high in potassium. Numerous countries in the Americas have started salt reduction programs. The challenge now is to engage other countries. A reduction in population salt intake will result in a major improvement in public health along with major health-related cost savings.

  15. Cardiovascular Risk in Malaysia: causes, consequences and prevention

    NARCIS (Netherlands)

    Selvarajah, S.

    2012-01-01

    Cardiovascular disease forms the highest morbidity and mortality worldwide and disproportionately affects low and middle-income developing countries. In developing countries, cardiovascular morbidity and mortality tend to affect the (younger) working adults. This poses a significant burden to the ec

  16. Diet, nutrition and the prevention of hypertension and cardiovascular diseases

    NARCIS (Netherlands)

    Reddy, K.S.; Katan, M.B.

    2004-01-01

    Cardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases

  17. 40 CFR 68.170 - Prevention program/Program 2.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Prevention program/Program 2. 68.170 Section 68.170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.170 Prevention...

  18. The health effects of US unemployment insurance policy: Does income from unemployment benefits prevent cardiovascular disease?

    NARCIS (Netherlands)

    S. Walter (Stefan); M.M. Glymour (Maria); M. Avendano (Mauricio)

    2014-01-01

    textabstractObjective: Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypot

  19. Cancer Prevention Fellowship Program (CPFP) | Division of Cancer Prevention

    Science.gov (United States)

    The Cancer Prevention Fellowship provides a strong foundation for scientists and clinicians to train in the field of cancer prevention and control. This structured, multidisciplinary program offers early career scientists from different health disciplines a variety of postdoctoral training opportunities . | Training to form a strong foundation in cancer prevention and control for scientists and clinicians.

  20. [Physical activity in basic and primary prevention of cardiovascular disease].

    Science.gov (United States)

    Sobieszczańska, Małgorzata; Kałka, Dariusz; Pilecki, Witold; Adamus, Jerzy

    2009-06-01

    On account of the frequency of appearing and character of atherosclerosis cardiac vascular disease, one of the most crucial elements of effective fight against it is preparation of complex preventive programs including as vast number of population as possible. Consequently, Benjamin and Smitch suggested attaching the notion of basic prevention to the standard division into primary and secondary one. The basic prevention, carrying out in the general population, should concern genetic predisposition, psychosocial factors, keeping up proper body weight, healthy eating and physical activity. Especially high hopes are connected with high efficiency, simplicity and low money-consumption of preventive activities associated with physical activity modification, which has a crucial influence on reducing negative impact of atherosclerosis hazard. The results of numerous scientific research, carried out in many countries and on various, large groups, proved undoubtedly that at the healthy adult people of both sex the systematic physical activity of moderate intensification plays an essential part in preventing CVD and decreasing the death risk because of that reason as well. Moreover, systematic physical exercises show many other health-oriented actions, thanks to which they have an influence on decreasing premature and total death rate. The risk of incidence of civilization-related diseases such as diabetes type II, hypertension, obesity, osteoporosis, tumors (of large intestine, breast, prostatic gland) and depression has decreased significantly. Unequivocally positive influence has been proved at many observations dedicated to health recreational physical activity and physical activity connected with professional work based on aerobe effort. The positive effects have been also observed at children population and senior population which is more and more numerous and the most at risk. The beneficial action of physical activity is connected with direct effect on organism

  1. Prevention of cardiovascular risk in women who had hypertension during pregnancy after 36 weeks gestation

    NARCIS (Netherlands)

    van Kesteren, Floortje; Visser, Sanne; Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Poppel, Mireille N. M.; Tamsma, Jouke T.; Mol, Ben W.; de Groot, Christianne J.

    2015-01-01

    Objective: To analyse preventive interventions of women with cardiovascular risk factors postpartum. Methods: 3.5 years postpartum, women with history of hypertension in pregnancy were invited for a questionnaire, 1 year after a cardiovascular risk assessment. Results: Two hundred and fifty-seven wo

  2. The Polypill in the Prevention of Cardiovascular Disease

    NARCIS (Netherlands)

    Lafeber, M.

    2013-01-01

    Overwhelming data from clinical trials show that pharmacological interventions with aspirin, statins and blood pressure (BP)-lowering agents considerably reduce the risk of cardiovascular events and total mortality. Therefore, current international treatment guidelines recommend to prescribe statins

  3. Reduced or modified dietary fat for preventing cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Lee Hooper

    Full Text Available ABSTRACT: BACKGROUND: Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol, but their effects on important health outcomes are less clear. OBJECTIVE: To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. METHODS: Search methods: For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL, Medline and Embase, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria: Trials fulfilled the following criteria: 1 randomized with appropriate control group, 2 intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions, 3 not multi factorial, 4 adult humans with or without cardiovascular disease, 5 intervention at least six months, 6 mortality or cardiovascular morbidity data available. Data collection and analysis: Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. MAIN RESULTS: This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%. Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides, of at least two years duration and in studies of men (not of women. There were no clear effects of dietary fat

  4. Prevalence and prevention of cardiovascular disease and diabetes mellitus.

    Science.gov (United States)

    Balakumar, Pitchai; Maung-U, Khin; Jagadeesh, Gowraganahalli

    2016-11-01

    Noncommunicable diseases (NCDs) have become important causes of mortality on a global scale. According to the report of World Health Organization (WHO), NCDs killed 38 million people (out of 56 million deaths that occurred worldwide) during 2012. Cardiovascular diseases accounted for most NCD deaths (17.5 million NCD deaths), followed by cancers (8.2 million NCD deaths), respiratory diseases (4.0 million NCD deaths) and diabetes mellitus (1.5 million NCD deaths). Globally, the leading cause of death is cardiovascular diseases; their prevalence is incessantly progressing in both developed and developing nations. Diabetic patients with insulin resistance are even at a greater risk of cardiovascular disease. Obesity, high cholesterol, hypertriglyceridemia and elevated blood pressure are mainly considered as major risk factors for diabetic patients afflicted with cardiovascular disease. The present review sheds light on the global incidence of cardiovascular disease and diabetes mellitus. Additionally, measures to be taken to reduce the global encumbrance of cardiovascular disease and diabetes mellitus are highlighted.

  5. Cardiovascular disease prevention in rural Nigeria in the context of a community based health insurance scheme: QUality Improvement Cardiovascular care Kwara-I (QUICK-I

    Directory of Open Access Journals (Sweden)

    Alli Shade

    2011-03-01

    Full Text Available Abstract Background Cardiovascular diseases (CVD are a leading contributor to the burden of disease in low- and middle-income countries. Guidelines for CVD prevention care in low resource settings have been developed but little information is available on strategies to implement this care. A community health insurance program might be used to improve patients' access to care. The operational research project "QUality Improvement Cardiovascular care Kwara - I (QUICK-I" aims to assess the feasibility of CVD prevention care in rural Nigeria, according to international guidelines, in the context of a community based health insurance scheme. Methods/Design Design: prospective observational hospital based cohort study. Setting: a primary health care centre in rural Nigeria. Study population: 300 patients at risk for development of CVD (patients with hypertension, diabetes, renal disease or established CVD who are enrolled in the Hygeia Community Health Plan. Measurements: demographic and socio- economic data, physical and laboratory examination, CVD risk profile including screening for target organ damage. Measurements will be done at 3 month intervals during 1 year. Direct and indirect costs of CVD prevention care will be estimated. Outcomes: 1 The adjusted cardiovascular quality of care indicator scores based on the "United Kingdom National Health Services Quality and Outcome Framework". 2 The average costs of CVD prevention and treatment per patient per year for patients, the clinic and the insurance company. 3 The estimated net health care costs of standard CVD prevention care per quality-adjusted life year gained. Analysis: The primary outcomes, the score on CVD quality indicators and cost data will be descriptive. The quality scores and cost data will be used to describe the feasibility of CVD prevention care according to international guidelines. A cost-effectiveness analysis will be done using a Markov model. Discussion Results of QUICK-I can

  6. Firearm injury prevention training in Preventive Medicine Residency programs.

    Science.gov (United States)

    Khubchandani, Jagdish; Price, James H; Dake, Joseph A

    2009-08-01

    Preventive medicine plays a central role in the reducing the number of deaths due to preventable causes of premature deaths. General Preventive Medicine Residency programs have not been studied in relation to training in this area. A three-wave mail survey was conducted with email and telephone follow-ups. The outcome measures were the portion of program directors involved in training residents on firearm injury prevention issues and their perceived benefits and barriers of training residents on firearm injury prevention issues. Only 25% of the programs provided formal training on firearm injury prevention. Program directors who provided formal training perceived significantly higher number of benefits to offering such training than did directors who did not provide such training but no significant difference was found between the two for number of perceived barriers. If preventive medicine residency graduates are to play a role in reducing premature morbidity and mortality from firearms it will require more residencies to offer formal training in this area. The Association for Prevention Teaching and Research needs to develop guidelines on specific curriculum topics regarding firearm injury prevention.

  7. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention.

    Science.gov (United States)

    Millán, Jesús; Pintó, Xavier; Muñoz, Anna; Zúñiga, Manuel; Rubiés-Prat, Joan; Pallardo, Luis Felipe; Masana, Luis; Mangas, Alipio; Hernández-Mijares, Antonio; González-Santos, Pedro; Ascaso, Juan F; Pedro-Botet, Juan

    2009-01-01

    Low-density lipoprotein (LDL) cholesterol concentration has been the prime index of cardiovascular disease risk and the main target for therapy. However, several lipoprotein ratios or "atherogenic indices" have been defined in an attempt to optimize the predictive capacity of the lipid profile. In this review, we summarize their pathophysiological aspects, and highlight the rationale for using these lipoprotein ratios as cardiovascular risk factors in clinical practice, specifying their cut-off risk levels and a target for lipid-lowering therapy. Total/high-density lipoprotein (HDL) cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol.

  8. Chocolate and Prevention of Cardiovascular Disease: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Ding Xin

    2006-01-01

    Full Text Available Abstract Background Consumption of chocolate has been often hypothesized to reduce the risk of cardiovascular disease (CVD due to chocolate's high levels of stearic acid and antioxidant flavonoids. However, debate still lingers regarding the true long term beneficial cardiovascular effects of chocolate overall. Methods We reviewed English-language MEDLINE publications from 1966 through January 2005 for experimental, observational, and clinical studies of relations between cocoa, cacao, chocolate, stearic acid, flavonoids (including flavonols, flavanols, catechins, epicatechins, and procynadins and the risk of cardiovascular disease (coronary heart disease (CHD, stroke. A total of 136 publications were selected based on relevance, and quality of design and methods. An updated meta-analysis of flavonoid intake and CHD mortality was also conducted. Results The body of short-term randomized feeding trials suggests cocoa and chocolate may exert beneficial effects on cardiovascular risk via effects on lowering blood pressure, anti-inflammation, anti-platelet function, higher HDL, decreased LDL oxidation. Additionally, a large body of trials of stearic acid suggests it is indeed cholesterol-neutral. However, epidemiologic studies of serum and dietary stearic acid are inconclusive due to many methodologic limitations. Meanwhile, the large body of prospective studies of flavonoids suggests the flavonoid content of chocolate may reduce risk of cardiovascular mortality. Our updated meta-analysis indicates that intake of flavonoids may lower risk of CHD mortality, RR = 0.81 (95% CI: 0.71–0.92 comparing highest and lowest tertiles. Conclusion Multiple lines of evidence from laboratory experiments and randomized trials suggest stearic acid may be neutral, while flavonoids are likely protective against CHD mortality. The highest priority now is to conduct larger randomized trials to definitively investigate the impact of chocolate consumption on long

  9. The novel role of epigenetics in primary prevention of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Claudio Napoli

    2012-11-01

    Full Text Available A great deal of evidences indicate that impaired fetal growth and in utero exposure to risk factors, especially maternal hypercholesterolemia, may be relevant for human pathophysiological signs of atherosclerosis and subsequent development of cardiovascular disease (CVD during different life stages. Despite the underlying mechanisms of fetal programming are still unknown, epigenetics has been suggested as one of the possible explanations for the associations between intrauterine risk factors and CVD development. Indeed, a lot of translational studies support the hypothesis that epigenetic changes are related to increased CVD risk although it is still not possible to establish a direct causality in humans. Notably, epigenetic modifications can be reversible through therapeutic approaches employing histone deacetylase inhibitors, histone acetyltransferase inhibitors and commonly used drugs like statins. Thus, the whole comprehension of these mechanisms will provide in the next future the rationale for the development of novel tools to be used in the primary prevention and therapy of CVD.

  10. Consensus document for the use of the Polypill in the secondary prevention of cardiovascular disease.

    Science.gov (United States)

    González-Juanatey, José Ramón; Mostaza, José María; Lobos, José María; Abarca, Benjamín; Llisterri, José Luis; Baron-Esquivias, Gonzalo; Galve, Enrique; Lidón, Rosa María; Garcia-Moll, Francisco Xavier; Sánchez, Pedro Luis; Suárez, Carmen; Millán, Jesús; Pallares, Vicente; Alemán, José Juan; Egocheaga, Isabel

    2017-02-09

    Cardiovascular disease is a chronic disorder which is usually already at an advanced stage when the first symptoms develop. The fact that the initial clinical presentation can be lethal or highly incapacitating emphasizes the need for primary and secondary prevention. It is estimated that the ratio of patients with good adherence to secondary prevention of cardiovascular disease is low and also decreases gradually over time. The Polypill for secondary prevention of cardiovascular disease is the first fixed-dose combination therapy of salicylic acid, atorvastatin and ramipril approved in Spain. The purpose of this consensus document was to define and recommend, through the evidence available in the literature and clinical expert opinion, the impact of treatment adherence in the secondary prevention of cardiovascular disease and the use of the Polypill in daily clinical practice as part of a global strategy including adjustments in patient lifestyle. A RAND/UCLA methodology based on scientific evidence, as well as the collective judgment and clinical expertise of an expert panel was used for this assessment. As a result, a final report of recommendations on the impact of the lack of adherence to treatment of secondary prevention of cardiovascular disease and the effect of using a Polypill in adherence of patients was produced. The recommendations included in this document have been addressed to all those specialists, cardiologists, internists and primary care physicians with competence in prescribing and monitoring patients with high and very high cardiovascular risks.

  11. Telmisartan to prevent recurrent stroke and cardiovascular events

    DEFF Research Database (Denmark)

    Yusuf, Salim; Diener, Hans-Christoph; Sacco, Ralph L;

    2008-01-01

    BACKGROUND: Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin-angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood pres...

  12. Telmisartan to prevent recurrent stroke and cardiovascular events

    NARCIS (Netherlands)

    Yusuf, Salim; Diener, Hans-Christoph; Sacco, Ralph L.; Cotton, Daniel; Ounpuu, Stephanie; Lawton, William A.; Palesch, Yuko; Martin, Renee H.; Albers, Gregory W.; Bath, Philip; Bornstein, Natan; Chan, Bernard P. L.; Chen, Sien-Tsong; Cunha, Luis; Dahlof, Bjorn; de Keyser, Jacques; Donnan, Geoffrey A.; Estol, Conrado; Gorelick, Philip; Gu, Vivian; Hermansson, Karin; Hilbrich, Lutz; Kaste, Markku; Lu, Chuanzhen; Machnig, Thomas; Pais, Prem; Roberts, Robin; Skvortsova, Veronika; Teal, Philip; Toni, Danilo; VanderMaelen, Cam; Voigt, Thor; Weber, Michael; Yoon, Byung-Woo

    2008-01-01

    Background: Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin-angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood pressur

  13. Which patients should receive aspirin for primary prevention of cardiovascular disease? An economic evaluation

    NARCIS (Netherlands)

    Annemans, L.; Lamotte, M.; Kubin, M.; Evers, T.; Verheugt, F. W. A.

    2006-01-01

    Low-dose aspirin is a standard care for secondary prevention of cardiovascular disease (CVD). Its use in primary prevention is less widely accepted, however, despite recent meta-analyses and US and European guidelines supporting its use in individuals at increased CVD risk. The aim of this study was

  14. Anti-inflammatory Strategies to Prevent Diabetic Cardiovascular Disease.

    Science.gov (United States)

    Jialal, I; Devaraj, S

    2015-08-01

    Diabetes is a proinflammatory state and inflammation is crucial in the genesis of vascular complications. While there are many anti-inflammatory strategies, most of which have been shown to reduce inflammation in diabetes, there is sparse data on reduction in cardiovascular events (CVEs). To date, the only anti-inflammatory strategies that have been shown to reduce CVE in diabetes include statins, angiotensin receptor blockers, metformin, and pioglitazone. We also discuss the role of novel emerging therapies.

  15. New cardiovascular targets to prevent late onset Alzheimer disease.

    Science.gov (United States)

    Claassen, Jurgen A H R

    2015-09-15

    The prevalence of dementia rises to between 20% and 40% with advancing age. The dominant cause of dementia in approximately 70% of these patients is Alzheimer disease. There is no effective disease-modifying pharmaceutical treatment for this neurodegenerative disease. A wide range of Alzheimer drugs that appeared effective in animal models have recently failed to show clinical benefit in patients. However, hopeful news has emerged from recent studies that suggest that therapeutic strategies aimed at reducing cardiovascular disease may also reduce the prevalence of dementia due to Alzheimer disease. This review summarizes the evidence for this link between cardiovascular disease and late onset Alzheimer dementia. Only evidence from human research is considered here. Longitudinal studies show an association between high blood pressure and pathological accumulation of the protein amyloid-beta42, and an even stronger association between vascular stiffness and amyloid accumulation, in elderly subjects. Amyloid-beta42 accumulation is considered to be an early marker of Alzheimer disease, and increases the risk of subsequent cognitive decline and development of dementia. These observations could provide an explanation for recent observations of reduced dementia prevalence associated with improved cardiovascular care.

  16. Edible mushrooms: role in the prevention of cardiovascular diseases.

    Science.gov (United States)

    Guillamón, Eva; García-Lafuente, Ana; Lozano, Miguel; D'Arrigo, Matilde; Rostagno, Mauricio A; Villares, Ana; Martínez, José Alfredo

    2010-10-01

    Edible mushrooms are a valuable source of nutrients and bioactive compounds in addition to a growing appeal for humans by their flavors and culinary features. Recently, they have become increasingly attractive as functional foods for their potential beneficial effects on human health. Hence, food industry is especially interested in cultivated and wild edible mushrooms. Cardiovascular diseases are one of the most prevalent causes of morbidity and mortality in the Western world. Several investigations have shown the influence of mushrooms intake on some metabolic markers (total, LDL, HDL cholesterol, fasting triacylglycerol, homocysteine, blood pressure, homeostatic function and oxidative and inflammatory damage), which potentially may reduce the risk of suffering cardiovascular diseases. Relevant nutritional aspects of mushrooms include a high fiber supply, a low fat content with low trans isomers of unsaturated fatty acids and a low concentration of sodium as well as the occurrence of components such as eritadenine, phenolic compounds, sterols (such as ergosterol), chitosan, triterpenes, etc., which are considered as important responsible agents for some hitherto healthy properties. The aims of this review are to report putative positive effects of mushrooms consumption on cardiovascular diseases risk markers and to identify some putative bioactive compounds involved in these effects.

  17. Latest evidence of the effects of the Mediterranean diet in prevention of cardiovascular disease.

    Science.gov (United States)

    Chiva-Blanch, G; Badimon, L; Estruch, Ramon

    2014-10-01

    The first step in the prevention of cardiovascular disease is healthy lifestyle and diet. Recent systematic reviews of observational studies ranked Mediterranean diet as the most likely dietary model to provide cardiovascular protection. This review updates the knowledge on the effects of Mediterranean diet from observational and randomized trials published in the last year. The results of the PREDIMED study, a randomized trial providing a higher level of scientific evidence than cohort studies, confirmed that the Mediterranean diet reduces the incidence of cardiovascular events. This effect may be exerted by reducing blood pressure; improving glucose metabolism, lipid profile, and lipoprotein particle characteristics; and decreasing inflammation and oxidative stress. It may also stem from a favorable interaction between diet and gene polymorphisms related to cardiovascular risk factors and events. These recent results allow us to recommend Mediterranean diet to subjects at high risk for cardiovascular disease with the highest level of scientific evidence.

  18. Emerging Cardiovascular Risk Research: Impact of Pets on Cardiovascular Risk Prevention

    OpenAIRE

    Pamela J Schreiner

    2016-01-01

    Animals interact with humans in multiple ways, including as therapy and service animals, commercially as livestock, as wildlife, and in zoos. But the most common interaction is as companion animals in our homes, with an estimated 180 million cats and dogs living in US households. While pet ownership has been reported to have many health benefits, the findings are inconsistent. Cardiovascular risk factors such as lipids, glucose, obesity, and heart rate variability have improved, worsened, or ...

  19. Rosuvastatin as part of the primary prevention strategy against cardiovascular disease.

    OpenAIRE

    Meško, Jasna; Brus, Sanja; Barbič-Žagar, Breda

    2013-01-01

    Patients with established cardiovascular disease (CVD) are the ones that are most commonly considered for therapeutic intervention in order to prevent progression of the disease. In contrast, patients without manifested CVD and at increased risk are often left untreated, even though they would have the greatest benefits from early risk reduction in terms of CVD prevention. According to the recently published European CVD prevention guidelines, the reduction of LDL cholesterol must be of prime...

  20. 40 CFR 68.175 - Prevention program/Program 3.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.175 Prevention program/Program... of training provided—classroom, classroom plus on the job, on the job; and (2) The type of competency... the most recent change that triggered management of change procedures and the date of the most...

  1. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention

    Directory of Open Access Journals (Sweden)

    Jesús Millán

    2009-09-01

    Full Text Available Jesús Millán1, Xavier Pintó2, Anna Muñoz3, Manuel Zúñiga4, Joan Rubiés-Prat5, Luis Felipe Pallardo6, Luis Masana7, Alipio Mangas8, Antonio Hernández-Mijares9, Pedro González-Santos10, Juan F Ascaso11, Juan Pedro-Botet121Hospital Universitario Gregorio Marañón, Madrid, Spain; 2Hospital Universitario Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain; 3Solvay Pharma, Barcelona, Spain; 4Hospital Marqués de Valdecilla, Santander, Spain; 5Hospital Vall d’Hebrón, Barcelona, Spain; 6Hospital Universitario La Paz, Madrid, Spain; 7Hospital Sant Joan, Reus, Tarragona, Spain; 8Hospital Universitario Puerta del Mar, Cádiz, Spain; 9Hospital Universitario Dr Peset, Valencia, Spain; 10Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; 11Hospital Clínico Universitario, Valencia, Spain; 12Hospital del Mar, Barcelona, SpainAbstract: Low-density lipoprotein (LDL cholesterol concentration has been the prime index of cardiovascular disease risk and the main target for therapy. However, several lipoprotein ratios or “atherogenic indices” have been defined in an attempt to optimize the predictive capacity of the lipid profile. In this review, we summarize their pathophysiological aspects, and highlight the rationale for using these lipoprotein ratios as cardiovascular risk factors in clinical practice, specifying their cut-off risk levels and a target for lipid-lowering therapy. Total/high-density lipoprotein (HDL cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol.Keywords: apolipoproteins

  2. Pleiotropic preventive effects of dietary polyphenols in cardiovascular diseases.

    Science.gov (United States)

    Kishimoto, Y; Tani, M; Kondo, K

    2013-05-01

    Polyphenols are common constituents of the diet, and research on their health benefits has developed quickly over the past few years. Our purpose is to review recent findings highlighting daily dietary polyphenol intake and the diverse function of polyphenols and their possible relationships to cardiovascular disease (CVD). Several cohort studies have reported an inverse relationship between the daily consumption of polyphenols and CVD risk. Many studies showed that beverages could be a large source of polyphenols. Our previous findings provide that Japanese people intake polyphenols mainly from beverages, especially coffee and green tea (in descending order of polyphenol content). Many kinds of polyphenols act as an antioxidant against low-density lipoprotein oxidation, which is known to promote atherosclerosis. Recent accumulating evidence suggests that dietary polyphenols could exert their cardioprotective actions through their potential to improve metabolic disorder and vascular inflammation. These findings raise the possibility that polyphenols have a wide variety of roles in the intestine, liver and vascular tissue. In addition to identifying mechanisms of polyphenol bioactivity by basic research, much more epidemiological and clinical evidence linking reduced cardiovascular risk with dietary polyphenols intake are needed.

  3. Utilization of preventive care services and their effect on cardiovascular outcomes in the United States

    Directory of Open Access Journals (Sweden)

    Varun Vaidya

    2011-01-01

    Full Text Available Varun Vaidya, Gautam Partha, Jennifer HowePharmacy Health Care Administration, Department of Pharmacy Practice, University of Toledo College of Pharmacy, Toledo, OH, USAObjective: To describe and analyze utilization of preventive care services and their effect on cardiovascular outcomes in the United States.Methods: Data from the 2007 Medical Expenditure Panel Survey (MEPS were used to analyze utilization of preventive care services and their effect on cardiovascular outcomes. Recommendations by the Seventh Report of the Joint Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and the National Cholesterol Education Program were used to determine appropriate levels of preventive care utilization. Utilization of blood pressure screening and cholesterol checkup services were used as the dependent variable, while age, gender, race, ethnicity, insurance status, and perceived health status were used as independent variables. Since guidelines differ for people with elevated blood pressure, respondents with elevated blood pressure were identified in the MEPS database by self-reported diagnosis. Descriptive statistics were used to describe the population, while a multivariate logistic regression model was built to predict odds of utilizing appropriate levels of preventive services.Results: Total number of adult respondents for which data were available for blood pressure checkup and cholesterol checkup was 20,523 and 15,784, respectively. Overall, MEPS respondents were found to adhere to guideline recommendations for preventive care utilization. Multivariate logistic regression showed that odds of utilization of preventive care services were higher for elderly patients (age >65 years for blood pressure (odds ratio [OR] = 2.39, 95% confidence interval [CI]: 1.92–2.97 and cholesterol (OR = 3.05, 95% CI: 2.18–4.27 preventive services compared with younger population (age 18–54 years. Males had much lower odds of

  4. Gender and HIV / AIDS: transforming prevention programs.

    Science.gov (United States)

    Gupta, G R

    1995-11-01

    The Women and AIDS Research Program (International Center for Research on Women) has identified a series of obstacles to preventing HIV infection among women, including social norms that mandate female ignorance about sexual matters, women's economic dependence on men, widespread acceptance of male promiscuity, and violence against women. Most AIDS prevention programs fail to challenge these contextual determinants and continue to focus on the promotion of condom use among men. Recommendations to empower women and improve their status are dismissed as long-term measures outside the domain of AIDS prevention. Feasible, however, is the modification of existing AIDS prevention programs to ensure they are gender-sensitive. This would mean measures such as providing services at times that are convenient to women and integrating services to reduce waiting and travelling times. To address the contextual issues at the root of women's vulnerability to HIV, AIDS prevention programs can link up with economic interventions such as credit programs, agricultural extension services, and women's cooperatives. Moreover, AIDS programs can provide HIV-infected women with social support through group educational sessions or counseling. Finally, because improvements in women's socioeconomic status are essential for the success of all AIDS prevention, program managers should be in the forefront of broader struggles to enact policy changes to eliminate gender-based discrimination and inequality.

  5. DIETA Y PREVENCIÓN SECUNDARIA DE LA ENFERMEDAD CARDIOVASCULAR Diet and secondary prevention of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Luis Alberto Ángel Arango

    2011-01-01

    mortalidad en pacientes con angina y favorecen la recurrencia de arritmias ventriculares (B-III.Background. There is abundant evidence regarding the effects of diet as a strategy for managing cardiovascular risk factors in primary prevention, covering all types of situations and complications including a whole range of studies from cases and controls, retrospective cohorts, prospective studies to controlled random clinical trial. Objectives. Establishing evidence from recent studies and revised and updated clinical practice guidelines about secondary prevention of cardiovascular disease by dietary management. Materials and methods. Databases were electronically searched using the words «secondary prevention» and connectors «heart» and «cardiovascular risk.» Only studies whose main objective had been the reduction of new cardiovascular events were accepted. Results. A Mediterranean-type diet was shown to be associated with lower overall mortality rates, particularly due to cardiac causes. A cholesterol-reducing diet lowered the recurrent heart-attack rate and appearance of angina, as well as recurrent heart-attacks associated with omega 3 fatty acid 18 consumption (recommendations and level of evidence: B-IIa. A fish fat oil rich diet increased the risk of death and sudden death from cardiac causes in subjects suffering from angina and favored the recurrence of ventricular arrhythmias (B-III. Omega-3 fatty acids from fish and vegetables did not reduce greater cardiovascular events in patients with suitable antihypertensive, antithrombotic and dyslipidaemia (BIII pharmacological therapy. Conclusions. Mediterranean-type diets and those reducing cholesterol rich in omega-3 fatty acids probably have a favourable effect on preventing secondary cardiovascular disease (B-IIa. Such effect disappears when associated with pharmacological treatment of cardiovascular risk factors (B-III. Omega-3 fatty acids probably increase mortality in patients suffering from angina and favour

  6. Dyslipidemia management in primary prevention of cardiovascular disease:Current guidelines and strategies

    Institute of Scientific and Technical Information of China (English)

    Aditya D Hendrani; Tolulope Adesiyun; Renato Quispe; Steven R Jones; Neil J Stone; Roger S Blumenthal; Seth S Martin

    2016-01-01

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making costeffective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

  7. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies.

    Science.gov (United States)

    Hendrani, Aditya D; Adesiyun, Tolulope; Quispe, Renato; Jones, Steven R; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

    2016-02-26

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

  8. Is the high-risk strategy to prevent cardiovascular disease equitable?

    DEFF Research Database (Denmark)

    Wallach Kildemoes, Helle; Diderichsen, Finn; Krasnik, Allan

    2012-01-01

    ABSTRACT: BACKGROUND: Statins are increasingly prescribed to prevent cardiovascular disease (CVD) in asymptomatic individuals. Yet, it is unknown whether those at higher CVD risk - i.e. individuals in lower socio-economic position (SEP) - are adequately reached by this high-risk strategy. Aim......: To examine whether the Danish implementation of the strategy to prevent cardiovascular disease (CVD) by initiating statin (HMG-CoA reductase inhibitor) therapy in high-risk individuals is equitable across socioeconomic groups. METHODS: Design: Cohort study. Setting and participants: Applying individual...

  9. Program Administration | Division of Cancer Prevention

    Science.gov (United States)

    Governance Structure Recognizing the importance of an integrated approach to preventative drug development, there is a unified Governance Structure for the PREVENT Program responsible for coordinating and integrating available resources. With the goal of reaching go/no-go decisions as efficiently as possible, the purpose is to ensure a pragmatic approach to drug development and a clear path to market. |

  10. School-Based Child Abuse Prevention Programs

    Science.gov (United States)

    Brassard, Marla R.; Fiorvanti, Christina M.

    2015-01-01

    Child abuse is a leading cause of emotional, behavioral, and health problems across the lifespan. It is also preventable. School-based abuse prevention programs for early childhood and elementary school children have been found to be effective in increasing student knowledge and protective behaviors. The purpose of this article is to help school…

  11. Home Delivery Medicament Program: access, inactivity and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Roque da Silva Araújo

    Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.

  12. Cost-effectiveness of aspirin treatment in the primary prevention of cardiovascular disease events in subgroups based on age, gender, and varying cardiovascular risk

    NARCIS (Netherlands)

    Greving, J.P.; Buskens, E.; Koffijberg, H.; Algra, A.

    2008-01-01

    Background-Aspirin is effective for the primary prevention of cardiovascular events, but it remains unclear for which subgroups of individuals aspirin is beneficial. We assessed the cost-effectiveness of aspirin separately for men and women of different ages with various levels of cardiovascular dis

  13. Oral cleft prevention program (OCPP

    Directory of Open Access Journals (Sweden)

    Wehby George L

    2012-11-01

    Full Text Available Abstract Background Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted. Methods/design This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P, on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg to that of a historical control group. The study has been approved by IRBs (ethics committees of all involved sites. Results will be disseminated through publications and presentations at scientific meetings. Discussion The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study

  14. Role of n-3 series polyunsaturated fatty acids in cardiovascular disease prevention

    Directory of Open Access Journals (Sweden)

    Lee AH

    2011-09-01

    Full Text Available Andy H Lee1, Naoko Hiramatsu21School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia; 2Laboratory of Nutritional Science, School of Human Science and Environment, University of Hyogo, Himeji, Hyogo, JapanAbstract: Cardiovascular disease is a major cause of morbidity and mortality worldwide. Its prevention through a healthy lifestyle and appropriate diet is important. Omega-3 polyunsaturated fatty acids (n-3 PUFA therapy has shown promise in both primary and secondary prevention of cardiovascular disease. This commentary discusses the nutritional role of n-3 PUFA, including its metabolism and physiological role, comparison with n-6 series PUFA, as well as complications due to deficiency. Clinical use of n-3 PUFA for the prevention and treatment of cardiovascular disease, recommended intake, and potential adverse effects will also be examined. The available scientific evidence suggests that its supplementation and clinical use ranging from 0.4 to 1 g/day can provide tangible benefits. However, further studies are required to determine optimal dosing and the relative ratio of docosahexaenoic acid and eicosapentaenoic acid that provides maximal cardioprotection and treatment of cardiovascular disease.Keywords: alpha-linolenic acid, docosahexaenoic acid, eicosapentaenoic acid, cardiovascular disease, fish oil, polyunsaturated fatty acids

  15. [Dyslipidemias: a pending challenge in cardiovascular prevention. Consensus document from CEIPC/SEA Committee].

    Science.gov (United States)

    Royo Bordonada, Miguel Ángel; Lobos Bejarano, José María; Millán Núñez-Cortés, Jesús; Villar Álvarez, Fernando; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Guijarro Herráiz, Carlos; de Pablo Zarzosa, Carmen; Pedro-Botet Montoya, Juan; Santiago Nocito, Ana de

    2011-06-11

    In Spain, where cardiovascular disease (CVD) is the leading cause of death, hypercholesterolemia, one of the most prevalent risk factors in adults, is poorly controlled. Dyslipidemia should not be approached in isolation, but in the context of overall cardiovascular risk (CVR). Measurement of CVR facilitates decision making, but should not be the only tool nor should it take the place of clinical judgment, given the limitations of the available calculation methods. This document, prepared by the Interdisciplinary Spanish Committee on Cardiovascular Prevention, at the proposal of the Spanish Society of Arteriosclerosis, reviews the cardiovascular prevention activities of the regional health authorities, scientific societies and medical professionals. An initiation of a national strategy on cardiovascular prevention is proposed based on lifestyle modification (healthy diet, physical activity and smoking cessation) through actions in different settings. At the population level, regulation of food advertising, elimination of trans fats and reduction of added sugar are feasible and cost-effective interventions to help control dyslipidemias and reduce CVR. In the health setting, it is proposed to facilitate the application of guidelines, improve training for medical professionals, and include CVR assessment among the quality indicators. Scientific societies should collaborate with the health authorities and contribute to the generation and transmission of knowledge. Finally, it is in the hands of professionals to apply the concept of CVR, promote healthy lifestyles, and make efficient use of available pharmacological treatments.

  16. 77 FR 31827 - Pipeline Safety: Pipeline Damage Prevention Programs

    Science.gov (United States)

    2012-05-30

    ... Safety: Pipeline Damage Prevention Programs AGENCY: Pipeline and Hazardous Materials Safety... excavation damage prevention law enforcement programs; establish an administrative process for making... excavation damage prevention law enforcement programs; and establish the adjudication process...

  17. Neuroleptic malignant syndrome: a preventive program.

    Science.gov (United States)

    Fernando, M L; Manchanda, R; Kirk, C

    1992-03-01

    Neuroleptic Malignant Syndrome is a very serious side effect of antipsychotic medications. The paper describes a preventative program which was instituted in an inpatient unit of a provincial psychiatric hospital. There have been no mortalities from Neuroleptic Malignant Syndrome (NMS) during this program. A suspicion of NMS by clinical evaluation and laboratory tests resulted in prompt management. The recommended management plan is described.

  18. Validation of a Poison Prevention Program.

    Science.gov (United States)

    Gill, Noel C.; Braden, Barbara T.

    Two way analyses of variance and cross-group descriptive comparisons assessed the effectiveness of the Siop Poison Prevention Program, which included an educational program and the use of warning labels, on improving verbal and visual discrimination of poisonous and nonpoisonous products for preschool children. The study sample consisted of 156…

  19. A Cardiovascular Health Program for Latinos Supplemented with Pedometers

    Science.gov (United States)

    Trudnak, Tara; Lloyd, Angela; Westhoff, Wayne W.; Corvin, Jaime

    2011-01-01

    Background: Physical inactivity is an important modifiable risk factor for many chronic diseases which disproportionately affect Latinos in the U.S. Targeting at-risk Latinos for prevention and intervention programs to increase physical activity can help decrease their risk for developing these diseases. Purpose: The purpose of this study was to…

  20. Effectiveness of programmes as part of primary prevention demonstrated on the example of cardiovascular diseases and the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2011-01-01

    inclusion criteria. These studies confirm the effectiveness of the primary prevention programmes. Physical activity programs seem to have a stronger effect than nutrition programmes. Psychological programmes prove as well effectiveness, if they include cognitive behaviour therapy. The identified economical studies indicate that programmes for cardiovascular prevention can be conducted cost-effectively. Interventions that focus on the general population turn out to be particularly cost-effective and sustainable. Discussion: There is a wide range of primary preventive effective lifestyle-related interventions with high evidence. The outcomes and results are consistent with the recommendations of the two identified evidence-based guidelines regarding the recommendations on lifestyle and healthy nutrition. Furthermore, the cost-effectiveness of primary prevention services is proven. With regard to the economical studies it is however worth noting that this result is based on very few publications. The transferability has to be critically assessed as the studies mainly originate from the American health system. Conclusion: On the whole a comprehensive setting approach with educative, somatic, psychosocial and activity therapeutic components is recommended. The sustainability of a prevention intervention must be ensured from programme to programme. Long-term studies are necessary to make valid statements regarding the sustainable effectiveness: There is an essential deficit in the current practiced evaluation of the use of primary prevention services provided by the health insurance – mainly regarding the comprehensive setting approach – regarding the evidence-based evaluation of the prescribed preventive interventions. With regard to the ethical, social and economical evaluation the research situation is deficient. The situation has to be particularly analyzed for the socially deprived and one has to respond to their specific needs for prevention.

  1. Factors affecting use of preventive tests for cardiovascular risk among Greeks.

    Science.gov (United States)

    Pappa, Evelina; Kontodimopoulos, Nick; Papadopoulos, Angelos A; Pallikarona, Georgia; Niakas, Dimitris; Tountas, Yannis

    2009-10-01

    Data from a Greek national representative sample was used to investigate socio-demographic, self-perceived health, and health risk factors that determine the use of cardiovascular preventive tests (blood pressure, cholesterol and blood glucose). Chi-square and logistic regression analyses were used (p < 0.05). Older age, marriage, regular family doctor and chronic diseases increased the likelihood of receiving preventive tests, whereas low education and alcohol consumption reduced the likelihood of having these tests. The effect of obesity varied. Interventions which improve the knowledge of the poorly educated and empower the preventive role of the physicians may redress the inequalities and improve the effectiveness of preventive services utilization.

  2. Dyslipidemias in the prevention of cardiovascular disease: risks and causality.

    Science.gov (United States)

    Graham, Ian; Cooney, Marie-Therese; Bradley, David; Dudina, Alexandra; Reiner, Zeljko

    2012-12-01

    Atherosclerotic cardiovascular disease is now the major global cause of death, despite reductions in CVD deaths in developed societies. Dyslipidemias are a major contributor, but the mass occurrence of CVD relates to the combined effects of hyperlipidemia, hypertension, and smoking. Total blood cholesterol and LDL-cholesterol relate to CVD risk in an independent and graded manner and fulfill the criteria for causality. Therapeutic reduction of these lipid fractions is associated with improved outcomes. There is good evidence that HDL-cholesterol, triglycerides, and Lp(a) relate to CVD although the evidence for a causal relationship is weaker. The HDL association with CVD is largely independent of other risk factors whereas triglycerides may be more important as signaling a need to look intensively for other measures of risk such as central obesity, hypertension, low HDL-cholesterol, and glucose intolerance. Lp(a) is an inherited risk marker. The benefit of lowering it is uncertain, but it may be that its impact on risk is attenuated if LDL-cholesterol is low.

  3. Omega-3 fatty acids in the prevention and control of cardiovascular disease.

    Science.gov (United States)

    Mata López, P; Ortega, R M

    2003-09-01

    Cardiovascular disease is one of the main causes of death in developed countries. Several factors are involved in its appearance and progress, among which nutrition enjoys a certain protagonism. Until recently, the dietetic criteria for preventing and controlling cardiovascular disease were mainly restrictive (at least in terms of energy and fat intake), but such advice is difficult to follow, and without careful monitoring can lead to deficiencies that might negatively affect quality of life and perhaps even life expectancy. Several investigations show that some components of the lipid fraction of the diet, such as omega-3 fatty acids, are beneficial with respect to cardiovascular disease, and these have become the centre of much attention. This paper reviews the results of some of these studies and evaluates the benefit of these fatty acids in the prevention of coronary heart disease. The sources of omega-3 fatty acids, their recommended consumption, possible mechanisms of action and potential adverse effects are discussed.

  4. Statins in the prevention of cardiovascular events in patients with renal failure.

    Science.gov (United States)

    Buemi, Michele; Floccari, Fulvio; Nostro, Lorena; Campo, Susanna; Caccamo, Chiara; Sturiale, Alessio; Aloisi, Carmela; Giacobbe, Maria Stella; Frisina, Nicola

    2007-03-01

    HMG-CoA reductase inhibitors (statins) are among the most widely used hypolypemizing drugs with a pleiotropic activity. Numerous clinical trials have demonstrated that statins can have a significant effect in the prevention of cardiovascular diseases in the general population. In patients with renal failure, this drug preserves the hypolypemizing efficacy found in the general population without increasing their unwanted side-effects. The re-analysis of data from epidemiological studies conducted on the general population has confirmed that statins provide cardiovascular protection also in subjects with renal failure. These data have been partly confirmed by the findings made by 4D (Die Deutsche Diabetes Dialyse Studie) and Alert studies, conducted on diabetic patients on dialysis and patients with renal transplants, respectively. The results of other studies, such as AURORA, SHARP, REnal and Vascular End stage Disease, and ESPLANADE, clearly indicate that statins prevent cardiovascular disease in patients with renal insufficiency, just as they do in the general population.

  5. Polypills: essential medicines for cardiovascular disease secondary prevention?

    Science.gov (United States)

    Huffman, Mark D; Yusuf, Salim

    2014-04-15

    In 1977, the World Health Organization (WHO) developed its first Model List of Essential Medicines to guide countries in the creation of national formularies and policies for access, quality, and use of essential medicines as part of achieving the right to health. In 2012, the WHO announced its goal of reducing the number of premature deaths (List of Essential Medicines to include polypill therapy for secondary CVD prevention. In July 2013, the updated 18th Model List of Essential Medicines was released without inclusion of polypill therapy for secondary CVD prevention. In this article, we argue that polypill therapy meets the criteria for essential medicines and that inclusion in the Model List of Essential Medicines will facilitate its access and has the potential to avoid a few million premature deaths and related morbidity from CVD at low cost.

  6. Functional foods for dyslipidaemia and cardiovascular risk prevention.

    Science.gov (United States)

    Sirtori, Cesare R; Galli, Claudio; Anderson, James W; Sirtori, Elena; Arnoldi, Anna

    2009-12-01

    A food can be regarded as 'functional' if it can demonstrate a beneficial efficacy on one or more target functions in the body in a convincing way. Beyond adequate nutritional qualities, functional foods should either improve the state of health and wellbeing and/or reduce the risk of disease. Functional foods that are marketed with claims of heart disease reduction focus primarily on the major risk factors, i.e. cholesterol, diabetes and hypertension. Some of the most innovative products are designed to be enriched with 'protective' ingredients, believed to reduce risk. They may contain, for example, soluble fibre (from oat and psyllium), useful both for lowering cholesterol and blood pressure, or fructans, effective in diabetes. Phytosterols and stanols lower LDL-cholesterol in a dose-dependent manner. Soya protein is more hypocholesterolaemic in subjects with very high initial cholesterol and recent data indicate also favourable activities in the metabolic syndrome. n-3 Fatty acids appear to exert significant hypotriacylglycerolaemic effects, possibly partly responsible for their preventive activity. Dark chocolate is gaining much attention for its multifunctional activities, useful both for the prevention of dyslipidaemia as well as hypertension. Finally, consensus opinions about tea and coffee have not emerged yet, and the benefits of vitamin E, garlic, fenugreek and policosanols in the management of dyslipidaemia and prevention of arterial disease are still controversial.

  7. Cardiovascular disease and obesity prevention in Germany: an investigation into a heterogeneous engineering project

    NARCIS (Netherlands)

    Niewöhner, J.; Döring, M.; Kontopodis, M.; Madarász, J.; Heintze, C.

    2011-01-01

    Cardiovascular diseases present the leading cause of death worldwide. Over the last decade, their preventio has become not only a central medical and public health issue but also a matter of political concern as well as a major market for pharma, nutrition, and exercise. A preventive assemblage has

  8. Baseline albuminuria predicts the efficacy of blood pressure-lowering drugs in preventing cardiovascular events

    NARCIS (Netherlands)

    Boersma, C.; Postma, M.J.; Visser, S.T.; Atthobari, J.; de Jong, P.E.; de Jong-van den Berg, L.T.; Gansevoort, R.T.

    2008-01-01

    AIMS Albuminuria has been proven to be associated with cardiovascular (CV) events in specific patient populations, but also in the general population. This study aimed to investigate whether the efficacy of blood pressure-lowering agents in preventing CV events depends on baseline urinary albumin ex

  9. Self-Efficacy and Perceived Control in the Prevention of Cardiovascular Disease

    NARCIS (Netherlands)

    Carpi Ballester, Amparo; Gonzalez Navarro, Pilar; Zurriaga Llorens, Rosario; Marzo Campos, Juan Carlos; Buunk, Abraham P.

    2010-01-01

    From the Theory of Planed Behaviour (TPB), the aim of this study is to analyse the effect of self-efficacy and perceived control on intention and preventive behaviors of cardiovascular disease. To this end, 359 participants were evaluated in an empirical study. Data were analysed using the statistic

  10. Primary prevention of cardiovascular diseases in primary care: prove principles and persistent practice

    NARCIS (Netherlands)

    Scheltens, T.

