Researches Regarding the Adaptation Process of the Species Miscanthus Giganteus under the Conditions of Fly Ash Deposit from Utvin, Timis County

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Benoni Lixandru

2013-05-01

Full Text Available Miscanthus giganteus is a large, perennial (up to 20 years grass hybrid of M. sinensis and M. sacchariflorus native to Japan. Is a C4 carbon fixation plant, and thus exhibits greater photosynthetic efficiency and lower water use requirements than other kinds of plants. It has very low nutritional requirements – it has high nitrogen use efficiency and therefore is capable of growing well on barren land without the aid of heavy fertilization. M. giganteus is a sterile hybrid, therefore propagates vegetative through its rhizomes and that it is a completely non-invasive species. In this paper are presented the results of this grass species growing on fly ash deposit Utvin after the first year from the planting. Order to stimulate the process of vegetative from the first year, have used three different fertilizing: with sewage sludge, with cattle manure and mineral supplement such as N.P.K. We have also provided an adequate irrigation during dry periods of the summer. The best germination percentage was obtained in variants fertilized with sewage sludge and manure of cattle. Further the same variations recorded a good growth rate and higher biomass production. However, good production of biomass produced in the first year of all variants show a good adaptability of the species M. giganteus to arid biotope conditions of the fly ash dump.

Primary and secondary prevention of breast cancer.

Science.gov (United States)

Kolak, Agnieszka; Kamińska, Marzena; Sygit, Katarzyna; Budny, Agnieszka; Surdyka, Dariusz; Kukiełka-Budny, Bożena; Burdan, Franciszek

2017-12-23

Breast cancer is the most common cancer among women and is the second cancer frequently occurring worldwide of newly-diagnosed cancers. There is much evidence showing the influence of life style and environmental factors on the development of mammary gland cancer (high-fat diet, alcohol consumption, lack of physical exercise), the elimination of which (primary prevention) may contribute to a decrease in morbidity and mortality. Secondary prevention, comprising diagnostic tests (e.g. mammography, ultrasonography, magnetic resonance imaging, breast self-examination, as well as modern and more precise imaging methods) help the early detection of tumours or lesions predisposing to tumours. The aim of this study paper is to review current knowledge and reports regarding primary and secondary prevention of breast cancer. It is estimated that nearly 70% of malign tumours are caused by environmental factors, whereas in breast cancer this percentage reaches 90-95%. There are national programmes established in many countries to fight cancer, where both types of prevention are stressed as serving to decrease morbidity and mortality due to cancers. Cancer prevention is currently playing a key role in the fight against the disease. Behaviour modification, as well as greater awareness among women regarding breast cancer, may significantly contribute towards reducing the incidence of this cancer. Another important aspect is the number of women undergoing diagnostic tests, which still remains at an unsatisfactory level.

Genetic variation in Miscanthus x giganteus and the importance of estimating genetic distance tresholds for differentiating clones

DEFF Research Database (Denmark)

Glowacka, K; Clark, L; Adhikari, S

2015-01-01

Miscanthus × giganteus (Mxg) is an important bioenergy feedstock crop, however, genetic diversity among legacy cultivars may be severely constrained. Only one introduction from Japan to Denmark of this sterile, triploid, vegetatively propagated crop was recorded in the 1930s. We sought to determi...... new triploid Mxg progeny ranged from 0.46 to 0.56. Though genetic diversity among the Mxg legacy cultivars is critically low, new crosses can provide much-needed variation to growers......Miscanthus × giganteus (Mxg) is an important bioenergy feedstock crop, however, genetic diversity among legacy cultivars may be severely constrained. Only one introduction from Japan to Denmark of this sterile, triploid, vegetatively propagated crop was recorded in the 1930s. We sought to determine...... if the Mxg cultivars in North America were all synonyms, and if they were derived from the European introduction. We used 64 nuclear and five chloroplast simple sequence repeat (SSR) markers to estimate genetic similarity for 27 Mxg accessions from North America, and compared them with six accessions from...

Growth characteristics and nutrient depletion of Miscanthus x ogiformis Honda 'Giganteus' suspension cultures

DEFF Research Database (Denmark)

Holme, Inger Bæksted

1998-01-01

The growth characteristics and nutrient depletion in suspension cultures of Miscanthus ogiformis Honda ‘Giganteus' grown in media containing either Murashige and Skoog or N6 basal nutrient salts were studied during a culture period of 15 days. Proline was added to both media in concentrations from...... to the MS suspension cultures. Sucrose was hydrolysed into its monosaccharide components in the culture medium. Glucose was depleted faster than fructose indicating a preference for glucose as a carbohydrate source of the M. ogiformis cultures. The high water uptake by the suspension aggregates 12 to 15...

Ethics and Issues of Secondary Prevention Efforts in Child Sexual Abuse.

Science.gov (United States)

McCartan, Kieran F; Merdian, Hannah L; Perkins, Derek E; Kettleborough, Danielle

2017-08-01

This article discusses the ethical, practical, and moral issues surrounding secondary prevention efforts of child sexual abuse from a professional and practice-based perspective. Transcripts of a semistructured consultation event with n = 15 international experts on the secondary prevention of child sexual abuse were analysed using thematic qualitative analysis. The research identified four main critical areas linked to secondary prevention efforts, including, the psychology of self-reporting and disclosure; the interaction with and within existing legal, social, and professional frameworks; the scale and type of an appropriate response; and potential hurdles (i.e., within media, public, politics). The article outlines these areas, highlighting participant perspectives on risk-enhancing and mitigating factors for each domain.

The Effect of Trichoderma on Heavy Metal Mobility and Uptake by Miscanthus giganteus, Salix sp., Phalaris arundinacea, and Panicum virgatum

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Malgorzata J. Kacprzak

2014-01-01

Full Text Available The effect of land application of biomaterials based on two strains of Trichoderma fungus on phytoremediation processes was studied. Six metals (Cd, Cr, Cu, Pb, Zn, and Ni were analysed in soil and soil leachate as well as in plant tissues. The translocation index (Ti and metal bioconcentration factors (BCF calculated for the inoculated plants were increased compared to the noninoculated control, except for Pb and Salix sp. Simultaneously, the mobilisation of metals in soil solution as an effect of biomaterials was noted. The highest values of Ti—339% (for Cr, 190% (for Ni, and 110% (for Cu—were achieved for the combination Miscanteus giganteus and Trichoderma MSO1. The results indicated that the application of fungus has positive effects on increasing the biomass, soil parameters (C, N, and P, and solubility of heavy metals in soil and therefore in enhancing phytoextraction for Miscanthus giganteus L., Panicum virgatum L., Phalaris arundinacea L., and Salix sp.

Risk stratification in secondary cardiovascular prevention.

Science.gov (United States)

Lazzeroni, Davide; Coruzzi, Paolo

2018-02-19

Worldwide, more than 7 million people experience acute myocardial infarction (AMI) every year (1), and although substantial reduction in mortality has been obtained in recent decades, one-year mortality rates are still in the range of 10%. Among patients who survive AMI, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of AMI (2). Despite the evidence that lifestyle changes and risk factors management strongly improve long-term prognosis, preventive care post-AMI remains sub-optimal. Cross-sectional data from the serially conducted EUROASPIRE surveys in patients with established ischemic heart disease (IHD) and people at high cardiovascular risk have demonstrated a high prevalence of unhealthy lifestyle, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure and lipid goals (3). Secondary prevention programmes, defined as the level of preventive care focusing on early risk stratification, are highly recommended in all IHD patients, to restore quality of life, maintain or improve functional capacity and prevent recurrence.