    2009-01-01

    Prevention of cardiovascular diseases in clinical practice includes identification of persons at high risk, assessing the well known risk factors, proper estimation and optimal communication of CVD risk and appropriate allocation of therapies, all with the aim to ultimately improve outcomes for pati

  11. The future of metabolic syndrome and cardiovascular disease prevention: polyhype or polyhope?: tales from the polyera

    NARCIS (Netherlands)

    Franco, O.; Karnik, K.; Bonneux, L.G.A.

    2007-01-01

    Recently society has been witnessing the rise of a new era in the prevention and treatment of the metabolic syndrome and cardiovascular disease: the Polyera. This new era started when a promising concept – the Polypill – was introduced by Wald et al. in 2003. The Polypill is a theoretical combinatio

  12. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries.

    LENUS (Irish Health Repository)

    Kotseva, Kornelia

    2009-03-14

    The first and second EUROASPIRE surveys showed high rates of modifiable cardiovascular risk factors in patients with coronary heart disease. The third EUROASPIRE survey was done in 2006-07 in 22 countries to see whether preventive cardiology had improved and if the Joint European Societies\\' recommendations on cardiovascular disease prevention are being followed in clinical practice.

  13. Personalized nutrition and cardiovascular disease prevention: From Framingham to PREDIMED.

    Science.gov (United States)

    Konstantinidou, Valentini; Daimiel, Lidia; Ruiz, Lidia Angeles Daimiel; Ordovás, Jose M

    2014-05-01

    Diet is considered the cornerstone for the prevention of age-related diseases, and a low-fat diet has been considered for decades as the most suitable alternative to achieve this goal. However, mounting evidence supports the efficacy of other alternatives, such as the Mediterranean diet. Nevertheless, it is well known that people present a dramatic range of responses to similar environmental challenges, and it has been shown that some of this variability is rooted in the genome. In fact, this knowledge is driving the field of nutrigenetics. The finding of interactions between diet and genetic variants has led to intense research and debate about the effectiveness of personalized nutrition as a more suitable tool for the prevention of chronic diseases than the traditional 1-size-fits-all recommendations. Here, we provide some of our own examples that illustrate the progression of nutrigenetics through the years, from the initial studies within the Framingham Heart Study, to the most recent use of large consortia, such as the Cohorts for Heart and Aging Research in Genomic Epidemiology, and ending up with large dietary intervention studies, such as the PREDIMED (Prevención con Dieta Mediterránea) study. These recent approaches are providing more robust and clinically relevant gene-diet interactions. Therefore, although the current evidence level of applying genomic information to tailoring is at its early stages, the prospect of widespread incorporation of nutrigenetics to the clinical practice is encouraging.

  14. The Tsim Tsoum Approaches for Prevention of Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    R. B. Singh

    2010-01-01

    proinflammatory status of blood vessels, cardiomyocytes, liver cells and neurones; (a and (b are phenotype-related and depend on genetic, environmental and developmental factors. As such, they appear as universal markers for holistic health and these may be important in the pathogenesis of cardiovascular diseases and cancer, which is the main consideration of Tsim Tsoum concept.

  15. Sex differences in cardiovascular risk factors and disease prevention.

    Science.gov (United States)

    Appelman, Yolande; van Rijn, Bas B; Ten Haaf, Monique E; Boersma, Eric; Peters, Sanne A E

    2015-07-01

    Cardiovascular disease (CVD) has been seen as a men's disease for decades, however it is more common in women than in men. It is generally assumed in medicine that the effects of the major risk factors (RF) on CVD outcomes are the same in women as in men. Recent evidence has emerged that recognizes new, potentially independent, CVD RF exclusive to women. In particular, common disorders of pregnancy, such as gestational hypertension and diabetes, as well as frequently occurring endocrine disorders in women of reproductive age (e.g. polycystic ovary syndrome (PCOS) and early menopause) are associated with accelerated development of CVD and impaired CVD-free survival. With the recent availability of prospective studies comprising men and women, the equivalency of major RF prevalence and effects on CVD between men and women can be examined. Furthermore, female-specific RFs might be identified enabling early detection of apparently healthy women with a high lifetime risk of CVD. Therefore, we examined the available literature regarding the prevalence and effects of the traditional major RFs for CVD in men and women. This included large prospective cohort studies, cross-sectional studies and registries, as randomised trials are lacking. Furthermore, a literature search was performed to examine the impact of female-specific RFs on the traditional RFs and the occurrence of CVD. We found that the effects of elevated blood pressure, overweight and obesity, and elevated cholesterol on CVD outcomes are largely similar between women and men, however prolonged smoking is significantly more hazardous for women than for men. With respect to female-specific RF only associations (and no absolute risk data) could be found between preeclampsia, gestational diabetes and menopause onset with the occurrence of CVD. This review shows that CVD is the main cause of death in men and women, however the prevalence is higher in women. Determination of the CV risk profile should take into

  16. Early insulin treatment to prevent cardiovascular disease in prediabetes and overt diabetes.

    Science.gov (United States)

    Roman, G; Hancu, N

    2009-02-01

    Type 2 diabetes mellitus (DM) is a major risk factor for cardiovascular disease (CVD), and CVD represents the leading cause of death in people with type 2 DM. The cardiovascular risk is increased long before diabetes is diagnosed, in the prediabetes stage, when impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) develop. These stages are characterized by dysglycemia, defined as any elevated fasting or postprandial glycemia, extending from the normal range into diabetic range, associated with an increased risk of CVD. Due to metabolic memory demonstrated for type 2 DM as well, early interventions addressed to achieve and maintain glycemic control are required for long-term benefits in terms of both microvascular and macrovascular complications. The recommendation of early insulin therapy in type 2 DM is sustained by its pleiotropic effects, which may be cardioprotective and potentially anti-atherosclerotic. Insulin therapy in prediabetes and earlier in type 2 DM, could be a strategy in preventing cardiovascular disease and type 2 DM progression. To test this hypothesis, a large trial has been designed. Outcome Reduction with an Initial Glargine Intervention trial (ORIGIN) is an international, multicenter, randomized controlled, 2 x 2 factorial trial, investigating the possibility to prevent cardiovascular morbidity and mortality in people with type 2 DM, IGT, and/or IFG, and high cardiovascular risk by treating the normoglycemia with either insulin glargine or omega-3 fatty acid, compared to the standard intervention.

  17. Development and evaluation of a patient centered cardiovascular health education program for insured patients in rural Nigeria (QUICK - II

    Directory of Open Access Journals (Sweden)

    Osibogun Akin

    2011-03-01

    Full Text Available Abstract Background In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is likely to improve shortcomings in adherence. This paper describes a study that aims to develop a cardiovascular health education program for patients participating in a subsidized insurance plan in Nigeria and to evaluate the applicability and effectiveness in patients at increased risk for cardiovascular disease. Methods/Design Design: The study has two parts. Part 1 will develop a cardiovascular health education program, using qualitative interviews with stakeholders. Part 2 will evaluate the effectiveness of the program in patients, using a prospective (pre-post observational design. Setting: A rural primary health center in Kwara State, Nigeria. Population: For part 1: 40 patients, 10 healthcare professionals, and 5 insurance managers. For part 2: 150 patients with uncontrolled hypertension or other cardiovascular risk factors after one year of treatment. Intervention: Part 2: patient-centered cardiovascular health education program. Measurements: Part 1: Semi-structured interviews to identify stakeholder perspectives. Part 2: Pre- and post-intervention assessments including patients' demographic and socioeconomic data, blood pressure, body mass index and self-reporting measures on medication adherence and perception of care. Feasibility of the intervention will be measured using process data. Outcomes: For program development (part 1: overview of healthcare professionals' perceptions on barriers and facilitators to care, protocol for patient education, and protocol implementation plan. For program evaluation (part 2: changes in patients' scores on adherence to medication and life style changes, blood pressure, and other physiological and self

  18. Feasibility of recruiting families into a heart disease prevention program based on dietary patterns

    Science.gov (United States)

    Offspring of parents with a history of cardiovascular disease (CVD) inherit a similar genetic profile and share diet and lifestyle behaviors. This study aimed to evaluate the feasibility of recruiting families at risk of CVD to a dietary prevention program, determine the changes in diet achieved, an...

  19. The role of homocysteine-lowering B-vitamins in the primary prevention of cardiovascular disease.

    Science.gov (United States)

    Debreceni, Balazs; Debreceni, Laszlo

    2014-06-01

    Cardiovascular disease (CVD) is the leading cause of mortality in the Western world. The effort of research should aim at the primary prevention of CVD. Alongside statin therapy, which is maintained to be an effective method of CVD prevention, there are alternative methods such as vitamin B substitution therapy with folic acid (FA), and vitamins B12 and B6 . B-vitamins may inhibit atherogenesis by decreasing the plasma level of homocysteine (Hcy)-a suspected etiological factor for atherosclerosis-and by other mechanisms, primarily through their antioxidant properties. Although Hcy-lowering vitamin trials have failed to demonstrate beneficial effects of B-vitamins in the prevention of CVD, a meta-analysis and stratification of a number of large vitamin trials have suggested their effectiveness in cardiovascular prevention (CVP) in some aspects. Furthermore, interpretation of the results from these large vitamin trials has been troubled by statin/aspirin therapy, which was applied along with the vitamin substitution, and FA fortification, both of which obscured the separate effects of vitamins in CVP. Recent research results have accentuated a new approach to vitamin therapy for CVP. Studies undertaken with the aim of primary prevention have shown that vitamin B substitution may be effective in the primary prevention of CVD and may also be an option in the secondary prevention of disease if statin therapy is accompanied by serious adverse effects. Further investigations are needed to determine the validity of vitamin substitution therapy before its introduction in the protocol of CVD prevention.

  20. Which interventions offer best value for money in primary prevention of cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Linda J Cobiac

    Full Text Available BACKGROUND: Despite many decades of declining mortality rates in the Western world, cardiovascular disease remains the leading cause of death worldwide. In this research we evaluate the optimal mix of lifestyle, pharmaceutical and population-wide interventions for primary prevention of cardiovascular disease. METHODS AND FINDINGS: In a discrete time Markov model we simulate the ischaemic heart disease and stroke outcomes and cost impacts of intervention over the lifetime of all Australian men and women, aged 35 to 84 years, who have never experienced a heart disease or stroke event. Best value for money is achieved by mandating moderate limits on salt in the manufacture of bread, margarine and cereal. A combination of diuretic, calcium channel blocker, ACE inhibitor and low-cost statin, for everyone with at least 5% five-year risk of cardiovascular disease, is also cost-effective, but lifestyle interventions aiming to change risky dietary and exercise behaviours are extremely poor value for money and have little population health benefit. CONCLUSIONS: There is huge potential for improving efficiency in cardiovascular disease prevention in Australia. A tougher approach from Government to mandating limits on salt in processed foods and reducing excessive statin prices, and a shift away from lifestyle counselling to more efficient absolute risk-based prescription of preventive drugs, could cut health care costs while improving population health.

  1. Local government`s pollution prevention program

    Energy Technology Data Exchange (ETDEWEB)

    Swanson, D. [Boulder Country Pollution Prevention Program, Boulder, CO (United States)

    1996-12-31

    The pollution prevention program operated by the Health Department of Boulder County is called Business Partners for a Clean Environment (Business Partners). It is a cooperative effort among local businesses, the City of Boulder, Boulder County, and the Boulder Chamber of Commerce. This nonregulatory, incentive-based program provides industry with pollution prevention information and technical assistance necessary to reduce and/or eliminate environmental waste. This paper provides an overview of the program development, creation of partnerships and trust, and some of the results from implementation of the program. Following the first 18 months of the program, 35 businesses were recognized as Business Partners. The Business Partners program has also received an achievement award from the National Association of Counties for promoting {open_quotes}responsible, responsive, and effective government{close_quotes} and two governor`s awards from the State of Colorado. Participating businesses have demonstrated that a pollution prevention program can reduce environmental waste, increase employee safety, and decrease costs. 4 refs., 4 figs., 5 tabs.

  2. Effectiveness of bullying and violence prevention programs.

    Science.gov (United States)

    Stagg, Sharon J; Sheridan, Daniel

    2010-10-01

    Workplace bullying is a significant occupational health problem worldwide. Nurses are vulnerable to workplace bullying. During interactions with staff nurses, occupational health nurses have crucial opportunities to identify victims of workplace bullying and provide effective techniques for preventing and managing workplace bullying behaviors. The purpose of this systematic review was to identify best practices for preventing and managing workplace bullying among staff nurses. The best method found to control and stop workplace bullying involves cognitive rehearsal of responses to common bullying behaviors. Translation of the 3-hour workplace bullying prevention and management program is discussed.

  3. Prevention Programs for Refugee Mental Health.

    Science.gov (United States)

    Williams, Carolyn L.

    Refugee movements impose tremendous psychological and physical trauma on survivors, making refugees a high risk group for psychopathology and psychosocial adjustment problems. This paper explores the traditional impediments to developing prevention programs for refugees and describes public mental health strategies that could be used for different…

  4. Effectiveness of programs to prevent school bullying

    NARCIS (Netherlands)

    Baldry, A.C.; Farrington, D.P.

    2007-01-01

    Sixteen major evaluations of programs to prevent school bullying, conducted in 11 different countries, are reviewed in detail. Of these 16 evaluations, 8 produced desirable results, 2 produced mixed results, 4 produced small or negligible effects, and 2 produced undesirable results. These varying fi

  5. An Empirically Supported Eating Disorder Prevention Program.

    Science.gov (United States)

    Phelps, LeAdelle; Sapia, Jennifer; Nathanson, David; Nelson, Linda

    2000-01-01

    An eating disorder prevention program was completed with middle school, high school, and college females. Some successful outcomes included: (1) facilitating an acknowledgement of pressures to attain a model skeletal look; (2) changing attitudes about standards of beauty; and (3) altering the participants' current and future intentional use of…

  6. International Library Program to Prevent Nuclear Holocaust.

    Science.gov (United States)

    Sable, Martin H.

    1985-01-01

    Suggests that International Federation of Library Associations act as agent of UNESCO and arrange through its member national library associations to hold lectures and teach-ins, organize discussion groups, and publish and distribute pamphlets dealing with danger of nuclear holocaust. Suggested war-preventive activities, program structures, and…

  7. The role of vitamin supplementation in the prevention of cardiovascular disease events.

    Science.gov (United States)

    Desai, Chirag K; Huang, Jennifer; Lokhandwala, Adil; Fernandez, Aaron; Riaz, Irbaz Bin; Alpert, Joseph S

    2014-09-01

    The production, sale, and consumption of multiple vitamins is a multibillion-dollar industry. Most Americans take some form of supplement ostensibly for prevention of cardiovascular disease. It has been claimed that vitamin A retards atherogenesis. Vitamin C is an antioxidant and is thought to possibly decrease free radical-induced endothelial injury, which can lead to atherosclerotic plaque formation. Vitamin E has been extensively studied for its possible effects on platelet function as well as inhibition of foam-cell formation. Low levels of vitamin D have been thought to negatively impact myocardial structure and increase the risk for cardiovascular events. Increased intake of vitamin B6, B12, and folate has been associated with reduction of homocysteine levels; elevated homocysteine blood levels have been associated with the occurrence of stroke, heart attack, and cardiovascular death. The purpose of this study was to review the currently available literature for vitamin supplementation with respect to prevention of cardiovascular disease. Unfortunately, the current evidence suggests no benefit exists with vitamin supplementation in the general US population. Further research is needed to evaluate whether there are specific populations that might benefit from vitamin supplementation.

  8. The power of a balanced diet and lifestyle in preventing cardiovascular disease.

    Science.gov (United States)

    Herder, Rachel; Demmig-Adams, Barbara

    2004-01-01

    We examine the physiologic changes involved in the onset of cardiovascular disease (CVD) as well as multiple dietary and lifestyle factors that either promote or prevent CVD. Dietary fats (saturated, monounsaturated, n-3 and n-6 polyunsaturated, and trans fats), antioxidants, and carbohydrates, as well as alcohol consumption, exercise, smoking, and infections, are evaluated. Epidemiologic studies and clinical trials are discussed in light of the underlying mechanisms.

  9. Losartan-antioxidant hybrids: novel molecules for the prevention of hypertension-induced cardiovascular damage.

    Science.gov (United States)

    García, Gonzalo; Rodríguez-Puyol, Manuel; Alajarín, Ramón; Serrano, Isabel; Sánchez-Alonso, Patricia; Griera, Mercedes; Vaquero, Juan J; Rodríguez-Puyol, Diego; Alvarez-Builla, Julio; Díez-Marqués, María L

    2009-11-26

    We report the first examples of a new series of antioxidant-sartan hybrids (AO-sartans), which were made by adding an antioxidant fragment to the hydroxymethyl side chain of losartan. Experiments performed in cultured cells demonstrate that these new hybrids retain the ability to block the angiotensin II effect with increased antioxidant ability. In hypertensive rats, these compounds show properties that suggest they may be more useful than losartan for controlling hypertension and preventing hypertension-induced cardiovascular damage.

  10. Developing a focused scald-prevention program.

    Science.gov (United States)

    Cagle, Kathleen M; Davis, James W; Dominic, William; Ebright, Steffanie; Gonzales, Wendy

    2006-01-01

    Scalds account for a high percentage of burn injuries in young children. The purpose of this project was to use a formative evaluation process to design a pilot scald-prevention program for a high-risk population. The burn registry and U.S. Census were used to define a high-risk population. A total of 53 children younger than age 6 were admitted to a local burn center with scalds during a 4-year period. Cooking or food accounted for 84% of these injuries. A total of 21% of the patients resided in one zip code, representing an incidence rate of 23 per 100,000, which was statistically significant. Focus group meetings were conducted with parents in this zip code. They were queried about scald injury knowledge, prevention practices, and attitudes toward interventions. A prevention program was designed based on the findings. Workshops are conducted with high-risk groups in the zip code. Attendees consent to a home visit where prevention practices are assessed and taught. A pre/post test and home risk assessment survey is used to measure change. The Burn Registry, U.S. Census, and focus groups were complimentary formative evaluation measures that assisted in developing a targeted scald prevention project.

  11. [Spanish adaptation of the 2016 European Guidelines on cardiovascular disease prevention in clinical practice].

    Science.gov (United States)

    Royo-Bordonada, M Á; Armario, P; Lobos Bejarano, J M; Pedro-Botet, J; Villar Alvarez, F; Elosua, R; Brotons Cuixart, C; Cortés, O; Serrano, B; Cammafort Babkowski, M; Gil Núñez, A; Pérez, A; Maiques, A; de Santiago Nocito, A; Castro, A; Alegría, E; Baeza, C; Herranz, M; Sans, S; Campos, P

    The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than <10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse.

  12. PREVENT Cancer Preclinical Drug Development Program (PREVENT) | Division of Cancer Prevention

    Science.gov (United States)

    The PREVENT program provides a structure for the introduction of new agents, drugs and vaccines to inhibit, retard or reverse the cancer process. The program was designed to optimize translational opportunities from discovery to the clinic, and provide a mechanism to identify and study efficacy and pharmacodynamics biomarkers that will help in phase II trials to evaluate drug effects.  | Research pipeline for new prevention interventions and biomarkers headed toward clinical trials.

  13. A Polypill for primary prevention of cardiovascular disease: A feasibility study of the World Health Organization

    Directory of Open Access Journals (Sweden)

    Gunaratne Padma S

    2011-01-01

    Full Text Available Abstract Background The feasibility of conducting a large-scale Polypill clinical trial in developing countries remains unclear. More information is needed regarding the efficacy in reducing the risk factors of cardiovascular disease (CVD, side effects, improvement in adherence and physician/patient "acceptability" of the Polypill. Methods We conducted an open-label, parallel-group, randomized clinical trial involving three sites in Sri Lanka that enrolled a total of 216 patients without established CVD. The trial compared a Polypill (75 mg aspirin, 20 mg simvastatin, 10 mg lisinopril and 12.5 mg hydrochlorothiazide to Standard Practice. After randomization, patients were followed monthly for three months. Pre-specified primary outcomes included reduction in systolic blood pressure, total cholesterol and estimated 10-year CVD risk. We also evaluated the recruitment process and acceptability of the Polypill by both physicians and patients. Results Patients were recruited in a six-month period as planned. Two hundred three patients (94.0% completed the treatment program and returned for their three-month follow-up visits. No safety concerns were reported. These findings suggest a high rate of patient acceptability, a finding that is bolstered by the majority of patients completing the trial (90% indicating that they would take the Polypill "for life" if proven to be effective in reducing CVD risk. Approximately 86% of the physicians surveyed agreed with and supported use of the Polypill for primary prevention and 93% for secondary prevention of CVD. Both the Polypill and Standard Practice resulted in marked reductions in systolic blood pressure, total cholesterol and 10-year risk of CVD. However, the differences between the treatment groups were not statistically significant. Conclusions We successfully completed a Polypill feasibility trial in Sri Lanka. We were able to document high acceptability of the Polypill to patients and physicians. We

  14. Promoting health and wellness in the workplace: a unique opportunity to establish primary and extended secondary cardiovascular risk reduction programs.

    Science.gov (United States)

    Arena, Ross; Guazzi, Marco; Briggs, Paige D; Cahalin, Lawrence P; Myers, Jonathan; Kaminsky, Leonard A; Forman, Daniel E; Cipriano, Gerson; Borghi-Silva, Audrey; Babu, Abraham Samuel; Lavie, Carl J

    2013-06-01

    Given the burden of cardiovascular disease (CVD), increasing the prevalence of healthy lifestyle choices is a global imperative. Currently, cardiac rehabilitation programs are a primary way that modifiable risk factors are addressed in the secondary prevention setting after a cardiovascular (CV) event/diagnosis. Even so, there is wide consensus that primary prevention of CVD is an effective and worthwhile pursuit. Moreover, continual engagement with individuals who have already been diagnosed as having CVD would be beneficial. Implementing health and wellness programs in the workplace allows for the opportunity to continually engage a group of individuals with the intent of effecting a positive and sustainable change in lifestyle choices. Current evidence indicates that health and wellness programs in the workplace provide numerous benefits with respect to altering CV risk factor profiles in apparently healthy individuals and in those at high risk for or already diagnosed as having CVD. This review presents the current body of evidence demonstrating the efficacy of worksite health and wellness programs and discusses key considerations for the development and implementation of such programs, whose primary intent is to reduce the incidence and prevalence of CVD and to prevent subsequent CV events. Supporting evidence for this review was obtained from PubMed, with no date limitations, using the following search terms: worksite health and wellness, employee health and wellness, employee health risk assessments, and return on investment. The choice of references to include in this review was based on study quality and relevance.

  15. Global cardiovascular disease prevention: a call to action for nursing: multilevel policies.

    Science.gov (United States)

    Burke, Lora E; Thompson, David R; Roos, Sabine; van Rijssen, Annemieke; Verdouw, H C L Lenneke; Troe, Eva

    2011-01-01

    This section, multilevel policies, reviews the impact that has been and can be made by health policy changes at multiple levels, strategies and resources for increasing adherence to population prevention recommendations, and how changes at the microlevel and macrolevel of the environment can provide opportunities and rewards for healthy behaviors and disincentives for unhealthy behaviors. Policies that support primary prevention of cardiovascular disease require the participation of numerous stakeholders at multiple levels, such as governmental and regulatory agencies. Such policy changes support a healthy lifestyle, as in designated smoke-free areas; laws that mandate that food purveyors reduce sodium and fat content or, eliminate trans-fats; and availability of safe parks and bike and walking trails; and also provide a supportive environment that in turn reinforces adherence to primary prevention. Health-related policies have a major impact at the societal level in both developed and developing countries; thus, it is important to understand the role that policy plays in promoting a healthier lifestyle and the prevention of cardiovascular disease. This section discusses how health policies can impact primary prevention and adherence to healthful recommendations, with examples focused on physical activity and diet.

  16. Chronic Beryllium Disease Prevention Program Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S

    2012-03-29

    This document describes how Lawrence Livermore National Laboratory (LLNL) meets the requirements and management practices of federal regulation 10 CFR 850, 'Chronic Beryllium Disease Prevention Program (CBDPP).' This revision of the LLNL CBDPP incorporates clarification and editorial changes based on lessons learned from employee discussions, observations and reviews of Department of Energy (DOE) Complex and commercial industry beryllium (Be) safety programs. The information is used to strengthen beryllium safety practices at LLNL, particularly in the areas of: (1) Management of small parts and components; and (2) Communication of program status to employees. Future changes to LLNL beryllium activities and on-going operating experience will be incorporated into the program as described in Section S, 'Performance Feedback.'

  17. A systematic review on the application of cardiovascular risk prediction models in pharmacoeconomics, with a focus on primary prevention

    NARCIS (Netherlands)

    Stevanovic, Jelena; Postma, Maarten J.; Pechlivanoglou, Petros

    2012-01-01

    Background: Long-term trials on the effectiveness of pharmacological treatment for primary cardiovascular disease prevention are scant. For that reason risk prediction models are used as a tool to project changes in cardiovascular disease incidence due to changes in risk factor levels observed in sh

  18. Development and evaluation of a patient centered cardiovascular health education program for insured patients in rural Nigeria (QUICK-II)

    NARCIS (Netherlands)

    A.O. Odusola; M. Hendriks; C. Schultsz; K. Stronks; J. Lange; A. Osibogun; T. Akande; S. Alli; P. Adenusi; K. Agbede; J. Haafkens

    2011-01-01

    BACKGROUND: In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is like

  19. Views on primary prevention of cardiovascular disease - an interview study with Swedish GPs

    Directory of Open Access Journals (Sweden)

    Wahlström Rolf

    2010-06-01

    Full Text Available Abstract Background General practitioners (GPs have gradually become more involved in the prevention of cardiovascular disease (CVD, both through more frequent prescribing of pharmaceuticals and by giving advice regarding lifestyle factors. Most general practitioners are now faced with decisions about pharmaceutical or non-pharmaceutical treatment for primary prevention every day. The aim of this study was to explore, structure and describe the views on primary prevention of cardiovascular disease in clinical practice among Swedish GPs. Methods Individual interviews were conducted with 21 GPs in southern Sweden. The interview transcripts were analysed using a qualitative approach, inspired by phenomenography. Results Two main categories of description emerged during the analysis. One was the degree of reliance on research data regarding the predictability of real risk and the opportunities for primary prevention of CVD. The other was the allocation of responsibility between the patient and the doctor. The GPs showed different views, from being convinced of an actual and predictable risk for the individual to strongly doubting it; from relying firmly on protection from disease by pharmaceutical treatment to strongly questioning its effectiveness in individual cases; and from reliance on prevention of disease by non-pharmaceutical interventions to a total lack of reliance on such measures. Conclusions The GPs' different views, regarding the rationale for and practical management of primary prevention of CVD, can be interpreted as a reflection of the complexity of patient counselling in primary prevention in clinical practice. The findings have implications for development and implementation of standard treatment guidelines, regarding long-time primary preventive treatment.

  20. Primary prevention of cardiovascular disease: A review of contemporary guidance and literature.

    Science.gov (United States)

    Stewart, Jack; Manmathan, Gavin; Wilkinson, Peter

    2017-01-01

    Cardiovascular disease is a significant and ever-growing problem in the United Kingdom, accounting for nearly one-third of all deaths and leading to significant morbidity. It is also of particular and pressing interest as developing countries experience a change in lifestyle which introduces novel risk factors for cardiovascular disease, leading to a boom in cardiovascular disease risk throughout the developing world. The burden of cardiovascular disease can be ameliorated by careful risk reduction and, as such, primary prevention is an important priority for all developers of health policy. Strong consensus exists between international guidelines regarding the necessity of smoking cessation, weight optimisation and the importance of exercise, whilst guidelines vary slightly in their approach to hypertension and considerably regarding their approach to optimal lipid profile which remains a contentious issue. Previously fashionable ideas such as the polypill appear devoid of in-vivo efficacy, but there remain areas of future interest such as the benefit of serum urate reduction and utility of reduction of homocysteine levels.

  1. Primary prevention of cardiovascular disease: A review of contemporary guidance and literature

    Directory of Open Access Journals (Sweden)

    Jack Stewart

    2017-01-01

    Full Text Available Cardiovascular disease is a significant and ever-growing problem in the United Kingdom, accounting for nearly one-third of all deaths and leading to significant morbidity. It is also of particular and pressing interest as developing countries experience a change in lifestyle which introduces novel risk factors for cardiovascular disease, leading to a boom in cardiovascular disease risk throughout the developing world. The burden of cardiovascular disease can be ameliorated by careful risk reduction and, as such, primary prevention is an important priority for all developers of health policy. Strong consensus exists between international guidelines regarding the necessity of smoking cessation, weight optimisation and the importance of exercise, whilst guidelines vary slightly in their approach to hypertension and considerably regarding their approach to optimal lipid profile which remains a contentious issue. Previously fashionable ideas such as the polypill appear devoid of in-vivo efficacy, but there remain areas of future interest such as the benefit of serum urate reduction and utility of reduction of homocysteine levels.

  2. ASSESSMENT OF CARDIOVASCULAR AUTONOMIC FUNCTION IN ASYMPTOMATIC OBESE YOUNG ADULTS - PREVENTION IS BETTER THAN CURE

    Directory of Open Access Journals (Sweden)

    P Vijetha

    2015-07-01

    Full Text Available Back ground: Obesity is emerging global epidemic in young adults who form the productive group of the society. This has been called as new world syndrome and is a massive reflection of social, economic and cultural problems currently faced by the developing and developed countries. As cardiac autonomic dysfunction often coexists with obesity, early detection of autonomic impairment by simple investigations of autonomic function, can be potentially important to prevent future complications. Objective: To identify cardiovascular autonomic dysfunction in asymptomatic obese young adults. Study design: This study was conducted in the department of Physiology at Kakatiya Medical College, Warangal, A.P, 30 apparently healthy obese subjects of both sex with BMI > 25 kg/sqm were taken as study group. Age and sex matched 30 normal weight subjects (BMI 18.5-22.9 kg/ sqm taken as control group. Methods: Ewing’s battery of 5 noninvasive cardiovascular reflex tests were done for assessing autonomic function. These autonomic function parameters were correlated with BMI, Unpaired Student‘t’ test and Pearson correlation coefficient test were used for statistical analysis. Results: Mean values of all cardiovascular reflex tests were significantly lower in the study group. Conclusion: The results indicate that cardiovascular autonomic dysfunction is present in otherwise healthy obese young adults.

  3. Preventive effect of continuous quality improvement on the malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    赵班

    2013-01-01

    Objective To investigate the preventive effect of continuous quality improvement (CQI) on malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly patients undergoing peritoneal dialysis.Methods A single-center prospective self-controlled study was performed.32 stable elderly patients to undergo continuous ambulatory peritoneal dialysis (CAPD) were included.The continuous quality improvement program was conducted by using the 4-step problem-solving

  4. The U.S. prevention of cardiovascular disease guidelines and implications for implementation in LMIC.

    Science.gov (United States)

    Wong, Nathan D; Moran, Andrew E

    2014-12-01

    The 2013 guidelines for the Prevention of Cardiovascular Disease released by the American College of Cardiology and the American Heart Association included guidelines of assessment of cardiovascular disease (CVD) risk, lifestyle management, management of overweight and obesity, and treatment of blood cholesterol. In addition, there were also 2014 guidelines on hypertension management released by members appointed to the Eighth Joint National Committee. Taken together, these guidelines, though extensively discussed and disseminated in the United States, have not been widely recognized beyond the United States, nor have their implications been considered for lower- and middle-income developing countries. With an estimated 80% of the global burden in CVD occurring in developing countries, it is important to develop strategies to adequately detect those at increased CVD risk and to manage their risk through lifestyle and where appropriate, pharmacologic means. Though certain aspects of each guideline may be suitable for implementation globally, including in developing countries, other recommendations would be unrealistic for many countries based on local epidemiology and resources. CVD prevention priorities can be set using guidance from recently published CVD prevention guidelines if appropriately modified to the context of lower- and middle-income developing countries. Establishment of global CVD prevention standards and rapid adaptation and dissemination of clinical guidelines are of paramount importance if we are to make significant progress into achieving World Health Organization 2025 goals to reduce the burden from CVD and other noncommunicable diseases.

  5. A polypill strategy to improve global secondary cardiovascular prevention: from concept to reality.

    Science.gov (United States)

    Castellano, José M; Sanz, Ginés; Fernandez Ortiz, Antonio; Garrido, Ester; Bansilal, Sameer; Fuster, Valentin

    2014-08-12

    The prevention of cardiovascular disease (CVD) by using a polypill has gained increasing momentum as a strategy to contain progression of the disease. Since its initial conception just over a decade ago, only a handful of trials have been completed assessing the efficacy and safety of this innovative concept. The results of these trials have supported the viability of the polypill in CVD prevention and management, albeit with a few caveats, essentially related to the lack of evidence on the effect of the polypill to effectively reduce cardiovascular events. The polypill has the potential to control the global health epidemic of CVD by effectively reaching underdeveloped regions of the world, simplifying healthcare delivery, improving cost-effectiveness, increasing medication adherence, and supporting a comprehensive prescription of evidence-based cardioprotective drugs. Major trials underway will provide definitive evidence on the efficacy of the polypill in reducing cardiovascular events in a cost-effective manner. The results of these studies will determine whether a polypill strategy can quell the burgeoning public health challenge of CVD and will potentially provide the evidence to implement an effective, simple, and innovative solution to restrain the global CVD pandemic.

  6. Potential Role of Polyphenols in the Prevention of Cardiovascular Diseases: Molecular Bases.

    Science.gov (United States)

    Gormaz, Juan Guillermo; Valls, Nicolas; Sotomayor, Camilo; Turner, Thomas; Rodrigo, Ramón

    2016-01-01

    Cardiovascular diseases (CVD) are the leading cause of mortality worldwide. It is widely accepted that oxidative stress plays a key role in their development and progression; hence oxidative damage might be abrogated by antioxidants. Polyphenols are phytochemicals showing extensively studied antioxidant properties in-vivo. Most representative sources of these compounds include fruits, greens, nuts, herbs, cocoa, tea and coffee. Epidemiological evidence suggests an association between the consumption of polyphenol-rich vegetables and the reduction of cardiovascular disease prevalence. This fact could be related to the anti-inflammatory, antithrombotic and vasodilatory effects of polyphenols. Even though these biological effects could be mainly attributed to the antioxidant activity of polyphenols, other pharmacological mechanisms should also be considered. The latter could comprise direct anti-inflammatory effects, modulation of intracellular signaling and gene expression, improvement of nitric oxide homeostasis, as well as platelet antiaggregation. However, it is noticeable that protocols of interventions to evaluate the properties of polyphenols have failed to show the same positive results reported from observational studies. At present, a controversy exists regarding the actual effectiveness of polyphenols in preventing cardiovascular diseases. Therefore, an improvement of the available knowledge about polyphenol pharmacokinetics, together with a better understanding of the mechanisms of action of these compounds, could be of great benefit. Thus, a rational support for the development of interventional designs could provide reliable evidence on the actual role of polyphenols in CVD prevention.

  7. Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China.

    Science.gov (United States)

    Wu, Yangfeng; Benjamin, Emelia J; MacMahon, Stephen

    2016-06-14

    With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved.

  8. cardiovasculares

    Directory of Open Access Journals (Sweden)

    Cristina Guerrero

    2006-01-01

    Full Text Available Uno de los aspectos que más discusión ha suscitado en los últimos tiempos entre quienes nos dedicamos al estudio de la emoción tiene que ver con la eventual asociación entre percepción, valoración y respuesta fisiológica. Esto es, siguiendo la máxima aristotélica, cabría cuestionar si las cosas son como son o son como cada quien las percibe. El objetivo de este experimento ha sido establecer la existencia de una conexión entre percepción de control y responsividad cardiovascular. La muestra estudiada ha estado conformada por estudiantes de la Universidad de Castellón; todos ellos han participado de forma voluntaria. La prueba de estrés ha consistido en un examen real de una asignatura troncal de la titulación que cursaban los participantes. Así pues, utilizando una situación de estrés real, hipotetizamos que las respuestas cardiovasculares (medidas a través de la tasa cardiaca, la presión sanguínea sistólica y la presión sanguínea diastólica dependen de la percepción de control que el individuo tiene, o cree tener, sobre la situación.

  9. Programa para mejorar marcadores de riesgo cardiovascular en escolares mexicanos A program to improve some cardiovascular risk factors in Mexican school age children

    Directory of Open Access Journals (Sweden)

    Otilia Perichart-Perera

    2008-06-01

    Full Text Available OBJETIVO: Evaluar el efecto de un programa de actividad física sobre los marcadores de riesgo cardiovascular en escolares mexicanos. MATERIAL Y MÉTODOS: Escolares de dos escuelas públicas de Querétaro (n= 360, 8-14 años realizaron una rutina de actividad física durante 16 semanas (febrero a mayo de 2006. Se compararon mediciones antropométricas, de presión arterial y química sanguínea, antes y después de la intervención. RESULTADOS: La presión sistólica, los triacilglicéridos y el colesterol total disminuyeron de forma significativa en los escolares. La reducción de los lípidos fue mayor en los escolares con valores iniciales alterados. En niñas con riesgo cardiovascular inicial, el puntaje de conglomerado de riesgo disminuyó en grado considerable. No se observaron cambios en el IMC, circunferencia de cintura e insulina sé-rica. CONCLUSIONES: La aplicación de una rutina de ejercicio sencilla tiene efectos notorios sobre los indicadores de riesgo cardiovascular en escolares. Estos resultados pueden considerarse un modelo de intervención para paliar los efectos de la obesidad infantil.OBJECTIVE: To assess the effect of a physical activity intervention on cardiovascular risk factors in Mexican school-age children. MATERIAL AND METHODS: Children from two public schools in Queretaro (n=360, 8-14 years old performed a 20-minute physical activity routine every school day during 16 weeks (February-May 2006. Anthropometric, blood pressure and biochemical assessment was done before and after implementation. RESULTS: Systolic blood pressure, triglyceride and total cholesterol levels decreased significantly. The decrease in lipid and lipoprotein levels was higher in children with high baseline levels. In high-risk girls, the cardiovascular risk cluster score decreased significantly. No change in BMI, waist circumference, or insulin was observed. CONCLUSION: A simple physical activity program modified several cardiovascular risk markers

  10. Medication effectiveness may not be the major reason for accepting cardiovascular preventive medication

    DEFF Research Database (Denmark)

    Harmsen, Charlotte Gry; Støvring, Henrik; Jarbøl, Dorte Ejg

    2012-01-01

    Shared decision-making and patients' choice of interventions are areas of increasing importance, not least seen in the light of the fact that chronic conditions are increasing, interventions considered important for public health, and still non-acceptance of especially risk-reducing treatments of...... and reasoning for accepting or declining a cardiovascular preventive medication offer.......Shared decision-making and patients' choice of interventions are areas of increasing importance, not least seen in the light of the fact that chronic conditions are increasing, interventions considered important for public health, and still non-acceptance of especially risk-reducing treatments...... of cardiovascular diseases (CVD) is prevalent. A better understanding of patients' medication-taking behavior is needed and may be reached by studying the reasons why people accept or decline medication recommendations. The aim of this paper was to identify factors that may influence people's decisions...

  11. Omega-3 Fatty Acids and Primary and Secondary Prevention of Cardiovascular Disease.

    Science.gov (United States)

    Cao, Yong; Lu, Lei; Liang, Jun; Liu, Min; Li, Xianchi; Sun, RongRong; Zheng, Yi; Zhang, Peiying

    2015-05-01

    The prevalence of cardiovascular disease (CVD) is increasing dramatically especially in developing countries like India. CVD is a leading cause of morbidity and mortality. There has been a growing awareness of the role of nutrients in the prevention of CVD. One specific recommendation in the battle against CVD is the increased intake of omega-3 fatty acids, which are polyunsaturated fatty acids. Studies have reported inverse associations of CVD with dietary intake of omega-3 fatty acids, suggesting that omega-3 fatty acids supplementation might exert protective effects on CVD. They exert their cardioprotective effect through multiple mechanisms. Omega-3 fatty acid therapy has shown promise as a useful tool in the primary and secondary prevention of CVD. This review briefly summarizes the effects of omega-3 fatty acids in primary and secondary prevention of CVD.

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

    Science.gov (United States)

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

  13. [Physical cardiovascular activity in the physical preventive medecine of the diabetes mellitus type 2].

    Science.gov (United States)

    Rodríguez Rodríguez, Luis Pablo

    2009-01-01

    The indication of physical activity in patients with Diabetes mellitus type 2 and in the metabolic syndrome has a scientific proven evidence. There does no exist a general definite program of this activity. There is designed his methodology, modality, intensity, frequency and duration. The first results are presented in diabete type 2 patients and of them those who meet with metabolic syndrome by means of evaluation of the HbA1c, total cholesterol, triglycerides and IMC. On emphasizes that there is reached a very high and linear decrease of the HbA1c, with the individualized program of physical cardiovascular activity.

  14. Cardiovascular disease prevention in rural Nigeria in the context of a community based health insurance scheme: QUality improvement cardiovascular care Kwara-I (QUICK-I)

    NARCIS (Netherlands)

    M. Hendriks (Maaike); L.M. Brewster (Lizzy); F.W.N.M. Wit (Ferdinand); O.A. Bolarinwa (Oladimeji Akeem); A.O. Odusola (Aina Olufemi); E. Orlewska (William Ken); N. Bindraban (Navin); A. Vollaard (Albert); S. Alli (Shade); P. Adenusi (Peju); K. Agbede (Kayode); T.M. Akande (Tanimola); J. Lange (Joep); C. Schultsz (Constance)

    2011-01-01

    textabstractBackground: Cardiovascular diseases (CVD) are a leading contributor to the burden of disease in low- and middle-income countries. Guidelines for CVD prevention care in low resource settings have been developed but little information is available on strategies to implement this care. A co

  15. Cardiovascular disease prevention in rural Nigeria in the context of a community based health insurance scheme: QUality Improvement Cardiovascular care Kwara-I (QUICK-I)

    NARCIS (Netherlands)

    M. Hendriks; L. Brewster; F. Wit; O.A. Bolarinwa; A.O. Odusola; W. Redekop; N. Bindraban; A. Vollaard; S. Alli; P. Adenusi; K. Agbede; T. Akande; J. de Lange; C. Schultsz

    2011-01-01

    Background: Cardiovascular diseases (CVD) are a leading contributor to the burden of disease in low- and middle-income countries. Guidelines for CVD prevention care in low resource settings have been developed but little information is available on strategies to implement this care. A community heal

  16. Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2012-04-01

    The aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.

  17. 75 FR 23637 - Injury and Illness Prevention Program

    Science.gov (United States)

    2010-05-04

    ... Occupational Safety and Health Administration 29 CFR Part 1910 Injury and Illness Prevention Program AGENCY... Prevention Programs, referred to as ``I2P2.'' OSHA plans to use the information gathered at these meetings in developing an Injury and Illness Prevention Program proposed rule. The discussions will be informal and...

  18. 49 CFR 195.442 - Damage prevention program.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Damage prevention program. 195.442 Section 195.442... PIPELINE Operation and Maintenance § 195.442 Damage prevention program. (a) Except as provided in paragraph... section. (1) The state has adopted a one-call damage prevention program under § 198.37 of this chapter;...

  19. 75 FR 80734 - Chronic Beryllium Disease Prevention Program

    Science.gov (United States)

    2010-12-23

    ... CFR Part 850 RIN 1992-AA39 Chronic Beryllium Disease Prevention Program AGENCY: Office of Health... beryllium disease prevention program. The Department solicits comment and information on the permissible... course of action regarding its chronic beryllium disease prevention program. DATES: All comments on...

  20. Assessing Cardiovascular Health Using Life's Simple 7 in a Chinese Population Undergoing Stroke Prevention

    Institute of Scientific and Technical Information of China (English)

    Qiong Yang; Bin Zhang; Pan Deng; Lu Chen; Jing-Ran Wang; Dong-Sheng Fan

    2015-01-01

    Background:The American Heart Association/American Stroke Association proposed a metric called Life's Simple 7 (LS7) to define cardiovascular health (CVH).The presence of a large number of ideal components of CVH is associated with lower cardiovascular disease and all-cause mortality.We aimed to assess CVH using LS7 in a Chinese population undergoing primary and secondary stroke prevention.Methods:Patients with either ischemic stroke or cardiovascular risk factors were enrolled in the study from October 2010 to July 2013.LS7 components were scored as poor (0 points),intermediate (1 point),or ideal (2 points).The overall LS7 score was categorized as inadequate (0-4),average (5-9),or optimal (10-14) CVH.The Chi-square test,Mann-Whitney U-test,and Kruskal-Wallis test were used.Results:In total,706 patients were enrolled.(1) The distribution of the overall LS7 score (n =255) indicated that 9.4%,82.4%,and 8.2% of the patients had inadequate,average,and optimal CVH,respectively.The proportion of patients with optimal CVH undergoing secondary stroke prevention was lower than that for patients undergoing primary stroke prevention (3.8% vs.12.8%,P =0.005).The vast majority of participants (76.1%) presented with ≤2 ideal health components.(2) The proportions of patients with poor,intermediate,and ideal status,respectively,for the following LS7 components were assessed:Total cholesterol (n =275; 5.1%,73.8%,and 21.1%),blood pressure (n =351 ;32.5%,59.0%,and 8.5%),blood glucose (n =280; 9.3%,39.6%,and 51.1%),physical activity (n =540; 90.7%,8.7%,and 0.6%),diet (n =524;0.2%,92.4%,and 7.4%),smoking (n =619; 20.7%,2.9%,and 76.4%),and body mass index (n =259; 6.6%,35.5%,and 57.9%).Conclusions:Few Chinese patients undergoing stroke prevention had optimal CVH (determined using LS7).Additionally,fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention.In particular,physical activity

  1. Nitrergic system and plasmatic methylarginines: Evidence of their role in the perinatal programming of cardiovascular diseases.

    Science.gov (United States)

    Bassareo, Pier Paolo; Mussap, Michele; Bassareo, Valentina; Flore, Giovanna; Mercuro, Giuseppe

    2015-12-01

    Atherosclerosis, in turn preceded by endothelial dysfunction, underlies a series of important cardiovascular diseases. Reduced bioavailability of endothelial nitric oxide, by increasing vascular tone and promoting platelet aggregation, leukocyte adhesion, and smooth muscle cell proliferation, plays a key role in the onset of the majority of cardiovascular diseases. In addition, high blood levels of asymmetric dimethylarginine, a potent inhibitor of nitric oxide synthesis, are associated with future development of adverse cardiovascular events and cardiac death. Recent reports have demonstrated that another methylarginine, i.e., symmetric dimethylarginine, is also involved in the onset of endothelial dysfunction and hypertension. Almost a decade ago, prematurity at birth and intrauterine growth retardation were first associated with a potential negative influence on the cardiovascular apparatus, thus constituting risk factors or leading to early onset of cardiovascular diseases. This condition is referred to as cardiovascular perinatal programming. Accordingly, cardiovascular morbidity and mortality are higher among former preterm adults than in those born at term. The aim of this paper was to undertake a comprehensive literature review focusing on cellular and biochemical mechanisms resulting in both reduced nitric oxide bioavailability and increased methylarginine levels in subjects born preterm. Evidence of the involvement of these compounds in the perinatal programming of cardiovascular risk are also discussed.

  2. Genetic influences on blood lipids and cardiovascular disease risk: tools for primary prevention.

    Science.gov (United States)

    Ordovas, José M

    2009-05-01

    Genetic polymorphism in human populations is part of the evolutionary process that results from the interaction between the environment and the human genome. Recent changes in diet have upset this equilibrium, potentially influencing the risk of most common morbidities such as cardiovascular diseases, obesity, diabetes, and cancer. Reduction of these conditions is a major public health concern, and such a reduction could be achieved by improving our ability to detect disease predisposition early in life and by providing more personalized behavioral recommendations for successful primary prevention. In terms of cardiovascular diseases, polymorphisms at multiple genes have been associated with differential effects in terms of lipid metabolism; however, the connection with cardiovascular disease has been more elusive, and considerable heterogeneity exists among studies regarding the predictive value of genetic markers. This may be because of experimental limitations, the intrinsic complexity of the phenotypes, and the aforementioned interactions with environmental factors. The integration of genetic and environmental complexity into current and future research will drive the field toward the implementation of clinical tools aimed at providing dietary advice optimized for the individual's genome. This may imply that dietary changes are implemented early in life to gain maximum benefit. However, it is important to highlight that most reported studies have focused on adult populations and to extrapolate these findings to children and adolescents may not be justified until proper studies have been carried out in these populations and until the ethical and legal issues associated with this new field are adequately addressed.

  3. Is it possible to prevent morbidity on post cardiovascular surgery applying low level laser therapy?

    Science.gov (United States)

    Pinto, Nathali C.; Baptista, Ivany Machado d. C.; Pereira, Mara Helena C.; Serrão, Nelson F.; Pomerantzeff, Pablo M. A.; Chavantes, Maria Cristina

    2014-03-01

    Background and Objective: Complications following cardiovascular surgery incision are common in mediastinitis and wound dehiscence form, a 47% mortality rate remaining. Low Level Laser Therapy (LLLT) has been employed mainly to its effectiveness analgesic and anti-inflammatory actions, aiding the tissue repair process. The aim of this study was to evaluate infrared LLLT onto surgical incision in patients submitted to cardiovascular surgery. Materials and Methods: 40 patients were divided in two groups: Placebo Group (G1) - conventional therapy + "Laser pointer" and Laser Group (G2) - conventional therapy + Infrared Laser irradiation on surgical incision. Diode Laser was employed, C.W. mode, around the surgical wound bed, on immediate Post Operative (PO), 1st PO and 3rd PO with the following parameters: wavelength (λ): 830nm, P=35mW, E=0,75J. Results: G2 didn't present any complication and 5% of patients in G1 developed incision dehiscence and infection. On 7thPO, still a large amount of G1 patients showed pain and unquestionable inflammatory signs surrounding the surgical wound, when compared to G2. Besides, hospital stay in Laser Group was 2 times shorter than in Placebo Group (p-value=0.001). Conclusion: Infrared Laser denoted to be safe and exceptionally valuable tools in preventing morbidities on post cardiovascular surgeries.

  4. Quality of secondary cardiovascular prevention in specialised care in the Netherlands: the SOLID study

    Science.gov (United States)

    van Galen, M.M.; Jonker, J.J.C.; Vermeer, F.; Grobbee, D.E.

    2004-01-01

    Objective To determine the extent to which Dutch patients with a history of cardiovascular disease and high cholesterol levels, treated in specialised care, are achieving low-cholesterol targets as defined by national guidelines. Design Hospital-based cohort study. Setting Practices of 41 hospital-based cardiologists and internists in the Netherlands. Subjects 7377 patients. Results Forty-one percent of the patients with an indication for secondary cardiovascular prevention by lipid-lowering drug treatment were receiving medication and were achieving cholesterol targets, 42% were receiving lipid-lowering medication but had cholesterol levels above target, 11% were not receiving treatment, and 5% had no recent lipid measurements. Conclusion Compared with previous studies, the SOLID study shows that a relatively large percentage of the Dutch patients under specialised care with a history of cardiovascular disease and an indication for cholesterol-reducing therapy are currently being treated. A considerable proportion of the patients, however, are still not receiving optimal treatment and more than 10% are not being treated at all. ImagesFigure 1Figure 2 PMID:25696252

  5. Comparison of primary care models in the prevention of cardiovascular disease - a cross sectional study

    Directory of Open Access Journals (Sweden)

    Hogg William

    2011-10-01

    Full Text Available Abstract Background Primary care providers play an important role in preventing and managing cardiovascular disease. This study compared the quality of preventive cardiovascular care delivery amongst different primary care models. Methods This is a secondary analysis of a larger randomized control trial, known as the Improved Delivery of Cardiovascular Care (IDOCC through Outreach Facilitation. Using baseline data collected through IDOCC, we conducted a cross-sectional study of 82 primary care practices from three delivery models in Eastern Ontario, Canada: 43 fee-for-service, 27 blended-capitation and 12 community health centres with salary-based physicians. Medical chart audits from 4,808 patients with or at high risk of developing cardiovascular disease were used to examine each practice's adherence to ten evidence-based processes of care for diabetes, chronic kidney disease, dyslipidemia, hypertension, weight management, and smoking cessation care. Generalized estimating equation models adjusting for age, sex, rurality, number of cardiovascular-related comorbidities, and year of data collection were used to compare guideline adherence amongst the three models. Results The percentage of patients with diabetes that received two hemoglobin A1c tests during the study year was significantly higher in community health centres (69% than in fee-for-service (45% practices (Adjusted Odds Ratio (AOR = 2.4 [95% CI 1.4-4.2], p = 0.001. Blended capitation practices had a significantly higher percentage of patients who had their waistlines monitored than in fee-for-service practices (19% vs. 5%, AOR = 3.7 [1.8-7.8], p = 0.0006, and who were recommended a smoking cessation drug when compared to community health centres (33% vs. 16%, AOR = 2.4 [1.3-4.6], p = 0.007. Overall, quality of diabetes care was higher in community health centres, while smoking cessation care and weight management was higher in the blended-capitation models. Fee-for-service practices

  6. The roles of community pharmacists in cardiovascular disease prevention and management

    Directory of Open Access Journals (Sweden)

    George J

    2011-05-01

    Full Text Available There is ample evidence in the international literature forpharmacist involvement in the prevention and managementof cardiovascular disease (CVD conditions in primary care.Systematic reviews and meta-analyses have confirmed thesignificant clinical benefits of pharmacist interventions for arange of CVD conditions and risk factors. Evidence generatedin research studies of Australian community pharmacistinvolvement in CVD prevention and management issummarised in this article.Commonwealth funding through the Community PharmacyAgreements has facilitated research to establish the feasibilityand effectiveness of new models of primary care involvingcommunity pharmacists. Australian community pharmacistshave been shown to effect positive clinical, humanistic andeconomic outcomes in patients with CVD conditions.Improvements in blood pressure, lipid levels, medicationadherence and CVD risk have been demonstrated usingdifferent study designs. Satisfaction for GPs, pharmacists andconsumers has also been reported. Perceived ‘turf’encroachment, expertise of the pharmacist, space, time andremuneration are challenges to the implementation of diseasemanagement services involving community pharmacists.

  7. Comprehensive strategies for the prevention and control of diabetes and cardiovascular diseases in Africa: future directions.

    Science.gov (United States)

    Muna, Walinjom F T

    2013-01-01

    The countries of the Sub Saharan African region have insufficient resources and healthcare systems that are poorly adapted to cope with the longstanding burden associated with communicable diseases and the ongoing HIV/AIDS pandemic. In addition, the rising burden of non-communicable diseases, including diabetes, cardiovascular diseases, and their risk factors, poses additional challenges. These countries need to urgently develop strategies to address these challenges of disease prevention and control. These strategies will require a new vision and more relevant and 'suitable' vocabulary in dealing with healthcare design, planning and implementation (using a cross-sectorial approach). Lessons learnt from the past (e.g. primary health care) in sub-Saharan Africa and other regions of the world may equally prove useful in developing strategies for the prevention and control of non-communicable diseases. Any potential strategy must emphasize the crucial role of economic, social, and environmental health determinants as well as the use of appropriate health technology.

  8. Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation.

    Science.gov (United States)

    Buttar, Harpal S; Li, Timao; Ravi, Nivedita

    2005-01-01

    Hypertension, myocardial infarction, atherosclerosis, arrhythmias and valvular heart disease, coagulopathies and stroke, collectively known as cardiovascular diseases (CVDs), contribute greatly to the mortality, morbidity and economic burden of illness in Canada and in other countries. It has been estimated that over four million Canadians have high blood pressure, a comorbid condition that doubles or triples the risk of CVD. According to the Heart and Stroke Foundation of Canada, CVDs caused 36% of deaths in 2001 and were responsible for 18% of the total hospital costs in Canada. The majority of Canadians exhibit at least one CVD-related risk factor, such as tobacco smoking, physical inactivity, diabetes, obesity, hypertension, a lack of daily fruit and vegetable consumption, and psychosocial factors, making these people more prone to developing a serious CVD-related illness in the future. It is therefore important that CVD-related causes and concerns be addressed. Given the scope and prevalence of CVDs, it is obvious that a population health approach - 'prevention is better than cure' - would be the most appropriate model to adopt to deal with this ubiquitous health problem and to reduce the costs of hospitalization, long-term medication and rehabilitation. The focus of the present review is to evaluate and compare the results of epidemiological, experimental and clinical studies, reporting on the influence of physical activity, dietary intervention, obesity and cigarette smoking on cardiovascular health and the prevention of CVDs. The prophylactic measures must be dealt with collectively because there is overwhelming evidence that the occurrence of CVDs can be reduced by approximately 80% by making lifestyle modifications. The preventive strategies against CVDs must be targeted at a primary health promotion level before some of the important underlying causes of CVD seriously afflict a person or a population at large. Such preventive approaches would help in

  9. Smoking and cardiovascular health: A review of the epidemiology, pathogenesis, prevention and control of tobacco

    Directory of Open Access Journals (Sweden)

    Prasad D

    2009-11-01

    Full Text Available The causal associations between cigarette smoking and human diseases are irrefutable. In this review, we focus on the epidemiological pattern of cigarette smoking on cardiovascular risk, the underlying mechanistic process of such a causal link, how to prevent premature cardiovascular morbidity and mortality particularly through smoking cessation, and the health benefits of such cessation measures. Finally, we conclude our review summarizing a few of the proven evidence-based tobacco control strategies and policies from across the globe. We did not conduct a systematic review but followed a similar structure. We abstracted the most relevant published literature on the electronic databases, namely, PubMed, Embase and the Cochrane Library applying specific search terms. We also searched gray literature and consulted experts in the field for cross-references. Smoking has been estimated to cause about 11% of all deaths due to cardiovascular disease. Smoking contributes to the pathogenesis of coronary artery disease and sudden death through a variety of mechanisms, including the promotion of atherosclerosis, the triggering of coronary thrombosis, coronary artery spasm, and cardiac arrhythmias, and through reduced capacity of the blood to deliver oxygen. Smoking cessation also confers substantial benefits on people with serious heart disease. Smoking cessation should be viewed as therapeutic rather than preventive intervention, similar to treating asymptomatic hypertension. Smoking cessation is highly cost-effective relative to other frequently used medical and surgical interventions. Tobacco related illnesses are important public health issues worldwide. It has been estimated that there are1.1 billion smokers worldwide and 250 million of them live in India.

  10. [Prevention of cardiovascular diseases through sport and physical activity: A question of intensity?].

    Science.gov (United States)

    Wernhart, S; Dinic, M; Pressler, A; Halle, M

    2015-05-01

    Coronary artery disease is the leading cause of death worldwide. A sedentary lifestyle accounts for 9% of premature mortality and creates a substantial health economic burden. Measurement of physical activity in daily practice refers to metabolic equivalent tasks and assessment of cardiopulmonary fitness to measurements of peak oxygen uptake during ergometry, which can be used to classify an individual's physical activity and maximum exercise capacity. Physical activity is a multifunctional intervention tool in prevention, which exerts its effects on multiple biochemical pathways, in contrast to conventional drug therapy. These changes reduce cardiovascular morbidity and mortality. Moderate physical exercise reduces blood pressure, improves insulin sensitivity and dyslipidemia, improves body composition and enhances weight reduction. Exercise of higher intensity seems to have superior effects compared to moderate intensity training; however, the training volume also seems to be important, as negative effects of long-term intensive training have been reported, e.g. atrial fibrillation or coronary sclerosis. Overall, exercise training has a major role in primary prevention of cardiovascular disease but seems to have a maximum threshold for benefit, which may be exceeded by some individuals.

  11. The Role of the Nrf2/ARE Antioxidant System in Preventing Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Robert E. Smith

    2016-11-01

    Full Text Available It is widely believed that consuming foods and beverages that have high concentrations of antioxidants can prevent cardiovascular diseases and many types of cancer. As a result, many articles have been published that give the total antioxidant capacities of foods in vitro. However, many antioxidants behave quite differently in vivo. Some of them, such as resveratrol (in red wine and epigallocatechin gallate or EGCG (in green tea can activate the nuclear erythroid-2 like factor-2 (Nrf2 transcription factor. It is a master regulator of endogenous cellular defense mechanisms. Nrf2 controls the expression of many antioxidant and detoxification genes, by binding to antioxidant response elements (AREs that are commonly found in the promoter region of antioxidant (and other genes, and that control expression of those genes. The mechanisms by which Nrf2 relieves oxidative stress and limits cardiac injury as well as the progression to heart failure are described. Also, the ability of statins to induce Nrf2 in the heart, brain, lung, and liver is mentioned. However, there is a negative side of Nrf2. When over-activated, it can cause (not prevent cardiovascular diseases and multi-drug resistance cancer.

  12. Worksite Characteristics and Environmental and Policy Supports for Cardiovascular Disease Prevention in New York State

    Directory of Open Access Journals (Sweden)

    Ian Brissette, PhD

    2008-04-01

    Full Text Available IntroductionWorksite policy and environmental supports that promote physical activity, healthy eating, stress management, and preventive health screenings can contribute to the prevention of cardiovascular disease and lower employer costs. This study examines the availability of these four categories of supports in a statewide survey of New York State worksites.MethodsIn 2002, we recruited a statewide sample of worksites in New York State with 75 or more employees to participate in a mailed survey assessing worksite policy and environmental supports for wellness and health promotion. The overall response rate was 34.8%. The analysis included data from 832 worksites.ResultsWorksite size was an independent predictor of health promotion supports with small (75–99 employees and medium-small (100–199 employees worksites reporting significantly fewer policy and environmental supports in all four categories than worksites with 300 or more employees. Worksites in which most employees were nonwhite reported fewer supports for physical activity, healthy eating, and stress management than worksites in which most employees were white. A wellness committee or wellness coordinator was associated with more health promotion supports, regardless of the size of the worksite or composition of its workforce.ConclusionWorksites with fewer than 200 employees have an increased need for assistance in establishing environmental and policy supports promoting cardiovascular health. Worksites that have a wellness committee or coordinator are better able to establish and sustain supports with the potential to improve the health of their workers.

  13. Sandia National Laboratories California Pollution Prevention Program Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Janet S.; Farren, Laurie J.

    2007-04-01

    The annual program report provides detailed information about all aspects of the SNL/CA Pollution Prevention Program for a given calendar year. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. The program report describes the activities undertaken during the past year, and activities planned in future years to implement the Pollution Prevention Program, one of six programs that supports environmental management at SNL/CA.

  14. Sandia National Laboratories, California Pollution Prevention Program annual report.

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Janet S.; Farren, Laurie J.

    2010-03-01

    The annual program report provides detailed information about all aspects of the SNL/CA Pollution Prevention Program for a given calendar year. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. The program report describes the activities undertaken during the past year, and activities planned in future years to implement the Pollution Prevention Program, one of six programs that supports environmental management at SNL/CA.

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

    Directory of Open Access Journals (Sweden)

    Tina Karwalajtys

    2010-09-01

    Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice

  16. A Survey of GPs Awareness and Use of Risk Assessment Tools and Cardiovascular Disease Prevention Guidelines.

    Science.gov (United States)

    Byrne, D; O'Connor, L; Jennings, S; Bennett, K; Murphy, A W

    2015-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. This study aimed to benchmark awareness and use of CVD risk assessment (RA) tools and prevention guidelines in Irish general practice. 493 (18%) Irish general practitioners (GPs) were invited to participate in a cross-sectional study in 2011. 213 (43%) GPs responded with most being male (n = 128, 58.2%) and aged ≥ 45 years (n = 124, 56.8%). While 197 (92.5%) GPs were aware of at least one RA tool, only 69 (32.4%) GPs reported frequent use. 187 (87.8%) GPs were aware of one or more CVD prevention guidelines with 115 (54.0%) GPs reporting frequent use of at least one guideline. No age or gender difference observed. Barriers to implementation of CVD prevention guidelines were lack of remuneration, too many CVD guidelines and time constraints. Most Irish GPs were aware of RA tools and CVD prevention guidelines with half reporting frequent use of guidelines.

  17. Creencias en fumadores pertenecientes a un programa de salud cardiovascular Beliefs in Smokers pertaining to program of cardiovascular healt

    Directory of Open Access Journals (Sweden)

    Renata Virginia González Consuegra

    2004-11-01

    Full Text Available La presente investigación mediante abordaje cuanti-cualitativo, identifica las creencias de consumidores de tabaco, usuarios de un programa de promoción de la salud cardiovascular en la ciudad de Bogota Colombia, Sur América. A partir de entrevista en profundidad grabada a 15 personas del grupo de promoción de la salud cardiovascular, quienes voluntariamente constituyeron la muestra provisoria hasta lograr la saturación de la temática en cuestión; se obtuvo información que se consideró a partir de la Técnica de Análisis de Contenido propuesta por Bardín, lográndose con ello una descripción amplia de factores motivacionales y desalentadores para el tabaquismo.The present investigation by means of boarding cuanti-qualitative, identifies the beliefs of consumers tobacco, users of a program of promotion of the cardiovascular health in the city of Bogotá Colombia, the South America. To start off, of interview to recorded depth of 15 people of the promotion group, who voluntarily constituted the provisory sample until obtaining the thematic saturation of the at issue one, information which it was considered from the technique of propose Analysis of Content by Badin, being obtained with it an ample description of motivacionales and discouraging factors for the tabacco smocking.

  18. Long chain N-3 polyunsaturated fatty acids in the prevention of allergic and cardiovascular disease.

    Science.gov (United States)

    van den Elsen, Lieke; Garssen, Johan; Willemsen, Linette

    2012-01-01

    The diet is considered to have a major impact on human health. Dietary lipids including long chain polyunsaturated fatty acids (LCPUFA) possess potent immunomodulatory activities. Over the last decades the incidence of inflammatory disorders including allergic and cardiovascular diseases (CVD) has been rising. This phenomenon is associated with deficiencies in N-3 LCPUFA, found in fatty fish, and increased content of N-6 LCPUFA in the Western diet. LCPUFA act via different mechanisms including membrane fluidity, raft composition, lipid mediator formation, signaling pathways and transmembrane receptors. N-3 LCPUFA eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can reduce the development of allergic disease by affecting both the innate and adaptive immune system involved in the initiation and persistence of allergic disease. Fish oil has been shown to be effective in the primary prevention of allergic disease in infants at risk when supplemented during pregnancy and lactation. Subtle effects of N-3 LCPUFA on the outcome of the immune response may underlie these protective effects. This review describes the currently reported effects of LCPUFA on dendritic cells, T cells, B cells and mast cells. Also CVD are positively affected by N-3 LCPUFA. Populations consuming high amounts of oily fish are protected against CVD. Moreover N-3 LCPUFA are effective in the secondary prevention of cardiovascular events. Amongst other effects, EPA and DHA have been shown to suppress endothelial cell activation hereby reducing adhesion molecule expression and endothelial cell - leukocyte interactions. This review describes the mechanistic basis of the preventive role for N-3 LCPUFA in allergic disease and CVD.

  19. 77 FR 19799 - Pipeline Safety: Pipeline Damage Prevention Programs

    Science.gov (United States)

    2012-04-02

    ... Administration 49 CFR Parts 196 and 198 Pipeline Safety: Pipeline Damage Prevention Programs; Proposed Rule #0;#0... Pipeline Safety: Pipeline Damage Prevention Programs AGENCY: Pipeline and Hazardous Materials Safety... criteria and procedures for determining the adequacy of state pipeline excavation damage prevention...

  20. 49 CFR 192.614 - Damage prevention program.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Damage prevention program. 192.614 Section 192.614... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.614 Damage prevention program. (a... section (b)(1) or (b)(2) of this section. (1) The state has adopted a one-call damage prevention...

  1. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Piepoli, Massimo Francesco; Corrà, Ugo; Benzer, Werner

    2010-01-01

    Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to card......Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR...... clinical disease have been created and commented....

  2. Bienestar: A Diabetes Risk-Factor Prevention Program.

    Science.gov (United States)

    Trevino, Robert P.; Pugh, Jacqueline A.; Hernandez, Arthur E.; Menchaca, Velma D.; Ramirez, Robert R.; Mendoza, Monica

    1998-01-01

    The Bienestar Health Program is a diabetes risk-factor prevention program targeting Mexican American fourth graders. Program goals are to decrease overweight and dietary fats. The program is based on social cognitive theory and uses culturally relevant material. Preliminary evaluation indicates the program significantly decreases dietary fat,…

  3. Atherosclerosis stabilization with PCSK-9 inhibition: An evolving concept for cardiovascular prevention.

    Science.gov (United States)

    Robinson, Jennifer G; Heistad, Donald D; Fox, Keith A A

    2015-12-01

    Monoclonal antibodies (mAbs) to proprotein convertase subtilisin/kexin type 9 (PCSK-9) can further lower LDL-C by ≥60% in statin-treated patients. Preliminary data suggest they may reduce cardiovascular (CVD) events. Ongoing PCSK-9 mAb cardiovascular outcomes trials could provide the opportunity to determine whether a "legacy effect" similar to that observed for statins will occur over the post-trial observation period. We hypothesize these trials could demonstrate that (1) very aggressive LDL-C lowering with PCSK-9 mAbs added to background statin therapy will induce extensive atherosclerosis stabilization and regression in the large majority of treated patients, and (2) continued maintenance therapy with high intensity statin therapy (with or without ezetimibe) should then inhibit new plaque formation, with a long-term prevention of CVD events. The necessity of expensive lifetime treatment with PCSK-9 inhibitors could then be avoided in all but a small subset of patients who could benefit from longer treatment.

  4. Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

    Science.gov (United States)

    Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

    2008-06-01

    This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented.

  5. Modifying Health Behavior to Prevent Cardiovascular Diseases: A Nationwide Survey among German Primary Care Physicians

    Directory of Open Access Journals (Sweden)

    Sven Schneider

    2014-04-01

    Full Text Available Cardiovascular diseases (CVD are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72% and alcohol (61% consumption, to encourage them to increase their levels of physical activity (72%, and to assist them in adjusting to a more healthy diet (66%, and in achieving a healthy body weight (69%. However, only between 23% (quitting smoking and 49% (diet modification of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD.

  6. The mobile revolution--using smartphone apps to prevent cardiovascular disease.

    Science.gov (United States)

    Neubeck, Lis; Lowres, Nicole; Benjamin, Emelia J; Freedman, S Ben; Coorey, Genevieve; Redfern, Julie

    2015-06-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Mobile technology might enable increased access to effective prevention of CVDs. Given the high penetration of smartphones into groups with low socioeconomic status, health-related mobile applications might provide an opportunity to overcome traditional barriers to cardiac rehabilitation access. The huge increase in low-cost health-related apps that are not regulated by health-care policy makers raises three important areas of interest. Are apps developed according to evidenced-based guidelines or on any evidence at all? Is there any evidence that apps are of benefit to people with CVD? What are the components of apps that are likely to facilitate changes in behaviour and enable individuals to adhere to medical advice? In this Review, we assess the current literature and content of existing apps that target patients with CVD risk factors and that can facilitate behaviour change. We present an overview of the current literature on mobile technology as it relates to prevention and management of CVD. We also evaluate how apps can be used throughout all age groups with different CVD prevention needs.

  7. Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology.

    Science.gov (United States)

    Lloyd-Jones, Donald M; Huffman, Mark D; Karmali, Kunal N; Sanghavi, Darshak M; Wright, Janet S; Pelser, Colleen; Gulati, Martha; Masoudi, Frederick A; Goff, David C

    2017-03-28

    The Million Hearts Initiative has a goal of preventing 1 million heart attacks and strokes-the leading causes of mortality-through several public health and healthcare strategies by 2017. The American Heart Association and American College of Cardiology support the program. The Cardiovascular Risk Reduction Model was developed by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to assess a value-based payment approach toward reduction in 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) by implementing cardiovascular preventive strategies to manage the "ABCS" (aspirin therapy in appropriate patients, blood pressure control, cholesterol management, and smoking cessation). The purpose of this special report is to describe the development and intended use of the Million Hearts Longitudinal ASCVD Risk Assessment Tool. The Million Hearts Tool reinforces and builds on the "2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk" by allowing clinicians to estimate baseline and updated 10-year ASCVD risk estimates for primary prevention patients adhering to the appropriate ABCS over time, alone or in combination. The tool provides updated risk estimates based on evidence from high-quality systematic reviews and meta-analyses of the ABCS therapies. This novel approach to personalized estimation of benefits from risk-reducing therapies in primary prevention may help target therapies to those in whom they will provide the greatest benefit, and serves as the basis for a Center for Medicare & Medicaid Services program designed to evaluate the Million Hearts Cardiovascular Risk Reduction Model.

  8. The primary prevention of cardiovascular disease: nurse practitioners using behaviour modification strategies.

    Science.gov (United States)

    Farrell, Todd Charles; Keeping-Burke, Lisa

    2014-01-01

    Cardiovascular disease (CVD) places great financial strain on the health care system and dramatically affects individual quality of life. As primary health care providers, nurse practitioners (NPs) are ideally positioned to advise clients on risk factor and lifestyle modifications that ameliorate the impact of CVD. While the lifestyle targets for CVD prevention are established, the most effective means of achieving these goals remain uncertain. Behaviour modification strategies, including motivational interviewing (MI) and the transtheoretical model (TTM), have been suggested, but neither approach is established as being more efficacious than the other. In this paper, evidence on the effectiveness of the two approaches for modifying smoking, diet, and exercise behaviour are presented, and a recommendation for NP practice is made.

  9. Aspirin dosing frequency in the primary and secondary prevention of cardiovascular events.

    Science.gov (United States)

    Kim, Joonseok; Becker, Richard C

    2016-04-01

    Aspirin has been a cornerstone of cardiovascular disease prevention since the late 1980s. Despite the popularity of aspirin and its wide use, the proper dosing and frequency of aspirin has yet to be determined. Early aspirin trials focused on its utility in broad target populations, but this strategy did not magnify the benefit of aspirin, and rather increased the complication rate. We have learned from previous studies that laboratory and clinical response to aspirin therapy in patients with different conditions and settings are diverse. This difference in aspirin response necessitates a personalized, tailored aspirin therapy. We aim to perform a comprehensive review of the current evidence surrounding aspirin responsiveness in several distinct patient populations and the rationale of different aspirin frequency and dosing strategies. Our conclusions call for future studies to determine individualized aspirin strategies to maximize the benefit and minimize the risk of aspirin.

  10. [Work-related musculoskeletal disorders in dentistry professionals. 2. Prevention, ergonomic strategies and therapeutic programs].

    Science.gov (United States)

    Sartorio, F; Franchignoni, F; Ferriero, G; Vercelli, S; Odescalchi, L; Augusti, D; Migliario, M

    2005-01-01

    In dental professionals the risk of developing work-related musculoskeletal disorders (WMSD) can be minimized through a combination of prevention, ergonomic strategies, and specific therapeutic programs. Prevention includes early identification of symptoms, analysis of working posture and activity, and the evaluation of equipment (such as dental instruments, position of the dental unit, patient and operator chairs, and lighting). The ergonomic strategies are based on identifying the best daily timetable (including periodic pauses) and most efficient team organization, as well as establishing the correct position that should be held at the patient chair. Finally specific therapeutic programs are very important in preventing or treating WMSD. In fact, fitness exercises such as mobilization, stretching or muscular and cardiovascular training are recognized as fundamental for dental professionals, and when WMSD occurs physiatric care and physical therapy are recommended.

  11. Youth exposure to violence prevention programs in a national sample.

    Science.gov (United States)

    Finkelhor, David; Vanderminden, Jennifer; Turner, Heather; Shattuck, Anne; Hamby, Sherry

    2014-04-01

    This paper assesses how many children and youth have had exposure to programs aimed at preventing various kinds of violence perpetration and victimization. Based on a national sample of children 5-17, 65% had ever been exposed to a violence prevention program, 55% in the past year. Most respondents (71%) rated the programs as very or somewhat helpful. Younger children (5-9) who had been exposed to higher quality prevention programs had lower levels of peer victimization and perpetration. But the association did not apply to older youth or youth exposed to lower quality programs. Disclosure to authorities was also more common for children with higher quality program exposure who had experienced peer victimizations or conventional crime victimizations. The findings are consistent with possible benefits from violence prevention education programs. However, they also suggest that too few programs currently include efficacious components.

  12. 26. Cardiovascular risk assessment for Saudi university employees and their families: developing a framework for provision of an evidence-based cardiovascular disease preventative programme.

    Directory of Open Access Journals (Sweden)

    R. Alzeidan

    2016-07-01

    Full Text Available In the Kingdom of Saudi Arabia (KSA, cardiovascular diseases (CVDs are the primary cause of death among adults, representing 46% of total mortality in 2014. This study’s objectives were to assess the prevalence of cardiovascular risk factors (CVRFs, and calculate the cardiovascular risk (CVR among King Saud University employees and their families. Moreover, it aimed at assessing the possible effects of living in KSA on the heart health of expatriate employees and their families.A cross-sectional study was conducted on 4500 university employees and their families aged ⩾18 years old, using the World Health Organization STEPwise approach to surveillance of CVRFs. CVR was then calculated for participants using the Framingham Coronary Heart Risk Score calculator. The mean age of participants was 39.3±13.4 years. The prevalence of CVRFs was as follows: low fruit/vegetable consumption of 10% risk to develop CVD within the following 10-years. Furthermore, this study showed that expatriates had significant negative effects on behavioural risk factors after residing in KSA, namely: high rate of physical inactivity, high consumption of fast food, low consumption of fruit and vegetable. However, there was no effect on the pattern of tobacco use. The prevalence of CVRFs is substantially high among the study population. To combat the future expected burden of CVDs, a proposed prevention programme for employees’ cardiovascular wellness is designed and recommended to be implemented and institutionalized within the university.

  13. 74. Cardiovascular risk assessment for Saudi university employees and their families: Developing a framework for provision of an evidence-based cardiovascular disease preventative programme

    Directory of Open Access Journals (Sweden)

    R. Alzeidan

    2016-07-01

    Full Text Available In the Kingdom of Saudi Arabia (KSA, cardiovascular diseases (CVDs are the primary cause of death among adults, representing 46% of total mortality in 2014. This study’s objectives were to assess the prevalence of cardiovascular risk factors (CVRFs, and calculate the cardiovascular risk (CVR among King Saud University employees and their families. Moreover, it aimed at assessing the possible effects of living in KSA on the heart health of expatriate employees and their families. A cross-sectional study was conducted on 4500 university employees and their families aged ⩾18 years old, using the World Health Organization STEPwise approach to surveillance of CVRFs. CVR was then calculated for participants using the Framingham Coronary Heart Risk Score calculator. The mean age of participants was 39.3 ± 13.4 years. The prevalence of CVRFs was as follows: low fruit/vegetable consumption of 10% risk to develop CVD within the following 10-years. Furthermore, this study showed that expatriates had significant negative effects on behavioural risk factors after residing in KSA, namely: high rate of physical inactivity, high consumption of fast food, low consumption of fruit and vegetable. However, there was no effect on the pattern of tobacco use. The prevalence of CVRFs is substantially high among the study population. To combat the future expected burden of CVDs, a proposed prevention programme for employees’ cardiovascular wellness is designed and recommended to be implemented and institutionalized within the university.

  14. Cancer Prevention Fellowship Program | Division of Cancer Prevention

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Jiménez Francisco

    2010-06-01

    Full Text Available Abstract Background 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. Methods/Design 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. Discussion 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.

  16. Developing a research agenda for cardiovascular disease prevention in high-risk rural communities.

    Science.gov (United States)

    Melvin, Cathy L; Corbie-Smith, Giselle; Kumanyika, Shiriki K; Pratt, Charlotte A; Nelson, Cheryl; Walker, Evelyn R; Ammerman, Alice; Ayala, Guadalupe X; Best, Lyle G; Cherrington, Andrea L; Economos, Christina D; Green, Lawrence W; Harman, Jane; Hooker, Steven P; Murray, David M; Perri, Michael G; Ricketts, Thomas C

    2013-06-01

    The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.

  17. A systematic review on the application of cardiovascular risk prediction models in pharmacoeconomics, with a focus on primary prevention

    NARCIS (Netherlands)

    Stevanovic, J.; Postma, M.J.; Pechlivanoglou, P.

    2012-01-01

    OBJECTIVES: In the absence of long-term randomized clinical trials (RCTs) on the effectiveness of pharmacological treatment for primary cardiovascular disease (CVD) prevention, risk prediction models are used to project changes in CVD incidence due to changes on risk factor levels observed in short-

  18. Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

    NARCIS (Netherlands)

    Nguyen, Thi-Phuong-Lan; Wright, E Pamela; Nguyen, Thanh-Trung; Schuiling-Veninga, C C M; Bijlsma, M J; Nguyen, Thi-Bach-Yen; Postma, Maarten

    2016-01-01

    OBJECTIVE: To inform development of guidelines for hypertension management in Vietnam, we evaluated the cost-effectiveness of different strategies on screening for hypertension in preventing cardiovascular disease (CVD). METHODS: A decision tree was combined with a Markov model to measure incrementa

  19. Functional foods for the prevention and treatment of cardiovascular diseases: cholesterol and beyond.

    Science.gov (United States)

    Rudkowska, Iwona; Jones, Peter J H

    2007-05-01

    Cardiovascular disease (CVD) is a major cause of death and disability in many developed countries. The purpose of this literature review is to establish a recommendation for the intake of functional food ingredients in a healthy diet--such as plant sterols (PSs) in low-fat and functional matrices, fatty acid composition and other nutrients of tree nuts and flavonoids in dark chocolate--for the prevention and treatment of CVD. These three specific functional foods are explored in this review, since there is a higher potential for their increased consumption by the population to prevent CVD. First, PS have been added to various nontraditional matrices, such as low-fat products and functional oils, which have shown cholesterol-lowering effects in most clinical trials. Secondly, a growing number of clinical studies indicate that the beneficial effect of tree nuts may not only be due to their fatty acid composition but to other key nutrients, which may provide supplementary health benefits, such as endothelial cell function, as well as decreasing total cholesterol and low-density lipoprotein cholesterol (LDL-C). Lastly, flavonoids in dark chocolate may protect LDL-C particles from undergoing oxidative modification. However, some gaps in our knowledge need to be filled before firm recommendations can be made for habitual dark chocolate consumption. Overall, these functional foods should be considered as an addition to current lipid-lowering recommendations for improving CVD risk.

  20. Lycopene and Its Antioxidant Role in the Prevention of Cardiovascular Diseases-A Critical Review.

    Science.gov (United States)

    Müller, Lars; Caris-Veyrat, Catherine; Lowe, Gordon; Böhm, Volker

    2016-08-17

    The present review is based mainly on papers published between 2000 and 2011 and gives information about the properties of the carotenoid lycopene in chemical and biological systems and its possible role in preventing cardiovascular diseases (CVD). The main aim of this report is to highlight its role as an antioxidant, also reported are bioactive properties that may influence the development of foam cells and protection against endothelial cell damage. The paper will also examine recent observations that lycopene may improve blood flow and reduce inflammatory responses. Lycopene possesses antioxidant properties in vitro, and some epidemiological studies have reported protective effects against the progression of CVD. The oxidation of human low density lipoproteins (LDL) is a fundamental mechanism in the initiation of atherosclerosis. A beneficial role of lycopene as antioxidant in the prevention of CVD is suggested but the data are still controversial. Lycopene is believed to be the most potent carotenoid antioxidant in vitro. Tissue culture experiments and animal studies support potential cardioprotective effects for lycopene and other carotenoids in the blood. Most studies showed beneficial effects of lycopene to individuals who are antioxidant-deficient like elderly patients, or humans exposed to higher levels of oxidative stress like smokers, diabetics, hemodialysis patients and acute myocardial infarction patients. By defining the right population and combining antioxidant potentials of lycopene with vitamins and other bioactive plant compounds, the beneficial role of lycopene in CVD can be clarified in future studies.

  1. Recent dietary guidelines to prevent and treat cardiovascular disease, diabetes, and obesity.

    Science.gov (United States)

    Wylie-Rosett, Judith; Mossavar-Rahmani, Yasmin; Gans, Kim

    2002-01-01

    Nutrition guidelines are emphasizing dietary patterns as primary and secondary prevention trials provide increasing evidence of the importance of lifestyle changes to prevent/control cardiovascular disease (CVD) risk factors such as diabetes and hypertension. Despite the increasing evidence that weight loss and modified dietary patterns are effective, there is considerable debate about the level of carbohydrate that will be most beneficial. Epidemiologic studies indicate that certain ethnic and racial minority groups have increased CVD risk with higher rates of obesity, hypertension, diabetes, and stroke. Immigrant and Native American populations have had a dramatic rise in obesity, diabetes, and ultimately CVD with acculturation, accompanied by a higher fat intake and decreased physical activity. Culturally tailored intervention approaches are being used to reduce risk. The lack of third-party payment still limits the availability of nutrition services. However, medical nutrition therapy is covered by Medicare for diabetes and pending legislation will extend coverage to CVD. Medical education researchers have developed tools such as the WAVE (Weight, Activity, Variety and Excess) pocket guide as a quick method to facilitate addressing referral for medical nutrition therapy that can be readily incorporated into practice settings.

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

    Science.gov (United States)

    Kones, Richard

    2010-12-09

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

  3. Sandia National Laboratories, California Pollution Prevention Program annual report.

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Janet S.

    2011-04-01

    The annual program report provides detailed information about all aspects of the SNL/CA Pollution Prevention Program for a given calendar year. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. The program report describes the activities undertaken during the past year, and activities planned in future years to implement the Pollution Prevention Program, one of six programs that supports environmental management at SNL/CA. Pollution Prevention supports the goals and objectives to increase the procurement and use of environmentally friendly products and materials and minimize the generation of waste (nonhazardous, hazardous, radiological, wastewater). Through participation on the Interdisciplinary Team P2 provides guidance for integration of environmentally friendly purchasing and waste minimization requirements into projects during the planning phase. Table 7 presents SNL's corporate objectives and targets that support the elements of the Pollution Prevention program.

  4. Childhood socioeconomic position, young adult intelligence and fillings of prescribed medicine for prevention of cardiovascular disease in middle-aged men

    DEFF Research Database (Denmark)

    Kriegbaum, Margit; Kildemoes, Helle Wallach; Rasmussen, Jeppe Nørgaard

    2014-01-01

    To explore the relationship between childhood socioeconomic position (SEP) and filling of medicine prescriptions for prevention of cardiovascular diseases (CVDs), with young adult intelligence (IQ) as a potential mediator.......To explore the relationship between childhood socioeconomic position (SEP) and filling of medicine prescriptions for prevention of cardiovascular diseases (CVDs), with young adult intelligence (IQ) as a potential mediator....

  5. Preventing Substance Abuse: A Comprehensive Program for Catholic Educators.

    Science.gov (United States)

    McCorry, Frank

    This book provides information for teachers about drugs and their effects on body and mind, and explains the role of teachers in effective drug education, prevention, and assistance programs. Suggestions on preventing drug abuse are also directed to the Catholic community and parents, along with a challenge to introduce programs on the local,…

  6. A Program on Preventing Sexual Assault Directed toward Greek Leaders.

    Science.gov (United States)

    Baker, Tamara; Boyd, Cynthia

    This paper discusses a program that uses the leadership and status of Greek system officers to prevent sexual assault at a large university. This program aims to prevent future assaults by altering the conditions of a rape-prone culture. The presentation comprises a definition and two examples of acquaintance rape situations, a discussion of…

  7. Acute and chronic cardiovascular effects of hyperkalemia: new insights into prevention and clinical management.

    Science.gov (United States)

    McCullough, Peter A; Beaver, Thomas M; Bennett-Guerrero, Elliott; Emmett, Michael; Fonarow, Gregg C; Goyal, Abhinav; Herzog, Charles A; Kosiborod, Mikhail; Palmer, Biff F

    2014-01-01

    The plasma pool of potassium is a partial reflection of the overall body, transient cellular shifts, and potassium elimination regulated by the kidneys. Potassium concentrations elevating above the upper limit of normal (> 5.0 mEq/L) have become more common in cardiovascular practice due to the growing population of patients with chronic kidney disease and the broad applications of drugs that modulate potassium excretion by either reducing production of angiotensin II (angiotensin-converting enzyme inhibitors, direct renin inhibitors, beta-adrenergic receptor antagonists), blocking angiotensin II receptors (angiotensin receptor blockers), or antagonizing the action of aldosterone on mineralocorticoid receptors (mineralocorticoid receptor antagonists). In addition, acute kidney injury, critical illness, crush injuries, and massive red blood cell transfusions can result in hyperkalemia. Progressively more severe elevations in potassium are responsible for abnormalities in cardiac depolarization and repolarization and contractility. Untreated severe hyperkalemia results in sudden cardiac death. Traditional management steps have included reducing dietary potassium and discontinuing potassium supplements; withdrawal of exacerbating drugs; acute treatment with intravenous calcium gluconate, insulin, and glucose; nebulized albuterol; correction of acidosis with sodium bicarbonate for short-term shifts out of the plasma pool; and, finally, gastrointestinal ion exchange with oral sodium polystyrene sulfonate in sorbitol, which is mainly used in the hospital and is poorly tolerated due to gastrointestinal adverse effects. This review explores hyperkalemia as a complication in cardiovascular patients and highlights new acute, chronic, and preventative oral therapies (patiromer calcium, cross-linked polyelectrolyte, ZS-9) that could potentially create a greater margin of safety for vulnerable patients with combined heart and kidney disease.

  8. Evaluation of the Urban Crime Prevention Program. Executive Summary.

    Science.gov (United States)

    Roehl, Janice A.; Cook, Royer F.

    The Urban Crime Prevention Program (UCPP) was designed to combat urban crime through the establishment of 85 innovative neighborhood-based crime prevention projects across nine cities for 18 months. UCPP's main goals were to increase citizen participation in innovative neighborhood crime prevention efforts, to bolster the capabilities of…

  9. Evidence supporting primary prevention of cardiovascular diseases with statins: Gaps between updated clinical results and actual practice.

    Science.gov (United States)

    Bruckert, Eric; Ferrières, Jean

    2014-03-01

    The use of pharmacological lipid-lowering intervention in individuals with hypercholesterolaemia and known cardiovascular disease or diabetes/chronic kidney disease is well established. Current European Society of Cardiology guidelines recommend immediate initiation of drugs in adjunct to lifestyle intervention in these patients at high or very high cardiovascular risk. In these clinical settings, statins are generally chosen as the first-choice drug intervention, in consideration of the robust evidence showing a reduction in all-cause mortality and major adverse cardiac events (MACE). In contrast, primary prevention with statins, even in the subset of patients at high-risk of cardiovascular events, is not well implemented. This might be related to a lack of public awareness regarding the actual risk associated with prolonged exposure to high concentrations of low-density lipoprotein cholesterol (LDL-C) and uncertainties in the clinical evidence coming from the earliest trials in this patient subset. However, recent observational studies suggest that lowering LDL-C earlier in life and for a longer duration can substantially decrease the burden of cardiovascular disease and mortality. Moreover, results from recent well-conducted large meta-analyses of randomized clinical trials showed that primary prevention with statins reduced all-cause mortality by 14% and MACE by > 20% - findings similar to those observed for the use of statins in secondary prevention. Recently published American Heart Association/American College of Cardiology guidelines on the treatment of blood cholesterol emphasize that primary prevention using high-dose statins in individuals with LDL-C ≥ 190 mg/dL induces a benefit in atherosclerotic cardiovascular risk reduction that clearly exceeds the potential for adverse effects. We aim in this review to discuss the new data that advocate the use of statins in primary prevention earlier and more frequently, putting the efficacy evidence into

  10. Major Programs | Division of Cancer Prevention

    Science.gov (United States)

    The Division of Cancer Prevention supports major scientific collaborations, research networks, investigator-initiated grants, postdoctoral training, and specialized resources across the United States. |

  11. The Value of Continued Followup in a Preventive Medicine Program

    Science.gov (United States)

    Villafana, C.; Mockbee, J.

    1970-01-01

    Continued monitoring of hypertension and cholesterol levels in NASA employees by regularly scheduled medical examinations prevents an increase in employee disability and cardiovascular mortality rates. Adequate therapeutic control for younger hypertensive employees is demonstrated by records on mortality and heart diseases over a period of 28 months. It confirmed the importance of systolic blood pressure as diagnostic tool for the inherent risk factor. The prevalence of additional coronary risk factors among employees with hypercholesterolemia is considerably less than in employees with hypertension.