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

Science.gov (United States)

Chatterjee, Susmita; Sarkar, Anupam; Rao, Krishna D

2016-01-01

Postpartum heammorrhage (PPH), defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment) in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg). An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention. This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach. The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1) per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6) million to the government to implement the primary prevention compared to the secondary prevention strategy. As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary prevention

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

Directory of Open Access Journals (Sweden)

Susmita Chatterjee

Full Text Available Postpartum heammorrhage (PPH, defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg. An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention.This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach.The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1 per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6 million to the government to implement the primary prevention compared to the secondary prevention strategy.As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary

Organic compounds in root exudates of Miscanthus × Giganteus greef et deu and limitation of microorganisms in its rhizosphere by nutrients

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Hana Kaňová

2010-01-01

Full Text Available This study was conducted to determine the composition of sugars and organic acids in root exudates of Miscanthus × Giganteus and to find out if microorganisms of the rhizospheric soil are limited by mi­ne­ral nutrients. The following sugars and organic acids were determined in root exudates of this plant: glucose, saccharose, and acids such as succinic, propionic, citric, tartaric, malic, oxalic, ascorbic, acetic and fumaric. Respiration of soil from rhizosphere of Miscanthus × Giganteus was found to be limited by N, K and Ca. Respiration rate after application of mineral compounds increased in following orther: nitrate > calcium > potassium > ammonium, giving approx. 165, 99, 52 and 31 % increase compared to control. Further research is necessary to determine the role of plant nutrients from the point of their limitations for rhizosphere microorganisms, to broader very rare knowledges in this topic, especially for polluted soils to stimulate efficiency of phytoremediations.

Intrastrain Comparison of the Chemical Composition and Antioxidant Activity of an Edible Mushroom, Pleurotus giganteus, and Its Potent Neuritogenic Properties

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Chia-Wei Phan

2014-01-01

Full Text Available Two strains of Pleurotus giganteus (commercial and wild were tested for their ability to induce neurite outgrowth in rat pheochromocytoma (PC12 and mouse neuroblastoma-2a (N2a cells. Treatment with the mushroom extracts resulted in neuronal differentiation and neuronal elongation, but not nerve growth factor (NGF production. Linoleic acid (4.5–5.0%, w/w which is a major fatty acid present in the ethanol extract promoted NGF biosynthesis when augmented with low concentration of NGF (5 ng/mL. The two strains of mushroom were found to be high in protein (154–192 g kg−1, total polysaccharides, phenolics, and flavonoids as well as vitamins B1, B2, and B3. The total phenolics present in the mushroom extracts were positively correlated to the antioxidant activity (free radical scavenging, ferric reducing power, and lipid peroxidation inhibition. To conclude, P. giganteus could potentially be used in well-balanced diet and as a source of dietary antioxidant to promote neuronal health.

Esophageal variceal ligation in the secondary prevention of variceal ...

African Journals Online (AJOL)

Pan African Medical Journal ... Introduction: Long-term outcome of patients after band ligation have been poorly defined. ... endoscopic band ligation, liver cirrhosis, complication of band ligation, esophageal varices, secondary prevention ...

Vigas de concreto reforçadas com bambu Dendrocalamus giganteus. I: análise experimental Concrete beams reinforced with bamboo (Dendrocalamus giganteus. I: experimental analysis

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Humberto C. Lima Júnior

2005-12-01

Full Text Available Neste trabalho, apresenta-se e se discute um estudo experimental sobre o comportamento estrutural de vigas de concreto reforçadas com bambu. Ensaiaram-se dez vigas de concreto armado, sendo oito vigas armadas longitudinalmente com varas de bambu Dendrocalamus giganteus e duas vigas de referência, armadas com barras de aço. Duas variáveis foram estudadas: a taxa de armadura longitudinal (1,6 e 3,2% e a relação área/perímetro das varas de bambu (0,25 e 0,33 cm. Para cada combinação de variáveis foram confeccionadas duas vigas. Curvas força vs. deslocamento e força vs. deformação dos materiais são apresentadas e discutidas. Constatou-se que o comportamento estrutural das vigas de concreto reforçadas com bambu segue a teoria de flexão de Bernoulli-Kirchoff, sendo possível a aplicação dos procedimentos usuais de dimensionamento do concreto armado no projeto desses elementos. Observou-se, também, que a capacidade de carga dessas vigas se assemelha à das vigas de aço; contudo, estas são mais rígidas que aquelas.In this paper, an experimental study about bamboo reinforced concrete beams is presented and discussed. Ten reinforced concrete beams were tested, where eight of them were reinforced with Dendrocalamus giganteus bamboo-splint and two reference beams were reinforced with steel bars. Two factors were studied: the longitudinal reinforcement ratio (1.6 and 3.2% and the area/perimeter ratio of the bamboo-splint (0.25 and 0.33 cm. For each factor combination, two beams were cast. Force vs. displacement and force vs. strain curves are presented and discussed. It was found out that the structural behaviour of bamboo-concrete beams follow the Bernoulli-Kirchoff bending theory. Therefore, the usual design procedures of reinforced concrete can be used to design the bamboo-concrete beams. The load capacity of the bamboo-concrete beams is almost the same as that of reinforced with steel; nevertheless, are more stiffer than those

Secondary stroke prevention: challenges and solutions

OpenAIRE

Esenwa, Charles; Gutierrez, Jose

2015-01-01

Charles Esenwa, Jose GutierrezDepartment of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USAAbstract: Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dy...

Old and new oral anticoagulants for secondary stroke prevention in atrial fibrillation

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Tommaso Sacquegna

2015-12-01

Full Text Available Vitamin K antagonists, such as warfarin, used in oral anticoagulation therapy currently represent the standard drugs for the primary and secondary prevention of stroke in non-valvular atrial fibrillation (AF, with a relative risk reduction close to 70%. Newer oral anticoagulants, such as direct thrombin inhibitors (i.e., dabigatran and direct factor Xa inhibitors (i.e., apixaban and rivaroxaban have been recently compared with warfarin in large randomized trials for stroke prevention in AF. The new oral anticoagulants showed, compared with warfarin, no statistically significant difference in the rate of stroke or systemic embolism in secondary prevention (patients with previous transient ischemic attack or stroke subgroups. With regard to safety, the risk of intracranial bleeding was reduced with new anticoagulants compared with warfarin. Indirect treatment comparisons of clinical trials on secondary prevention cohorts showed no significant difference in efficacy among apixaban, rivaroxaban, and dabigatran; but dabigatran 110 mg was associated with less intracranial bleedings than rivaroxaban.

Secondary prevention for coronary artery disease: are we following the guidelines?

LENUS (Irish Health Repository)

Syed, I A A

2012-02-01

BACKGROUND: Secondary prevention pharmacotherapy in post-myocardial infarction (MI) patients reduces the risk of subsequent coronary events and overall mortality. International guidelines recommend use of aspirin, beta-blockers, ACE inhibitors and statins in post-MI patients. AIMS: We performed this audit to review the compliance of prescribing practices, in a regional hospital in Ireland, with international guidelines for secondary prevention of coronary artery disease. METHODS: We performed a retrospective case review of 172 patients diagnosed with MI during a 1-year period between January and December 2007. RESULTS: A total of 134 patients fulfilled the inclusion criteria. On discharge, aspirin was prescribed to 131 (97.76%) patients, clopidogrel to 126 (94%), beta-blockers to 117 (87%), ACE inhibitor to 87 (65%), ARB to 10 (7%) and statins to 116 (87%). CONCLUSION: Our audit shows that targets for prescription of secondary prevention medications were not met in a small but significant proportion of patients and calls for review of discharge practices and education to improve compliance with guidelines.

Implantable Cardioverter-defibrillator Therapy for Hypertrophic Cardiomyopathy: Usefulness in Primary and Secondary Prevention.