  12. Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT.

    Science.gov (United States)

    DeFilipp, Zachariah; Duarte, Rafael F; Snowden, John A; Majhail, Navneet S; Greenfield, Diana M; Miranda, José López; Arat, Mutlu; Baker, K Scott; Burns, Linda J; Duncan, Christine N; Gilleece, Maria; Hale, Gregory A; Hamadani, Mehdi; Hamilton, Betty K; Hogan, William J; Hsu, Jack W; Inamoto, Yoshihiro; Kamble, Rammurti T; Lupo-Stanghellini, Maria Teresa; Malone, Adriana K; McCarthy, Philip; Mohty, Mohamad; Norkin, Maxim; Paplham, Pamela; Ramanathan, Muthalagu; Richart, John M; Salooja, Nina; Schouten, Harry C; Schoemans, Helene; Seber, Adriana; Steinberg, Amir; Wirk, Baldeep M; Wood, William A; Battiwalla, Minoo; Flowers, Mary E D; Savani, Bipin N; Shaw, Bronwen E

    2016-08-01

    Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all-cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with an estimated prevalence of MetS of 31% to 49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to review literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.

  13. Metabolic syndrome and cardiovascular disease following hematopoietic cell transplantation: screening and preventive practice recommendations from CIBMTR and EBMT.

    Science.gov (United States)

    DeFilipp, Z; Duarte, R F; Snowden, J A; Majhail, N S; Greenfield, D M; Miranda, J L; Arat, M; Baker, K S; Burns, L J; Duncan, C N; Gilleece, M; Hale, G A; Hamadani, M; Hamilton, B K; Hogan, W J; Hsu, J W; Inamoto, Y; Kamble, R T; Lupo-Stanghellini, M T; Malone, A K; McCarthy, P; Mohty, M; Norkin, M; Paplham, P; Ramanathan, M; Richart, J M; Salooja, N; Schouten, H C; Schoemans, H; Seber, A; Steinberg, A; Wirk, B M; Wood, W A; Battiwalla, M; Flowers, M E D; Savani, B N; Shaw, B E

    2017-02-01

    Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31-49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal of reviewing literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.

  14. Metabolic syndrome and cardiovascular disease following hematopoietic cell transplantation: screening and preventive practice recommendations from CIBMTR and EBMT

    Science.gov (United States)

    DeFilipp, Zachariah; Duarte, Rafael F.; Snowden, John A.; Majhail, Navneet S.; Greenfield, Diana M.; Miranda, José López; Arat, Mutlu; Baker, K. Scott; Burns, Linda J.; Duncan, Christine N.; Gilleece, Maria; Hale, Gregory A.; Hamadani, Mehdi; Hamilton, Betty K.; Hogan, William J.; Hsu, Jack W.; Inamoto, Yoshihiro; Kamble, Rammurti T.; Lupo-Stanghellini, Maria Teresa; Malone, Adriana K.; McCarthy, Philip; Mohty, Mohamad; Norkin, Maxim; Paplham, Pamela; Ramanathan, Muthalagu; Richart, John M.; Salooja, Nina; Schouten, Harry C.; Schoemans, Helene; Seber, Adriana; Steinberg, Amir; Wirk, Baldeep M.; Wood, William A.; Battiwalla, Minoo; Flowers, Mary E.D.; Savani, Bipin N.; Shaw, Bronwen E.

    2016-01-01

    Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31–49% amongst HCT recipients. While MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to review literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors. PMID:27184625

  15. The potential of socio-psychological models for the development of prevention programs (Part 1

    Directory of Open Access Journals (Sweden)

    Bovina I.B.

    2014-12-01

    Full Text Available This paper considers the problem of designing prevention programs in health and disease. We note that smoking cessation on the planet would reduce mortality from various types of cancer by 25%, and would also save the lives of hundreds of thousands of people who die each year from heart attacks. Losing weight by only 10% through proper nutrition and exercise would reduce the incidence of cardiovascular disease, as well as certain types of cancer. Based on the literature review, we reveal the different types of prevention, show the importance of preventive measures aimed at the patient's immediate environment. Among the main difficulties associated with the development of effective prevention programs we discuss the following: 1 ignoring the psychological mechanisms of behavior change; 2 irrelevance of media broadcast methods in prevention campaigns; 3 the time between the problem behavior and its negative effects on health. We discuss the potential of social influence models for the development of prevention programs in the field of health and disease.

  16. Primary prevention with statins in cardiovascular diseases: A Saudi Arabian perspective.

    Science.gov (United States)

    Mahmood, D; Jahan, K; Habibullah, K

    2015-07-01

    Cardiovascular disease (CVD) constitutes one of the major causes of deaths and disabilities, globally claiming 17.3 million lives a year. Incidence of CVD is expected to rise to 25 million by 2030, and Saudi Arabia, already witnessing a rapid rise in CVDs, is no exception. Statins are the drugs of choice in established CVDs. In the recent past, evidence was increasingly suggesting benefits in primary prevention. But over the last decade Saudi Arabia has a witnessed significant rise in CVD-related deaths. Smoking, high-fat, low-fiber dietary intake, lack of exercise, sedentary life, high blood cholesterol and glucose levels were reported as frequent CVD-risk factors among Saudis, who may therefore be considered for primary prevention with statin. The prevalence of dyslipidemia, in particular, indicates that treatment should be directed at reducing the disorder with lipid-modifying agents and therapeutic lifestyle changes. The recent American College of Cardiology (ACC)/American Heart Association (AHA) guidelines has reported lowering the low-density lipoprotein cholesterol (LDL-C) target levels, prescribed by the 2011 European Society of Cardiology (ESC)/the European Atherosclerosis Society (EAS). The new ACC/AHA guidelines have overemphasized the use of statin while ignoring lipid targets, and have recommended primary prevention with moderate-intensity statin to individuals with diabetes aged 40-75 years and with LDL-C 70-189 mg/dL. Treatment with statin was based on estimated 10-year atherosclerotic-CVD (ASCVD) risk in individuals aged 40-75 years with LDL-C 70 to 189 mg/dL and without clinical ASCVD or diabetes. Adoption of the recent ACC/AHA guidelines will lead to inclusion of a large population for primary prevention with statins, and would cause over treatment to some who actually would not need statin therapy but instead should have been recommended lifestyle modifications. Furthermore, adoption of this guideline may potentially increase the incidences

  17. Teen Dating Violence Prevention Program Assessment

    Science.gov (United States)

    Lucas, Quincy Arrianna Rose

    2013-01-01

    The American Psychological Association (APA) has identified the prevention of and intervention in relationship violence as a top priority (APA, n.d.). According to the Center for Disease Control and Prevention's 2012 Teen Dating Violence Fact Sheet, dating violence is a serious problem in the United States. In accordance with Foshee et al. (1998):…

  18. Barriers and strategies for identifying and managing risk factors of cardiovascular diseases in levels of preventing, screening, and treating

    Directory of Open Access Journals (Sweden)

    Saber Azami Aghdash

    2015-11-01

    Full Text Available Introduction: Cardiovascular diseases (CVD are of the main causes of mortality in the world and impose a heavy economic, social, and health burden on society. Therefore, the objective of this study was to determine the barriers and strategies for identifying and managing risk factors of CVD in levels of preventing, screening, and treating. Methods: During present qualitative study with phenomenological approach, 60 subjects of cardiologists, nurses, patients, and their relatives were selected based on purposive sampling from educational-medical cardiothoracic subspecialty centers. Data were collected using an open-ended questionnaire and was extracted and analyzed with content analysis method. Results: Barriers were divided into three groups of individual barriers (low awareness, delay in referring for treatment and screening, incorrect beliefs, and not caring about health, socio-economic barriers (high costs, lack of resources, mental and psychological pressures, and health care barriers (non-alignment of doctors, being therapy-oriented, managerial and planning weaknesses, and lack of health care facilities. The most important presenting strategies are: providing public educations, improving family physician program, reduction of costs, cooperation of patients, and using functional indices to evaluate and improve the quality of services. Conclusion: Low awareness of people, high costs of services, lack of health care facilities, socio-cultural problems of people, and delay in referring of people, for treatment and screening are of the most important barriers of proper identifying and managing risk factors of CVD. Strategies provided in this study to overcome these barriers could be used.

  19. How to stay heart healthy in 2011: considerations for the primary prevention of cardiovascular disease in women.

    Science.gov (United States)

    Davis, Melinda B; Duvernoy, Claire S

    2011-07-01

    More women die of cardiovascular disease than any other cause. Effective primary prevention depends on accurate assessment of risk status. While most risk factors are similar for men and women, risk factors may differ in magnitude between the sexes, and recognition of gender-specific risk factors such as gestational diabetes, hypertensive syndromes of pregnancy and polycystic ovarian syndrome provides opportunities for early intervention and prevention. Obesity, hypertension and hyperlipidemia affect both genders; however, women often postpone addressing these risk factors until later in life. The American Heart Association emphasizes that all women are at cardiovascular risk and should maintain a healthy lifestyle and avoid smoking. Blood pressure, hyperlipidemia and diabetes should be aggressively treated. Current available data regarding proposed preventive drug therapies including daily aspirin, HRT, vitamin D and omega-3 fatty acid supplements will be reviewed.

  20. Effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of cardiovascular disease: protocol for an overview of systematic reviews

    Science.gov (United States)

    Studzin´ski, Krzysztof; Tomasik, Tomasz; Krzyszton´, Janusz; Józ´wiak, Jacek; Windak, Adam

    2017-01-01

    Introduction Major clinical practice guidelines recommend assessing risk of cardiovascular disease (CVD) using absolute/global/total CVD risk scores. However, the effectiveness of using them in clinical practice, despite publication of numerous randomised controlled trials (RCTs), is still poorly understood. To summarise and analyse current knowledge in this field, we will carry out an overview of existing systematic reviews (SRs). The objective of this overview will be to assess the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD compared with standard care. Methods and analysis We will include SRs and meta-analyses which take into account RCTs and quasi-RCTs investigating the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD. SRs will be retrieved from 4 bibliographical databases and reference lists of identified reviews. Additionally, the PROSPERO database will be searched for unpublished, ongoing or recently completed SRs. 2 reviewers will assess the SRs independently for eligibility and bias. The data will be extracted to a special form. Any disagreement will be resolved by discussion. In case of lack of consensus, a third author will arbitrate. The overview of SRs will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Ethics and dissemination Ethics approval is not required for overview of SRs. We will summarise evidence concerning whether use of the absolute/global/total CVD risk scoring tools in primary prevention of CVD is effective and supported with scientific data or not. If we face unsatisfactory confirmation, we will highlight a need for further research and advice on how to plan such a study. We will submit the results of our study for peer-review publication in a journal indexed in the international bibliographic database of biomedical information. PMID:28274967

  1. The blockade of renin-angiotensin-aldosterone system in hemodialysis patients to control hypertension and prevent cardiovascular disease: optimal pharmacotherapy.

    Science.gov (United States)

    Morishita, Yoshiyuki; Kusano, Eiji

    2011-10-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in hemodialysis (HD) patients. Hypertension (HT) is a major risk factor for CVD. The renin-angiotensin-aldosterone system (RAAS) plays pivotal roles in the pathogenesis of HT in HD patients. Previous studies suggested that the blockade of RAAS may be effective to control blood pressure (BP) and to prevent CVD in HD patients. A certain level of preventive effects against CVD by RAAS blockade in HD patients has been reported independently from a BP lowering effect. This review focuses on the effect of blocking RAAS in HD patients for the control of HT and the prevention of CVD.

  2. Vitamin D deficiency in early life and the potential programming of cardiovascular disease in adulthood.

    Science.gov (United States)

    Gezmish, Oksan; Black, Mary Jane

    2013-08-01

    Vitamin D deficiency is a major worldwide public health problem affecting people of all ages, from infants to the elderly. Of particular concern is the high incidence of vitamin D deficiency in women during pregnancy and lactation, leading to the exposure of the growing fetus/infant to inadequate levels of vitamin D, which is essential for normal development. Vitamin D deficiency in adulthood is linked to the etiology of hypertension and to a multitude of adverse cardiovascular outcomes. It is now well-established that the antecedents of cardiovascular disease can originate very early in life. The purpose of this review is to highlight how maternal vitamin D deficiency, and its effects in upregulating the fetal renin-angiotensin system and altering cardiomyocyte growth in the fetal heart, has the potential to program long-term vulnerability to cardiovascular disease.

  3. Therapy for triggered acute risk prevention in subjects at increased cardiovascular risk.

    Science.gov (United States)

    Tofler, Geoffrey H; Spinaze, Monica; Shaw, Elizabeth; Buckley, Thomas

    2013-06-15

    Heavy physical exertion, emotional stress, heavy meals, and respiratory infection transiently increase the risk of myocardial infarction, sudden cardiac death, and stroke; however, it remains uncertain how to use this information for disease prevention. We determined whether it was feasible for those with either risk factors for cardiovascular disease (CVD) or known CVD to take targeted medication for the hazard duration of the triggering activity to reduce their risk. After a run-in of 1 month, 20 subjects (12 women and 8 men) aged 68.6 years (range 58 to 83) recorded for 2 months all episodes of physical and emotional stress, heavy meal consumption, and respiratory infection. For each episode, the subjects were instructed to take either aspirin 100 mg and propranolol 10 mg (for physical exertion and emotional stress) or aspirin 100 mg alone (for respiratory infection and heavy meal consumption) and to record their adherence. Adherence with taking the appropriate medication was 86% according to the diary entries, with 15 of 20 subjects (75%) achieving ≥80% adherence. Propranolol taken before exertion reduced the peak heart rate compared with similar exercise during the run-in period (118 ± 21 vs 132 ± 16 beats/min, p = 0.016). Most subjects (85%) reported that it was feasible to continue taking the medication in this manner. In conclusion, it is feasible for those with increased CVD risk to identify potential triggers of acute CVD and to take targeted therapy at the time of these triggers.

  4. A Program for Teaching Primary Preventive Social Skills.

    Science.gov (United States)

    Kapp-Simon, Kathy A.; Simon, Dennis J.

    This paper presents an overview of a systematic primary prevention program for promoting social competency in junior high school students, including a summary of goals, method, techniques, leadership requirements, and evaluation research. The Social Skills Training Program is described as a curriculum-based, small group program which teaches…

  5. Fluoride Programs in the School Setting: Preventive Dental Health.

    Science.gov (United States)

    Rebich, Theodore, Jr.; And Others

    1982-01-01

    Two types of school-based programs that increase students' use of fluoride for preventive dental health are described. In fluoride mouthrinse programs, teachers give their students a fluoride solution once a week in a paper cup. In areas where the level of fluoride in the water supply is insufficient, the flouride tablet program is used. (JN)

  6. A Cognitive Behavioral Depression Prevention Program for Early Adolescents

    Science.gov (United States)

    Miloseva, Lence

    2013-01-01

    The aim of this study was to present results of our one year experience with Cognitive Behavioral Psychology Program, in order to contribute to the building of whole school approach and positive psychology preventive mental health problems model. Based on Penn Resilience program (PRP), we modify and create program for early adolescents: how to…

  7. Statin-centric versus low-density lipoprotein-centric approach for atherosclerotic cardiovascular disease prevention: a Singapore perspective

    Science.gov (United States)

    Yan, Peter; Tan, Eng Kiat Kevin; Choo, Jason Chon Jun; Liew, Choon Fong Stanley; Lau, Titus; Waters, David D

    2016-01-01

    The link between cholesterol levels and atherosclerotic cardiovascular disease (ASCVD) is well-established. In Singapore, there is an increasing prevalence of risk factors for ASCVD. Like many Asian countries, Singapore’s population is rapidly ageing and increasingly sedentary, which predisposes individuals to chronic health problems. Current international and local guidelines recommend statin therapy for the primary and secondary prevention of ASCVD. However, despite the effectiveness of statin therapy, some studies have highlighted that Asian patients with cardiovascular disease are not achieving target lipid goals. Furthermore, it is widely believed that the responses of Asians (both patients and physicians) to statin therapy are different from those of their Western counterparts. Experts convened in 2014 to determine the impact of current guidelines on clinical practice in Singapore. This review summarises the key findings and recommendations of these guidelines, and presents key principles to aid clinicians to manage the cardiovascular risk of their patients more effectively. PMID:27439304

  8. Mixed methods evaluation of targeted case finding for cardiovascular disease prevention using a stepped wedged cluster RCT

    Directory of Open Access Journals (Sweden)

    Marshall Tom

    2012-10-01

    Full Text Available Abstract Background A pilot project cardiovascular prevention was implemented in Sandwell (West Midlands, UK. This used electronic primary care records to identify untreated patients at high risk of cardiovascular disease then invited these high risk patients for assessment by a nurse in their own general practice. Those found to be eligible for treatment were offered treatment. During the pilot a higher proportion of high risk patients were started on treatment in the intervention practices than in control practices. Following the apparent success of the prevention project, it was intended to extend the service to all practices across the Sandwell area. However the pilot project was not a robust evaluation. There was a need for an efficient evaluation that would not disrupt the planned rollout of the project. Methods/design Project nurses will sequentially implement targeted cardiovascular case finding in a phased way across all general practices, with the sequence of general practices determined randomly. This is a stepped wedge randomised controlled trial design. The target population is patients aged 35 to 74, without diabetes or cardiovascular disease whose ten-year cardiovascular risk, (determined from data in their electronic records is ≥20%. The primary outcome is the number of high risk patients started on treatment, because these data could be efficiently obtained from electronic primary care records. From this we can determine the effects of the case finding programme on the proportion of high risk patients started on treatment in practices before and after implementation of targeted case finding. Cost-effectiveness will be modelled from the predicted effects of treatments on cardiovascular events and associated health service costs. Alongside the implementation it is intended to interview clinical staff and patients who participated in the programme in order to determine acceptability to patients and clinicians. Practical

  9. Evaluation of a Bullying Prevention Program

    Science.gov (United States)

    Hallford, Abby; Borntrager, Cameo; Davis, Joanne L.

    2006-01-01

    In order to address the federal "No Child Left Behind Act", the state of Oklahoma required that all public schools address the problem of bullying. Although numerous anti-bullying programs exist, few have been evaluated to determine their effectiveness. The present study evaluated the effectiveness of one such program,…

  10. Journalism as a Dropout Prevention Program.

    Science.gov (United States)

    O'Donoghue, Steve

    1992-01-01

    Recounts the story of "The Media Academy," a successful special program at Fremont Academy in Oakland, California, which challenges at-risk students to excel in journalism. Notes that the program is built on three firm tenets: heterogeneous classes, writing across the curriculum, and "less is more"--fewer topics in greater depth. (NKA)

  11. Searching for preventive measures of cardiovascular events in aged Japanese taxi drivers--the daily rhythm of cardiovascular risk factors during a night duty day.

    Science.gov (United States)

    Hattori, M; Azami, Y

    2001-12-01

    Previous studies have shown that Japanese taxi drivers are exposed to more risk factors and have a higher mortality rate due to cardiovascular disease than other occupational groups. We investigated the effect of night taxi driving with a view to preventing acute events of cardiovascular disease among aged taxi drivers. Twenty-nine taxi drivers (41-67 years old) were examined for urine normetanephrine/creatinine, von Willebrand factor, anti-thrombin III, t-plasminogen activator-plasminogen activator inhibitor 1-complex, hematocrit, blood glucose and blood pressure in the morning and at midnight during a duty day and in the following morning. At the same time, the blood pressure and blood glucose of 46 taxi drivers (43-67 years old) in the morning after a night duty with little sleep and in the morning after daytime work and subsequent night sleep were compared. The results obtained indicate that the aggravation of sympathetic nervous system functions with disturbed circadian rhythms, increased blood coagulation and blood concentration, endothelial injury and the elevation of blood glucose at midnight or the next morning were induced by their night work. These conditions are supposed to favour acute vascular events in aged taxi drivers. Preventive measures considered include social support for anticoagulant food and water intake, short exercise and walking as well as taking a rest and a nap during night work.

  12. High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease.

    Science.gov (United States)

    Hussain, Syed R; Macaluso, Andrea; Pearson, Stephen J

    Moderate-intensity continuous training (MICT) has long been considered the most effective exercise treatment modality for the prevention and management of cardiovascular disease (CVD), but more recently high-intensity interval training (HIIT) has been viewed as a potential alternative to MICT in accruing such benefits. HIIT was initially found to induce significant improvements in numerous physiological and health-related indices, to a similar if not superior extent to MICT. Since then, many studies have attempted to explore the potential clinical utility of HIIT, relative to MICT, with respect to treating numerous cardiovascular conditions, such as coronary artery disease, heart failure, stroke, and hypertension. Despite this, however, the efficacy of HIIT in reversing the specific symptoms and risk factors of these cardiovascular pathologies is not well understood. HIIT is often perceived as very strenuous, which could render it unsafe for those at risk of or afflicted with CVD, but these issues are also yet to be reviewed. Furthermore, the optimal HIIT protocol for each of the CVD cohorts has not been established. Thus, the purpose of this review article is to (1) evaluate the efficacy of HIIT relative to MICT in the prevention and management of cardiovascular conditions, and (2) explore any potential safety issues surrounding the suitability and/or tolerability of HIIT for patients with CVD, and the potential optimal prescriptive variables of HIIT for application in the clinical environment.

  13. Development of a hospital-based cardiovascular risk factor reduction program for the community: Beyond Heart Disease.

    Science.gov (United States)

    Lipon, K R; Carlson, L R

    1994-01-01

    The current and future trend of the health care delivery system is prevention and health promotion. Long-term viability of hospitals depends on meeting community health education needs. With heart disease as the leading cause of death among adults nationwide, hospitals have an opportunity to offer appropriate lifestyle theory and guidance beyond conventional medical and interventional practices. Sequoia Hospital in Redwood City is one of the first hospitals in Northern California to develop a comprehensive outpatient program to complement its world renowned cardiovascular services. This paper details the Beyond Heart Disease (BHD) program designed by nurses. The goal of this program is to effectively help people reduce their risk of coronary events via successful long-term risk factor interventions. BHD, a unique medical and business venture, spans a six-week period. Group members meet in the evening for two hours, twice a week. The program includes lipid testing, a complete program syllabus, didactic lectures, small group discussion, support and goal-setting, nutritional analysis, and experiential stress reduction sessions.

  14. Sensitivity of cardiovascular risk factors, as part of the campaign of healthy companies and their essential contribution to the safety of a nuclear installation; Sensibilizacion sobre los factores de riesgos cardiovasculares como parte de la campana de empresas saludables y su contribucion esencial en la seguridad de una instalacion nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Castillejo Puertas, F. M.

    2014-07-01

    Prevention campaigns are essential to curb the incidence of cardiovascular disease, to plan prevention programs, discovering, assessing and treating risk factors, affecting asymptomatic subjects, threaten, is the most effective and efficient measure to reduce cardiovascular disease. (Author)

  15. Universal Adolescent Depression Prevention Programs: A Review

    Science.gov (United States)

    Carnevale, Teresa D.

    2013-01-01

    Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several…

  16. STATINS IN THE TREATMENT AND PREVENTION OF CARDIOVASCULAR DISEASES: REPETITION OF THE PAST AND OPTIMISM FOR THE FUTURE

    Directory of Open Access Journals (Sweden)

    L. N. Malay

    2014-01-01

    Full Text Available Statins, the most common drugs for reduction in lipid levels, are “strategic” medicinal products for the treatment and prevention of cardiovascular diseases caused by atherosclerosis. The milestones of lipid-lowering therapy history are presented as well as its contemporary aims and their implementation with focus on rosuvastatin. Data of recent metaanalysis regarding statins efficacy in primary and secondary prevention of cardiovascular complications, good safety and tolerability profile were presented. Treatment of patients with acute coronary syndrome with modern statins in high doses is discussed specially. Clinical case study of long-term treatment with rosuvastatin 20 mg/day is described. Frequency of statin prescriptions and achievements of target lipid levels in real medical practice among population of Russian patients is evaluated according to results of LIS study and PROFILE registry. Results of Russian studies of therapeutic equivalence of generic drug with original rosuvastatin are presented.

  17. The health effects of US unemployment insurance policy: does income from unemployment benefits prevent cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Stefan Walter

    Full Text Available OBJECTIVE: Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypothesis that more generous benefits reduce CVD risk. METHODS: Cohort data came from 16,108 participants in the Health and Retirement Study (HRS aged 50-65 at baseline interviewed from 1992 to 2010. Data on first and recurrent CVD diagnosis assessed through biennial interviews were linked to the generosity of unemployment benefit programmes in each state and year. Using state fixed-effect models, we assessed whether state changes in the generosity of unemployment benefits predicted CVD risk. RESULTS: States with higher unemployment benefits had lower incidence of CVD, so that a 1% increase in benefits was associated with 18% lower odds of CVD (OR:0.82, 95%-CI:0.71-0.94. This association remained after introducing US census regional division fixed effects, but disappeared after introducing state fixed effects (OR:1.02, 95%-CI:0.79-1.31.This was consistent with the fact that unemployment was not associated with CVD risk in state-fixed effect models. CONCLUSION: Although states with more generous unemployment benefits had lower CVD incidence, this appeared to be due to confounding by state-level characteristics. Possible explanations are the lack of short-term effects of unemployment on CVD risk. Future studies should assess whether benefits at earlier stages of the life-course influence long-term risk of CVD.

  18. Terapia hormonal de reemplazo en prevención cardiovascular: ¿Dónde estamos parados? Hormone replacement therapy and cardiovascular prevention: Where are we now?

    Directory of Open Access Journals (Sweden)

    Jorge Lermna

    2008-06-01

    of physiological mechanisms suggesting that estrogens could be responsible for this cardiovascular protection, and retrospective analysis of clinical studies showed that post menopausal women who had used hormonal replacement therapy (HRT suffered less cardiovascular events. These observations stimulated the execution of several prospective, randomized clinical trials (some of them with a large number of patients and prolonged follow-up in post menopausal women, with the aim of proving the hypothesis that HRT could prevent major cardiovascular events. Such hypothesis could not be demonstrated in any of those studies because HRT was not beneficial, and in several cases it was even deleterious in some aspects. Criticism has arisen over some of the methodological aspects of those prospective trials, basically regarding the age of the included patients and the timing of the beginning of HRT. There are also biological reasons that can explain the contradiction. A new hypothesis, also based on experimental and clinical observations, suggests the possibility that beginning HRT in younger women and earlier after menopause could yield different results.

  19. High-intensity interval training vs. moderate-intensity continuous training in the prevention/management of cardiovascular disease

    OpenAIRE

    S Hussain; Macaluso, A; Pearson, S.

    2016-01-01

    Moderate-intensity continuous training (MICT) has long been considered the most effective exercise treatment modality for the prevention and management of cardiovascular disease, but more recently high-intensity interval training (HIIT) has emerged into the clinical environment has been viewed as a potential alternative to MICT in accruing such benefits. HIIT was initially found to induce significant improvements in numerous physiological and health-related indices, to a similar if not superi...

  20. Preventing eating disorder pathology: common and unique features of successful eating disorders prevention programs.

    Science.gov (United States)

    Ciao, Anna C; Loth, Katie; Neumark-Sztainer, Dianne

    2014-07-01

    Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors' descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research.

  1. Preventing Eating Disorder Pathology: Common and Unique Features of Successful Eating Disorders Prevention Programs

    Science.gov (United States)

    Ciao, Anna C.; Loth, Katie; Neumark-Sztainer, Dianne

    2014-01-01

    Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors’ descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research. PMID:24821099

  2. A Multilevel Evaluation of a Comprehensive Child Abuse Prevention Program

    Science.gov (United States)

    Lawson, Michael A.; Alameda-Lawson, Tania; Byrnes, Edward C.

    2012-01-01

    Objectives: The purpose of this study is to examine the extent to which participation in a county-wide prevention program leads to improvements in protective factors associated with child abuse prevention (CAP) and whether improvements in measured protective factors relate to decreased odds of child abuse. Method: Using multilevel growth modeling,…

  3. Single session of integrated "Silver Yoga" program improves cardiovascular parameters in senior citizens

    Directory of Open Access Journals (Sweden)

    Ananda Balayogi Bhavanani

    2015-06-01

    Conclusion: There is a healthy reduction in HR, BP and derived cardiovascular indices following a single yoga session in geriatric subjects. These changes may be attributed to enhanced harmony of cardiac autonomic function as a result of coordinated breath-body work and mind-body relaxation due to an integrated and #8220;Silver Yoga and #8221; program. [J Intercult Ethnopharmacol 2015; 4(2.000: 134-137

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

    Science.gov (United States)

    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.

  5. DRUGS FOR PRIMARY PREVENTION OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE: AN OVERVIEW OF SYSTEMATIC REVIEWS

    Science.gov (United States)

    Karmali, Kunal N.; Lloyd-Jones, Donald M.; Berendsen, Mark; Goff, David C.; Sanghavi, Darshak M.; Brown, Nina; Korenovska, Liliya; Huffman, Mark D.

    2016-01-01

    Importance The Million Hearts initiative emphasizes the “ABCS” - aspirin, blood pressure control, cholesterol management, and smoking cessation. Evidence for the effects of drugs used to achieve the ABCS has not been comprehensively synthesized in primary atherosclerotic cardiovascular disease (ASCVD) prevention. Objective To compare the efficacy and safety of aspirin, blood pressure-lowering therapy, statin, and tobacco cessation drugs on fatal and non-fatal ASCVD outcomes in primary ASCVD prevention. Evidence Review Structured search of the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA), MEDLINE, EMBASE, and PROSPERO International Prospective Systematic Review Trial Register to identify systematic reviews published from January 1, 2005, to June 17, 2015, that reported the effect of aspirin, BP-lowering therapy, statin, or tobacco cessation drugs on ASCVD events in individuals without prevalent ASCVD. Additional studies were identified by searching the reference lists of included systematic reviews, meta-analyses, and health technology assessment reports. Reviews were selected according to predefined criteria and appraised formethodologic quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool (range, 0–11). Studies were independently reviewed for key participant and intervention characteristics. Outcomes that were meta-analyzed in each included review were extracted. Qualitative synthesis was performed, and data were analyzed from July 2 to August 13, 2015. Findings From a total of 1967 reports, 35 systematic reviews of randomized clinical trials were identified, including 15 reviews of aspirin, 4 reviews of BP-lowering therapy, 12 reviews of statins, and 4 reviews of tobacco cessation drugs. Methodologic quality varied, but 30 reviews had AMSTAR ratings of 5 or higher. Compared with placebo, aspirin (relative risk [RR], 0.90; 95%CI, 0.85–0.96) and

  6. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  7. Crafting a Successful Bully Prevention Program

    Science.gov (United States)

    McMurrer-Shank, Marlene R.

    2010-01-01

    Bullying continues to be a serious problem in schools everywhere, and states are enacting laws that target bullying and harassment on campus. Several state legislatures have proposed laws that require schools to establish anti-bullying policies and programs. Therefore, education leaders and school business officials should ensure that the bully…

  8. Teen Risk-Taking: Promising Prevention Programs and Approaches.

    Science.gov (United States)

    Eisen, Marvin; Pallitto, Christina; Bradner, Carolyn; Bolshun, Natalya

    This guidebook explores some of the practical issues associated with finding, choosing, and starting potentially effective prevention programs for at-risk preteens and teens. The guidebook is based on a study of 51 intervention programs that identified elements and delivery mechanisms that were associated with their effectiveness. A closer look at…

  9. A Quasi-Experimental Analysis of Schoolwide Violence Prevention Programs

    Science.gov (United States)

    Barnes, Tia Navelene; Leite, Walter; Smith, Stephen W.

    2017-01-01

    Violence prevention programs are commonplace in today's schools, though reviews of the literature reveal mixed empirical findings on their effectiveness. Often, these programs include a variety of components such as social skills training, student mentoring, and activities designed to build a sense of school community that have not been tested for…

  10. New Areas for Preventive Programing: Sudden Infant Death Syndrome.

    Science.gov (United States)

    Lowman, Joseph

    Crisis intervention programs for persons experiencing the sudden death of family members or surviving natural disasters have been advocated as methods of primary prevention, although few have actually been implemented. A program utilizing nurses to deliver grief intervention to parents losing a baby to Sudden Infant Death Syndrome (SIDS) was…

  11. A Primary Prevention Program to Reduce Bulimia and Anorexia Nervosa.

    Science.gov (United States)

    Cullari, Salvatore; Redmon, William K.

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

  12. Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

    Science.gov (United States)

    Martini, Gilbert R., Jr.

    1991-01-01

    A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

  13. Role of ASA in the primary and secondary prevention of cardiovascular events.

    NARCIS (Netherlands)

    Casado-Arroyo, R.; Bayrak, F.; Sarkozy, A.; Chierchia, G.B.; Asmundis, C. de; Brugada, P.

    2012-01-01

    Cardiovascular disease, which includes coronary heart disease, cerebrovascular disease and peripheral artery disease, is the leading cause of death in developed countries. Evidence from basic research, clinical investigations, observational epidemiologic studies and randomized clinical trials has pr

  14. Activity Surveillance and Hawthorne Effect to Prevent Programming Plagiarism

    Directory of Open Access Journals (Sweden)

    Sufian Sufian

    2010-01-01

    Full Text Available Problem statement: Course instructors are facing serious problems in dealing with students who plagiarize programs especially when the number of students in the course is high. Among the proposed approach to handle this problem is by using automatic detection of plagiarism in programming projects. Preventive action is required rather than curing the problem so that programming students get the right message from the beginning. Approach: To address this problem, a surveillance system was proposed to record every programming activity. It is developed in an integrated development environment so that programming activity profile in Java format is created when students are developing their Java program. A non-intrusive and non-experimental setting approach was applied in which hidden data collection is conducted to observe students’ behavior in natural programming setting. Experimental study effect i.e., Hawthorne effect and effect of expectation on subject behavior was exploited as prevention on plagiarism. Surveillance system produces two file types: Activity log to keep programming activity log information and Backup file to save the program writing record. Results: The proposed programming activity surveillance system, DwiCoder presented a programming activity report at the end of each programming session. Students can assess their own progress in developing a program in these three activities: Compilation, execution and modification. The report was presented in a simple and meaningful way to encourage student spend their own time in programming activity. Conclusion: By using DwiCoder, student’s programming activity is continuously monitored and their behavior is under control. This system provides an effective prevention method in tackling plagiarism.

  15. Partner Services in STD Prevention Programs: A Review

    Science.gov (United States)

    Hogben, Matthew; Collins, Dayne; Hoots, Brooke; O’Connor, Kevin

    2015-01-01

    Background Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this paper, we review current literature with the goal of informing STD prevention programs. Methods We searched the literature for systematic reviews. We found nine reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, infections). We abstracted major conclusions and recommendations from the reviews. Results Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well-supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. Conclusions Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. STD prevention needs program-level research and development to generate this portfolio. PMID:26779688

  16. Advances in Integrating Traditional and Omic Biomarkers When Analyzing the Effects of the Mediterranean Diet Intervention in Cardiovascular Prevention

    Science.gov (United States)

    Fitó, Montserrat; Melander, Olle; Martínez, José Alfredo; Toledo, Estefanía; Carpéné, Christian; Corella, Dolores

    2016-01-01

    Intervention with Mediterranean diet (MedDiet) has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers of oxidation, inflammation, cellular adhesion, adipokine production, and pro-thrombotic state. Although the benefits of the MedDiet have been attributed to its richness in antioxidants, the mechanisms by which it exercises its beneficial effects are not well known. It is thought that the integration of omics including genomics, transcriptomics, epigenomics, and metabolomics, into studies analyzing nutrition and cardiovascular diseases will provide new clues regarding these mechanisms. However, omics integration is still in its infancy. Currently, some single-omics analyses have provided valuable data, mostly in the field of genomics. Thus, several gene-diet interactions in determining both intermediate (plasma lipids, etc.) and final cardiovascular phenotypes (stroke, myocardial infarction, etc.) have been reported. However, few studies have analyzed changes in gene expression and, moreover very few have focused on epigenomic or metabolomic biomarkers related to the MedDiet. Nevertheless, these preliminary results can help to better understand the inter-individual differences in cardiovascular risk and dietary response for further applications in personalized nutrition. PMID:27598147

  17. Red wine polyphenols prevent metabolic and cardiovascular alterations associated with obesity in Zucker fatty rats (Fa/Fa.

    Directory of Open Access Journals (Sweden)

    Abdelali Agouni

    Full Text Available BACKGROUND: Obesity is associated with increased risks for development of cardiovascular diseases. Epidemiological studies report an inverse association between dietary flavonoid consumption and mortality from cardiovascular diseases. We studied the potential beneficial effects of dietary supplementation of red wine polyphenol extract, Provinols, on obesity-associated alterations with respect to metabolic disturbances and cardiovascular functions in Zucker fatty (ZF rats. METHODOLOGY/PRINCIPAL FINDINGS: ZF rats or their lean littermates received normal diet or supplemented with Provinols for 8 weeks. Provinols improved glucose metabolism by reducing plasma glucose and fructosamine in ZF rats. Moreover, it reduced circulating triglycerides and total cholesterol as well as LDL-cholesterol in ZF rats. Echocardiography measurements demonstrated that Provinols improved cardiac performance as evidenced by an increase in left ventricular fractional shortening and cardiac output associated with decreased peripheral arterial resistances in ZF rats. Regarding vascular function, Provinols corrected endothelial dysfunction in aortas from ZF rats by improving endothelium-dependent relaxation in response to acetylcholine (Ach. Provinols enhanced NO bioavailability resulting from increased nitric oxide (NO production through enhanced endothelial NO-synthase (eNOS activity and reduced superoxide anion release via decreased expression of NADPH oxidase membrane sub-unit, Nox-1. In small mesenteric arteries, although Provinols did not affect the endothelium-dependent response to Ach; it enhanced the endothelial-derived hyperpolarizing factor component of the response. CONCLUSIONS/SIGNIFICANCE: Use of red wine polyphenols may be a potential mechanism for prevention of cardiovascular and metabolic alterations associated with obesity.

  18. Advances in Integrating Traditional and Omic Biomarkers When Analyzing the Effects of the Mediterranean Diet Intervention in Cardiovascular Prevention.

    Science.gov (United States)

    Fitó, Montserrat; Melander, Olle; Martínez, José Alfredo; Toledo, Estefanía; Carpéné, Christian; Corella, Dolores

    2016-09-02

    Intervention with Mediterranean diet (MedDiet) has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers of oxidation, inflammation, cellular adhesion, adipokine production, and pro-thrombotic state. Although the benefits of the MedDiet have been attributed to its richness in antioxidants, the mechanisms by which it exercises its beneficial effects are not well known. It is thought that the integration of omics including genomics, transcriptomics, epigenomics, and metabolomics, into studies analyzing nutrition and cardiovascular diseases will provide new clues regarding these mechanisms. However, omics integration is still in its infancy. Currently, some single-omics analyses have provided valuable data, mostly in the field of genomics. Thus, several gene-diet interactions in determining both intermediate (plasma lipids, etc.) and final cardiovascular phenotypes (stroke, myocardial infarction, etc.) have been reported. However, few studies have analyzed changes in gene expression and, moreover very few have focused on epigenomic or metabolomic biomarkers related to the MedDiet. Nevertheless, these preliminary results can help to better understand the inter-individual differences in cardiovascular risk and dietary response for further applications in personalized nutrition.

  19. Advances in Integrating Traditional and Omic Biomarkers When Analyzing the Effects of the Mediterranean Diet Intervention in Cardiovascular Prevention

    Directory of Open Access Journals (Sweden)

    Montserrat Fitó

    2016-09-01

    Full Text Available Intervention with Mediterranean diet (MedDiet has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers of oxidation, inflammation, cellular adhesion, adipokine production, and pro-thrombotic state. Although the benefits of the MedDiet have been attributed to its richness in antioxidants, the mechanisms by which it exercises its beneficial effects are not well known. It is thought that the integration of omics including genomics, transcriptomics, epigenomics, and metabolomics, into studies analyzing nutrition and cardiovascular diseases will provide new clues regarding these mechanisms. However, omics integration is still in its infancy. Currently, some single-omics analyses have provided valuable data, mostly in the field of genomics. Thus, several gene-diet interactions in determining both intermediate (plasma lipids, etc. and final cardiovascular phenotypes (stroke, myocardial infarction, etc. have been reported. However, few studies have analyzed changes in gene expression and, moreover very few have focused on epigenomic or metabolomic biomarkers related to the MedDiet. Nevertheless, these preliminary results can help to better understand the inter-individual differences in cardiovascular risk and dietary response for further applications in personalized nutrition.

  20. Efficacy of Standard and Intensive Statin Treatment for the Secondary Prevention of Cardiovascular and Cerebrovascular Events in Diabetes Patients: A Meta-Analysis

    OpenAIRE

    de Vries, Folgerdiena M.; Johan Kolthof; Postma, Maarten J.; Petra Denig; Eelko Hak

    2014-01-01

    AIMS: To estimate the efficacy of standard and intensive statin treatment in the secondary prevention of major cardiovascular and cerebrovascular events in diabetes patients. METHODS: A systematic search was conducted in Medline over the years 1990 to September 2013. Randomized, double-blind, clinical trials comparing a standard-dose statin with placebo or a standard-dose statin with an intensive-dose statin for the secondary prevention of cardiovascular and cerebrovascular events in diabetes...

  1. Assessing Cardiovascular Health Using Life′s Simple 7 in a Chinese Population Undergoing Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Qiong Yang

    2015-01-01

    Conclusions: Few Chinese patients undergoing stroke prevention had optimal CVH (determined using LS7. Additionally, fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention. In particular, physical activity and diet status in this population require improvement.

  2. Suicide Prevention in the Dot Com Era: Technological Aspects of a University Suicide Prevention Program

    Science.gov (United States)

    Manning, Jessica; VanDeusen, Karen

    2011-01-01

    Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this…

  3. Variaciones en la prevención del riesgo cardiovascular: estudio poblacional Variation in the prevention of cardiovascular risk factors. A population-based study

    Directory of Open Access Journals (Sweden)

    I. Ruiz Pérez

    2003-02-01

    until they are performed with the same frequency as among physicians and nurses. Efforts should be directed to increasing cardiovascular prevention programs in health centers.

  4. Optimizing Violence Prevention Programs: An Examination of Program Effectiveness among Urban High School Students

    Science.gov (United States)

    Thompkins, Amanda C.; Chauveron, Lisa M.; Harel, Ofer; Perkins, Daniel F.

    2014-01-01

    Background: While demand for youth violence prevention programs increases, the ability of the school-day schedule to accommodate their time requirements has diminished. Viable school-based prevention programs must strike a balance between brevity and effectiveness. This article reports results from an effectiveness trial of a 12-session…

  5. An emerging trend in functional foods for the prevention of cardiovascular disease and diabetes: Marine algal polyphenols.

    Science.gov (United States)

    Murray, Margaret; Dordevic, Aimee L; Ryan, Lisa; Bonham, Maxine P

    2016-11-11

    Marine macroalgae are gaining recognition among the scientific community as a significant source of functional food ingredients. Due to the harsh environments in which macroalgae survive, they produce unique bioactive compounds that are not found in terrestrial plants. Polyphenols are the predominant bioactive compound in brown algae and are accountable for the majority of its biological activity. Phlorotannins are a type of polyphenol that are unique to marine sources and have exhibited protective effects against hyperglycaemia, hyperlipidaemia, inflammation and oxidative stress, known risk factors for cardiovascular disease and diabetic complications, in cell culture, animal studies and some human studies. This review updates the information on marine polyphenols, with a particular focus on phlorotannins and their potential health benefits in relation to the prevention and treatment of risk factors for type 2 diabetes and cardiovascular diseases.

  6. Vascular nitric oxide and superoxide anion contribute to sex-specific programmed cardiovascular physiology in mice.

    Science.gov (United States)

    Roghair, Robert D; Segar, Jeffrey L; Volk, Kenneth A; Chapleau, Mark W; Dallas, Lindsay M; Sorenson, Anna R; Scholz, Thomas D; Lamb, Fred S

    2009-03-01

    Intrauterine environmental pertubations have been linked to the development of adult hypertension. We sought to evaluate the interrelated roles of sex, nitric oxide, and reactive oxygen species (ROS) in programmed cardiovascular disease. Programming was induced in mice by maternal dietary intervention (DI; partial substitution of protein with carbohydrates and fat) or carbenoxolone administration (CX, to increase fetal glucocorticoid exposure). Adult blood pressure and locomotor activity were recorded by radiotelemetry at baseline, after a week of high salt, and after a week of high salt plus nitric oxide synthase inhibition (by l-NAME). In male offspring, DI or CX programmed an elevation in blood pressure that was exacerbated by N(omega)-nitro-l-arginine methyl ester administration, but not high salt alone. Mesenteric resistance vessels from DI male offspring displayed impaired vasorelaxation to ACh and nitroprusside, which was blocked by catalase and superoxide dismutase. CX-exposed females were normotensive, while DI females had nitric oxide synthase-dependent hypotension and enhanced mesenteric dilation. Despite the disparate cardiovascular phenotypes, both male and female DI offspring displayed increases in locomotor activity and aortic superoxide production. Despite dissimilar blood pressures, DI and CX-exposed females had reductions in cardiac baroreflex sensitivity. In conclusion, both maternal malnutrition and fetal glucocorticoid exposure program increases in arterial pressure in male but not female offspring. While maternal DI increased both superoxide-mediated vasoconstriction and nitric oxide mediated vasodilation, the balance of these factors favored the development of hypertension in males and hypotension in females.

  7. SUPPRESSION OF RENIN-ANGIOTENSIN SYSTEM TO PREVENT COMPLICATIONS OF CARDIOVASCULAR DISEASES: CURRENT "ROLES" DISTRIBUTION FROM CLINICAL PHARMACOLOGIST’S POINT OF VIEW

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevskiy

    2011-01-01

    Full Text Available A role of angiotensin-converting enzyme (ACE inhibitors in cardiovascular diseases treatment and prevention is discussed. Some large randomized clinical trials are analyzed. Physical and chemical properties of drugs and its evidence base are considered among possible factors of ACE inhibitors choice. A problem of ACE inhibitor choice is also discussed in context of secondary prevention of cardiovascular complications in arterial hypertension and after myocardial infarction. It is concluded that the choice of any drug for cardiovascular disease treatment is mainly determined by its evidence base.

  8. Information resources for US Department of Energy pollution prevention programs

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, K.L.; Snowden-Swan, L.J.; Butner, R.S.

    1994-01-01

    In support of the US Department of Energy`s (DOE`s) pollution prevention efforts being conducted under the aegis of DOE`s Office of Environmental Restoration and Waste Management (EM) program, Pacific Northwest Laboratory was tasked with evaluating pollution prevention information resources. The goal of this activity was to improve the effectiveness of DOE`s pollution prevention activities through improved information flow, both within the complex, and more specifically, between DOE and other organizations that share similar pollution prevention challenges. This report presents our findings with respect to the role of information collection and dissemination within the complex, opportunities for teaming from successes of the private sector, and specific information needs of the DOE pollution prevention community. These findings were derived from a series of interviews with pollution prevention coordinators from across the DOE complex, review of DOE site and facility pollution prevention plans, and workshops with DOE information users as well as an information resources workshop that brought together information specialists from private industry, non-profit organizations, as well as state and regional pollution prevention assistance programs.

  9. Evaluating the SOS suicide prevention program: a replication and extension

    Directory of Open Access Journals (Sweden)

    Glanovsky Jaime

    2007-07-01

    Full Text Available Abstract Background Suicide is a leading cause of death for children and youth in the United States. Although school based programs have been the principal vehicle for youth suicide prevention efforts for over two decades, few have been systematically evaluated. This study examined the effectiveness of the Signs of Suicide (SOS prevention program in reducing suicidal behavior. Methods 4133 students in 9 high schools in Columbus, Georgia, western Massachusetts, and Hartford, Connecticut were randomly assigned to intervention and control groups during the 2001–02 and 2002–03 school years. Self-administered questionnaires were completed by students in both groups approximately 3 months after program implementation. Results Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group. Students' race/ethnicity, grade, and gender did not alter the impact of the intervention on any of the outcomes assessed in this analysis. Conclusion This study has confirmed preliminary analysis of Year 1 data with a larger and more racially and socio-economically diverse sample. SOS continues to be the only universal school-based suicide prevention program to demonstrate significant effects of self-reported suicide attempts in a study utilizing a randomized experimental design. Moreover, the beneficial effects of SOS were observed among high school-aged youth from diverse racial/ethnic backgrounds, highlighting the program's utility as a universal prevention program. Trial registration clinicaltrials.gov NCT000387855.

  10. Seaweeds as Preventive Agents for Cardiovascular Diseases: From Nutrients to Functional Foods

    Directory of Open Access Journals (Sweden)

    Susana M. Cardoso

    2015-11-01

    Full Text Available Being naturally enriched in key nutrients and in various health-promoting compounds, seaweeds represent promising candidates for the design of functional foods. Soluble dietary fibers, peptides, phlorotannins, lipids and minerals are macroalgae’s major compounds that can hold potential in high-value food products derived from macroalgae, including those directed to the cardiovascular-health promotion. This manuscript revises available reported data focusing the role of diet supplementation of macroalgae, or extracts enriched in bioactive compounds from macroalgae origin, in targeting modifiable markers of cardiovascular diseases (CVDs, like dyslipidemia, oxidative stress, vascular inflammation, hypertension, hypercoagulability and activation of the sympathetic and renin-angiotensin systems, among others. At last, the review also describes several products that have been formulated with the use of whole macroalgae or extracts, along with their claimed cardiovascular-associated benefits.

  11. Physical activity and cardiovascular prevention: Is healthy urban living a possible reality or utopia?

    Science.gov (United States)

    Buscemi, Silvio; Giordano, Carla

    2017-02-16

    Favoring correct lifestyles is the most important measure to contrast cardiovascular diseases and the epidemic of high cardiovascular risk conditions, such as obesity, diabetes, and hypertension. Lifestyle is a broad expression that includes diet, physical exercise, and psychological and socio-economic factors, each of which must be taken into due consideration because of their intertwining influences, which may be a barrier to healthy changes at both the individual and population levels. While physical activity has probably received less attention in the last decades, it is likely the most important among the modifiable risk factors for cardiovascular diseases. Improving the habitual physical activity level is an achievable goal, and even small improvements may have important favorable effects on health. Strategies at the population level have to be urgently taken, and involve not only public health, but also administrators and politicians, starting from a rethinking of our cities.

  12. Pollution prevention program for new projects -- Lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    Lum, J. [Dept. of Energy, Washington, DC (United States)

    1993-03-01

    The purpose of this presentation is to relay the experience of the Office of New Production Reactors (NP) in developing and implementing its pollution prevention program. NP was established to plan, design, and construct a new safe and environmentally acceptable nuclear reactor capacity necessary to provide an assured supply of tritium to maintain the nation`s long-term deterrent capability. The Program offered the Department of Energy an opportunity to demonstrate its commitment to environmental protection via minimization of environmental releases; new design offers the best opportunity for pollution prevention. The NP pollution prevention program was never fully implemented because NP`s tritium production design activity was recovery terminated. The information in this paper represented lessons learned from the last three years of NP operation.

  13. Medication effectiveness may not be the major reason for accepting cardiovascular preventive medication: A population-based survey

    Directory of Open Access Journals (Sweden)

    Harmsen Charlotte

    2012-08-01

    Full Text Available Abstract Background Shared decision-making and patients’ choice of interventions are areas of increasing importance, not least seen in the light of the fact that chronic conditions are increasing, interventions considered important for public health, and still non-acceptance of especially risk-reducing treatments of cardiovascular diseases (CVD is prevalent. A better understanding of patients’ medication-taking behavior is needed and may be reached by studying the reasons why people accept or decline medication recommendations. The aim of this paper was to identify factors that may influence people’s decisions and reasoning for accepting or declining a cardiovascular preventive medication offer. Methods From a random sample of 4,000 people aged 40–59 years in a Danish population, 1,169 participants were asked to imagine being at increased risk of cardiovascular disease and being offered a preventive medication. After receiving ‘complete’ information about effectiveness of the medication they were asked whether they would accept medication. Finally, they were asked about reasons for the decision. Results A total of 725 (67% of 1,082 participants accepted the medication offer. Even quite large effects of medication (up to 8 percentage points absolute risk reduction had a smaller impact on acceptance to medication than personal experience with cardiovascular disease. Furthermore, increasing age of the participant and living with a partner were significantly associated with acceptance. Some 45% of the respondents accepting justified their choice as being for health reasons, and they were more likely to be women, live alone, have higher income and higher education levels. Among those who did not accept the medication offer, 56% indicated that they would rather prefer to change lifestyle. Conclusions Medication effectiveness seems to have a moderate influence on people’s decisions to accept preventive medication, while factors such as

  14. Health benefits of high-density lipoproteins in preventing cardiovascular diseases.

    Science.gov (United States)

    Berrougui, Hicham; Momo, Claudia N; Khalil, Abdelouahed

    2012-01-01

    Plasma levels of high-density lipoprotein (HDL) are strongly and inversely correlated with atherosclerotic cardiovascular diseases. However, it is becoming clear that a functional HDL is a more desirable target than simply increasing HDL-cholesterol levels. The best known antiatherogenic function of HDL particles relates to their ability to promote reverse cholesterol transport from peripheral cells. However, HDL also possesses antioxidant, anti-inflammatory, and antithrombotic effects. This review focuses on the state of knowledge regarding assays of HDL heterogeneity and function and their relationship to cardiovascular diseases.

  15. Measures and programs for preventing violence in school

    Directory of Open Access Journals (Sweden)

    Gašić-Pavišić Slobodanka Ž.

    2004-01-01

    Full Text Available In many countries across the world schools are no longer a safe place for both students and school staff. Violence in school is an issue scarcely studied in Serbia and there are few articles in domestic professional literature. At national and local level there are not developed strategies nor programs for preventing violence among students in our schools. There are no data about planned, systematic and organized prevention of violence in the practice of our schools. The data obtained by investigations indicate that it is necessary to apply adequate programs for preventing violence among students in our schools, despite the finding that violence in school is not that much conspicuous and serious problem like in other countries (USA Israel, Japan, Austria, Germany. On the basis of relevant literature review the present paper high­lights some very popular and less notorious measures and prevention programs applied in various countries. The aim of the paper is to transmit basic and essential pieces of information so as to gain insight into diverse existing approaches to prevention of violent behavior in school hopefully to encourage our schools to pay more attention to preventing violence in school as soon as possible before it is too late.

  16. A review of omega-3 ethyl esters for cardiovascular prevention and treatment of increased blood triglyceride levels

    Directory of Open Access Journals (Sweden)

    Clemens von Schacky

    2006-09-01

    Full Text Available Clemens von SchackyMedizinische Klinik and Poliklinik Innenstadt, University of Munich, Munich, GermanyAbstract: The two marine omega-3 fatty acids eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA, prevalent in fish and fish oils, have been investigated as a strategy towards prophylaxis of atherosclerosis. While the results with fish and fish oils have been not as clear cut, the data generated with the purified ethyl ester forms of these two fatty acids are consistent. Although slight differences in biological activity exist between EPA and DHA, both exert a number of positive actions against atherosclerosis and its complications. EPA and DHA as ethyl esters inhibit platelet aggregability, and reduce serum triglycerides, while leaving other serum lipids essentially unaltered. Glucose metabolism has been studied extensively, and no adverse effects were seen. Pro-atherogenic cytokines are reduced, as are markers of endothelial activation. Endothelial function is improved, vascular occlusion is reduced, and the course of coronary atherosclerosis is mitigated. Heart rate is reduced, and heart rate variability is increased by EPA and DHA. An antiarrhythmic effect can be demonstrated on the supraventricular and the ventricular level. More importantly, two large studies showed reductions in clinical endpoints like sudden cardiac death or major adverse cardiac events. As a consequence, relevant cardiac societies recommend using 1 g/day of EPA and DHA for cardiovascular prevention, after a myocardial infarction and for prevention of sudden cardiac death.Keywords: sudden cardiac death, major adverse cardiac events, cardiovascular prevention, eicosapentaenoic acid, docosahexaenoic acid

  17. Effectiveness and Evaluation of Crime Prevention Programs in Minas Gerais

    Directory of Open Access Journals (Sweden)

    Claudio Beato

    2014-05-01

    Full Text Available This essay analyzes previous studies evaluating the effectiveness of the crime prevention policies adopted by the Government of Minas Gerais (Brazil. In this work, greater emphasis is placed on studies evaluating outcomes than on studies dealing with the process of setting up and implementing programs and projects. In order to allow a more systematic discussion, the Maryland Scale, which categorizes research and evaluations according to the methodological strengths and weaknesses in five levels, is employed. Subsequently, the authors draw a parallel between Brazil and other settings. Finally, this essay lays out the implications of this discussion regarding the prevention programs

  18. The Prevention of Liver Cancer by HBV Vaccine Program

    Institute of Scientific and Technical Information of China (English)

    TAO Xiong

    2002-01-01

    Objective To recognize the HBV vaccine program for prevention of the hepatic cancer.Methods To discuss the relation between the HBV and hepatic cancer arising, and to discuss the immunology respond of the HBV vaccine (HBV surface antigen protein) in our patient group. Result Our data indicates that the predisposing of the HBV infection is required for the hepatic cancer arising and for the high expression of the AFP gene, and our data indicates that the HBV vaccine can induce highly immuno respond in about 78.8 % of the adult for achieving the HBV prevention status and the hepatic cancer prevention status.

  19. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS: First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS: The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION: 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  20. Endothelial and cardiac progenitors: boosting, conditioning and (re)programming for cardiovascular repair.

    Science.gov (United States)

    Pesce, Maurizio; Burba, Ilaria; Gambini, Elisa; Prandi, Francesca; Pompilio, Giulio; Capogrossi, Maurizio C

    2011-01-01

    Preclinical studies performed in cell culture and animal systems have shown the outstanding ability of stem cells to repair ischemic heart and lower limbs by promoting the formation of new blood vessels and new myocytes. In contrast, clinical studies of stem cell administration in patients with myocardial ischemia have revealed only modest, although promising, results. Basic investigations have shown the feasibility of adult cells reprogramming into pluripotent cells by defined factors, thus opening the way to the devise of protocols to ex vivo derive virtually unexhausted cellular pools. In contrast, cellular and molecular studies have indicated that risk factors limit adult-derived stem cell survival, proliferation and engraftment in ischemic tissues. The use of fully reprogrammed cells raises safety concerns; therefore, adult cells remain a primary option for clinicians interested in therapeutic cardiovascular repair. Pharmacologic approaches have been devised to restore the cardiovascular repair ability of failing progenitors from patients at risk. In the present contribution, the most advanced pharmacologic approaches to (re)program, boost, and condition endothelial and cardiac progenitor cells to enhance cardiovascular regeneration are discussed.

  1. Vitamin D and the Prevention of Hypertension and Cardiovascular Diseases: A Review of the Currenct Evidence

    NARCIS (Netherlands)

    Geleijnse, J.M.

    2011-01-01

    Vitamin D plays an essential role in bone mineralization and calcium homeostasis. More recently, there has been growing evidence for a role of vitamin D in extraskeletal health, including beneficial effects in the cardiovascular system. Daylight exposure and vitamin D intake in many western populati

  2. Personal medical decision making : for prevention of a first cardiovascular event

    NARCIS (Netherlands)

    B.S. Ferket (Bart)

    2013-01-01

    markdownabstract__Abstract__ Atherosclerotic cardiovascular disease (CVD) remains the leading cause of mortality worldwide, accounting for approximately 30% of total mortality. In the Netherlands, the total number of coronary attacks a year is estimated to be 82,100: 6.13 per 1,000 men and 3.91 per

  3. Aspirin in the prevention of cardiovascular disease in type 2 diabetes

    NARCIS (Netherlands)

    Hovens, Marcel Maria Christiaan

    2010-01-01

    In the first of this thesis, results are summarized of a randomised crossover trial on the effects of aspirin on markers of inflammation, coagulation and number of endothelial progenitor cells in type 2 diabetic patients without cardiovascular disease. In the second part, results of two systematic r

  4. Sudden infant death syndrome prevention: a model program for NICUs.

    Science.gov (United States)

    McMullen, Sherri L; Lipke, Bethann; LeMura, Catherine

    2009-01-01

    Health care providers' opinions can influence how parents place their infant to sleep. Neonatal nurses can improve how they teach and model safe infant sleep practices to parents. To increase neonatal nurses' knowledge, a sudden infant death syndrome (SIDS) prevention program was implemented. Program components included a computerized teaching tool, a crib card, sleep sacks, and discharge instructions. Initial program evaluation showed that 98 percent of infants slept supine and 93 percent slept in sleep sacks in open cribs. However, nurses continued to swaddle some infants with blankets to improve thermoregulation. To increase nursing compliance in modeling safe infant sleep practices, Halo SleepSack Swaddles were provided for nurses to use in place of a blanket to regulate infant temperature. Recent data show that 100 percent of infants in open cribs are now sleeping supine wearing a Halo Swaddle or a traditional Halo SleepSack. This model program can easily be replicated to enhance neonatal nurses' knowledge about SIDS prevention.

  5. The Work Disability Prevention CIHR Strategic Training Program: Program Performance After 5 Years of Implementation

    NARCIS (Netherlands)

    Loisel, P.; Hong, Q.N.; Imbeau, D.; Lippel, K.; Guzman, J.; MacEachen, E.; Corbiere, M.; Santos, B.R.; Anema, J.R.

    2009-01-01

    Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and atti

  6. Resveratrol Prevents Cardiovascular Complications in the SHR/STZ Rat by Reductions in Oxidative Stress and Inflammation

    Directory of Open Access Journals (Sweden)

    Rebecca K. Vella

    2015-01-01

    Full Text Available The cardioprotective effects of resveratrol are well established in animal models of metabolic disease but are yet to be investigated in a combined model of hypertension and diabetes. This study investigated the ability of resveratrol’s antioxidant and anti-inflammatory effects to prevent cardiovascular complications in the spontaneously hypertensive streptozotocin-induced diabetic rat. Diabetes was induced in eight-week-old male spontaneously hypertensive rats via a single intravenous injection of streptozotocin. Following this, resveratrol was administered orally for an eight-week period until the animals were sixteen weeks of age. Upon completion of the treatment regime assessments of oxidative stress, lipid peroxidation, inflammation, and cardiovascular function were made. Resveratrol administration to hypertensive-diabetic animals did not impact upon blood glucose or haemodynamics but significantly reduced oxidative stress, lipid peroxidation, and inflammatory cytokines. Reductions in systemic levels of oxidative stress and inflammation conferred improvements in vascular reactivity and left ventricular pump function and electrophysiology. This study demonstrates that resveratrol administration to hypertensive diabetic animals can elicit cardioprotective properties via antioxidant and anti-inflammatory effects. The observed preservation of cardiovascular function was independent of changes in blood glucose concentration and haemodynamics, suggesting that oxidative stress and inflammation are key components within the pathological cascade associated with hypertension and diabetes.

  7. Cherokee Choices: a diabetes prevention program for American Indians.

    Science.gov (United States)

    Bachar, Jeffrey J; Lefler, Lisa J; Reed, Lori; McCoy, Tara; Bailey, Robin; Bell, Ronny

    2006-07-01

    In 1999, the Centers for Disease Control and Prevention (CDC) provided Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) funds to the Eastern Band of Cherokee Indians to develop a community-based intervention to improve the health of this rural, mountainous community in North Carolina. During the first year of the Cherokee Choices program, team members conducted formative research, formed coalitions, and developed a culturally appropriate community action plan for the prevention of type 2 diabetes, particularly among children. The Eastern Band of Cherokee Indians has higher rates of obesity and type 2 diabetes than the U.S. and North Carolina general populations. The Cherokee Choices program includes three main components: elementary school mentoring, worksite wellness for adults, and church-based health promotion. A social marketing strategy, including television advertisements and a television documentary series, supports the three components. School policy was altered to allow Cherokee Choices to have class time and after-school time devoted to health promotion activities. School staff have shown an interest in improving their health through attendance at fitness sessions. The credibility of the program has been validated through multiple invitations to participate in school events. Participants in the worksite wellness program have met dietary and physical activity goals, had reductions in body fat, and expressed enthusiasm for the program. A subcoalition has been formed to expand the worksite wellness component and link prevention efforts to health care cost reduction. Participants in the church program have walked more than 31,600 miles collectively.

  8. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

    Science.gov (United States)

    Zomer, Ella; Owen, Alice; Magliano, Dianna J; Liew, Danny

    2012-01-01

    Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Design Best case scenario analysis using a Markov model. Setting Australian Diabetes, Obesity and Lifestyle study. Participants 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Main outcome measures Treatment effects associated with dark chocolate consumption derived from published meta-analyses were used to determine the absolute number of cardiovascular events with and without treatment. Costs associated with cardiovascular events and treatments were applied to determine the potential amount of funding required for dark chocolate therapy to be considered cost effective. Results Daily consumption of dark chocolate (polyphenol content equivalent to 100 g of dark chocolate) can reduce cardiovascular events by 85 (95% confidence interval 60 to 105) per 10 000 population treated over 10 years. $A40 (£25; €31; $42) could be cost effectively spent per person per year on prevention strategies using dark chocolate. These results assume 100% compliance and represent a best case scenario. Conclusions The blood pressure and cholesterol lowering effects of dark chocolate consumption are beneficial in the prevention of cardiovascular events in a population with metabolic syndrome. Daily dark chocolate consumption could be an effective cardiovascular preventive strategy in this population. PMID:22653982

  9. Feasibility of Recruiting Families into a Heart Disease Prevention Program Based on Dietary Patterns.

    Science.gov (United States)

    Schumacher, Tracy L; Burrows, Tracy L; Thompson, Deborah I; Spratt, Neil J; Callister, Robin; Collins, Clare E

    2015-08-21

    Offspring of parents with a history of cardiovascular disease (CVD) inherit a similar genetic profile and share diet and lifestyle behaviors. This study aimed to evaluate the feasibility of recruiting families at risk of CVD to a dietary prevention program, determine the changes in diet achieved, and program acceptability. Families were recruited into a pilot parallel group randomized controlled trial consisting of a three month evidence-based dietary intervention, based on the Mediterranean and Portfolio diets. Feasibility was assessed by recruitment and retention rates, change in diet by food frequency questionnaire, and program acceptability by qualitative interviews and program evaluation. Twenty one families were enrolled over 16 months, with fourteen families (n = 42 individuals) completing the study. Post-program dietary changes in the intervention group included small daily increases in vegetable serves (0.8 ± 1.3) and reduced usage of full-fat milk (-21%), cheese (-12%) and meat products (-17%). Qualitative interviews highlighted beneficial changes in food purchasing habits. Future studies need more effective methods of recruitment to engage families in the intervention. Once engaged, families made small incremental improvements in their diets. Evaluation indicated that feedback on diet and CVD risk factors, dietetic counselling and the resources provided were appropriate for a program of this type.

  10. Feasibility of Recruiting Families into a Heart Disease Prevention Program Based on Dietary Patterns

    Directory of Open Access Journals (Sweden)

    Tracy L. Schumacher

    2015-08-01

    Full Text Available Offspring of parents with a history of cardiovascular disease (CVD inherit a similar genetic profile and share diet and lifestyle behaviors. This study aimed to evaluate the feasibility of recruiting families at risk of CVD to a dietary prevention program, determine the changes in diet achieved, and program acceptability. Families were recruited into a pilot parallel group randomized controlled trial consisting of a three month evidence-based dietary intervention, based on the Mediterranean and Portfolio diets. Feasibility was assessed by recruitment and retention rates, change in diet by food frequency questionnaire, and program acceptability by qualitative interviews and program evaluation. Twenty one families were enrolled over 16 months, with fourteen families (n = 42 individuals completing the study. Post-program dietary changes in the intervention group included small daily increases in vegetable serves (0.8 ± 1.3 and reduced usage of full-fat milk (−21%, cheese (−12% and meat products (−17%. Qualitative interviews highlighted beneficial changes in food purchasing habits. Future studies need more effective methods of recruitment to engage families in the intervention. Once engaged, families made small incremental improvements in their diets. Evaluation indicated that feedback on diet and CVD risk factors, dietetic counselling and the resources provided were appropriate for a program of this type.

  11. Cardiovascular adaptations in weightlessness: The influence of in-flight exercise programs on the cardiovascular adjustments during weightlessness and upon returning to Earth

    Science.gov (United States)

    Bennett, C. H.

    1981-01-01

    The effect of in-flight exercise programs on astronauts' cardiovascular adjustments during spaceflight weightlessness and upon return to Earth was studied. Physiological changes in muscle strength and volume, cardiovascular responses during the application of lower body negative pressure, and metabolic activities during pre-flight and flight tests were made on Skylab crewmembers. The successful completion of the Skylab missions showed that man can perform submaximal and maximal aerobic exercise in the weightless enviroment without detrimental trends in any of the physiologic data. Exercise tolerance during flight was unaffected. It was only after return to Earth that a tolerance decrement was noted. The rapid postflight recovery of orthostatic and exercise tolerance following two of the three Skylab missions appeared to be directly related to total in-flight exercise as well as to the graded, regular program of exercise performed during the postflight debriefing period.

  12. 49 CFR 198.35 - Grants conditioned on adoption of one-call damage prevention program.

    Science.gov (United States)

    2010-10-01

    ... prevention program. 198.35 Section 198.35 Transportation Other Regulations Relating to Transportation... Prevention Program § 198.35 Grants conditioned on adoption of one-call damage prevention program. In... considers whether a State has adopted or is seeking to adopt a one-call damage prevention program...

  13. A SCHOOL-BASED INTERVENTION PROGRAM FOR IMPROVING THE RISK FACTORS FOR CARDIOVASCULAR DISEASE AT AGES 12 TO 16.

    Directory of Open Access Journals (Sweden)

    Konstantinos Laparidis

    2010-06-01

    Full Text Available Background. Cardiovascular disease begins in childhood and this can be correlated with the presence of risk factors in adults. It is reasonable to initiate healthful lifestyle training in childhood to promote improved cardiovascular health in adult life. The purpose of the study was to evaluate the effectiveness of a school-basedprogram designed to reduce specific modifiable risk factors for preventing cardiovascular diseases.Methods. The sample was 343 students (160 boys, 183 girls aged 12–16 years from the prefecture of Larissa, Greece. The duration of intervention was 1 school year. The practical part of intervention took place during the class of physical education, while the theoretical part took place in the classroom. Measurements weretaken at the beginning, in the middle and at the end of the intervention. The following parameters were measured: weight, height, blood pressure, heart rate, components of the Healthy Eating Index, VO2max,Fitnessgram test battery (1 mile run-walk, trunk lift, push up, curl up, back saver sit and reach.Results. There were significant differences between the school-groups in the 1 mile run walk (p<0,001,90o push up test (p<0,001, Healthy Eating Index (p<0,001, fruit component (p<0,001, saturated fat intake(p<0,05 and variety component (p<0,001. In the intervention group there was significant increase in VO2max(p<0,05, in the weight (p<0,001, in the Healthy Eating Index (p<0,05, in the trunk lift test (p<0,001, in the push up test (p<0,05, in the sit and reach test (p<0,001 and in the component of fruits (p<0,001, while there was significant reduction in the 1 mile run walk test (p<0,001, in the body mass index (p<0,05 and in the component of saturated fat (p<0,05.Conclusion. The intervention program was successfully implemented in schools and there were many significant and positive effects. These results highlight the importance of multicomponent programs for theprevention of CVD in schools. Additional

  14. Eating Disorder Prevention Programs: A Meta-Analytic Review

    Science.gov (United States)

    Stice, Eric; Shaw, Heather

    2004-01-01

    This meta-analysis of eating disorder prevention programs found that intervention effects ranged from an absence of any effects to reductions in current and future eating pathology. Certain effects persisted as long as 2 years and were superior to minimal-intervention control conditions. Larger effects occurred for selected (vs. universal),…

  15. Using Youth Participatory Evaluation to Improve a Bullying Prevention Program

    Science.gov (United States)

    Duke, Adrienne M.; Sollie, Donna L.; Silva, Kelcie

    2016-01-01

    We conducted a youth participatory evaluation of a bullying prevention curriculum before the curriculum was implemented in communities. We partnered with youths from a young women leaders' program to reduce the number of lessons in an existing curriculum and determine which activities were likely to have the greatest impact. To evaluate the…

  16. NCI Community Oncology Research Program Approved | Division of Cancer Prevention

    Science.gov (United States)

    On June 24, 2013, the National Cancer Institute (NCI) Board of Scientific Advisors approved the creation of the NCI Community Oncology Research Program (NCORP). NCORP will bring state-of-the art cancer prevention, control, treatment and imaging clinical trials, cancer care delivery research, and disparities studies to individuals in their own communities. |

  17. U.S. Teachers' Perceptions of School Violence Prevention Programs

    Science.gov (United States)

    Chestnut, Natakie

    2016-01-01

    In response to high profile violent incidents and crimes, many schools have developed plans that address school discipline to create a school climate and culture wherein everyone is valued and treated with respect. The problem that prompted this study is teachers are struggling with effectively implementation prevention program. The purpose of…

  18. A Primary Prevention Program: Teaching Models I and II.

    Science.gov (United States)

    Harlan, Nancy T; Tschiderer, Patricia A.

    Two teaching models of a service delivery program designed to prevent speech-language problems in lower socioeconomic children were compared. Specific goals included increasing mothers' awareness of the sensory input to which infants are responsive and increasing mothers' abilities to read infant nonverbal signals. In Model 1, two speech-language…

  19. Developing a Culturally Appropriate Depression Prevention Program: Opportunities and Challenges

    Science.gov (United States)

    Cardemil, Esteban V.; Kim, Saeromi; Davidson, Tatiana; Sarmiento, Ingrid A.; Ishikawa, Rachel Zack; Sanchez, Monica; Torres, Sandra

    2010-01-01

    This paper describes the experiences of the first author and his colleagues in the development and implementation of a depression prevention program that specifically targets Latina mothers. Building on the earlier papers that highlight the underutilization of mental health services by Latinos in general, this paper will make the case that the…

  20. DETERMINANTS OF PREVENTIVE BEHAVIOR REGARDING CARDIOVASCULAR DISEASES AND RISK FACTORS IN PATIENTS WITH ESSENTIAL HYPERTENSION AND CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    D. Yu. Platonov

    2011-01-01

    Full Text Available Aim. To analyze potential determinants of preventive behavior (PB in patients with essential hypertension (HT and chronic ischemic heart disease (CIHD, and to establish their significance and hierarchy. Material and methods. Patients with HT (n=285 and CIHD (n=223 were studied. Questioning of all patients was performed to assess the characteristics of their PB. Differentiated multivariate analysis of activity and efficacy of PB determinants was performed in HT and CIHD patients by the method of step-by-step backward logistic regression. Results. Awareness of the cardiovascular diseases (CVD and its prevention (odds ratio [OR] 6.08 as well as high level of general education (OR=2.29 were the most significant determinants of active PB in HT patients. Sufficient social support (OR=3.77, awareness of CVD and its prevention (OR=3.16 were the most significant determinants of active PB in patients with CIHD. Efficacy of PB in patients with HT and CIHD mostly depends on satisfaction of medical service (OR=10.2 and 6.63, respectively, social support (OR=6.25 and 10.5, respectively, adequate awareness of CVD and its prevention (OR, 6.92 and 6.64, respectively. Conclusion. PB activity and efficacy in patients with HT and CIHD depends on many contributing and impeding factors. Disregarding these factors can result in failure in preventive efforts at both individual and population levels.

  1. APOPTOSIS: MUERTE CELULAR PROGRAMADA. ASPECTOS ENERALES Y SU RELACIÓN CON LAS ENFERMEDADES CARDIOVASCULARES / Apoptosis: programmed cellular death. General aspects and its relation with cardiovascular diseases.

    Directory of Open Access Journals (Sweden)

    Mirka Navas Contino

    2009-06-01

    Full Text Available The apoptosis is a very important and definitive form of cellular death, and has a close relation with cardiovascular diseases. A review of this topic is made in this work taking into account not only the antecedents of this process but also the general aspects involved in it. One of the main challenges for cardiovascular medicine in the next decades is to prevent the development of cardiacinsufficiency. To achieve this goal it will be necessary to increase the knowledge on the mechanisms which signal the beginning and evolution of the functional deterioration of the myocardium. The overcoming of these difficulties could turn the apoptosis into a paradigmatic example of the cellular-molecular approach which nowadays is a must for the understanding of the heart and blood vessels diseases.

  2. Celecoxib-related gastroduodenal ulcer and cardiovascular events in a randomized trial for gastric cancer prevention

    Institute of Scientific and Technical Information of China (English)

    Guo-Shuang Feng; Harry HX Xia; Ji-You Li; Shiu Kum Lam; Wei-Cheng You; Jun-Ling Ma; Benjamin CY Wong; Lian Zhang; Wei-Dong Liu; Kai-Feng Pan; Lin Shen; Xiao-Dong Zhang; Jie Li

    2008-01-01

    AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind,placebo-controlled study.METHODS: From 2004 to 2006, a total of 1024 Chinese patients (aged 35 to 64 years) with severe chronic atrophic gastritis, intestinal metaplasia or dysplasia were randomly assigned to receive 200 mg of celecoxib twice daily or placebo in Linqu County (Shandong Province, China), a high-risk area of gastric cancer. All gastroduodenal ulcer and cardiovascular events occurred were recorded and the patients were followed up for 1.5 years after treatment. At the end of the trial, a systematic interview survey about other adverse events was conducted.RESULTS: Gastroduodenal ulcer was detected in 19 of 463 (3.72%) patients who Received: celecoxib and 17 of 473 (3.31%) patients who Received placebo,respectively (odds ratio = 1.13, 95% CI = 0.58-2.19).Cardiovascular (CV) events occurred in 4 patients who received celecoxib and in 5 patients who received placebo,respectively.Compared with those who received placebo,patients who received celecoxib had no significant increase in occurrence of Cvevents (hazard ratio = 0.84,95% CI =0.23-3.15).Among the adverse events acquired by interview survey,only the frequency of bloating was significantly higher in patients treated with celecoxib than in those treated with placebo.CONCLUSION:Treatment of gastric cancer with celecoxib is not associated with increased risk of gastroduodenal ulcer and cardiovascular events.

  3. Functional Foods and Nutraceuticals in the Primary Prevention of Cardiovascular Diseases

    OpenAIRE

    Alissa, Eman M.; Gordon A Ferns

    2012-01-01

    Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Dietary factors are important in the pathogenesis of CVD and may to a large degree determine CVD risk, but have been less extensively investigated. Functional foods are those that are thought to have physiological benefits and/or reduce the risk of chronic disease beyond their basic nutritional functions. The food industry has started to market products labelled as “functional foods.” Alth...

  4. [Breastfeeding as a method to prevent cardiovascular diseases in the mother and the child].

    Science.gov (United States)

    Aguilar Cordero, María José; Madrid Baños, Nayra; Baena García, Laura; Mur Villar, Norma; Guisado Barrilao, Rafael; Sánchez López, Antonio Manuel

    2015-05-01

    Introducción: La lactancia materna es una práctica recomendada desde las instituciones sanitarias nacionales e internaciones, debido a los beneficios que reporta para la salud, tanto del lactante como de la madre. Se ha comprobado que los problemas cardiovasculares de las madres que lactan son menores que las de aquellas que no lo han hecho nunca, entre ellos, la hipertensión arterial. Objetivo: El objetivo de esta revisión es analizar los estudios que han investigado la lactancia materna, como protección frente a los problemas cardiovasculares de la madre y el niño. Métodos: Se ha efectuado una búsqueda sistemática y se seleccionaron 12 meta-análisis o revisiones, 7 artículos originales de ensayos clínicos, 39 estudios de cohorte o longitudinales y 14 estudios correlacionales de muestra amplia y descriptivos. Resultados/conclusión: La enfermedad cardiovascular es la principal causa de muerte de las mujeres en todo el mundo. La dieta, el ejercicio, dejar de fumar y el control de la presión arterial son todos reconocidos como elementos clave en la prevención de las enfermedades cardiovasculares. Se ha demostrado que la lactancia materna influye positivamente en los niveles de la presión arterial materna y del niño, tanto a corto como a largo plazo. Es, pues, necesario facilitar más información a la población para promocionar la lactancia materna y conocer así sus beneficios.

  5. Angiotensin II receptor blockers and cardiovascular protection: Focus on left ventricular hypertrophy regression and atrial fibrillation prevention

    Directory of Open Access Journals (Sweden)

    Cesare Cuspidi

    2008-02-01

    Full Text Available Cesare Cuspidi1,2, Francesca Negri2, Alberto Zanchetti31Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy; 2Policlinico di Monza; 3Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Università di Milano, and Istituto Auxologico Italiano, Milan, ItalyAbstract: Left ventricular hypertrophy (LVH and atrial fibrillation (AF are strong predictors of cardiovascular (CV morbidity and mortality, independently of blood pressure levels and other modifiable and nonmodifiable risk factors. The actions of circulating and tissue angiotensin II, mediated by AT1 receptors, play an important role in the development of a wide spectrum of cardiovascular alterations, including LVH, atrial enlargement and AF. Growing experimental and clinical evidence suggests that antihypertensive drugs may exert different effects on LVH regression and new onset AF in the setting of arterial hypertension. Since a number of large and adequately designed studies have found angiotensin II receptor blockers (ARBs to be more effective in reducing LVH than beta-blockers and data are also available showing their effectiveness in preventing new or recurrent AF, it is reasonable to consider this class of drugs among first line therapies in patients with hypertension and LVH (a very high risk phenotype predisposing to AF and as adjunctive therapy to antiarrhythmic agents in patients undergoing pharmacological or electrical cardioversion of AF.Keywords: angiotensin II receptor blockers, left ventricular hypertrophy, atrial fibrillation

  6. Factors associated with the completion of falls prevention program.

    Science.gov (United States)

    Batra, Anamica; Page, Timothy; Melchior, Michael; Seff, Laura; Vieira, Edgar Ramos; Palmer, Richard C

    2013-12-01

    Falls and fear of falling can affect independence and quality of life of older adults. Falls prevention programs may help avoiding these issues if completed. Understanding factors that are associated with completion of falls prevention programs is important. To reduce fear of falling and increase activity levels, a Matter of Balance (MOB) and un Asunto de Equilibrio (ADE) workshops were offered to 3420 older adults in South Florida between 1 October 2008 and 31 December 2011. Workshops were conducted in English or Spanish over eight, 2-hour sessions. Participants completed a demographic and a pre-post questionnaire. Factors associated with program completion were identified using logistic regression. For MOB, females were more likely to complete the program (OR = 2.076, P = 0.02). For ADE, females, moderate and extreme interference by falls in social activities were found to affect completion (OR = 2.116, P = 0.001; OR = 2.269, P = 0.003 and OR = 4.133, P = 0.008, respectively). Different factors predicted completion of both programs. Awareness of these factors can help lower the attrition rates, increase benefits and cost effectiveness of program. Future research needs to explore why certain groups had a higher likelihood of completing either program.

  7. Functional Foods and Nutraceuticals in the Primary Prevention of Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Eman M. Alissa

    2012-01-01

    Full Text Available Cardiovascular disease (CVD is now the leading cause of death globally and is a growing health concern. Dietary factors are important in the pathogenesis of CVD and may to a large degree determine CVD risk, but have been less extensively investigated. Functional foods are those that are thought to have physiological benefits and/or reduce the risk of chronic disease beyond their basic nutritional functions. The food industry has started to market products labelled as “functional foods.” Although many review articles have focused on individual dietary variables as determinants of CVD that can be modified to reduce the risk of CVD, the aim of this current paper was to examine the impact of functional foods in relation to the development and progression of CVD. Epidemiologic studies have demonstrated the association between certain dietary patterns and cardiovascular health. Research into the cardio-protective potential of their dietary components might support the development of functional foods and nutraceuticals. This paper will also compare the effect of individual bioactive dietary compounds with the effect of some dietary patterns in terms of their cardiovascular protection.

  8. Functional foods and nutraceuticals in the primary prevention of cardiovascular diseases.

    Science.gov (United States)

    Alissa, Eman M; Ferns, Gordon A

    2012-01-01

    Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Dietary factors are important in the pathogenesis of CVD and may to a large degree determine CVD risk, but have been less extensively investigated. Functional foods are those that are thought to have physiological benefits and/or reduce the risk of chronic disease beyond their basic nutritional functions. The food industry has started to market products labelled as "functional foods." Although many review articles have focused on individual dietary variables as determinants of CVD that can be modified to reduce the risk of CVD, the aim of this current paper was to examine the impact of functional foods in relation to the development and progression of CVD. Epidemiologic studies have demonstrated the association between certain dietary patterns and cardiovascular health. Research into the cardio-protective potential of their dietary components might support the development of functional foods and nutraceuticals. This paper will also compare the effect of individual bioactive dietary compounds with the effect of some dietary patterns in terms of their cardiovascular protection.

  9. Successful Bullying Prevention Programs: Influence of Research Design, Implementation Features, and Program Components

    Directory of Open Access Journals (Sweden)

    Bryanna Hahn Fox

    2012-12-01

    Full Text Available Bullying prevention programs have been shown to be generally effective in reducing bullying and victimization. However, the effects are relatively small in randomized experiments and greater in quasi-experimental and age-cohort designs. Programs that are more intensive and of longer duration (for both children and teachers are more effective, as are programs containing more components. Several program components are associated with large effect sizes, including parent training or meetings and teacher training. These results should inform the design and evaluation of anti-bullying programs in the future, and a system ofaccreditation of effective programs.

  10. Gender related differences in treatment and response to statins in primary and secondary cardiovascular prevention: The never-ending debate.

    Science.gov (United States)

    Cangemi, Roberto; Romiti, Giulio Francesco; Campolongo, Giuseppe; Ruscio, Eleonora; Sciomer, Susanna; Gianfrilli, Daniele; Raparelli, Valeria

    2017-03-01

    Statins are a main curbstone in the prevention of cardiovascular disease (CVD), pandemic in 21st century. CVD displays evident sex and gender differences, not only in clinical manifestation and outcomes but also in pharmacological treatment. Whether statin therapy should be differentially prescribed according to sex is a matter of debate. Aside a different pharmacological action, statins are not proven to be less effective in one gender comparing to the other, nor to be less safe. Nevertheless, up to date evidence shows that statins have not been adequately tested in women, especially in primary prevention trials. Since data-lacking, making a treatment decision on women is potentially harmful, although female individuals represent the majority of the population and they have a greater lifetime CVD risk. Therefore, adequately powered randomized control trials with longer follow-up are warranted to establish if a benefit on CV events and mortality prevention exists in both sexes. The aim of the present review is to summarize the sex and gender differences in statin use: it raises concerns and updates perspectives towards an evidence-based and sex-tailored prevention of CVD management.

  11. Suicide prevention program for the elderly: the experience in Japan.

    Science.gov (United States)

    Ono, Yutaka

    2004-03-01

    In this article, the author describes a suicide prevention program for the elderly in Japan carried out in a small town, Nagawamachi, Aomori. Because of the recent sharp increase in this town in the rate of suicides, we started to develop a suicide prevention program with the goal of trying to detect depression in its early stages. At first we adopted various questionnaires and used structured interviews, and then developed a screener for depression. Screening is an important part of our suicide prevention program, because elderly who are suicidal often do not recognize their distress is a treatable medical condition, partly due to a negative image of mental illness, and most of them do not seek medical help. The author underscores the importance of educational programs to address how to recognize the symptoms of depression and to develop a community network for the elderly to communicate with locals and support each other. It is also important to focus on a social schema to produce a society that respects "being" and not just "doing".

  12. EDUCATIONAL INTERVENTION FOR THE CARDIOVASCULAR PREVENTION IN ADOLESCENTS OF SECONDARY BASIC.

    Directory of Open Access Journals (Sweden)

    Yuri Arnold Domínguez

    2011-08-01

    Full Text Available Fundamento: Los estilos de vida saludables incorporados de manera temprana, podrían actuar sobre las más importantes conductas y factores de riesgo para la enfermedad vascular aterosclerótica, con el objeto de disminuir la incidencia de esta en la edad adulta. Objetivo: Evaluar la efectividad de la intervención educativa-participativa en los conocimientos de los estudiantes en relación a los factores de riesgos cardiovasculares. Material: Se realizó una intervención educativa, con un diseño cuasiexperimental, en el período comprendido entre Abril de 2007 y Octubre de 2008, en estudiantes de octavo grado de Secundarias Básicas de los municipios Habana Vieja (grupo intervenido y Centro Habana (grupo control. Se utilizaron la Pruebas no paramétricas de Chi cuadrado de Mc Nemar y Mantel- Haenszel. Resultados: Se obtuvieron asociaciones estadísticas significativas con un límite de confianza de un 95 %, entre el estado inicial y final de los conocimientos en relación a los factores de riesgos cardiovasculares en el grupo intervenido (p=0,0001, en el grupo de control (p=0,035 y entre el grupo estudio con respecto al grupo control post-intervención (p=0,0001. Conclusiones: Un programa educativo-participativo de promoción de salud y prevención de los principales factores de riesgos de enfermedad cardiovascular (hábitos alimentarios inadecuados, tabaquismo y sedentarismo en los adolescentes, contribuye a que cambien sus conocimientos, e incentiva la adopción de hábitos cotidianos y estilos de vida saludables.

  13. YOUNGSTER’S ATTITUDES TO SCHOOL-BASED PREVENTION PROGRAMS FOCUSED ON DRUG ABUSE PREVENTION

    Directory of Open Access Journals (Sweden)

    Barbora Odraskova

    2016-09-01

    Full Text Available paper focuses on primary prevention of drug addiction, in particular the primary prevention programs implemented in school environments. It contains the results of a quantitative research conducted using a non-standardized questionnaire method. The study objective was to identify differences in attitudes of a group of pupils towards the issue of drug addiction before and after they completed the school-based prevention program. The study found that after completing the school-based prevention program there was improvement in attitudes towards the issue of drug addiction in the specific group of pupils. The number of appropriate answers to the question “Alcohol makes people happy” increased by 18.82 %. respondents (62.70% disagreed that they would adapt themselves if their opinion differed to the majority. The number of positive answers to the question “Smoking is addictive” increased by 13.66%; the number of positive answers to the question “Drinking alcohol is harmful” increased by 24.93%; and all respondents agreed with the statement that smoking threatens health.

  14. The potential impact of new national guidance on primary prevention of cardiovascular disease in people living with HIV

    Directory of Open Access Journals (Sweden)

    Nadia Ahmed

    2014-11-01

    Full Text Available Introduction: Cardiovascular disease (CVD is the leading cause of death in England and Wales. As people living with HIV (PLWH age, proactive management of CVD risk factors is crucial. The long-awaited draft guidelines for CVD from the National Institute of Clinical Excellence (NICE propose lipid modification (with statins and lifestyle modification for 40–74 year olds with >10% (previously >20% 10-year risk of CVD using QRISK2. We currently use Framingham so compared 3 CVD risk calculators in our cohort and analyzed the impact of a change in CVD threshold on the proportion of our patients who would need intervention. Materials and Methods: Framingham, QRISK2 and JBS3 cardiovascular risk calculators were compared in a group of randomly selected patients. Then, to analyze the impact of a change in primary prevention threshold on our cohort, we interrogated a prospectively collected database to identify all individuals who had a documented Framingham risk assessment and applied the current/proposed thresholds accordingly. We performed the same analysis for the three calculator subgroup (recalculating Framingham risk. Finally we surveyed HIV services in England & Wales regarding their choice of calculator. Results: We compared the 3 CVD risk calculators in 100 patients, see Table 1.In terms of eligibility for primary prevention 20.9% (916/4383 had documented Framingham risk assessment as part of routine care. Using a 20% threshold, 8.8% (81/916 would require intervention, increasing to 35.2% (322/916 with a threshold for intervention of 10%. Restricting analysis to the 100 patients to whom we applied all three calculators resulted in the following proportion requiring intervention with a 20%/10% threshold, respectively: Framingham 28%/76%, QRISK2 20%/53%, JBS3 15%/42% (four patients were excluded due to incomplete data. Conclusions: Reducing the threshold for cardiovascular preventative measures to 10% vastly increases the number of patients

  15. Geocoding and social marketing in Alabama's cancer prevention programs.

    Science.gov (United States)

    Miner, Julianna W; White, Arica; Lubenow, Anne E; Palmer, Sally

    2005-11-01

    The Alabama Department of Public Health (ADPH) is collaborating with the National Cancer Institute to develop detailed profiles of underserved Alabama communities most at risk for cancer. These profiles will be combined with geocoded data to create a pilot project, Cancer Prevention for Alabama's Underserved Populations: A Focused Approach. The project's objectives are to provide the ADPH's cancer prevention programs with a more accurate and cost-effective means of planning, implementing, and evaluating its prevention activities in an outcomes-oriented and population-appropriate manner. The project links geocoded data from the Alabama Statewide Cancer Registry with profiles generated by the National Cancer Institute's cancer profiling system, Consumer Health Profiles. These profiles have been successfully applied to market-focused cancer prevention messages across the United States. The ADPH and the National Cancer Institute will evaluate the efficacy of using geocoded data and lifestyle segmentation information in strategy development and program implementation. Alabama is the first state in the nation not only to link geocoded cancer registry data with lifestyle segmentation data but also to use the National Cancer Institute's profiles and methodology in combination with actual state data.