Science.gov (United States)

Sarrias, Axel; Galve, Enrique; Sabaté, Xavier; Moya, Àngel; Anguera, Ignacio; Núñez, Elaine; Villuendas, Roger; Alcalde, Óscar; García-Dorado, David

2015-06-01

Hypertrophic cardiomyopathy is a frequent cause of sudden death. Clinical practice guidelines indicate defibrillator implantation for primary prevention in patients with 1 or more risk factors and for secondary prevention in patients with a history of aborted sudden death or sustained ventricular arrhythmias. The aim of the present study was to analyze the follow-up of patients who received an implantable defibrillator following the current guidelines in nonreferral centers for this disease. This retrospective observational study included all patients who underwent defibrillator implantation between January 1996 and December 2012 in 3 centers in the province of Barcelona. The study included 69 patients (mean age [standard deviation], 44.8 [17] years; 79.3% men), 48 in primary prevention and 21 in secondary prevention. The mean number of risk factors per patient was 1.8 in the primary prevention group and 0.5 in the secondary prevention group (P=.029). The median follow-up duration was 40.5 months. The appropriate therapy rate was 32.7/100 patient-years in secondary prevention and 1.7/100 patient-years in primary prevention (P<.001). Overall mortality was 10.1%. Implant-related complications were experienced by 8.7% of patients, and 13% had inappropriate defibrillator discharges. In patients with a defibrillator for primary prevention, the appropriate therapy rate is extremely low, indicating the low predictive power of the current risk stratification criteria. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Developmental and Post-Eruptive Defects in Molar Enamel of Free-Ranging Eastern Grey Kangaroos (Macropus giganteus) Exposed to High Environmental Levels of Fluoride

Science.gov (United States)

Kierdorf, Uwe; Death, Clare; Hufschmid, Jasmin; Witzel, Carsten; Kierdorf, Horst

2016-01-01

Dental fluorosis has recently been diagnosed in wild marsupials inhabiting a high-fluoride area in Victoria, Australia. Information on the histopathology of fluorotic marsupial enamel has thus far not been available. This study analyzed the developmental and post-eruptive defects in fluorotic molar enamel of eastern grey kangaroos (Macropus giganteus) from the same high-fluoride area using light microscopy and backscattered electron imaging in the scanning electron microscope. The fluorotic enamel exhibited a brownish to blackish discolouration due to post-eruptive infiltration of stains from the oral cavity and was less resistant to wear than normally mineralized enamel of kangaroos from low-fluoride areas. Developmental defects of enamel included enamel hypoplasia and a pronounced hypomineralization of the outer (sub-surface) enamel underneath a thin rim of well-mineralized surface enamel. While the hypoplastic defects denote a disturbance of ameloblast function during the secretory stage of amelogenesis, the hypomineralization is attributed to an impairment of enamel maturation. In addition to hypoplastic defects, the fluorotic molars also exhibited numerous post-eruptive enamel defects due to the flaking-off of portions of the outer, hypomineralized enamel layer during mastication. The macroscopic and histopathological lesions in fluorotic enamel of M. giganteus match those previously described for placental mammals. It is therefore concluded that there exist no principal differences in the pathogenic mechanisms of dental fluorosis between marsupial and placental mammals. The regular occurrence of hypomineralized, opaque outer enamel in the teeth of M. giganteus and other macropodids must be considered in the differential diagnosis of dental fluorosis in these species. PMID:26895178

Developmental and Post-Eruptive Defects in Molar Enamel of Free-Ranging Eastern Grey Kangaroos (Macropus giganteus Exposed to High Environmental Levels of Fluoride.