  16. Significance of Cardiac Rehabilitation on Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Krutika Gajjar

    2012-06-01

    Full Text Available Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medication,blood pressure control, diabetes management and stress management. The exercise component of a totalapproach to rehabilitation helps to overcome the fears and anxieties that so many people experience aftera heart attack. Aerobic exercise training program improves cardiovascular fitness in both healthyindividual and cardiac patients. Cardiac rehabilitation prevents and treat cardiovascular disease, reducescardiac risk factors, improving patient’s exercise capacity and enhancing quality of life. Aerobicexercise with intensity of approximately 60 to 70% of the maximal heart rate for 30 to 60 minutes, 3 to 4times a week, for 4 to 6 weeks enhances exercise capacity.

  17. Protect your heart: a culture-specific multimedia cardiovascular health education program.

    Science.gov (United States)

    Shah, Amy; Clayman, Marla L; Glass, Sara; Kandula, Namratha R

    2015-04-01

    South Asians, the second fastest growing racial/ethnic minority in the United States, have high rates of coronary heart disease. Few coronary heart disease prevention efforts target this population. The authors developed and tested a culture-specific, multimedia coronary heart disease prevention education program in English and Hindi for South Asians. Participants were recruited from community organizations in Chicago, Illinois, between June and October of 2011. Bilingual interviewers used questionnaires to assess participants' knowledge and perceptions before and after the patient education program. The change from pretest score to posttest score was calculated using a paired t test. Linear regression was used to determine the association between posttest scores and education and language. Participants' (N = 112) average age was 41 years, 67% had more than a high school education, and 50% spoke Hindi. Participants' mean pretest score was 15 (SD = 4). After the patient education program, posttest scores increased significantly among all participants (posttest score = 24, SD = 4), including those with limited English proficiency. Lower education was associated with a lower posttest score (β = -2.2, 95% CI [-0.68, -3.83]) in adjusted regression. A culture-specific, multimedia patient education program significantly improved knowledge and perceptions about coronary heart disease prevention among South Asian immigrants. Culturally salient multimedia education may be an effective and engaging way to deliver health information to diverse patient populations.

  18. 49 CFR 198.37 - State one-call damage prevention program.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false State one-call damage prevention program. 198.37... REGULATIONS FOR GRANTS TO AID STATE PIPELINE SAFETY PROGRAMS Adoption of One-Call Damage Prevention Program § 198.37 State one-call damage prevention program. A State must adopt a one-call damage...

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

    Directory of Open Access Journals (Sweden)

    Vanessa Blanco

    2014-04-01

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

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

    Science.gov (United States)

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

    2014-04-04

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

  1. Results of a focused scald-prevention program.

    Science.gov (United States)

    Cagle, Kathleen M; Davis, James W; Dominic, William; Gonzales, Wendy

    2006-01-01

    Scalds are a leading cause of burn injury for young children. A focused prevention program was developed in the zip code accounting for the majority of scald burns. This study investigated the effect of the program. Families in the high-risk area were identified at clinics, community centers, and schools. Parent workshops and home visits were the interventions used. A pretest was administered at the workshop to measure baseline knowledge. A post-test was administered at either the home visit or by telephone to measure change in knowledge. A survey was used to measure baseline scald risks in the home. Home visits were used to reinforce information from workshops, evaluate the home environment, and assist parents to make environmental changes. Changes to the home environments were made, with antiscald devices installed in the shower, sink, or bathtub depending on parent preference. The survey was repeated on a follow-up home visit to determine whether parents adhered to environmental changes and safety practices. The postmeasurements were performed from 6 to 12 months after the initial measurement. More than 900 parents attended the initial workshops, and 173 consented to participate in the follow-up study and took the pretest. Of these, 62 completed the post-test, and 48 participated in a home visit. The mean pretest score was 72 +/- 1%, and mean post-test score was 85 +/- 1% (P burns in the homes in which the focused prevention program took place. This study demonstrates that a focused burn-prevention program can identify high-risk groups, decrease the number of scald risks per home, and decrease the rate of scald burns in the population. This straightforward program could be used to intervene in high-risk groups in other communities.

  2. Saturated Fats Versus Polyunsaturated Fats Versus Carbohydrates for Cardiovascular Disease Prevention and Treatment.

    Science.gov (United States)

    Siri-Tarino, Patty W; Chiu, Sally; Bergeron, Nathalie; Krauss, Ronald M

    2015-01-01

    The effects of saturated fatty acids (SFAs) on cardiovascular disease (CVD) risk are modulated by the nutrients that replace them and their food matrices. Replacement of SFAs with polyunsaturated fatty acids has been associated with reduced CVD risk, although there is heterogeneity in both fatty acid categories. In contrast, replacement of SFAs with carbohydrates, particularly sugar, has been associated with no improvement or even a worsening of CVD risk, at least in part through effects on atherogenic dyslipidemia, a cluster of traits including small, dense low-density lipoprotein particles. The effects of dietary SFAs on insulin sensitivity, inflammation, vascular function, and thrombosis are less clear. There is growing evidence that SFAs in the context of dairy foods, particularly fermented dairy products, have neutral or inverse associations with CVD. Overall dietary patterns emphasizing vegetables, fish, nuts, and whole versus processed grains form the basis of heart-healthy eating and should supersede a focus on macronutrient composition.

  3. Health system barriers and facilitators to medication adherence for the secondary prevention of cardiovascular disease: a systematic review

    Science.gov (United States)

    Banerjee, Amitava; Khandelwal, Shweta; Nambiar, Lavanya; Saxena, Malvika; Peck, Victoria; Moniruzzaman, Mohammed; Faria Neto, Jose Rocha; Quinto, Katherine Curi; Smyth, Andrew; Leong, Darryl; Werba, José Pablo

    2016-01-01

    Background Secondary prevention is cost-effective for cardiovascular disease (CVD), but uptake is suboptimal. Understanding barriers and facilitators to adherence to secondary prevention for CVD at multiple health system levels may inform policy. Objectives To conduct a systematic review of barriers and facilitators to adherence/persistence to secondary CVD prevention medications at health system level. Methods Included studies reported effects of health system level factors on adherence/persistence to secondary prevention medications for CVD (coronary artery or cerebrovascular disease). Studies considered at least one of β blockers, statins, angiotensin–renin system blockers and aspirin. Relevant databases were searched from 1 January 1966 until 1 October 2015. Full texts were screened for inclusion by 2 independent reviewers. Results Of 2246 screened articles, 25 studies were included (12 trials, 11 cohort studies, 1 cross-sectional study and 1 case–control study) with 132 140 individuals overall (smallest n=30, largest n=63 301). 3 studies included upper middle-income countries, 1 included a low middle-income country and 21 (84%) included high-income countries (9 in the USA). Studies concerned established CVD (n=4), cerebrovascular disease (n=7) and coronary heart disease (n=14). Three studies considered persistence and adherence. Quantity and quality of evidence was limited for adherence, persistence and across drug classes. Studies were concerned with governance and delivery (n=19, including 4 trials of fixed-dose combination therapy, FDC), intellectual resources (n=1), human resources (n=1) and health system financing (n=4). Full prescription coverage, reduced copayments, FDC and counselling were facilitators associated with higher adherence. Conclusions High-quality evidence on health system barriers and facilitators to adherence to secondary prevention medications for CVD is lacking, especially for low-income settings. Full prescription coverage

  4. Effects of an aerobic exercise program on driving performance in adults with cardiovascular disease.

    Science.gov (United States)

    Gaudet, Jeffrey; Mekary, Saïd; Bélanger, Mathieu; Johnson, Michel

    2016-06-01

    Cardiovascular disease (CVD) has been linked to decreases in driving performance and an increased crash risk. Regular exercise has been linked to improved driving performance among healthy adults. The aim of the current study was to investigate the relationship between a 12-week cardiac rehabilitation (CR) program and driving performance among individuals with CVD. Twenty-five individuals, including 12 cardiac adults and 13 healthy adults, took part in this study. Simulated driving performance was assessed using a standardized demerit-based scoring system at 0 and 12 weeks. Cardiac participants completed a 12-week CR program between evaluations. At baseline, cardiac participants had a higher number of demerit points than healthy adults (120.9±38.1 vs. 94.7±28.3, P=0.04). At follow-up, there was an improvement in both groups' driving evaluations, but the improvement was greater among the cardiac group such that there was no longer a difference in driving performance between both groups (94.6±30 vs. 86.9±34.8, P=0.51). Participation in an aerobic exercise-based CR program appears to lead to improvements in simulated driving performances of individuals with CVD.

  5. Developmental programming of cardiovascular dysfunction by prenatal hypoxia and oxidative stress.

    Directory of Open Access Journals (Sweden)

    Dino A Giussani

    Full Text Available Fetal hypoxia is a common complication of pregnancy. It has been shown to programme cardiac and endothelial dysfunction in the offspring in adult life. However, the mechanisms via which this occurs remain elusive, precluding the identification of potential therapy. Using an integrative approach at the isolated organ, cellular and molecular levels, we tested the hypothesis that oxidative stress in the fetal heart and vasculature underlies the molecular basis via which prenatal hypoxia programmes cardiovascular dysfunction in later life. In a longitudinal study, the effects of maternal treatment of hypoxic (13% O(2 pregnancy with an antioxidant on the cardiovascular system of the offspring at the end of gestation and at adulthood were studied. On day 6 of pregnancy, rats (n = 20 per group were exposed to normoxia or hypoxia ± vitamin C. At gestational day 20, tissues were collected from 1 male fetus per litter per group (n = 10. The remaining 10 litters per group were allowed to deliver. At 4 months, tissues from 1 male adult offspring per litter per group were either perfusion fixed, frozen, or dissected for isolated organ preparations. In the fetus, hypoxic pregnancy promoted aortic thickening with enhanced nitrotyrosine staining and an increase in cardiac HSP70 expression. By adulthood, offspring of hypoxic pregnancy had markedly impaired NO-dependent relaxation in femoral resistance arteries, and increased myocardial contractility with sympathetic dominance. Maternal vitamin C prevented these effects in fetal and adult offspring of hypoxic pregnancy. The data offer insight to mechanism and thereby possible targets for intervention against developmental origins of cardiac and peripheral vascular dysfunction in offspring of risky pregnancy.

  6. Is suicide prevention possible? An evaluation of a prevention program among high school students

    OpenAIRE

    Córdova Moreno, María José Cubillas Rpdríguez, Rosario Román Pérez, María Alejandra; Centro d eInvestigacíon en Alimentación y Desarrollo, A.C. (CIAD, A.C.)

    2012-01-01

    To evaluate a secondary prevention program of suicide risk behavior in educated adolescentsand their families using a familial democratization focus. Method. A prospective, exploratory study in which participative methodology (reflection-action workshops) was employed; and a pre and post test evaluation of 81 secondary and tertiary education students and their families was applied. Results. A level-based analysis was used to note that some participants improved notably both in their levels of...

  7. The Role of Behavioral Counseling in STD Prevention Program Settings

    Science.gov (United States)

    Brookmeyer, Kathryn A.; Hogben, Matthew; Kinsey, Jennine

    2015-01-01

    Background Behavioral counseling for STD prevention is recommended for persons at risk, and the body of evidence yields numerous interventions that have STD preventive efficacy. What is needed is a review of the subset of these interventions that could be feasible in clinical settings, especially settings in STD prevention programs. Methods We reviewed existing systematic reviews of the literature and abstracted from them studies that fit the following criteria in that the interventions: (1) used no more than 60 minutes contact time in 1 to 2 sessions, (2) were individual-level and face to face, (3) took place in a clinical setting, (4) had STD outcomes available, (5) were based in the United States, (6) were peer-reviewed, and (7) had a control group. Results From 6 reviews (published 2006 – 2014) covering 91 studies, we found 13 analyses representing 11 intervention studies that fit the selection criteria. Of these 13, 5 returned lower STD rates in the intervention group at follow-up; one study reported a higher rate of STD in one subset of the intervention group (men who have sex with men: MSM). Studies with effects on STD at follow-up were quite similar to studies across populations, settings and follow-up periods, although successful interventions were more likely to demonstrate behavioral effects as well (5 of 5 versus 2 of 5 among 10 interventions measuring behavior change). Conclusions Counseling is likely to benefit some STD clinic attendees, although unlikely to benefit MSM. The balance of costs and benefits of implementing behavioral counseling in STD programs is unclear, but feasibility would be improved if behavioral counseling were implemented in the context of other prevention efforts. Because populations outside typical STD clinic settings could also benefit, programs may exercise a valuable role through partnerships. PMID:26779681

  8. Maternal citrulline supplementation prevents prenatal dexamethasone-induced programmed hypertension.

    Science.gov (United States)

    Tain, Y L; Sheen, J M; Chen, C C; Yu, H R; Tiao, M M; Kuo, H C; Huang, L T

    2014-05-01

    Glucocorticoids are administered to premature infants to accelerate pulmonary maturation. In experimental model, prenatal dexamethasone (DEX) results in reduced nephron number and adulthood hypertension. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase (NOS), can cause oxidative stress and is involved in the development of hypertension. L-citrulline can be converted to l-arginine (the substrate for NOS) in the body. Thus we intended to determine if maternal L-citrulline therapy can prevent prenatal DEX-induced programmed hypertension by restoration ADMA/nitric oxide (NO) balance, alterations of renin-angiotensin system (RAS) and sodium transporters, and epigenetic regulation by histone deacetylases (HDACs). Male offspring were assigned to four groups: control, pregnancy rats received intraperitoneal DEX (0.2 mg/kg body weight) daily on gestational days 15 and 16 (DEX), pregnancy rats received 0.25% L-citrulline in drinking water during the entire pregnancy and lactation period (CIT), and DEX + CIT. We found DEX group developed hypertension at 16 weeks of age, which was prevented by maternal L-citrulline therapy. Prenatal DEX exposure increased plasma ADMA concentrations and reduced renal NO production. However, L-citrulline reduced plasma ADMA level and increased renal level of NO in DEX + CIT group. Next, prenatal DEX-induced programmed hypertension is related to increased mRNA expression of angiotensin and angiotensin II type 1 receptor, and class I HDACs in the kidney. Prenatal DEX exposure increased renal protein abundance of Na(+)/Cl(-) cotransporter (NCC), which was prevented by L-citrulline therapy. The beneficial effects of L-citrulline therapy include restoration of ADMA/NO balance and alteration of NCC, to prevent the prenatal DEX-induced programmed hypertension.

  9. Cardiovascular Disease Self-Management: Pilot Testing of an mHealth Healthy Eating Program

    Directory of Open Access Journals (Sweden)

    Leila Pfaeffli Dale

    2014-03-01

    Full Text Available Cardiac rehabilitation (CR is crucial in the management of cardiovascular disease (CVD, yet attendance is poor. Mobile technology (mHealth offers a potential solution to increase reach of CR. This paper presents two development studies to determine mobile phone usage in adults with CVD and to evaluate the acceptability of an mHealth healthy eating CR program. Methods: CR attendees were surveyed to determine mobile phone usage rates. A second single-subject pilot study investigated perceptions of a 4-week theory-based healthy eating mHealth program and explored pre-post changes in self-efficacy. Results: 74 adults with CVD completed the survey (50/74 male; mean age 63 ± 10. Nearly all had mobile phones (70/74; 95% and used the Internet (69/74; 93%, and most were interested in receiving CR by text message (57/74; 77%. 20 participants took part in the healthy eating pilot study. Participants read all/most of the text messages, and most (19/20 thought using mobile technology was a good way to deliver the program. The website was not widely used as visiting the website was reported to be time consuming. Exploratory t-tests revealed an increase in heart healthy eating self-efficacy post program, in particular the environmental self-efficacy subset (Mean = 0.62, SD = 0.74, p = 0.001. Conclusions: Text messaging was seen as a simple and acceptable way to deliver nutrition information and behavior change strategies; however, future research is needed to determine the effectiveness of such programs.

  10. Preventive Adolescent Health Care in Family Practice: A Program Summary

    Directory of Open Access Journals (Sweden)

    Barry Knishkowy

    2006-01-01

    Full Text Available The AMA Guidelines for Adolescent Preventive Services (GAPS has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice–based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC program targeted all adolescent patients aged 12—18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57% of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.

  11. Doctors' knowledge, attitudes, and compliance with 2013 ACC/AHA guidelines for prevention of atherosclerotic cardiovascular disease in Singapore

    Directory of Open Access Journals (Sweden)

    Setia S

    2015-06-01

    Full Text Available Sajita Setia,1 Selwyn Sze-Wang Fung,2 David D Waters3 1Medical Affairs, Pfizer Pte Ltd, Singapore; 2Regional Medical Affairs, Pfizer Pte Ltd, Hong Kong; 3Department of Medicine, University of California, San Francisco, CA, USA Purpose: There is an unmet need for strategies to prevent atherosclerotic cardiovascular disease in Singapore. The main objective of this study was to investigate Singapore physicians’ response to the 2013 American College of Cardiology and American Heart Association (ACC/AHA guidelines for treatment of cholesterol and their impact on clinical practice. Methods: This survey was conducted in two stages, qualitative and quantitative. Physicians were initially screened on the basis of an initial screener questionnaire, and eligible physicians were then included in the study. Results: Qualitative (n=19 and quantitative (n=66 surveys were completed by eligible physicians from Singapore. Physicians were less familiar with the 2013 ACC/AHA guidelines (35% as compared with the Singapore Ministry of Health (MoH lipid guidelines 2006 (49%. Of the physicians whose opinion was sought on the ACC/AHA guidelines, more than 50% disagreed with the definition of high-, moderate-, and low-intensity statin therapy; recommendation of atorvastatin 40–80 mg and rosuvastatin 20–40 mg as medications for high-intensity statin therapy; and classification of individuals who would benefit from moderate- to high-intensity statin therapy. Most physicians assumed that Asians may be intolerant to high-intensity statin therapy. Conclusion: Although embracing the 2013 ACC/AHA guidelines in clinical practice is expected to provide better clinical care to patients, our study revealed high reluctance by physicians, especially in the use of high-dose statins. However, ACC/AHA guidelines can be easily adopted in Asia as there is a wealth of data available for atorvastatin in primary and secondary prevention of atherosclerotic cardiovascular disease with

  12. Economic evaluation of statins in high-risk patients treated for primary and secondary prevention of cardiovascular disease in Greece

    Directory of Open Access Journals (Sweden)

    Fragoulakis V

    2012-05-01

    Full Text Available Vassilis Fragoulakis, Georgia Kourlaba, Nikolaos ManiadakisDepartment of Health Services and Management, National School of Public Health, Athens, GreeceBackground: An economic evaluation was undertaken in order to assess several therapeutic alternatives (rosuvastatin, atorvastatin, simvastatin, and pravastatin for the prevention of primary and secondary cardiovascular events in high-risk patients in Greece.Methods: A probabilistic Markov model with five distinct states provided estimates over a 20-year time span. The relative effectiveness of comparators was based on the literature. The HellenicSCORE risk equation was used to forecast survival. The transition probabilities from acute myocardial infarction or stroke to death were estimated with reference to the Framingham study. In addition, Framingham scores were used to calculate the probability of nonfatal acute myocardial infarction or nonfatal stroke. Costs were estimated from the perspective of sickness funds and included direct medical costs valued in the year 2012. The total treatment cost accounted for the cost of drugs, routine examinations, and resources expended in the management of acute myocardial infarction, stroke, and death. The utility decrements used are those for the Greek population. A supplementary budget impact analysis was also conducted.Results: The mean discounted quality-adjusted life years in the case of males for the rosuvastatin arm were 10.18 versus 10.04, 9.94, and 9.88 for atorvastatin, simvastatin, and pravastatin, respectively. The mean total cost was €15,392, €16,438, €17,009, and €17,356 for rosuvastatin, atorvastatin, simvastatin, and pravastatin, respectively. Similar results were obtained in the case of females, while all analyses demonstrated a statistically significant difference at the 95% level of significance. The total burden of 100% (single use of rosuvastatin in a hypothetical cohort of 100 male patients for one year was €1.47 million

  13. [Differences between the 2013 and 2014 hypertension guidelines.: Position of the Central American and Caribbean Society for Hypertension and Cardiovascular Prevention].

    Science.gov (United States)

    Morales-Salinas, Alberto; Wyss, Fernando; Coca, Antonio; Ramírez, Agustín J; Valdez, Osiris; Valerio, Luis F

    2015-03-01

    Between the end of 2013 and the beginning of 2014 the most internationally influential hypertension guidelines were published. Although there are no major differences between them, there are discrepancies that can have an impact on treatment and prognosis for individuals with hypertension. This article analyzes the main controversial elements in the guides and presents the recommendations of the Sociedad Centroamericana y del Caribe de Hipertensión y Prevención Cardiovascular (Caribbean Society for Hypertension and Cardiovascular Prevention). The main differences are found a) in the categorization of prehypertension, b) in the use of global cardiovascular risk in the decision to begin antihypertensive treatment, c) in the validity of beta-blockers as first-line drugs in treating uncomplicated hypertension, and d) the increase in the therapeutic goal of maintaining values between global cardiovascular risk. Finally, seven recommendations by the Society based on the analysis are included.

  14. A Fitness Intervention Program within a Physical Education Class on Cardiovascular Endurance among Malaysia Secondary School Students

    Science.gov (United States)

    Rengasamy, Shabeshan; Raju, Subramaniam; Lee, Wee Akina Sia Seng; Roa, Ramachandran

    2014-01-01

    The aim of the study was to investigate the effect of a physical fitness intervention program within a physical education class on cardiovascular endurance of Malaysian secondary school boys and girls. A quasi experimental design was adopted for the study. Two schools in a district were randomly selected. In each school, two classes were randomly…

  15. Consensus document regarding cardiovascular safety at sports arenas: position stand from the European Association of Cardiovascular Prevention and Rehabilitation (EACPR), section of Sports Cardiology

    NARCIS (Netherlands)

    Borjesson, M.; Serratosa, L.; Carre, F.; Corrado, D.; Drezner, J.; Dugmore, D.L.; Heidbuchel, H.H.; Mellwig, K.P.; Panhuyzen-Goedkoop, N.M.; Papadakis, M.; Rasmusen, H.; Sharma, S.; Solberg, E.E.; Buuren, F. van; Pelliccia, A.

    2011-01-01

    Mass gathering events in sports arenas create challenges regarding the cardiovascular safety of both athletes and spectators. A comprehensive medical action plan, to ensure properly applied cardiopulmonary resuscitation, and wide availability and use of automated external defibrillators (AEDs), is e

  16. Preventing a Cardiovascular Disease Epidemic among Indigenous Populations through Lifestyle Changes

    Directory of Open Access Journals (Sweden)

    Lee Stoner

    2012-01-01

    Full Text Available Cardiovascular disease (CVD is the driving force behind the discrepancy in life expectancy between indigenous and non-indigenous groups in many countries. Preceding CVD many indigenous groups exhibit a cluster of cardiometabolic risk factors, including overweight-obesity, diabetes, high cholesterol, and high blood pressure. In turn, modifiable lifestyle risk factors contribute to the development of this cluster of cardiometabolic conditions. Modifiable lifestyle risk factors include, but are not limited to, physical inactivity, poor nutrition, excessive alcohol consumption, and cigarette smoking. Notably, these metabolic and lifestyle risk factors are relatively simple to monitor and track. The current review will look at modifiable cardiometabolic (overweight-obesity, diabetes mellitus, high cholesterol, and high blood pressure and lifestyle (physical inactivity, poor nutrition, risky alcohol behavior, and cigarette smoking risk factors among indigenous populations from Australia (Aboriginal Australians and Torres Strait Islanders, New Zealand (Mβori and the United States (Native Americans. Discussion will focus on the causal relationship between modifiable lifestyle risk factors and cardiometabolic outcomes, as well as, simple measurements for tracking these risk factors.

  17. The role of lifestyle change for prevention of cardiovascular disease in diabetes.

    Science.gov (United States)

    Staimez, Lisa R; Weber, Mary Beth; Gregg, Edward W

    2014-12-01

    The burden of cardiovascular disease (CVD) is disproportionately greater in those with diabetes than in the general population, including higher rates of hospitalization, stroke, myocardial infarction, and mortality. Health-promoting lifestyle factors reduce both diabetes and CVD in healthy individuals; however, the efficacy of these strategies for CVD reduction in people with preexisting diabetes is unclear. In this review, we describe the most recent evidence (2013-2014) surrounding the effects of lifestyle changes on CVD outcomes in those with diabetes, and we contextualize the evidence against a backdrop of earlier key findings. Two major randomized controlled trials were identified, providing opposing conclusions about the role of lifestyle factors on CVD events in those with diabetes. Other recent prospective observational analyses support associations of physical activity and reduced CVD risk in diabetes. Limitations across studies include the use of self-report for measurement of lifestyle or lifestyle change, the length of follow-up needed to measure CVD outcomes, and the role of participants' medications on associations of lifestyle factors and CVD outcomes. Equivocal findings from the two randomized controlled trials support the need for additional research to identify the specific lifestyle factors that reduce CVD mortality and macrovascular complications in populations with diabetes.

  18. Educational program for the prevention and management of school violence

    Directory of Open Access Journals (Sweden)

    Viriam Leiva Díaz

    2013-04-01

    Full Text Available This article presents the main results of the implementation of an educational program for the preventionand management of violence in public schools by teachers of first and second cycle, the program was taught bythe School of Nursing at the University of Costa Rica, with a total of 40 hours from January to February 2011. Weused various teaching strategies based on the educational needs of this group of teachers, which were shown in aprevious study and application of a needs assessment. Attended by 33 teachers, 32 women and one man. Of theparticipants, 30 completed the program. The main results are as follows: participants were able to acquire, buildor improve their knowledge about the prevention and treatment of school violence, and also learned varioustechniques and strategies for prevention and control of violence in schools. It is concluded that success inachieving the goals set for each of the sessions is directly related to the fact that the entire educational programstuck to the educational needs expressed by the participating population and its characteristics as teachers, usingprinciples of andragogy, which allowed understanding learning as a knowledge sharing among stakeholders

  19. Impact of rivaroxaban on stent thrombosis and secondary prevention of cardiovascular events in acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Krohn-Grimberghe M

    2014-05-01

    Full Text Available Marvin Krohn-Grimberghe, Christoph Bode, Constantin von zur MuhlenDepartment of Cardiology and Angiology I, Heart Center, University of Freiburg, GermanyAbstract: Angioplasty and stent implantation have greatly improved the outcome of patients with acute coronary syndrome. However, stents come with the risk of stent thrombosis, which is associated with a high rate of revascularization, myocardial infarction, and death. The inhibition of factor Xa due to rivaroxaban leads to an interruption of the intrinsic as well as the extrinsic coagulation pathway, which reduces thrombus formation as a potential mechanism to diminish the rate of stent thrombosis. In this review, we evaluate the role of rivaroxaban in the prevention of stent thrombosis and its general role in patients with acute coronary syndrome.Keywords: Rivaroxaban, stent thrombosis, acute coronary syndrome, secondary prevention

  20. The 'new genetics' in blood and cardiovascular research: applications to prevention and treatment.

    Science.gov (United States)

    Motulsky, A G

    1984-11-01

    Genetic approaches have become an important component of both fundamental and disease-oriented research. Certain diseases of the blood--the hemoglobinopathies--have been elucidated by the spectacular methods of molecular genetics. Some of these advances have already been incorporated in disease management. Often, common conditions such as coronary heart disease and hypertension show familial aggregation. Genetic analysis of these diseases together with biochemical and molecular methods are likely to be useful for further understanding and ultimate prevention and control.

  1. Analysis of industrial pollution prevention programs in selected Asian countries

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, S.Y. [Argonne National Lab., IL (United States). Environmental Assessment Div.]|[East-West Center, Honolulu, HI (United States)

    1995-05-01

    Industrialization in developing countries is causing increasing environmental damage. Pollution prevention (P2) is an emerging environmental concept that could help developing countries achieve leapfrog goals, bypassing old and pollutive technologies and minimizing traditional control practices. The current P2 promotion activities in Hong Kong, the Republic of Korea, the Philippines, Singapore, Taiwan, and Thailand are discussed. These programs, generally initiated in the last 5 years, are classified into five categories: awareness promotion, education and training, information transfer, technical assistance, and financial incentives. All important at the early stages of P2 promotion, these programs should inform industries of the benefits of P2 and help them identify applicable P2 measures. Participation in these programs is voluntary. The limited data indicate that adoption of P2 measures in these countries is not yet widespread. Recommendations for expanding P2 promotion activities include (1) strengthening the design and enforcement of environmental regulations; (2) providing P2 training and education to government workers, nongovernmental organizations and labor unions officials, university faculties, and news media; (3) tracking the progress of P2 programs; (4) implementing selected P2 mandatory measures; (5) identifying cleaner production technologies for use in new facilities; (6) implementing special programs for small and medium enterprises; and (7) expanding P2 promotion to other sectors, such as agriculture and transportation, and encouraging green design and green consumerism.

  2. Effect of a nurse-coordinated prevention programme on cardiovascular risk after an acute coronary syndrome: main results of the RESPONSE randomised trial

    NARCIS (Netherlands)

    Jorstad, Harald T.; Birgelen, von Clemens; Alings, A. Marco W.; Liem, Anho; Dantzig, van Jan Melle; Jaarsma, Wiebe; Lok, Dirk J.A.; Kragten, Hans J.A.; Vries, de Keesjan; Milliano, Paul A.R.; Withagen, Adrie J.A.M.; Scholte op Reimer, Wilma J.M.; Tijssen, Jan G.P.; Peters, Ron J.G.

    2013-01-01

    Objective To quantify the impact of a practical, hospital-based nurse-coordinated prevention programme on cardiovascular risk, integrated into the routine clinical care of patients discharged after an acute coronary syndrome, as compared with usual care only. Design RESPONSE (Randomised Evaluatio

  3. An Ounce of Prevention, a Pound of Uncertainty: The Cost-Effectiveness of School-Based Drug Prevention Programs.

    Science.gov (United States)

    Caulkins, Jonathan P.; Rydell, C. Peter; Everingham, Susan S.; Chiesa, James; Bushway, Shawn

    This book describes an analysis of the cost-effectiveness of model school-based drug prevention programs at reducing cocaine consumption. It compares prevention's cost-effectiveness with that of several enforcement programs and with that of treating heavy cocaine users. It also assesses the cost of nationwide implementation of model prevention…

  4. Acupuncture and Traditional Herbal Medicine Therapy Prevent Deliriumin Patients with Cardiovascular Disease in Intensive Care Units.

    Science.gov (United States)

    Matsumoto-Miyazaki, Jun; Ushikoshi, Hiroaki; Miyata, Shusaku; Miyazaki, Nagisa; Nawa, Takahide; Okada, Hideshi; Ojio, Shinsuke; Ogura, Shinji; Minatoguchi, Shinya

    2017-02-23

    The aim of this study was to determine the effect of combination therapy consisting of acupuncture and traditional herbal medicine (Kampo medicine) for reducing the incidence rate of delirium in patients with cardiovascular (CV) disease in ICUs. Twenty-nine patients who had been urgently admitted to the ICU in the control period were treated with conventional intensive care. Thirty patients in the treatment period received conventional therapy plus a combination therapy consisting of acupuncture and herbal medicine. Acupuncture treatment was performed once a day, and the herbal formula was administered orally three times a day during the first week of the ICU stay. The standard acupuncture points were GV20, Ex-HN3, HT7, LI4, Liv3, and KI3, and the main herbal preparation was Kamikihito. The incident rates of delirium, assessed using the confusion assessment method for ICU, in the treatment and control period were compared. The incidence rate of delirium was significantly lower in the treatment group than in the control group (6.6% vs. 37.9%, [Formula: see text]). Moreover, sedative drugs and non-pharmacological approaches against aggressive behavior of patients who were delirious were used less in the treatment group than in the control group. No serious adverse events were observed in the treatment group. Combination therapy consisting of acupuncture and herbal medicine was found to be effective in lowering the incidence of delirium in patients with CV disease in ICUs. Further studies with a large sample size and parallel randomized controlled design would be required to establish the effects of this therapy.

  5. Cardiovascular disease prevention for underserved patients using the Internet: bridging the digital divide.

    Science.gov (United States)

    Masucci, Michele M; Homko, Carol; Santamore, William P; Berger, Philip; McConnell, Timothy R; Shirk, Gail; Menapace, Francis; Bove, Alfred A

    2006-02-01

    For underserved populations, telemedicine can address the high prevalence and suboptimal control of cardiovascular disease (CVD) risk factors. However, Internet access issues may limit the successful application of telemedicine. We tested the hypothesis that computer skills, and not access per se, was the main obstacle to using the Internet for health care. After informed consent, 44 participants with little or no computer experience received 2 hours of training covering 14 basic computer use skills, Internet access, and our telemedicine system. The telemedicine system enables reporting blood pressure, weight, physical activity, cigarette use, provider feedback, personal medication information, and educational information about CVD risk factors. The patient population included 12 males and 32 females. Of this total were 23 African Americans. The average patient age was 60.4 +/- 3 years, and 64% had annual family incomes under 25,000 dollars. Eighty-two percent of the participants averaged 4 or higher (on a scale of 1 to 5) on basic computer skills. Only 11% had an average score below 3. Thirty-seven of 44 participants reported on their health status from a local Internet access site within 10 days. Participants' successful use of the telemedicine system was not correlated with age, gender, education level, or ownership of a computer. Computer skill score had a positive effect on system use. Underserved populations without computer experience or skills and at increased risk for CVD can be educated to use an Internet telemedicine system to communicate health status to their health care providers. Ownership of a computer was not a factor that predicted system use.

  6. Industrial pollution prevention programs in selected developing Asian countries

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, Shen-yann [Argonne National Lab., IL (United States)]|[East-West Center, Honolulu, HI (United States)

    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 environmental management alternatives.

  7. Participation in Prevention Programs for Dating Violence: Beliefs about Relationship Violence and Intention to Participate

    Science.gov (United States)

    Cornelius, Tara L.; Sullivan, Kieran T.; Wyngarden, Nicole; Milliken, Jennifer C.

    2009-01-01

    This study utilizes the Health Belief Model (HBM) to examine the factors related to the intention to participate in prevention programming for dating violence. Perceptions of susceptibility to future violence and the benefits of prevention programming appear to be the strongest predictors of participation in prevention programs. Perceptions of the…

  8. 10 CFR Appendix A to Part 850 - Chronic Beryllium Disease Prevention Program Informed Consent Form

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent Form A Appendix A to Part 850 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850—Chronic Beryllium Disease Prevention Program...

  9. Sustaining Teen Pregnancy Prevention Programs in Schools: Needs and Barriers Identified by School Leaders

    Science.gov (United States)

    Craft, Lesley R.; Brandt, Heather M.; Prince, Mary

    2016-01-01

    Background: To reduce teen pregnancy rates, prevention programs must be consistently available to large numbers of youth. However, prevention efforts have been historically conducted with little emphasis on ensuring program sustainability. This study examined the needs and barriers to sustaining teen pregnancy prevention (TPP) programming in…

  10. Pathology supported genetic testing and treatment of cardiovascular disease in middle age for prevention of Alzheimer's disease.

    Science.gov (United States)

    Kotze, Maritha J; van Rensburg, Susan J

    2012-09-01

    Chronic, multi-factorial conditions caused by a complex interaction between genetic and environmental risk factors frequently share common disease mechanisms, as evidenced by an overlap between genetic risk factors for cardiovascular disease (CVD) and Alzheimer's disease (AD). Single nucleotide polymorphisms (SNPs) in several genes including ApoE, MTHFR, HFE and FTO are known to increase the risk of both conditions. The E4 allele of the ApoE polymorphism is the most extensively studied risk factor for AD and increases the risk of coronary heart disease by approximately 40%. It furthermore displays differential therapeutic responses with use of cholesterol-lowering statins and acetylcholinesterase inhibitors, which may also be due to variation in the CYP2D6 gene in some patients. Disease expression may be triggered by gene-environment interaction causing conversion of minor metabolic abnormalities into major brain disease due to cumulative risk. A growing body of evidence supports the assessment and treatment of CVD risk factors in midlife as a preventable cause of cognitive decline, morbidity and mortality in old age. In this review, the concept of pathology supported genetic testing (PSGT) for CVD is described in this context. PSGT combines DNA testing with biochemical measurements to determine gene expression and to monitor response to treatment. The aim is to diagnose treatable disease subtypes of complex disorders, facilitate prevention of cumulative risk and formulate intervention strategies guided from the genetic background. CVD provides a model to address the lifestyle link in most chronic diseases with a genetic component. Similar preventative measures would apply for optimisation of heart and brain health.

  11. Promoting dietary change in the Stockholm Cancer Prevention Program.

    Science.gov (United States)

    Kanström, L; Holm, L E

    1992-01-01

    The Stockholm Cancer Prevention Program (SCPP) is a community-based program aimed at reducing cancer incidence and mortality by reducing risk factors related to life-style: dietary habits, tobacco use, and sunbathing. The program, which came about as a result of a political initiative and commitment, has as its dietary objectives to reduce fat intake to 30% of energy and to increase fiber intake to 30 g/day. SCPP strives to achieve these goals by simultaneously affecting food supply and food demand. To date, the program collaborates with 12 municipalities and several large occupational health services and restaurant chains. It has developed cook books for caterers and the general public and has organized food fairs targeting policymakers and those working with food, education, or health promotion. SCPP emphasizes collaboration across sectors of society and has initiated contests for students studying food service technology and for retailers with the aim of promoting dietary change. The intervention is based on the principles and strategies of community organization.

  12. The effectiveness of community-based programs for obesity prevention and control

    Directory of Open Access Journals (Sweden)

    Teixeira ME

    2011-12-01

    Full Text Available Elizabeth TeixeiraDrexel University College of Nursing and Health Professions, Philadelphia, PA, USAAbstract: Obesity is a major public health concern worldwide. The increasing prevalence of obesity in all ages, especially children and adolescents, has gained global attention and it is widely known that obesity increases the risk of many chronic conditions and illnesses, such as Type 2 Diabetes Mellitus (T2DM and cardiovascular disease (CVD. Obesity is a complex metabolic disorder, however, that is difficult to treat and manage. Therefore, despite the increased awareness about obesity-related health risks, obesity prevention and control has been a major challenge for health professionals. Lifestyle modification is easily prescribed, however, multiple barriers to implementation exist. Barriers include but are not limited to: behavioral and motivational factors, anti-fat bias, access to and reimbursement of educational programs, availability of healthy affordable foods, ongoing support systems that are culturally and community attuned, and comorbidities that limit physical activity and quality of life. Further, the current health care systems are not all designed to focus on health promotion and wellness. These contributing factors complicate weight management and control. Community-based programs are one potentially feasible approach that can assist individuals, families, and communities in developing healthy behaviors that promote and maintain weight loss. This review reports on nine worldwide current studies on the effectiveness of community-based programs in diverse populations targeting obesity. The purpose of this review is to examine evidenced-based interventions that can assist in the development of standard practices in the battle against obesity.Keywords: obesity, community, prevention, physical activity, nutrition

  13. Conceptualizing community mobilization for HIV prevention: implications for HIV prevention programming in the African context.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Community mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation.We aimed to identify the key domains of community mobilization (CM essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting.We studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge.CM DOMAINS INCLUDE: 1 shared concerns, 2 critical consciousness, 3 organizational structures/networks, 4 leadership (individual and/or institutional, 5 collective activities/actions, and 6 social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks.To date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural South Africa. While some adaptation of

  14. Moving Child Abuse and Neglect Prevention Programs Forward: Improving Program Evaluations.

    Science.gov (United States)

    Fink, Arlene; McCloskey, Lois

    1990-01-01

    Thirteen evaluations of programs to prevent child abuse and neglect are reviewed. The evaluations were characterized by careful attention to methodologic detail but lacked definitions of abuse or neglect. Important topics are omitted, such as the consequences and costs of medical neglect. (Author/JDD)

  15. 78 FR 20411 - Supplemental Nutrition Assistance Program: Nutrition Education and Obesity Prevention Grant Program

    Science.gov (United States)

    2013-04-05

    ... Obesity Prevention Grant Program AGENCY: Food and Nutrition Service (FNS), USDA. ACTION: Interim rule... that promote healthy food choices consistent with the current Dietary Guidelines for Americans (DGAs... the likelihood that SNAP participants and eligible low-income people will make healthy food...

  16. Community based prevention programs targeting all injuries for children

    Science.gov (United States)

    Spinks, A; Turner, C; McClure, R; Nixon, J

    2004-01-01

    Objective: Community based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in reducing all-cause injury in children 0–14 years of age. Methods: A comprehensive search of the literature was performed using the following study selection criteria: community based intervention study; children under 14 years; outcome measure was injury rates; and either a community control or an historical control was used in the design. Quality assessment and data abstraction were guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies. Results: Thorough electronic and library search techniques yielded only nine formally evaluated community based all-cause child injury prevention programs that have reported actual injury outcomes. Of these nine studies, seven provided high level evidence where contemporary control communities were used for comparison; the remaining two used a pre and post-design or time trend analysis where historical data from the community were used as the comparison. Only three of the seven studies with contemporary control communities found significant effect of the intervention; the two studies without controls noted significant reductions in injury rates after the intervention period. Conclusion: There is a paucity of research from which evidence regarding the effectiveness of community based childhood injury prevention programs can be obtained and hence a clear need to increase the effort on developing this evidence base. PMID:15178676

  17. Childhood socioeconomic position, young adult intelligence and fillings of prescribed medicine for prevention of cardiovascular disease in middle-aged men

    DEFF Research Database (Denmark)

    Kriegbaum, Margit; Kildemoes, Helle Wallach; Rasmussen, Jeppe Nørgaard;

    2014-01-01

    OBJECTIVES: To explore the relationship between childhood socioeconomic position (SEP) and filling of medicine prescriptions for prevention of cardiovascular diseases (CVDs), with young adult intelligence (IQ) as a potential mediator. DESIGN: Birth cohort study with logistic and Cox-proportional ......OBJECTIVES: To explore the relationship between childhood socioeconomic position (SEP) and filling of medicine prescriptions for prevention of cardiovascular diseases (CVDs), with young adult intelligence (IQ) as a potential mediator. DESIGN: Birth cohort study with logistic and Cox......-proportional hazard regression analyses of associations between childhood SEP, retrieved from birth certificates, and prevalence, initiation of and refill persistency for CVD preventive medicine. SETTING: Denmark. PARTICIPANTS: 8736 Danish men born in 1953, who had no CVD at the start of follow-up in 1995, were...

  18. Programs and Place: Risk and Asset Mapping for Fall Prevention

    Science.gov (United States)

    Smith, Matthew Lee; Towne, Samuel D.; Motlagh, Audry S.; Smith, Donald R.; Boolani, Ali; Horel, Scott A.; Ory, Marcia G.

    2017-01-01

    Identifying ways to measure access, availability, and utilization of health-care services, relative to at-risk areas or populations, is critical in providing practical and actionable information to key stakeholders. This study identified the prevalence and geospatial distribution of fall-related emergency medical services (EMS) calls in relation to the delivery of an evidence-based fall prevention program in Tarrant County, Texas over a 3-year time period. It aims to educate public health professionals and EMS first respondents about the application of geographic information system programs to identify risk-related “hot spots,” service gaps, and community assets to reduce falls among older adults. On average, 96.09 (±108.65) calls were received per ZIP Code (ranging from 0 calls to 386 calls). On average, EMS calls per ZIP Code increased from 30.80 (±34.70) calls in 2009 to 33.75 (±39.58) calls in 2011, which indicate a modest annual call increase over the 3-year study period. The percent of ZIP Codes offering A Matter of Balance/Volunteer Lay Leader Model (AMOB/VLL) workshops increased from 27.3% in 2009 to 34.5% in 2011. On average, AMOB/VLL workshops were offered in ZIP Codes with more fall-related EMS calls over the 3-year study period. Findings suggest that the study community was providing evidence-based fall prevention programming (AMOB/VLL workshops) in higher-risk areas. Opportunities for strategic service expansion were revealed through the identification of fall-related hot spots and asset mapping. PMID:28361049

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Supporting universal prevention programs: a two-phased coaching model.

    Science.gov (United States)

    Becker, Kimberly D; Darney, Dana; Domitrovich, Celene; Keperling, Jennifer Pitchford; Ialongo, Nicholas S

    2013-06-01

    Schools are adopting evidence-based programs designed to enhance students' emotional and behavioral competencies at increasing rates (Hemmeter et al. in Early Child Res Q 26:96-109, 2011). At the same time, teachers express the need for increased support surrounding implementation of these evidence-based programs (Carter and Van Norman in Early Child Educ 38:279-288, 2010). Ongoing professional development in the form of coaching may enhance teacher skills and implementation (Noell et al. in School Psychol Rev 34:87-106, 2005; Stormont et al. 2012). There exists a need for a coaching model that can be applied to a variety of teacher skill levels and one that guides coach decision-making about how best to support teachers. This article provides a detailed account of a two-phased coaching model with empirical support developed and tested with coaches and teachers in urban schools (Becker et al. 2013). In the initial universal coaching phase, all teachers receive the same coaching elements regardless of their skill level. Then, in the tailored coaching phase, coaching varies according to the strengths and needs of each teacher. Specifically, more intensive coaching strategies are used only with teachers who need additional coaching supports, whereas other teachers receive just enough support to consolidate and maintain their strong implementation. Examples of how coaches used the two-phased coaching model when working with teachers who were implementing two universal prevention programs (i.e., the PATHS curriculum and PAX Good Behavior Game [PAX GBG]) provide illustrations of the application of this model. The potential reach of this coaching model extends to other school-based programs as well as other settings in which coaches partner with interventionists to implement evidence-based programs.

  1. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

    Science.gov (United States)

    Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

    2016-05-01

    Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts.

  2. Diet for preventing cardiovascular diseases: light from Ancel Keys, distinguished centenarian scientist.

    Science.gov (United States)

    Mancini, M; Stamler, J

    2004-02-01

    On the great occasion of Professor Ancel Keys' 100th birthday (26 January,2004), it is particularly appropriate--and highly relevant for today and tomorrow--to note the highlights of his professional accomplishments and contributions: the Seven Countries Study (SCS) he initiated and led demonstrated unequivocally in its cross-population analyses that dietary saturated fat intake significantly influences serum cholesterol and the risk of coronary heart disease (CHD), and in turn serum cholesterol relates to CHD risk. In SCS analyses on the several thousand individual participants, it further showed that serum cholesterol, blood pressure, and cigarette smoking all have a continuous, graded, strong, independent, predictive relation to long-term CHD. These data have been critically invaluable for the definition of the major coronary risk factors and low risk status. In scores of metabolic ward feeding trials, Keys and colleagues also demonstrated that dietary saturates and cholesterol relate positively to serum cholesterol, polyunsaturates inversely, and they derived the predictive equation bearing Keys' name. They further showed that increased dietary fiber and weight loss by obese people contribute to reduction of serum cholesterol. All these data served importantly for the development of sound public policy for CHD prevention, and Keys--along with many colleagues all over the world whom he trained and inspired--pioneered in the struggle to achieve and apply that policy in modern public health and medical care.

  3. Vascular radiation therapy using Ho-166 for prevention of cardiovascular restenosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Hee; Choi, Byung Il; Kim, Han Soo; Kim, Won; Chun, Mi Son; Kang, Hae Jin; Oh, Young Taek; Kang, Seung Hee; Cho, Chul Woo [Ajou University, Suwon (Korea, Republic of)

    1997-07-01

    Endovascular irradiation with either a gamma or a beta source has been shown to reduce neo intimal proliferation. However, the effect of external beam radiation (EBR) on neo intimal hyperplasia in the various animal models is controversial. To determine the effect of the different doses of EBR on neo intimal hyperplasia, 36 Sprague-Dawley rats underwent carotid injury by using 2F Fogarty ballon and EBR with doses ranging from 5 to 20 Gy. Rats were= sacrificed after 2 weeks. The arteries were perfusion-fixed in paraformaldehyde. EBR was performed with 6 Mev electrons in a field of 3 x 5 cm using a linear accelerator. The dose was specified to depth of 15 mm. Histomorphometry was performed to compare external elastic lamina (EEL) area (mm2), lumen area (mm2) and neo intimal area (mm2) of the injured segments. ANOVA test was used to compare group means and unpaired t-test to compare low dose group (5-10 Gy) and high dose group (15-20 Gy). No statistically significant difference was found among each group in EEL and lumen area. Low dose EBR has no significant impact on neo intimal hyperplasia in rat carotid injury model. However, neo intimal area is significantly reduced in high dose group (p<0.01) indicating high dose EBR ({>=} 1500 Gy) markedly prevents neo intimal hyperplasia. (Author) 44 refs., 1 tab., 8 figs.

  4. Rationale, design, and baseline characteristics of a trial of prevention of cardiovascular and renal disease with Fosinopril and Pravastatin in nonhypertensive, nonhypercholesterolemic subjects with microalbuminuria (the Prevention of REnal and Vascular ENdstage Disease Intervention Trial [PREVEND IT])

    NARCIS (Netherlands)

    Diercks, GFH; Janssen, WMT; van Boven, AJ; Bak, AAA; de Jong, PE; Crijns, HJGM; van Gilst, WH

    2000-01-01

    This study describes the rationale, design, and baseline characteristics of a trial to determine whether treatment with fosinopril 20 mg/day and/or pravastatin 40 mg/day will prevent cardiovascular and renal disease in nonhypertensive (RR 10 mg/L once in an early morning spot urine and 15 to 300 mg/

  5. Project Hanford Management Contract (PHMC) pollution prevention program implementation plan

    Energy Technology Data Exchange (ETDEWEB)

    Place, B.G., Westinghouse Hanford

    1996-12-31

    This plan documents the Project Hanford Management Contract (PHMC) Pollution Prevention/Waste Minimization (P2/WMin) Program. The subject implementation plan has been updated to reflect the Fiscal Year (FY) 1997 contract structure in which Fluor Daniel Hanford, Inc. (FDH) is the management and integration contractor. The P2/WMin Program scope includes FDH as the principal PHMC contractor, and B&W Hanford Company (BWHC), Duke Engineering & Services Hanford, Inc. (DESH), Lockheed Martin Hanford Corporation, (LMHC), Numatec Hanford Corporation (NHC), Rust Federal Services of Hanford, Inc. (RFSH), and DynCorp Tri-Cities Services, Inc. (DYN) as PHMC contractors, as well as subcontracting enterprise companies, such as Fluor Daniel Northwest, Inc. (FDNW), Lockheed Martin Services, Inc. (LMSI), and Rust Federal Services Northwest (RFS), which provide engineering, operation, construction, maintenance, and computer services for the Hanford Site. The P2/WMin Program scope also includes all other subcontractor-affiliated enterprise companies, such as B&W Protec, Inc. (BWP), DE&S Northwest, Inc. (DESNW), and SGN Eurisys Services Corp. (SESC).

  6. Is carotid artery evaluation necessary for primary prevention in asymptomatic high-risk patients without atherosclerotic cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Kim GH

    2015-07-01

    Full Text Available GeeHee Kim,1 Ho-Joong Youn,2 Yun-Seok Choi,2 Hae Ok Jung,2 Wook Sung Chung,2 Chul-Min Kim1 1Department of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, 2Division of Cardiology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Objective: Routine measurement of the carotid intima–media thickness is not recommended in recent clinical practice guidelines for risk assessment of the first atherosclerotic cardiovascular disease (ASCVD event (the definition of which includes acute coronary syndromes, a history of myocardial infarction, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease presumed to be of atherosclerotic origin. The aim of the present study was to elucidate the role of carotid artery evaluation for primary prevention of ASCVD in asymptomatic high-risk patients visiting a teaching hospital.Methods: Eight hundred seventy-three patients (487 male [55.8%], mean age 59.4±11.5 years who were statin-naive and without ASCVD, which was proven by coronary angiography or coronary CT angiography, were enrolled in this study. The patients underwent carotid scanning in the Medical Department of St Mary’s Hospital from September 2003 to March 2009. ASCVD outcomes were evaluated for median follow-up of 1,402 days.Results: A total of 119 participants experienced ASCVD events. In multivariate Cox regression analysis, age (hazard ratio [HR] =1.026, 95% confidence interval [CI] =1.002–1.050, P=0.033, history of smoking (HR =1.751, 95% CI =1.089–2.815, P=0.021, statin therapy (HR =0.388, 95% CI =0.205–0.734, P=0.004, and carotid plaques (HR =1.556, 95% CI =1.009–2.400, P=0.045 were associated with ASCVD events. In middle-aged group (45≤ age <65, n=473, history of smoking (HR =1.995, 95% CI =1.142–3.485, P=0.015, statin therapy (HR =0.320, 95% CI =0.131

  7. Sandia National Laboratories, California pollution prevention annual program report for calendar year 2005.

    Energy Technology Data Exchange (ETDEWEB)

    Farren, Laurie J. (Sandia National Laboratories, Livermore, CA)

    2005-07-01

    The annual program report provides detailed information about all aspects of the SNL/CA Pollution Prevention Program for a given calendar year. It functions as supporting documentation to the ''SNL/CA Environmental Management System Program Manual''. The 2005 program report describes the activities undertaken during the past year, and activities planned in future years to implement the Pollution Prevention Program, one of six programs that supports environmental management at SNL/CA.

  8. Sandia National Laboratories California Pollution Prevention Program Annual Report February 2008.

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Janet S.; Farren, Laurie J.

    2008-03-01

    The annual program report provides detailed information about all aspects of the SNL/CA Pollution Prevention Program for a given calendar year. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. The program report describes the activities undertaken during the past year, and activities planned in future years to implement the Pollution Prevention Program, one of six programs that supports environmental management at SNL/CA.

  9. Caries risk and prevention: Evaluation of a preventive program in a clinic for children

    Directory of Open Access Journals (Sweden)

    Fábio Correia Sampaio

    2008-01-01

    Full Text Available Objective: The aim of this study was to verify the use of the Nexø caries risk assessment system together with the Cariogram® (School of Dentistry, Malmö, Sweden, in a preventive program for children at the cariology clinic at Federal University of Paraíba. Methods: A sample of 107 children (2- to 14-year-old was attended on two occasions. The patients’ clinical data (DMF-T, dmf-t, Bleeding index, OHI-S and those from the preventive procedures performed (professional cleaning, fluoride application, Cariogram® (School of Dentistry, Malmö, Sweden, Nexø caries risk were collected twice: first from the clinical record cards and on the second occasion by exams. Parents and guardians evaluated the clinical attendance in an interview and the children, by means of a VAS scale. According to the Nexø caries risk assessment system, 53 children (49.5% were classified at low risk (6. Data analysis was carried out using SPSS (11.0. Results: A positive correlation was observed between the two risk systems: Nexø and Cariogram® (School of Dentistry, Malmö, Sweden of chances of avoiding new caries lesions. The possibility of avoiding new caries lesions increased 5% in both groups and a discrete increase was observed in the other parameters. Conclusion: It can be concluded that the Nexø system associated with the Cariogram® (School of Dentistry, Malmö, Sweden, contributed to the assessment of the patients’ caries risk profile and to the success of the preventive program for children at the cariology clinic at Universidade Federal da Paraíba.

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

    Science.gov (United States)

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

    2008-09-01

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

  11. Antihypertensive medication versus health promotion for improving metabolic syndrome in preventing cardiovascular events: a success rate-oriented simulation study

    Directory of Open Access Journals (Sweden)

    Satoh Makiko

    2011-02-01

    Full Text Available Abstract Background In practice, it is difficult to compare the effectiveness of traditional antihypertensive treatment with that of health promotion in reducing incidence rate of cardiovascular disease (IRCVD, events/year. This simulation study compared the effectiveness of two approaches to reducing IRCVD in a sample population: a traditional approach, in which high-risk patients are treated with conventional antihypertensive medications, and a population-based approach, in which subjects participate in a health promotion program. Methods We constructed a simulation model for a sample population of middle-aged Japanese men whose systolic blood pressure (SBP levels are normally distributed (130 ± 20 mm Hg. The principal assumption was that IRCVD increases exponentially according to SBP. The population IRCVD was calculated as the product of the distribution of SBP multiplied by IRCVD at each SBP. The cumulative IRCVD was calculated by the definite integral from the lowest to the highest SBP of IRCVD at each SBP level. The success rates were calculated according to SBP and metabolic risk profiles in the two approaches, respectively. Results The reduction in IRCVD was twice as large for antihypertensive medications as it was for health promotion in several situations. For example, if adherence to antihypertensive treatment occurred at a realistic level, the decrease in IRCVD was estimated at 9.99 × 10-4. In contrast, even if the health program was promoted optimistically, the decrease in IRCVD was estimated at 4.69 × 10-4. Conclusions The success rate-oriented simulation suggests that prescribing antihypertensive medications is superior to promoting the health promotion program in reducing IRCVD in virtual middle-aged Japanese men.

  12. Effect of goal attainment theory based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: Randomized study.

    Science.gov (United States)

    Park, Moonkyoung; Song, Rhayun; Jeong, Jin-Ok

    2017-02-24

    Effect of goal-attainment-theory-based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: randomized study BACKGROUND: The behavioral modification strategies should be explored at the time of admission to lead the maximum effect of cardiovascular risk management.

  13. [Spanish interdisciplinary committee for cardiovascular disease prevention and the spanish society of cardiology position statement on dyslipidemia management. Differences between the European and american guidelines].

    Science.gov (United States)

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-04-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.

  14. Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology Position Statement on Dyslipidemia Management: differences between the European and American Guidelines.

    Science.gov (United States)

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-01-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.

  15. [Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines].

    Science.gov (United States)

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-01-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Full English text available from:www.revespcardiol.org/en.

  16. Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines.

    Science.gov (United States)

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2014-11-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.

  17. Title V Incentive Grants for Local Delinquency Prevention Programs. 2008 Report to Congress

    Science.gov (United States)

    Office of Juvenile Justice and Delinquency Prevention, 2011

    2011-01-01

    The "2008 Title V Report to Congress" marks a departure from the past. Before 2008, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) reported solely on the Community Prevention Grants program in its "Title V Report to Congress." This year, OJJDP is reporting on the four delinquency prevention programs that were…

  18. Are the current recommendations for the use of aspirin in primary prevention of cardiovascular disease applicable in low-income countries?

    Directory of Open Access Journals (Sweden)

    Noubiap JJ

    2015-08-01

    Full Text Available Jean Jacques N Noubiap,1,2 Jobert Richie N Nansseu3,41Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; 2Medical Diagnostic Center, Yaoundé, Cameroon; 3Sickle Cell Disease Unit, Mother and Child Centre, Chantal BIYA Foundation, Yaoundé, Cameroon; 4Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, CameroonAbstract: Although evidence has accumulated that long-term aspirin therapy is beneficial in secondary prevention of cardiovascular disease (CVD, a lot of controversies persist regarding the benefit of aspirin use in primary prevention of CVD. In low-income countries (LIC specifically, the decision to prescribe aspirin for primary CVD prevention is more problematic, as there is a dearth of evidence in this regard. Aspirin has been shown to have relative beneficial effects in preventing a first myocardial infarction, but not stroke. However, as stroke is the prevailing CVD in many LIC, especially in Africa, the benefit of aspirin in these settings is therefore questionable. Indeed, there is no published trial that has evaluated the benefits and risks of continuous aspirin therapy in populations of LIC. Furthermore, though cardiovascular risk assessment is crucial in decision-making for the use of aspirin in primary prevention of CVD, there are no risk assessment tools that have been validated in African populations. Studies are urgently warranted, to determine the usefulness of aspirin in primary prevention of CVD in low-income settings where the drug is highly available and affordable, as CVD is becoming the leading cause of deaths in LIC.Keywords: aspirin, cardiovascular disease, primary prevention, low-income countries

  19. How States are Implementing Evidence-Based Teen Pregnancy Prevention Programs Through the Personal Responsibility Education Program.

    OpenAIRE

    Susan Zief; Rachel Shapiro; Debra Strong

    2014-01-01

    Congress created the Personal Responsibility Education Program (PREP), an initiative to fund evidence-based teen pregnancy prevention programs, in 2010 to help reduce teen pregnancies and their negative consequences. The evaluation will expand the knowledge base on teen pregnancy prevention programs and help to identify decisions, successes, and challenges involved in replicating, adapting, and scaling up evidence-based programs. This issue brief documents key decisions state grantees made ab...

  20. Needlestick Injuries in Agriculture Workers and Prevention Programs.

    Science.gov (United States)

    Buswell, Minden L; Hourigan, Mary; Nault, André J; Bender, Jeffrey B

    2016-01-01

    were nonspecific. NSI in agriculture workers and veterinarians can result in significant bodily injury and loss of work. There is a need for varied and comprehensive educational programs for agricultural workers and veterinarians to prevent NSI on livestock operations.

  1. Feasibility of the Olweus Bullying Prevention Program in Low-Income Schools

    Science.gov (United States)

    Hong, Jun S.

    2009-01-01

    This article examines school response to bullying and youth aggression in upper/middle-class and low socioeconomic neighborhoods, and the feasibility of successfully implementing the Olweus Bullying Prevention Program in schools located in impoverished communities. The Olweus Bullying Prevention Program is one of the few programs that has proven…

  2. Cardiovascular evaluation of middle-aged/ senior individuals engaged in leisure-time sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation.

    Science.gov (United States)

    Borjesson, Mats; Urhausen, Alex; Kouidi, Evangelia; Dugmore, Dorian; Sharma, Sanjay; Halle, Martin; Heidbüchel, Hein; Björnstad, Hans Halvor; Gielen, Stephan; Mezzani, Alessandro; Corrado, Domenico; Pelliccia, Antonio; Vanhees, Luc

    2011-06-01

    Regular aerobic exercise at moderate intensities and an increased physical fitness are associated with a reduced risk of fatal and nonfatal coronary events in middle-aged individuals. In contrast, moderate and vigorous physical exertion is associated with an increased risk for cardiac events, including sudden cardiac death in individuals harbouring cardiovascular disease. The risk-benefit ratio may differ in relation to the individual’s age, fitness level, and presence of cardiovascular disease; sedentary individuals with underlying coronary artery disease are at greatest risk. The intention of the present position stand of the European Association of Cardiovascular Prevention and Rehabilitation is to encourage individuals to participate in regular physical activity and derive the benefits of physical exercise while minimizing the risk of cardiovascular adverse events. Therefore, the aim is to establish the most practical method of cardiovascular evaluation in middle-age/senior individuals, who are contemplating exercise or who are already engaged in nonprofessional competitive or recreational leisure sporting activity. These recommendations rely on existing scientific evidence, and in the absence of such, on expert consensus. The methodology of how middle-aged and older individuals should be evaluated appropriately before engaging in regular physical activity is both complex and controversial. On practical grounds the consensus panel recommend that such evaluation should vary according to the individual’s cardiac risk profile and the intended level of physical activity. Self assessment of the habitual physical activity level and of the risk factors, are recommended for screening of large populations. Individuals deemed to be at risk require further evaluation by a qualified physician. In senior/adult individuals with an increased risk for coronary events, maximal exercise testing (and possibly further evaluations) is advocated. Hopefully, the recommendations

  3. Aspirin and Simvastatin Combination for Cardiovascular Events Prevention Trial in Diabetes (ACCEPT-D: design of a randomized study of the efficacy of low-dose aspirin in the prevention of cardiovascular events in subjects with diabetes mellitus treated with statins

    Directory of Open Access Journals (Sweden)

    Tognoni Gianni

    2007-08-01

    Full Text Available Abstract Background Despite the high cardiovascular risk, evidence of efficacy of preventive strategies in individuals with diabetes is scant. In particular, recommendations on the use of aspirin in patients with diabetes mostly reflect an extrapolation from data deriving from other high risk populations. Furthermore, the putative additive effects of aspirin and statins in diabetes remain to be investigated. This aspect is of particular interest in the light of the existing debate regarding the need of multiple interventions to reduce total cardiovascular risk, which has also led to the proposal of a polypill. Aim of the study is to evaluate the efficacy of aspirin in the primary prevention of major cardiovascular events in diabetic patients candidate for treatment with statins. These preventive strategies will be evaluated on the top of the other strategies aimed at optimizing the care of diabetic patients in terms of metabolic control and control of the other cardiovascular risk factors. Methods/Design The ACCEPT-D is an open-label trial assessing whether 100 mg/daily of aspirin prevent cardiovascular events in patients without clinically manifest vascular disease and treated with simvastatin (starting dose 20 mg/die. Eligible patients will be randomly assigned to receive aspirin + simvastatin or simvastatin alone. Eligibility criteria: male and female individuals aged >=50 years with diagnosis of type 1 or type 2 diabetes, already on treatment with statins or candidate to start the treatment (LDL-cholesterol >=100 mg/dL persisting after 3 months of dietary advise. The primary combined end-point will include cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospital admission for cardiovascular causes (acute coronary syndrome, transient ischemic attack, not planned revascularization procedures, peripheral vascular disease. A total of 515 first events are needed to detect a reduction in the risk of major

  4. Clinical Holistic Medicine: The Dean Ornish Program (“Opening the Heart” in Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2006-01-01

    Full Text Available Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based, exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with holistic medical theories, like the Antonovsky concept of rehabilitating the sense of coherence and the life mission theory for holistic medicine. We believe there is a need for the allocation of resources for further research into the aspects of holistic health and its methods, where positive and significant results have been proven and reproduced at several sites.

  5. Effectiveness of School-based Drug Prevention Programs for Marijuana Use.

    Science.gov (United States)

    Tobler, Nancy S.; Lessard, Terri; Marshall, Diana; Ochshorn, Peter; Roona, Michael

    1999-01-01

    Synthesizes evaluation of drug use programs (N=37) in schools for grades 6-12 by coding program characteristics and calculating weighted effect sizes (WES) for marijuana use. Program type and sample size were found to be significant predictors of program effectiveness. The primary finding for prevention program planning is that interactive…

  6. Nutrição e exercício na prevenção e controle das doenças cardiovasculares Nutrition and exercise on cardiovascular disease prevention and control

    Directory of Open Access Journals (Sweden)

    Ana Beatriz Ribeiro Rique

    2002-12-01

    Full Text Available As doenças cardiovasculares constituem a principal causa de mortalidade no mundo e o seu crescimento significativo nos países em desenvolvimento alerta para o potencial impacto nas classes menos favorecidas. São influenciadas por um conjunto de fatores de risco, alguns modificáveis mediante alterações no estilo de vida, como a dieta adequada e o exercício regular. O objetivo da presente revisão é abordar esses aspectos a fim de prevenir e controlar as doenças cardiovasculares. O consumo de vegetais, frutas, grãos integrais, soja, azeite e peixes deve ser aumentado, ainda que limitando a quantidade de gordura. Os alimentos ricos em ácidos graxos saturados e trans devem ser evitados, assim como o uso excessivo de sal e bebidas alcoólicas. Além do exercício aeróbio, as atividades contra resistência vêm aumentando sua importância na reabilitação cardíaca. Essas mudanças de estilo de vida deveriam ser prioridades na Saúde Pública a fim de deter o avanço das doenças cardiovasculares em nosso país.Cardiovascular diseases represent the major worldwide cause of death, and their significant growth in developing countries alerts against their impact on underprivileged classes. Cardiovascular diseases are subject to a set of risk factors, some of which can be altered through changes in lifestyle, such as balanced diet and regular exercising. The purpose of this review is to approach these factors in order to prevent and control cardiovascular diseases. The consumption of vegetables, fruit, whole grains, soybeans, olive oil, and fish must be increased, although limiting the amount of fat. Saturated and trans fatty acids must be avoided, as well as excessive use of salt and alcoholic beverages. Besides aerobics, resistance training activities are increasing their importance in cardiac rehabilitation. Such lifestyle changes should be prioritized by Public Health authorities in order to hold back cardiovascular disease occurrence in

  7. Sequential cohort design applying propensity score matching to analyze the comparative effectiveness of atorvastatin and simvastatin in preventing cardiovascular events.

    Directory of Open Access Journals (Sweden)

    Arja Helin-Salmivaara

    Full Text Available Sequential cohort design (SCD applying matching for propensity scores (PS in accrual periods has been proposed to mitigate bias caused by channeling when calendar time is a proxy for strong confounders. We studied the channeling of patients according to atorvastatin and simvastatin initiation in Finland, starting from the market introduction of atorvastatin in 1998, and explored the SCD PS approach to analyzing the comparative effectiveness of atorvastatin versus simvastatin in the prevention of cardiovascular events (CVE.Initiators of atorvastatin or simvastatin use in the 45-75-year age range in 1998-2006 were characterized by their propensity of receiving atorvastatin over simvastatin, as estimated for 17 six-month periods. Atorvastatin (10 mg and simvastatin (20 mg initiators were matched 1∶1 on the PS, as estimated for the whole cohort and within each period. Cox regression models were fitted conventionally, and also for the PS matched cohort and the periodically PS matched cohort, to estimate the hazard ratios (HR for CVEs.Atorvastatin (10 mg was associated with a 11%-12% lower incidence of CVE in comparison with simvastatin (20 mg. The HR estimates were the same for a conventional Cox model (0.88, 95% confidence interval 0.85-0.91, for the analysis in which the PS was used to match across all periods and the Cox model was adjusted for strong confounders (0.89, 0.85-0.92, and for the analysis in which PS matching was applied within sequential periods (0.88, 0.84-0.92. The HR from a traditional PS matched analysis was 0.80 (0.77-0.83.The SCD PS approach produced effect estimates similar to those obtained in matching for PS within the whole cohort and adjusting the outcome model for strong confounders, but at the cost of efficiency. A traditional PS matched analysis without further adjustment in the outcome model produced estimates further away from unity.

  8. Pediatric Obesity: It’s Time for Prevention Before Conception Can Maternal Obesity Program Pediatric Obesity?

    Directory of Open Access Journals (Sweden)

    Zach Ferraro

    2008-01-01

    Full Text Available Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI, attenuate gestational weight gain (GWG and reduce postpartum weight retention (PPWR in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D and cardiovascular disease (CVD resulting from maternal obesity.

  9. Rheumatic Fever Prevention Program: long term evolution and outcomes

    Directory of Open Access Journals (Sweden)

    Cleonice Carvalho Coelho Mota

    2015-01-01

    Full Text Available This investigation aims to analyze the profile of long term evolution of rheumatic fever in children and adolescents and outcomes after the control of recurrences. The cohort involved 702 patients followed from 1.3 to 16.9 years covering the two periods, before and after the implementation of a prevention program. Besides the establishment of the Reference Center in the State of Minas Gerais and the implementation of strategies to promote the compliance to prophylaxis, a project for education of health professionals was carried out in 23 cities. In addition to the clinical and epidemiological profile, the severity of the disease was analyzed. Mixed lesions were found in 27.1%, valvar regurgitation in 72.9% and complete regression of the valvar lesions was seen in 34.4% of the patients, mostly presenting mild dysfunctions. The recurrence rate per patient-year was 0,058 and out of a total of 85 recurrences, 21,4% occurred in the first and 7,5% in the second period. More severe degrees of carditis and significant valvar sequels presented a higher prevalence in patients with recurrences. The comparative analysis between the two periods showed no changes regarding the age at the primary attack, gender, type and site of valvar lesions and affected joints; however, important modifications in the indices of severity were observed after the control of recurrences. A significant decrease in the prevalence of severe carditis, obstructive valvar sequels, hospital admissions, surgical approach and deaths was seen. This investigation showed that although the clinical profile of presentation remains unchanged, the control of repeated attacks can improve the morbimortality rates. In this context, the secondary prophylaxis should be the first priority in the control of the disease in developing countries, taking into account the difficulties found for effective primordial and primary prevention. Keywords: rheumatic fever, rheumatic heart disease, secondary

  10. Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam.

    Directory of Open Access Journals (Sweden)

    Thi-Phuong-Lan Nguyen

    Full Text Available To inform development of guidelines for hypertension management in Vietnam, we evaluated the cost-effectiveness of different strategies on screening for hypertension in preventing cardiovascular disease (CVD.A decision tree was combined with a Markov model to measure incremental cost-effectiveness of different approaches to hypertension screening. Values used as input parameters for the model were taken from different sources. Various screening intervals (one-off, annually, biannually and starting ages to screen (35, 45 or 55 years and coverage of treatment were analysed. We ran both a ten-year and a lifetime horizon. Input parameters for the models were extracted from local and regional data. Probabilistic sensitivity analysis was used to evaluate parameter uncertainty. A threshold of three times GDP per capita was applied.Cost per quality adjusted life year (QALY gained varied in different screening scenarios. In a ten-year horizon, the cost-effectiveness of screening for hypertension ranged from cost saving to Int$ 758,695 per QALY gained. For screening of men starting at 55 years, all screening scenarios gave a high probability of being cost-effective. For screening of females starting at 55 years, the probability of favourable cost-effectiveness was 90% with one-off screening. In a lifetime horizon, cost per QALY gained was lower than the threshold of Int$ 15,883 in all screening scenarios among males. Similar results were found in females when starting screening at 55 years. Starting screening in females at 45 years had a high probability of being cost-effective if screening biannually was combined with increasing coverage of treatment by 20% or even if sole biannual screening was considered.From a health economic perspective, integrating screening for hypertension into routine medical examination and related coverage by health insurance could be recommended. Screening for hypertension has a high probability of being cost-effective in

  11. (SPartners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    Directory of Open Access Journals (Sweden)

    Sehnert Scott T

    2008-12-01

    Full Text Available Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA. In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU faculty, clinicians, and health profession students was formed to "(Spartner" with elementary school physical education (PE teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (Spartnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1 improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2 increase the number of students achieving national recommendations for PA and nutrition; and 3 increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students

  12. Integrating an ecological approach into an Aboriginal community-based chronic disease prevention program: a longitudinal process evaluation

    Directory of Open Access Journals (Sweden)

    Maypilama Elaine

    2011-05-01

    Full Text Available Abstract Background Public health promotes an ecological approach to chronic disease prevention, however, little research has been conducted to assess the integration of an ecological approach in community-based prevention programs. This study sought to contribute to the evidence base by assessing the extent to which an ecological approach was integrated into an Aboriginal community-based cardiovascular disease (CVD and type 2 diabetes prevention program, across three-intervention years. Methods Activity implementation forms were completed by interview with implementers and participant observation across three intervention years. A standardised ecological coding procedure was applied to assess participant recruitment settings, intervention targets, intervention strategy types, extent of ecologicalness and organisational partnering. Inter-rater reliability for two coders was assessed at Kappa = 0.76 (p Results 215 activities were implemented across three intervention years by the health program (HP with some activities implemented in multiple years. Participants were recruited most frequently through organisational settings in years 1 and 2, and organisational and community settings in year 3. The most commonly utilised intervention targets were the individual (IND as a direct target, and interpersonal (INT and organisational (ORG environments as indirect targets; policy (POL, and community (COM were targeted least. Direct (HP→ IND and indirect intervention strategies (i.e., HP→ INT→ IND, HP→ POL → IND were used most often; networking strategies, which link at least two targets (i.e., HP→[ORG-ORG]→IND, were used the least. The program did not become more ecological over time. Conclusions The quantity of activities with IND, INT and ORG targets and the proportion of participants recruited through informal cultural networking demonstrate community commitment to prevention. Integration of an ecological approach would have been

  13. Effectiveness of a Lifestyle Intervention Program among Persons at High Risk for Cardiovascular Disease and Diabetes in a Rural Community

    Science.gov (United States)

    Vadheim, Liane M.; Brewer, Kari A.; Kassner, Darcy R.; Vanderwood, Karl K.; Hall, Taryn O.; Butcher, Marcene K.; Helgerson, Steven D.; Harwell, Todd S.

    2010-01-01

    Purpose: To evaluate the feasibility of translating the Diabetes Prevention Program (DPP) lifestyle intervention into practice in a rural community. Methods: In 2008, the Montana Diabetes Control Program worked collaboratively with Holy Rosary Healthcare to implement an adapted group-based DPP lifestyle intervention. Adults at high risk for…

  14. Cytokines and hs-CRP levels in individuals treated with low-dose aspirin for cardiovascular prevention: a population-based study (CoLaus Study).

    Science.gov (United States)

    Vaucher, Julien; Marques-Vidal, Pedro; Waeber, Gérard; Vollenweider, Peter

    2014-04-01

    Pro-inflammatory cytokines and high-sensitive C-reactive protein (hs-CRP) are associated with increased risk for cardiovascular disease. Low-dose aspirin for CV prevention is reported to have anti-inflammatory effects. The aim of this study was to determine the association between pro-inflammatory cytokines and hs-CRP levels and low-dose aspirin use for cardiovascular prevention in a population-based cohort (CoLaus Study). We assessed blood samples in 6085 participants (3201 women) aged 35-75years. Medications' use and indications were recorded. Among aspirin users (n=1'034; 17%), overall low-dose users (351; 5.8%) and low-dose for cardiovascular prevention users (324; 5.3%) were selected for analysis. Pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α were assessed by a multiplex particle-based flow cytometric assay and hs-CRP by an immunometric assay. Cytokines and hs-CRP were presented in quartiles. Multivariate analysis adjusting for sex, age, smoking status, body mass index, diabetes mellitus and immunomodulatory drugs showed no association between cytokines and hs-CRP levels and low-dose aspirin use for cardiovascular prevention, either comparing the topmost vs. the three other quartiles (OR 95% CI, 0.84 (0.59-1.18), 1.03 (0.78-1.32), 1.10 (0.83-1.46), 1.00 (0.67-1.69) for IL-1β, IL-6, TNF-α and hs-CRP, respectively), or comparing the topmost quartile vs. the first one (OR 95% CI, 0.87 (0.60-1.26), 1.19 (0.79-1.79), 1.26 (0.86-1.84), 1.06 (0.67-1.69)). Low-dose aspirin use for cardiovascular prevention does not impact plasma pro-inflammatory cytokine and hs-CRP levels in a population-based cohort.

  15. Overdose prevention in injecting opioid users: The role of substance abuse treatment and training programs

    Directory of Open Access Journals (Sweden)

    Ana Sarasa-Renedo

    2014-03-01

    Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.

  16. General practitioners’ use of absolute risk versus individual risk factors in cardiovascular disease prevention: an experimental study

    OpenAIRE

    Jansen, Jesse; Bonner, Carissa; McKinn, Shannon; Irwig, Les; Glasziou, Paul ,; Doust, Jenny; Teixeira-Pinto, Armando; Hayen, Andrew; Turner, Robin; McCaffery, Kirsten

    2014-01-01

    Objective To understand general practitioners’ (GPs) use of individual risk factors (blood pressure and cholesterol levels) versus absolute risk in cardiovascular disease (CVD) risk management decision-making. Design Randomised experiment. Absolute risk, systolic blood pressure (SBP), cholesterol ratio (total cholesterol/high-density lipoprotein (TC/HDL)) and age were systematically varied in hypothetical cases. High absolute risk was defined as 5-year risk of a cardiovascular event >15%, hig...

  17. OSTA program: A French follow up intervention program for suicide prevention.

    Science.gov (United States)

    Mouaffak, Fayçal; Marchand, Arnaud; Castaigne, Emmanuelle; Arnoux, Armelle; Hardy, Patrick

    2015-12-30

    Attempted suicide is a strong risk factor for subsequent suicidal behavior. In recent years, a particular interest has been given to follow-up interventions as a potential effective strategy in preventing recurrent suicidal behavior. We developed a follow-up intervention program called OSTA (organization of a suitable monitoring for suicide attempters) aimed at addressing this issue and tested its effectiveness in a 1-year randomized controlled trial. Individuals who attempted suicide and were admitted to the emergency department (ED) of Bicêtre Hospital (n=320) were randomly allocated to receive either the OSTA program or a control treatment. On an intention to treat basis, the proportion of patients who reattempted suicide did not differ significantly between the interventional group (IG) 14.5% (22/152) and the control group (CG) 14% (21/150). There were also no significant differences, between the two arms, in the number of suicide attempts. Although no significant difference has been found between the OSTA program and the control treatment concerning the rate of suicide reattempts, we believe that further studies should be conducted to test the effectiveness of more standardized follow-up studies in suicide prevention.

  18. SYMPOSIUM DEVOTED TO THE 10TH ANNIVERSARY OF THE JOURNAL “RATIONAL PHARMACOTHERAPY IN CARDIOLOGY” “ADVANCE IN CARDIOVASCULAR DISEASES PREVENTION AND MANAGEMENT IN THE PAST DECADE”. SEPTEMBER 25, 2014, KAZAN

    OpenAIRE

    2015-01-01

    Symposium devoted to the 10th anniversary of the journal “Rational Pharmacotherapy in Cardiology” “Advance in cardiovascular diseases prevention and management in the past decade”. September 25, 2014, Kazan.

  19. The Danish Cardiovascular Screening Trial (DANCAVAS)

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Rasmussen, Lars Melholt; Søgaard, Rikke

    2015-01-01

    /iliac aneurysms) and measurements of the ankle brachial blood pressure index (ABI) as part of a multifocal screening and intervention program for CVD in men aged 65-74. Attendance rate and compliance to initiated preventive actions must be expected to become of major importance. TRIAL REGISTRATION: Current......) a telemetric assessment of the heart rhythm, and (4) a measurement of the cholesterol and plasma glucose levels. Up-to-date cardiovascular preventive treatment is recommended in case of positive findings. OBJECTIVE: To investigate whether advanced cardiovascular screening will prevent death and cardiovascular...... events, and whether the possible health benefits are cost effective. OUTCOME: Registry-based follow-up on all cause death (primary outcome), and costs after 3, 5 and 10 years (secondary outcome). RANDOMIZATION: Each of the 45,000 individuals is, by EPIDATA, given a random number from 1-100. Those...

  20. 75 FR 35360 - Injury and Illness Prevention Program

    Science.gov (United States)

    2010-06-22

    ... monitoring performance, correcting program deficiencies, and improving program performance). Are these the.... Logistics for the meetings are being managed by Eastern Research Group (ERG), which will provide...

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

    Science.gov (United States)

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

    2012-01-01

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

  2. A Community Health Advisor Program to Reduce Cardiovascular Risk among Rural African-American Women

    Science.gov (United States)

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

    2009-01-01

    The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and…

  3. Quality of life and its association with cardiovascular risk factors in a community health care program population

    Directory of Open Access Journals (Sweden)

    Luiz Mário Baptista Martinelli

    2008-01-01

    Full Text Available OBJECTIVE: To evaluate quality of life in a population that attended a specific community event on health care education, and to investigate the association of their quality of life with the presence of cardiovascular risk factors INTRODUCTION: Interest in health-related quality of life is growing worldwide as a consequence of increasing rates of chronic disease. However, little is known about the association between quality of life and cardiovascular risk factors. METHODS: This study included 332 individuals. Demographics, blood pressure, body mass index, and casual glycemia were evaluated. The brief version of the World Health Organization Quality of Life questionnaire on quality of life was given to them. The medians of the scores obtained for the physical, psychological, emotional, and environmental domains were used as cutoffs to define "higher" and "lower" scores. A multinomial logistic regression model was used to define the parameters associated with lower scores. RESULTS: Diabetes mellitus, dyslipidemia, and obesity were associated with lower scores in the physical domain. Dyslipidemia was also associeted with lower scores in the psychological domain. Male gender and regular physical activity had protective effects on quality of life. Aging was inversely associated with decreased quality of life in the environmental domain. CONCLUSION: The presence of cardiovascular risk factors is related to a decreased quality of life. Conversely, male gender and regular physical activity had protective effects on quality of life. These findings suggest that exercising should be further promoted by health-related public programs, with a special focus on women.

  4. Application of infrared thermal imaging in the study of preventing cardiovascular and cerebrovascular diseases with Chinese medicine health food

    Science.gov (United States)

    Li, Ziru; Zhang, Xusheng

    2009-08-01

    To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, P<=0.01 for all the balance features. For the youth, the balance state of females was better than that of the males. But this sexual difference disappeared for the middle-aged and elderly group. Second, a double-blind randomized trial was carried out to study the influences of Shengyi capsule, a Chinese medicine health food with the function of helping to decrease serum lipid, on the balance features. The subjects were middle-aged and elderly people with lipid abnormality history. Shengyi capsule was taken by the trial group while Xuezhikang capsule (with lovastatin as the main effective component) by the control group for 108 days. The balance features of ITI showed that Shengyi was significantly better than Xuezhikang in improving the whole body balance of blood circulation (including the up and down, left and right, proximal and distal balance). The relative efficacy rate was 81.0% for the trial group and 33.3% for the control group, there was significant difference between the two groups (P=0.002). Shengyi could effectively decrease the low density lipoprotein cholesterol (LDL-C) but the effect of Xuezhikang in decreasing total cholesterol (TC) and LDL-C was better than Shengyi. Though the lipid-lowering effect of Shengyi was not as good as Xuezhikang, ITI reflected the obvious advantage of Shengyi in improving the whole body balance of blood circulation which

  5. Are ACE-inhibitors or ARB's still needed for cardiovascular prevention in high risk patients? Insights from profess and transcend.

    Science.gov (United States)

    Van Mieghem, W; Billiouw, J M; Brohet, C; Dupont, A G; Gazagnes, M D; Heller, F; Krzesinski, J M; Missault, L; Persu, A; Piérard, L; Rottiers, R; Vanhooren, G; Vervaet, P; Herman, A G

    2010-01-01

    The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurrence of major cardiovascular events in patients with proven atherosclerotic disease. The recently published results of the PRoFESS and TRANSCEND trials completed the much needed information concerning the use of an angiotensin receptor blocker for patients at high risk of cardiovascular events. PROFESS compared a therapy of telmisartan 80 mg daily with placebo in patients with a recent ischemic stroke. The difference in the primary outcome of first recurrent stroke was not statistically significant between telmisartan and placebo. The secondary outcome of major cardiovascular events showed a relative risk reduction (RRR) of 7% in favour of telmisartan. This tended to be significant (p = 0.06) despite a rather short follow-up period of only 28 months. In TRANSCEND 5926 patients at high risk for cardiovascular events were randomized to a treatment with telmisartan 80 mg daily or placebo for a mean duration of follow-up of 56 months. The primary composite outcome of cardiovascular death, myocardial infarction, stroke or hospitalization for heart failure showed a non-significant 8% RRR in favour of the telmisartan treated patients. The main secondary outcome of cardiovascular death and myocardial infarction or stroke as used in the HOPE trial showed a non-significant RRR of 13% in favour of telmisartan treated patients (p = 0.068 adjusted for multiplicity of comparisons). In comparing the Kaplan-Meier curves for the endpoint of major cardiovascular events used in HOPE, EUROPA, TRANSCEND and PRoFESS, the trends are similar. Results of most of the recently published trials have been neutral.This could partly be explained by major improvements in the optimal background therapy of the patients included. Nevertheless, the results of PRoFESS and TRANSCEND do not contradict the results from previous studies with

  6. The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program.

    Science.gov (United States)

    Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A; De La Rosa, Mario

    2012-01-01

    There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.

  7. Stacked Deck: An Effective, School-Based Program for the Prevention of Problem Gambling

    Science.gov (United States)

    Williams, Robert J.; Wood, Robert T.; Currie, Shawn R.

    2010-01-01

    School-based prevention programs are an important component of problem gambling prevention, but empirically effective programs are lacking. Stacked Deck is a set of 5-6 interactive lessons that teach about the history of gambling; the true odds and "house edge"; gambling fallacies; signs, risk factors, and causes of problem gambling; and…

  8. The Body Logic Program for Adolescents: A Treatment Manual for the Prevention of Eating Disorders

    Science.gov (United States)

    Varnado-Sullivan, Paula J.; Zucker, Nancy

    2004-01-01

    The Body Logic Program for Adolescents was developed as a two-stage intervention to prevent the development of eating disorder symptoms. Preliminary results indicate that this program shows promise as an effective prevention effort. The current article provides a detailed description of the protocol for implementing Body Logic Part I, a…

  9. Dissonance and Healthy Weight Eating Disorder Prevention Programs: A Randomized Efficacy Trial

    Science.gov (United States)

    Stice, Eric; Shaw, Heather; Burton, Emily; Wade, Emily

    2006-01-01

    In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only…

  10. Assess the Impact of an Online Tobacco Prevention Training Program on Teachers and Their Students

    Science.gov (United States)

    Chen, W. William; Sheu, Jiunn-Jye; Weng, Chung-Bang

    2013-01-01

    School-based tobacco prevention programs have been proven effective in reducing tobacco use. This evaluation aimed to assess the impact of an online tobacco prevention teacher training program on teachers and their students in Florida schools. A total of 344 teachers, including 72 K-3 grade teachers, 44 4th-5th grade teachers, and 228 6th-12th…

  11. The effect of a depression prevention program on negative cognitive style trajectories in early adolescents

    NARCIS (Netherlands)

    Kindt, K.C.M.; Kleinjan, M.; Janssens, J.M.A.M.; Scholte, R.H.J.

    2016-01-01

    As restructuring a negative cognitive style is a central skill taught in many depression prevention programs, we tested whether a universal prevention program evoked a change in negative cognitive style in adolescents. In addition, we examined distinct developmental trajectories of negative cognitiv

  12. Effect of an internally versus externally focused acl injury prevention program on injury risk

    NARCIS (Netherlands)

    Dallinga, J.; Benjaminse, A.; Gokeler, A.; Otten, Egbert; Lemmink, K.

    2014-01-01

    BACKGROUND: Anterior cruciate ligament (ACL) injury prevention programs have shown mixed results, which may be in part due to suboptimal training components. OBJECTIVE: Determine effects of a prevention program with external and internal focus of attention on (potential) biomechanical risk factors f

  13. Modeling the Bullying Prevention Program Preferences of Educators: A Discrete Choice Conjoint Experiment

    Science.gov (United States)

    Cunningham, Charles E.; Vaillancourt, Tracy; Rimas, Heather; Deal, Ken; Cunningham, Lesley; Short, Kathy; Chen, Yvonne

    2009-01-01

    We used discrete choice conjoint analysis to model the bullying prevention program preferences of educators. Using themes from computerized decision support lab focus groups (n = 45 educators), we composed 20 three-level bullying prevention program design attributes. Each of 1,176 educators completed 25 choice tasks presenting experimentally…

  14. Moving from Efficacy to Effectiveness in Eating Disorders Prevention: The Sorority Body Image Program

    Science.gov (United States)

    Becker, Carolyn Black; Ciao, Anna C.; Smith, Lisa M.

    2008-01-01

    Although eating disorders prevention research has begun to produce programs with demonstrated efficacy, many such programs simply target individuals as opposed to engaging broader social systems (e.g., schools, sororities, athletic teams) as participant collaborators in eating disorders prevention. Yet, social systems ultimately will be…

  15. 78 FR 35054 - Proposed Collection; Comment Request; Program to Prevent Smoking in Hazardous Areas (Pertains to...

    Science.gov (United States)

    2013-06-11

    ... Safety and Health Administration Proposed Collection; Comment Request; Program to Prevent Smoking in... 30 CFR 75.1702 prohibits persons from smoking or carrying smoking materials underground or in places... operators are required to develop programs to prevent persons from carrying smoking materials, matches,...

  16. Early Childhood Intervention Programs: Opportunities and Challenges for Preventing Child Maltreatment

    Science.gov (United States)

    Asawa, Lindsay E.; Hansen, David J.; Flood, Mary Fran

    2008-01-01

    Due to the destructive impact of child maltreatment and limited available funding to address its consequences, the value of preventive measures is evident. Early Childhood Intervention Programs (ECIPs) provide excellent opportunities to prevent and identify cases of child maltreatment, among other varied objectives. These programs are typically…

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

    Science.gov (United States)

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

    2008-01-01

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

  18. Prevention Counseling and Student Assistance Programs: A Review of the Literature

    Science.gov (United States)

    Loneck, Barry; Corrigan, Matthew J.; Videka, Lynn; Newman, Lucy J.; Reed, John Charles; Moonan, Kimberly E.

    2010-01-01

    Substance abuse prevention counseling can be found in two venues: school counseling and student assistance programs (SAPs). School prevention counseling is based on school psychology and guidance counseling. The authors of this article did not find any empirical studies of prevention counseling. Six criteria were used to assess the published…

  19. What's culture got to do with it? Prevention programs for African American adolescent girls.

    Science.gov (United States)

    Corneille, Maya A; Ashcroft, Amie M; Belgrave, Faye Z

    2005-11-01

    This paper examines prevention programming for African American girls by placing the prevention process within the larger African and African American cultural context. We provide an overview of the theories and issues we consider most relevant to African American culture, including Africentric theory, ethnic identity, gender identity and relational theory, developmental issues, the community context, and historical considerations. Drawing from our own drug prevention work, we provide examples of how to incorporate culture into prevention programs to make them most relevant for the target population. We also summarize our own efforts to create culturally appropriate prevention interventions and their impact on the girls in our programs. We conclude with suggested directions for future research into culture-specific prevention programs.

  20. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Carré, François; Heuschmann, Peter; hoffmann, Thomas

    2010-01-01

    of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction......Cardiac patients after an acute event and/or with chronic heart disease deserve special attention to restore their quality of life and to maintain or improve functional capacity. They require counselling to avoid recurrence through a combination of adherence to a medication plan and adoption...... and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention...

  1. Experiences and perceptions about cause and prevention of cardiovascular disease among people with cardiometabolic conditions: findings of in-depth interviews from a peri-urban Nepalese community

    Directory of Open Access Journals (Sweden)

    Natalia Oli

    2014-04-01

    Full Text Available Background: Nepal currently faces an increasing burden of cardiovascular disease (CVD. Earlier studies on health literacy and the behavior dimension of cardiovascular health reported a substantial gap between knowledge and practice. Objective: This qualitative study aimed to deepen understanding of the community perspective on cardiovascular health from the patients’ viewpoint. Design: We conducted in-depth interviews (IDIs with 13 individuals with confirmed heart disease, hypertension, or diabetes mellitus. All participants provided verbal consent. We used an IDI guide to ask respondents about their perception and experiences with CVD, particularly regarding causation and preventability. We manually applied qualitative content analysis to evaluate the data and grouped similar content into categories and subcategories. Results: Respondents perceived dietary factors, particularly consumption of salty, fatty, and oily food, as the main determinants of CVD. Similarly, our respondents unanimously linked smoking, alcohol intake, and high blood pressure with cardiac ailments but reported mixed opinion regarding the causal role of body weight and physical inactivity. Although depressed and stressed at the time of diagnosis, respondents learned to handle their situation better over time. Despite good family support for health care, the financial burden of disease was a major issue. All respondents understood the importance of lifestyle modification and relied upon health professionals for information and motivation. Respondents remarked that community awareness of CVD was inadequate and that medical doctors or trained local people should help increase awareness. Conclusions: This study provided insight into the perceptions of patients regarding CVD. Respondents embraced the importance of lifestyle modification only after receiving their diagnosis. Although better health care is important in terms of aiding patients to better understand and cope with

  2. THE PROBLEM OF STATIN USE IN PATIENTS WITH CARDIOVASCULAR DISEASES AND CONCOMITANT LIVER DISEASES. WHAT PREVENTS OVERCOMING STATINOPHOBIA?

    Directory of Open Access Journals (Sweden)

    S. N. Bel'diev

    2016-01-01

    Full Text Available According to a recent study, Russian physicians often and sometimes unreasonably find it impossible to use statins in patients with cardiovascular diseases and concomitant chronic liver diseases. Analysis of domestic publications of recent years reveals the following factors which can impede overcoming statinophobia: 1 fragmentary and contradictory statement of the problem "Statins and liver" in Russian clinical guidelines for management of patients with high cardiovascular risk; 2 common perception that isolated transaminase increase in response to statin therapy is an indicator of "cytolysis" or "cytolytic syndrome"; 3 unreasonably overestimated lipid-lowering activity of combination therapy with low doses of statins and ursodeoxycholic acid; 4 view of the inadmissibility of statin use in patients with transaminase levels more than three upper limit of normal. To overcome these shortcomings and mistakes it seems appropriate to issue national clinical guidelines on statin use in high cardiovascular risk patients with underlying liver disease and/or with elevated transaminases.

  3. Substance Abuse Minimization: Conceptualizing Prevention in Adolescent and Youth Programs.

    Science.gov (United States)

    Gullotta, Thomas; Adams, Gerald R.

    1982-01-01

    This article provides an overview of the historical and theoretical work on adolescent substance abuse with implications for preventive interventions. The focus is on illustration of the use of four basic prevention tools: education, competency promotion, community mobilization, and natural care giving. (Author)

  4. [Is folic acid effective for the prevention of cardiovascular events in patients with advanced or terminal chronic kidney disease?].

    Science.gov (United States)

    Peña, José; Claro, Juan Carlos

    2014-05-01

    Patients with chronic kidney disease have an increased cardiovascular risk. Several non-traditional factors have been showed to be associated with this risk, including hyperhomocysteinemia. The effects of reducing homocysteine levels with folic acid supplementation have been studied in a number of randomized trials, with mixed results. In this article we critically appraise two systematic reviews providing disparate conclusions about this question and we summarize their main findings using the GRADE methodology. We conclude that there are methodological differences that may explain the mixed results in both systematic reviews. Folic acid supplementation does not reduce cardiovascular morbidity or mortality in patients with chronic kidney disease at any stage.

  5. Real-world effectiveness of valsartan on hypertension and total cardiovascular risk: review and implications of a translational research program

    Directory of Open Access Journals (Sweden)

    Abraham I

    2011-03-01

    Full Text Available Ivo Abraham1,2, Karen MacDonald2, Christine Hermans3, Ann Aerts3, Christopher Lee2,4, Heidi Brié3, Stefaan Vancayzeele31Center for Health Outcomes and Pharmacoeconomic Research, and Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA; 2Matrix45, Earlysville, VA, USA; 3Novartis Pharma, Vilvoorde, Belgium; 4School of Nursing, Oregon Health and Science University, Portland, OR, USAAbstract: The pharmacological efficacy of various monotherapy, single pill, and combination therapies of the angiotensin II receptor blocker valsartan have been established, mainly through randomized controlled trials that used similar methodological and statistical platforms and thus enabled synthesis of evidence. The real world effectiveness of valsartan has been studied extensively, but the relative lack of scientific and technical congruence of these studies render synthesis virtually impossible. To date, all have focused on blood pressure outcomes, despite evidence-based calls to grade antihypertensive treatment to patients' total cardiovascular risk. We review a T3 translational research program of seven studies involving valsartan monotherapy as well as single and separate pill combinations, and the determinants and effect on blood pressure and total cardiovascular risk outcomes. All seven studies examined not only the impact of valsartan-based regimens on blood pressure values and control, but also, within a statistical hierarchical approach, the physician- and patient-related determinants of these blood pressure outcomes. Two studies also investigated the determinants and outcomes of valsartan-based treatment on total cardiovascular risk – among the first studies to use this risk coefficient as an outcome rather than only a determinant. These seven studies included a total of 19,533 patients, contributed by 3434 physician-investigators in Belgium – a country particularly well-suited for observational

  6. Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians - a population with the highest risk of premature coronary artery disease & diabetes.

    Science.gov (United States)

    Enas, Enas A; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C S; Mohan, Viswanathan

    2013-10-01

    Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians.

  7. Combined effect of blood pressure and total cholesterol levels on long-term risks of subtypes of cardiovascular death: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan.

    Science.gov (United States)

    Satoh, Michihiro; Ohkubo, Takayoshi; Asayama, Kei; Murakami, Yoshitaka; Sakurai, Masaru; Nakagawa, Hideaki; Iso, Hiroyasu; Okayama, Akira; Miura, Katsuyuki; Imai, Yutaka; Ueshima, Hirotsugu; Okamura, Tomonori

    2015-03-01

    No large-scale, longitudinal studies have examined the combined effects of blood pressure (BP) and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population. To investigate these relationships, a meta-analysis of individual participant data, which included 73 916 Japanese subjects (age, 57.7 years; men, 41.1%) from 11 cohorts, was conducted. During a mean follow-up of 15.0 years, deaths from coronary heart disease, ischemic stroke, and intraparenchymal hemorrhage occurred in 770, 724, and 345 cases, respectively. Cohort-stratified Cox proportional hazard models were used. After stratifying the participants by 4 systolic BP ×4 total cholesterol categories, the group with systolic BP ≥160 mm Hg with total cholesterol ≥5.7 mmol/L had the greatest risk for coronary heart disease death (adjusted hazard ratio, 4.39; P<0.0001 versus group with systolic BP <120 mm Hg and total cholesterol <4.7 mmol/L). The adjusted hazard ratios of systolic BP (per 20 mm Hg) increased with increases in total cholesterol categories (hazard ratio, 1.52; P<0.0001 in group with total cholesterol ≥5.7 mmol/L). Similarly, the adjusted hazard ratios of total cholesterol increased with increases in systolic BP categories (P for interaction ≤0.04). Systolic BP was positively associated with ischemic stroke and intraparenchymal hemorrhage death, and total cholesterol was inversely associated with intraparenchymal hemorrhage, but no significant interactions between BP and total cholesterol were observed for stroke. High BP and high total cholesterol can synergistically increase the risk for coronary heart disease death but not for stroke in the Asian population.

  8. A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

    Directory of Open Access Journals (Sweden)

    Suzuki Yuriko

    2008-09-01

    Full Text Available Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals. Discussion The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. Trial registration UMIN Clinical Trials Registry (UMIN-CTR UMIN000000460.

  9. Amblyopia prevention screening program in Northwest Iran (Ardabil

    Directory of Open Access Journals (Sweden)

    Habib Ojaghi

    2016-01-01

    Conclusions: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

  10. Developing Online Family Life Prevention and Education Programs

    Science.gov (United States)

    Hughes, Robert, Jr.; Bowers, Jill R.; Mitchell, Elissa Thomann; Curtiss, Sarah; Ebata, Aaron T.

    2012-01-01

    Although numerous online family life education programs have been developed over the past few years, there has been little discussion about best practices in the development of these programs. This article presents a framework to assist family life educators in the development and improvement of online programs from the initial problem analysis…

  11. Effectiveness of Two Versions of a STD/HIV Prevention Program

    Science.gov (United States)

    2002-01-01

    NAVAL HEALTH RESEARCH CENTER EFFECTIVENESS OF TWO VERSIONS OF A STD /HIV PREVENTION PROGRAM S. Booth-Kewley R. A. Shaffer...EFFECTIVENESS OF TWO VERSIONS OF AN STD /HIV PREVENTION PROGRAM 1NAVAL HEALTH RESEARCH CENTER P.O. BOX 85122 San Diego, CA 92186-5122...of a behavioral intervention called the STD /HIV Intervention Program (SHIP) in a sample of Marines. Marines were exposed to either a 6 hr or a 3 hr

  12. An Evaluation of the Implementation Fidelity and Outcomes of the Olweus Bullying Prevention Program in Three Elementary Schools in Virginia

    Science.gov (United States)

    Wood, Barbara F.

    2013-01-01

    Bullying continues to be a major concern in schools today. Many schools have implemented some type of bullying prevention program. The Olweus Bullying Prevention Program is one of these programs. Evaluation of the Olweus Bullying Prevention Program is typically done through the administration of the Olweus Bullying Questionnaire to students and…

  13. Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation

    OpenAIRE

    Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O’Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

    2014-01-01

    Background The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of t...

  14. Development and Process Evaluation of a 5-Week Exercise Program to Prevent Falls in People after Stroke: The FALLS Program.

    NARCIS (Netherlands)

    Duijnhoven, H.J.R. van; Kam, D. de; Hellebrand, W.; Smulders, E.; Geurts, A.C.H.; Weerdesteyn, V.

    2012-01-01

    Falls are a common complication after stroke, with balance and gait deficits being the most important risk factors. Taking into account the specific needs and capacities of people with stroke, we developed the FALLS program (FALL prevention after Stroke), based on the "Nijmegen falls prevention prog

  15. Preventing child maltreatment: a meta-analysis and systematic review of parenting programs

    OpenAIRE

    Chen, Mengtong; 陈孟彤.

    2013-01-01

    Child maltreatment—a serious public health problem—is a global phenomenon. Parenting programs are considered effective approaches to preventing child maltreatment; however, comprehensive understanding is still lacking of the effectiveness of such programs in all areas of outcomes and the way parenting programs work. This thesis consists of two parts: a quantitative synthesis of high-level evidence about program effects and a qualitative integration of program process. The thesis employs t...

  16. Atorvastatin reduces the risk of cardiovascular events in patients with carotid atherosclerosis: a secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

    DEFF Research Database (Denmark)

    Sillesen, H.; Amarenco, P.; Hennerici, M.G.

    2008-01-01

    BACKGROUND AND PURPOSE: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial found that treatment with atorvastatin 80 mg per day reduced the risk of stroke and cardiovascular events in patients with a recent transient ischemic attack (TIA) or stroke. We hypothesized...... this benefit would be greatest in the subgroup of patients with carotid stenosis. METHODS: The SPARCL trial randomized patients with TIA or stroke within 1 to 6 months without known coronary heart disease (CHD) and low-density lipoprotein cholesterol 100 to 190 mg/dL to treatment with atorvastatin 80 mg per...

  17. A Path Analysis of a Randomized "Promotora de Salud" Cardiovascular Disease-Prevention Trial among At-Risk Hispanic Adults

    Science.gov (United States)

    de Heer, Hendrik Dirk; Balcazar, Hector G.; Castro, Felipe; Schulz, Leslie

    2012-01-01

    This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of protective…

  18. A Path Analysis of a Randomized "Promotora de Salud" Cardiovascular Disease-Prevention Trial among At-Risk Hispanic Adults

    Science.gov (United States)

    de Heer, Hendrik Dirk; Balcazar, Hector G.; Castro, Felipe; Schulz, Leslie

    2012-01-01

    This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of…

  19. Prevention of cardiovascular disease based on lipid lowering treatment: a challenge for the Mexican health system Prevención de la enfermedad cardiovascular basada en tratamiento hipolipemiante: un reto para el sistema de salud de México

    Directory of Open Access Journals (Sweden)

    Francisco J Gómez-Pérez

    2010-01-01

    Full Text Available OBJECTIVE: To estimate the percentage of Mexican adults that may require lipid-lowering treatment according to National Cholesterol Education Program-III guidelines, using data from the National Health and Nutrition Survey 2006 (ENSANut 2006. MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9 to 12 hours fast. RESULTS: A cardiovascular risk equivalent was found in 13.8% and >2 risk factors were present in 31.5% of the population. LDL-C concentrations were above the treatment goal in 70% of the high-risk group and in 38.6% of subjects with >2 risk factors. Nearly 12 million Mexicans should be taught how to change their lifestyles and close to 8 million individuals require drug therapy to decrease their cardiovascular risk. CONCLUSIONS: Thirty percent of Mexican adults require some form of lipid-lowering treatment (lifestyle modifications in 36.25%, drug therapy in 24.19%.OBJETIVO: Calcular el porcentaje de adultos que requiere tratamiento hipolipemiante de acuerdo con las recomendaciones del Programa Nacional de Educación en Colesterol-III, usando los datos de la Encuesta Nacional de Salud y Nutrición 2006. MATERIAL Y MÉTODOS: Se incluyeron 4040 individuos con edad entre 20 y 69 años estudiados bajo un ayuno de 9 a 12 horas. RESULTADOS: Un equivalente de enfermedad cardiovascular fue identificado en 13.8% de los participantes. El 31.5% de la población tenía >2 factores de riesgo cardiovascular. La concentración de colesterol LDL estuvo arriba de la meta terapéutica en 70% de los casos con alto riesgo cardiovascular y en el 38.6% de los sujetos con >2 factores de riesgo. Cerca de 12 millones de mexicanos deben modificar su estilo de vida para reducir su concentración de colesterol LDL. Casi 8 millones califican para recibir tratamiento farmacológico. CONCLUSIONES: Una tercera parte de los adultos requiere alguna forma de tratamiento hipolipemiante (cambios en el estilo de vida: 36

  20. Prevention-Related Research Targeting African American Alternative Education Program Students

    Science.gov (United States)

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

    2014-01-01

    This article reports on a program of research that examined the background, planning, implementation, and evaluation of an after-school preventive intervention program within an ongoing urban alternative education program targeting African American students referred to the school because of their problematic behavior in regular schools. The…

  1. Preventing Non-Suicidal Self-Injury in Adolescents: The Signs of Self-Injury Program

    Science.gov (United States)

    Muehlenkamp, Jennifer J.; Walsh, Barent W.; McDade, Moira

    2010-01-01

    Non-suicidal self-injury (NSSI) continues to be a problem among youth and there is a great need for programming aimed at reducing NSSI in adolescents. The signs of self-injury program is the first known NSSI school-based prevention program for adolescents that attempts to increase knowledge, improve help-seeking attitudes and behaviors, and…

  2. A Meta-Analysis of School-Based Bullying Prevention Programs' Effects on Bystander Intervention Behavior

    Science.gov (United States)

    Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Therese D.

    2012-01-01

    This meta-analysis synthesized bullying prevention programs' effectiveness at increasing bystander intervention in bullying situations. Evidence from 12 school-based programs, involving 12,874 students, indicated that overall the programs were successful (Hedges's g = 0.20, 95% confidence interval [CI] = 0.11 to 0.29, p = 0.001), with larger…

  3. Process Evaluation of a Bullying Prevention Program: A Public School-County Health Partnership

    Science.gov (United States)

    Edmondson, Lynne; Hoover, John

    2008-01-01

    In this article, a process evaluation of a school-based, violence intervention program is presented. The program was modeled after bullying prevention programs described by Daniel Olweus (1993) whose components were implemented to achieve student safety goals. The process evaluation instrument used in this study was developed by a rural Midwestern…

  4. Development, Evaluation, and Future Directions of the Olweus Bullying Prevention Program

    Science.gov (United States)

    Limber, Susan P.

    2011-01-01

    The Olweus Bullying Prevention Program (OBPP) is a comprehensive, school-wide program that was designed in the mid-1980s to reduce bullying and achieve better peer relations among students in elementary, middle, and junior high school grades. Key program elements are described and a number of cultural adaptations to U.S. schools are noted. Several…

  5. Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs.

    Science.gov (United States)

    Kim, S; McLeod, J H; Williams, C; Hepler, N

    2000-01-01

    The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured

  6. Human Research Program Human Health Countermeasures Element Cardiovascular Risks Standing Review Panel (SRP)

    Science.gov (United States)

    Joyner, Michael

    2009-01-01

    The Cardiovascular Risk Standing Review Panel (SRP) evaluated several cardiovascular risks associated with space flight along with the ongoing and emerging plans to study these issues and potentially propose and/or develop countermeasures. The areas of focus included: 1) The risk of cardiac rhythm problems during prolonged space flight, and 2) Issues related to the risk of orthostatic intolerance during re-exposure to gravity. An emerging area of concern is radiation associated vascular injury. The risk of cardiac rhythm disturbances has emerged based on case reports only. No systematic study of this risk has been published. However, concerns about this risk are heightened by the age range of astronauts, the structural changes in the heart that occur during space flight, and the potential shifts in fluids and electrolytes. The current plan is to use prolonged Holter monitor EKG records made as part of the "Integrated Cardiovascular SMO" in space to determine more about the frequency and magnitude of this problem and to link this data to complementary data from the nutrition group on electrolytes. The SRP was supportive of this approach. The SRP also felt that any data related to cardiovascular risk in space should be better coordinated with the medical screening data that all astronauts undergo at regular intervals. Additionally, while there are potential privacy issues related to this suggestion, many of the current barriers to better coordination of experimental and clinical data appear to reflect longstanding cultural traditions at NASA that need rethinking. The risk of orthostatic intolerance during re-exposure to gravity was seen by the SRP as an area supported by a wealth of published physiological evidence. The SRP also felt that moving forward with the planned approach to countermeasures was reasonable and that extensive additional hypothesis testing on the physiology of orthostatic intolerance was not needed at this time. There was support for developing

  7. Prevention programs and special education: Considerations related to risk, social competence, and multiculturalism.

    Science.gov (United States)

    Gager, P J; Kress, J S; Elias, M J

    1996-06-01

    As one reviews the literature on culture-related factors influencing behavioral outcomes and responsiveness to preventive programs, it becomes clear that in addition to the more traditionally defined risk factors, "special education status" itself can be considered an at-risk cultural designation. Despite this additional vulnerability to failure, primary prevention programs for special education (SE) populations are found to be both underdeveloped and understudied. The authors discuss how issues of multiculturalism and cross-cultural competence can be understood and used to enhance the education of SE students. Recommendations are made to enhance the design and delivery of multiculturally sensitive health promotion and problem prevention programs for SE.

  8. Hanford Site Guide for Preparing and Maintaining Fenerator Group Pollution Prevention Program Documentation

    Energy Technology Data Exchange (ETDEWEB)

    PLACE, B.G.

    1999-11-01

    This document provides guidance to generator groups for preparing and maintaining documentation of Pollution Prevention/Waste Minimization (P2/WMin) Program activities. The guidance is one of a hierarchical series that includes the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan (DOE-RL, 1998a) and Prime Contractor implementation plans describing programs required by Resource Conservation and Recovery Act of 1976 (RCRA) 3002(b) and (300501) (RCRA and EPA, 1994). Documentation guidance for the following five P2/WMin elements are discussed: Fiscal Year (FY) Goals; Budget and Staffing; Waste Minimization (WMinn ) Assessments (WMAs); Pollution Prevention (P2) Reporting; WMin Certification.

  9. Effect of angiotensin receptor blockers in the prevention of type 2 diabetes and cardiovascular events: a meta-analysis of randomized trials

    Institute of Scientific and Technical Information of China (English)

    SONG Hui-fen; WANG Su; LI Hong-wei

    2012-01-01

    Background As the incidence of type 2 diabetes is rapidly increasing,prevention of the disease should be considered as a crucial objective in the near future.Several studies have shown angiotensin receptor blockers (ARBs) may contribute to the prevention of new-onset type 2 diabetes.This study was conducted to determine if ARBs as monotherapy or combination therapy may experience a decreased incidence of new-onset type 2 diabetes and prevent cardiovascular events.Methods Relevant experimental and clinical studies were identified by searching MEDLINE (1969 to May 30,2011) to extract a consensus of trial data involving the effect of ARBs on prevention of new-onset type 2 diabetes and cardiovascular events.Studies were included if they were randomized controlled trials versus placebo/routine therapy.A random-effects model was utilized.Subgroup and sensitivity analyses were conducted.Results Eleven trials were identified,including 82738 patients.ARBs prevented new-onset type 2 diabetes (odds ratio 0.8 (95% CI 0.76,0.85)).Regardless of indication for use,essential hypertension (seven trials),impaired glucose tolerance (one trial),cardiocerebrovascular disease (two trials) or heart failure (one trial),reductions in new-onset type 2 diabetes were maintained (0.75 (0.69,0.82),0.85 (0.78,0.92),0.80 (0.76,0.85) and 0.80 (0.64,0.99),respectively).No statistical heterogeneity was observed for any evaluation.However,ARBs did not significantly reduce the odds of all-cause mortality,myocardial infarction and heart failure versus control therapy among all of these studies.But ARBs did reduce the odds of cardiac death and heart failure among the heart failure study versus control therapy.Conclusion ARBs have significant ability to reduce risk of developing new-onset type 2 diabetes but does not improve cardiovascular outcomes over the study follow-up periods among all of included studies.

  10. Supporting Universal Prevention Programs: A Two-Phased Coaching Model

    Science.gov (United States)

    Becker, Kimberly D.; Darney, Dana; Domitrovich, Celene; Keperling, Jennifer Pitchford; Ialongo, Nicholas S.

    2013-01-01

    Schools are adopting evidence-based programs designed to enhance students' emotional and behavioral competencies at increasing rates (Hemmeter et al. in "Early Child Res Q" 26:96-109, 2011). At the same time, teachers express the need for increased support surrounding implementation of these evidence-based programs (Carter and Van Norman in "Early…

  11. Impact of a pedometer-based workplace health program on cardiovascular and diabetes risk profile

    DEFF Research Database (Denmark)

    Freak-Poli, Rosanne; Wolfe, Rory; Backholer, Kathryn

    2011-01-01

    %, OR: 1.3(1.0, 1.8)), sitting time (-0.6(-0.9, -0.3) hours/day), blood pressure (systolic: -1.8(-3.1, -.05) mmHg; diastolic: -1.8(-2.4, -1.3) mmHg) and waist circumference (-1.6(-2.4, -0.7) cm). In contrast, an increase was found for fasting total cholesterol (0.3(0.1, 0.4) mmol/L) and triglycerides (0......OBJECTIVE: To evaluate whether participation in a four-month, pedometer-based, physical activity, workplace health programme results in an improvement in risk factors for diabetes and cardiovascular disease. METHODS: Adults employed within Australia in primarily sedentary occupations.......1(0.0, 0.1) mmol/L). CONCLUSION: Completion of this four-month, pedometer-based, physical activity, workplace programme was associated with improvements in behavioural and anthropometric risk factors for diabetes and cardiovascular disease. Long-term evaluation is required to evaluate the potential...

  12. Comparing between spiritual well being of patients from the cardiovascular nursing program with individuals who are apparently healthy Comparación entre el bienestar espiritual de pacientes del Programa de Enfermería Cardiovascular y el de personas aparentemente sanas

    Directory of Open Access Journals (Sweden)

    SÁNCHEZ HERRERA BEATRIZ

    2008-07-01

    Full Text Available Objective: the study describes and compares the levels of spiritual well-being of the group of patients from the cardiovascular nursing program with those of the group of people with similar socio-demographic characteristics and who are apparently healthy. Methods: a quantitative approached was used of the des-criptive comparative type to measure the spiritual well-being which included the 43 people of the cardiovascular nursing program for the prevention of risk factors and 43 people with similar characteristics and who are apparently healthy. Results: they include the description of spiritual well-being of each one of the groups (people who attend the cardiovascular nursing program and individuals who are apparently healthy and the comparison between them. An average level of spiritual well-being among the cardiovascular nursing program individuals was found, and it was more committed in the existential dimension than in the religious one. In people who are apparently healthy, the general spiritual well-being level was high, with better results in the religious dimension than in the existential one. When comparing the levels of spiritual well-being in general and by the components, a significant difference was found between the groups with higher levels of spiritual well-being in general and by the components in the group of individuals who are apparently healthy. Discussion: The findings confirm the existence of a link between spirituality and cardiovascular health. The importance of an integral evaluation is emphasized and that should enable the understanding of the dynamics between the different life aspects of people with cardiovascular risk during the cardiovascular nursing program. The importance of including information on spiritual belief and practices is highlighted as a possible protecting factor in the cardiovascular health of people and a debate is open on the strategies to address the dimension of spiritual care and go

  13. Comparación entre el bienestar espiritual de pacientes del Programa de Enfermería Cardiovascular y el de personas aparentemente sanas Comparing between spiritual well being of patients from the cardiovascular nursing program with individuals who are apparently healthy

    Directory of Open Access Journals (Sweden)

    BEATRIZ SÁNCHEZ HERRERA

    2008-07-01

    trascender de la teoría a los hechos en lo referente a la integralidad en un cuidado que se base en la salud como conciencia expandida.Objective: the study describes and compares the levels of spiritual well-being of the group of patients from the cardiovascular nursing program with those of the group of people with similar socio-demographic characteristics and who are apparently healthy. Methods: a quantitative approached was used of the des-criptive comparative type to measure the spiritual well-being which included the 43 people of the cardiovascular nursing program for the prevention of risk factors and 43 people with similar characteristics and who are apparently healthy. Results: they include the description of spiritual well-being of each one of the groups (people who attend the cardiovascular nursing program and individuals who are apparently healthy and the comparison between them. An average level of spiritual well-being among the cardiovascular nursing program individuals was found, and it was more committed in the existential dimension than in the religious one. In people who are apparently healthy, the general spiritual well-being level was high, with better results in the religious dimension than in the existential one. When comparing the levels of spiritual well-being in general and by the components, a significant difference was found between the groups with higher levels of spiritual well-being in general and by the components in the group of individuals who are apparently healthy. Discussion: The findings confirm the existence of a link between spirituality and cardiovascular health. The importance of an integral evaluation is emphasized and that should enable the understanding of the dynamics between the different life aspects of people with cardiovascular risk during the cardiovascular nursing program. The importance of including information on spiritual belief and practices is highlighted as a possible protecting factor in the cardiovascular health of

  14. Cubozoan Venom-Induced Cardiovascular Collapse Is Caused by Hyperkalemia and Prevented by Zinc Gluconate in Mice

    OpenAIRE

    2012-01-01

    Chironex fleckeri (Australian box jellyfish) stings can cause acute cardiovascular collapse and death. We developed methods to recover venom with high specific activity, and evaluated the effects of both total venom and constituent porins at doses equivalent to lethal envenomation. Marked potassium release occurred within 5 min and hemolysis within 20 min in human red blood cells (RBC) exposed to venom or purified venom porin. Electron microscopy revealed abundant ~12-nm transmembrane pores i...

  15. COMPARATIVE STUDY OF FOOD SUPPLEMENTS USED ON THE ACTIVITY OF KINETIC ENDURANCE CHARAKTER APPLIED AS A CARDIOVASCULAR DISEASES PREVENTION

    OpenAIRE

    DIČE, Michal

    2009-01-01

    The aim of this thesis is to compare food supplements used on the activity of endurance character and their influence on the cardiovascular system. The teoretical part is pursued to the basic food components and their metabolism and to kinetic activities splitting. The practical part gives information about splitting of sports supplements used on the activity of endurance character, their usage and effects. It deals with the question of human organism behaviour during the strain of endurance ...

  16. Consumption of polyphenol-rich peach and plum juice prevents risk factors for obesity-related metabolic disorders and cardiovascular disease in Zucker rats.

    Science.gov (United States)

    Noratto, Giuliana; Martino, Hercia S D; Simbo, Sunday; Byrne, David; Mertens-Talcott, Susanne U

    2015-06-01

    Polyphenols from fruits have been implied in the prevention of risk factors for cardiometabolic disorders and cardiovascular disease. The purpose of this study was to investigate if the consumption of peach and plum juice has a protective effect against obesity and metabolic disorders that promote the development of cardiovascular diseases. Obese Zucker and lean rats were fed with peach, plum juice ad libitum or placebo. Body weight gain, biochemical markers and molecular markers for inflammation and cardiovascular disease in heart tissue were quantified. Results show that peach and plum juice consumption protected against a combination of obesity-induced metabolic disorders including hyperglycemia, insulin and leptin resistance, dyslipidemia and low-density lipoprotein oxidation. This was accompanied by a decreased expression of pro-atherogenic and pro-inflammatory biomarkers in plasma and heart tissues including intercellular cell adhesion molecule-1, monocyte chemotactic protein-1, NF-κB and foam cell adherence to aortic arches. In addition, peach and plum juice consumption decreased the levels of angiotensin II in plasma and its receptor Agtr1 in heart tissues, suggesting a role of peach and plum polyphenols as peroxisome proliferator-activated receptor-γ agonists. Furthermore, only plum juice significantly prevented body weight gain and increased the ratio high-density lipoprotein cholesterol/total cholesterol in plasma. This effect is most likely attributed to the plum's higher content of polyphenols (three times that of peach). Altogether, these results imply that cardioprotective effects can be achieved by replacing drinks high in sugar content with fruit juice rich in polyphenols in a diet.

  17. Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program

    Directory of Open Access Journals (Sweden)

    Yongyue Qi

    2012-01-01

    Full Text Available Cardiovascular disease (CVD remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001, fruit and vegetable consumption (p < 0.001, and decrease self-reported stress level (p = 0.006. The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.

  18. Effects of a parental program for preventing underage drinking - The NGO program strong and clear

    Directory of Open Access Journals (Sweden)

    Eriksson Charli

    2011-04-01

    Full Text Available Abstract Background The present study is an evaluation of a 3-year parental program aiming to prevent underage drinking. The intervention was implemented by a non-governmental organization and targeted parents with children aged 13-16 years old and included recurrent activities during the entire period of secondary school. The program consisted of four different types of group and self-administered activities: parent meetings, family dialogues, friend meetings, and family meetings. Methods A quasi-experimental design was used following parents and children with questionnaires during the three years of secondary school. The analytic sample consisted of 509 dyads of parents and children. Measures of parental attitudes and behaviour concerning underage drinking and adolescents' lifetime alcohol consumption and drunkenness were used. Three socio-demographic factors were included: parental education, school, and gender of the child. A Latent Growth Modelling (LGM approach was used to examine changes in parental behaviour regarding youth drinking and in young people's drinking behaviour. To test for the pre-post test differences in parental attitudes repeated measures ANOVA were used. Results The results showed that parents in the program maintained their restrictive attitude toward underage drinking to a higher degree than non-participating parents. Adolescents of participants were on average one year older than adolescents with non-participating parents when they made their alcohol debut. They were also less likely to have ever been drunk in school year 9. Conclusion The results of the study suggested that Strong and Clear contributed to maintaining parents' restrictive attitude toward underage drinking during secondary school, postponing alcohol debut among the adolescents, and significantly reducing their drunkenness.

  19. Slow breathing and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Ashish Chaddha

    2015-01-01

    Full Text Available Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  20. Slow breathing and cardiovascular disease.

    Science.gov (United States)

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  1. A systematic review of elderly suicide prevention programs

    DEFF Research Database (Denmark)

    Lapierre, Sylvie; Erlangsen, Annette; Waern, Margda

    2011-01-01

    BACKGROUND: Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area. AIMS: We carried out a systematic review to examine the results of interventions aimed at suicidal elderly persons and to identify successful strategies and areas ...

  2. Integrating Eating Disorder and Obesity Prevention Programs for Adolescents

    Science.gov (United States)

    Shaw, Heather; Ng, Janet; Stice, Eric

    2007-01-01

    Increasingly, researchers in the areas of eating disorders and obesity prevention are recognizing the benefits of collaborative efforts aimed at curbing the spectrum of eating-related disturbances. Research suggests that eating disorders and overweight tend to co-occur, and that individuals cross over from one eating-related disturbance to…

  3. Exercise-Based School Obesity Prevention Programs: An Overview

    Science.gov (United States)

    Yetter, Georgette

    2009-01-01

    Overweight and obesity are major health concerns for young people. Schools are particularly promising environments for preventing and treating obesity. The Institutes of Medicine recommends 60 minutes per day of physical activity for children and youth, including at least 30 minutes at school. Yet the amount of moderate to vigorous physical…

  4. Effects of Correspondence Training in an Abduction Prevention Training Program.

    Science.gov (United States)

    Olsen-Woods, Laurie A.; Miltenberger, Raymond G.; Foreman, Greg

    1998-01-01

    Examines the effects of adding correspondence training to a behavioral skills training package that taught abduction prevention skills to 31 children, ages 4-5 years. Results indicate that correspondence training did not improve correspondence between saying and doing target behaviors. However, both training approaches were equally effective in…

  5. Examing nursing students' understanding of the cardiovascular system in a BSN program

    Science.gov (United States)

    Stuart, Parker Emerson

    This study investigated the alignment of important cardiovascular system (CVS) concepts identified by expert nurses with nursing student's knowledge. Specifically, it focused on the prevalence of nursing students' alternative conceptions for these important concepts as a potential reason for a theory-practice gap in nursing (Corlett, 2000; Jordan, 1994). This is the first study to target nursing student alternative conceptions exclusively whereas other studies focused on diverse groups of undergraduates' CVS knowledge (Michael et al., 2002). The study was divided into two phases and used a case study approach with each phase of the study representing a single case. The first phase of the study sought to understand what CVS concepts expert nurses deemed relevant to their daily practice and how these experts used these concepts. The second phase identified nursing student alternative conceptions through the use of open-ended scenarios based on the results of phase I. For the first phase of the study involved four CVS expert nurses practicing in emergency rooms and cardiac intensive care units at two local hospitals. Interviews were used to elicit important CVS concepts. The expert nurses identified five broad concepts as important to their practice. These concepts were a) cardiovascular anatomical concepts; b) cardiovascular physiological concepts; c) homeostasis and diseases of the CVS; d) the interdependence and interaction of the CVS with other organ systems and e) the intersection of the CVS and technology in patient diagnosis and treatment. These finding reinforce concepts already being taught to nursing students but also suggest that instruction should focus more on how the CVS interacts with other organ systems and how technology and the CVS interact. The presence of alternative conceptions in the nursing students was examined through the use of open-ended questions. A total of 17 students fully completed the scenario questions. Results indicate that this

  6. When are statins cost-effective in cardiovascular prevention? A systematic review of sponsorship bias and conclusions in economic evaluations of statins.

    Directory of Open Access Journals (Sweden)

    Ferrán Catalá-López

    Full Text Available BACKGROUND: We examined sponsorship of published cost-effectiveness analyses of statin use for cardiovascular (CV prevention, and determined whether the funding source is associated with study conclusions. METHODS AND FINDINGS: We searched PubMed/MEDLINE (up to June 2011 to identify cost-effectiveness analyses of statin use for CV prevention reporting outcomes as incremental costs per quality-adjusted life years (QALY and/or life years gained (LYG. We examined relationships between the funding source and the study conclusions by means of tests of differences between proportions. Seventy-five studies were included. Forty-eight studies (64.0% were industry-sponsored. Fifty-two (69.3% articles compared statins versus non-active alternatives. Secondary CV prevention represented 42.7% of articles, followed by primary CV prevention (38.7% and both (18.7%. Overall, industry-sponsored studies were much less likely to report unfavourable or neutral conclusions (0% versus 37.1%; p<0.001. For primary CV prevention, the proportion with unfavourable or neutral conclusions was 0% for industry-sponsored studies versus 57.9% for non-sponsored studies (p<0.001. Conversely, no statistically significant differences were identified for studies evaluating secondary CV prevention (0% versus 12.5%; p=0.222. Incremental costs per QALY/LYG estimates reported in industry-sponsored studies were generally more likely to fall below a hypothetical willingness-to-pay threshold of US $50,000. CONCLUSIONS: Our systematic analysis suggests that pharmaceutical industry sponsored economic evaluations of statins have generally favored the cost-effectiveness profile of their products particularly in primary CV prevention.

  7. Preliminary examination of a couple-based eating disorder prevention program.

    Science.gov (United States)

    Ramirez, Ana L; Perez, Marisol; Taylor, Aaron

    2012-06-01

    The purpose of the current study was to investigate a new dissonance-based prevention program that is based on the dual pathway model of eating disorders within the context of an individual's romantic relationship. A total of 209 dating couples participated in a couple-based prevention program or an assessment-only condition and completed measures of body dissatisfaction, thin-ideal internalization, disordered eating, negative affect, and relationship satisfaction at two time points (approximately one week apart) and approximately half of the sample completed 1-month follow-up measures. The prevention program significantly reduced several key risk factors for eating disorders such as environmental pressures to be thin, internalization of the thin and athletic ideals, state body dissatisfaction, and actual-ideal body discrepancy. Initial support was found for the inclusion of couples in eating disorder prevention programs as a successful way of addressing the thin ideal and its detrimental effects for women.

  8. Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved.

    Science.gov (United States)

    Berz, Jonathan P B; Gergen Barnett, Katherine A; Gardiner, Paula; Saper, Robert B

    2015-11-01

    The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs.

  9. [The relation between economics and medicine in the implementation of a nationwide cardiovascular program].

    Science.gov (United States)

    Kvĕtenský, J; Chudý, P

    1990-01-19

    The health services, being part of the tertiary sphere, must rely as far as material resources are concerned on the results of the economic policy of the state. This has, however, also a feedback effect: economics can have favourable results only when the health status of the population permits the implementation of pretentious economic targets. Thus dialectic relations are involved. Nationwide health programmes must among others promote the health status of the population. It is, however, not possible for the health services to ensure these programmes self-handed. Every section of the population must be responsible for its share. This implies to legal, moral, economic professional, training and finally also political responsibility. The authors discuss the most important problems associated with ensuring mutual relations of these section in the implementation of the cardiovascular programme.

  10. Universal violence and child maltreatment prevention programs for parents: A systematic review

    Directory of Open Access Journals (Sweden)

    Elisa Rachel Pisani Altafim

    2016-04-01

    Full Text Available The present study aimed to review recent literature on universal violence and child maltreatment prevention programs for parents. The following databases were used: Web of Science, PsycINFO, PsycARTICLES, PubMed, LILACS, and SciELO. The keywords included the following: (Parenting Program or Parent Training or Parent Intervention and (Maltreatment or Violence or Violence Prevention. For inclusion in this review, the programs had to be structured, working in groups of parents aiming to improve parenting practices. Twenty-three studies were included, and 16 different types of parenting programs were identified. Ninety-one percent of the studies were conducted in developed countries. All the programs focused on the prevention of violence and maltreatment by promoting positive parenting practices. Only seven studies were randomized controlled trials. All studies that evaluated parenting strategies (n = 18, reported after the interventions. The programs also effectively improved child behavior in 90% of the studies that assessed this outcome. In conclusion, parenting educational programs appear to be an important strategy for the universal prevention of violence and maltreatment against children. Future studies should assess the applicability and effectiveness of parenting programs for the prevention of violence against children in developing countries. Further randomized control trials are also required.

  11. Psychosocial Prevention Education: A Comparison of Traditional vs. Thematic Prevention Programming for Youth

    Science.gov (United States)

    Newgent, Rebecca A.; Higgins, Kristin K.; Belk, Stephanie E.; Behrend, Bonni A. Nickens; Dunbar, Kelly A.

    2011-01-01

    Group counseling has been highlighted as one effective intervention for at-risk students, yet debate remains as to the comparable efficacy of traditional interventions versus thematic interventions. This study compared two psychosocial educational programs, the PEGS and ARK Programs, designed to help elementary school students with social skills…

  12. Attendance at Health Promotion Programs: Baseline Predictors and Program Outcomes.

    Science.gov (United States)

    Atkins, Catherine J.; And Others

    1990-01-01

    As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth or sixth grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. Correlates of attendance were low baseline scores on physical activity and cardiovascular fitness…

  13. Impact and cost of a 2-week community-based screening and awareness program for diabetes and cardiovascular risk factors in a Swiss canton

    Directory of Open Access Journals (Sweden)

    Bovet P

    2011-06-01

    Full Text Available Pascal Bovet1, Philippe Hirsiger2, Frédéric Emery3, Jessica De Bernardini2, Christophe Rossier3, Josefine Trebeljahr2, Isabelle Hagon-Traub21Institute of Social and Preventive Medicine (IUMSP, University of Lausanne and Centre Universitaire Hospitalier Vaudois (CHUV, Lausanne, Switzerland; 2Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland; 3Association of Pharmacists, Canton of Vaud, Lausanne, SwitzerlandBackground: Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place.Intervention and methods: A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000 in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG, and A1c if RBG was ≥7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program.Results: A total of 4222 participants (0.76% of all persons aged ≥18 years underwent the screening program (median age: 53 years, 63% females. Among participants not treated for diabetes, 3.7% had RBG ≥ 7.8 mmol/L and 1.8% had both RBG ≥ 7.0 mmol/L and A1c ≥ 6.5. Untreated blood pressure ≥140/90 mmHg and/or untreated cholesterol ≥5.2 mmol

  14. Prevention of transmitted infections in a pet therapy program: An exemplar.

    Science.gov (United States)

    Hardin, Pam; Brown, Janice; Wright, Mary Ellen

    2016-07-01

    The focus of the patient experience in health care delivery has afforded the opportunity to integrate pet therapy as a part of patient care. The purpose of this article is to present the implementation of a pet therapy program that includes guidelines for the prevention of transmitted infections. Consideration of infection prevention strategies has resulted in a 16-year program with no documented incidences of transmitted infections, averaging 20,000 pet therapy interactions per year.

  15. Implementation of a Tailored Kiosk-Based Injury Prevention Program in Pediatric Primary Care

    OpenAIRE

    2013-01-01

    This study identified behavioral and organizational barriers and facilitators related to the implementation of a clinic-based pediatric injury prevention program. Safe N′ Sound (SNS), an evidence-based tailored injury prevention program designed for pediatric primary care, was implemented in five pediatric clinics in North Carolina. Office managers participated in structured interviews; health care providers participated in focus groups. Waiting room observations were conducted in participati...

  16. Strengthening preventive care programs: a permanent challenge for healthcare systems; lessons from PREVENIMSS México

    OpenAIRE

    Cantón Sonia; Acosta Benjamín; Reyes Hortensia; Levy Santiago; Pérez-Cuevas Ricardo; Gutiérrez Gonzalo; Muñoz Onofre

    2010-01-01

    Abstract Background In 2001, the Instituto Mexicano del Seguro Social (IMSS) carried out a major reorganization to provide comprehensive preventive care to reinforce primary care services through the PREVENIMSS program. This program divides the population into programmatic age groups that receive specific preventive services: children (0-9 years), adolescents (10-19 years), men (20-59 years), women (20-59 years) and older adults (> = 60 years). The objective of this paper is to describe the i...

  17. 14 CFR 135.425 - Maintenance, preventive maintenance, and alteration programs.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance, preventive maintenance, and alteration programs. 135.425 Section 135.425 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.425...

  18. 14 CFR 135.433 - Maintenance and preventive maintenance training program.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance and preventive maintenance training program. 135.433 Section 135.433 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.433 Maintenance and...

  19. Program Evaluation of the "PREPaRE" School Crisis Prevention and Intervention Training Curriculum

    Science.gov (United States)

    Nickerson, Amanda B.; Serwacki, Michelle L.; Brock, Stephen E.; Savage, Todd A.; Woitaszewski, Scott A.; Louvar Reeves, Melissa A.

    2014-01-01

    This study details a program evaluation of the "PREPaRE School Crisis Prevention and Intervention Training Curriculum" ("PREPaRE"), conducted in the United States and Canada between 2009 and 2011. Significant improvements in crisis prevention and intervention attitudes and knowledge were shown among 875 "Crisis Prevention…

  20. Performing Gender: A Discourse Analysis of Theatre-Based Sexual Violence Prevention Programs

    Science.gov (United States)

    Iverson, Susan V.

    2006-01-01

    Among the numerous approaches that are employed to prevent sexual violence, the performance of scenarios has become one of the "promising practices" in U.S. postsecondary education. This article describes findings from a pilot study to analyze scripts used for theatre-based sexual violence prevention programs. Employing the method of…