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Uwe Kierdorf

Full Text Available Dental fluorosis has recently been diagnosed in wild marsupials inhabiting a high-fluoride area in Victoria, Australia. Information on the histopathology of fluorotic marsupial enamel has thus far not been available. This study analyzed the developmental and post-eruptive defects in fluorotic molar enamel of eastern grey kangaroos (Macropus giganteus from the same high-fluoride area using light microscopy and backscattered electron imaging in the scanning electron microscope. The fluorotic enamel exhibited a brownish to blackish discolouration due to post-eruptive infiltration of stains from the oral cavity and was less resistant to wear than normally mineralized enamel of kangaroos from low-fluoride areas. Developmental defects of enamel included enamel hypoplasia and a pronounced hypomineralization of the outer (sub-surface enamel underneath a thin rim of well-mineralized surface enamel. While the hypoplastic defects denote a disturbance of ameloblast function during the secretory stage of amelogenesis, the hypomineralization is attributed to an impairment of enamel maturation. In addition to hypoplastic defects, the fluorotic molars also exhibited numerous post-eruptive enamel defects due to the flaking-off of portions of the outer, hypomineralized enamel layer during mastication. The macroscopic and histopathological lesions in fluorotic enamel of M. giganteus match those previously described for placental mammals. It is therefore concluded that there exist no principal differences in the pathogenic mechanisms of dental fluorosis between marsupial and placental mammals. The regular occurrence of hypomineralized, opaque outer enamel in the teeth of M. giganteus and other macropodids must be considered in the differential diagnosis of dental fluorosis in these species.

Violence Prevention in United States Society of Jesus Secondary Schools

Science.gov (United States)

Simonds, Thomas Andrew

2009-01-01

Using data from a representative number of Society of Jesus secondary schools, the researcher reports what these schools are doing to prevent violence, and tests an explanatory model of school violence he created. The researcher proposes that this model can be used to explain and prevent school violence by identifying and addressing the…

Primary and secondary prevention in cardiovascular disease : an old-fashioned concept?

NARCIS (Netherlands)

van Venrooij, FV; Stolk, RP; Banga, JD; Erkelens, DW; Grobbee, DE

Objective. Is the concept of primary and secondary cardiovascular prevention an old-fashioned concept that needs to be re-defined? Design. Discussion paper. Results. Cardiovascular prevention means reduction of absolute risk for cardiovascular disease (CVD), irrespective of clinical stage.

Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome.

Science.gov (United States)

Ergatoudes, Constantinos; Thunström, Erik; Rosengren, Annika; Björck, Lena; Bengtsson Boström, Kristina; Falk, Kristin; Fu, Michael

2016-11-17

A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden. All patients who agreed to participate in the study (16.2%) were invited for a structured interview, physical examinations and laboratory analysis 2 years after AMI. Guideline-directed secondary preventive goals were defined as optimally controlled blood pressure, serum cholesterol, glucose, regular physical activity, smoking cessation and pharmacological treatment. The mean age of the study cohort (n = 200) at the index AMI was 63.0 ± 9.7 years, 79% were men. Only 3.5% of the cohort achieved all six guideline-directed secondary preventive goals 2 years after infarction. LDL therapy was used by 97% of the patients, beta-blockers by 83.0%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers by 76.5% and statins by 88.5%. During follow-up, non-fatal adverse cardiovascular events (cardiac hospitalization, recurrent acute coronary syndrome, angina pectoris, new percutaneous coronary intervention, new onset of atrial fibrillation, post-infarct heart failure, pacemaker implantation, stroke/transient ischemic attack (TIA), cardiac surgery and cardiac arrest) occurred in 47% of the cohort and readmission due to cardiac causes in 30%. Our data showed the failure of secondary prevention in our daily clinical practice and high rate of non-fatal adverse cardiovascular events 2 years after AMI.

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2017-01-01

in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

The evaluation of growth and phytoextraction potential of Miscanthus x giganteus and Sida hermaphrodita on soil contaminated simultaneously with Cd, Cu, Ni, Pb, and Zn.

Science.gov (United States)

Kocoń, Anna; Jurga, Beata

2017-02-01

One of the cheapest, environmentally friendly methods for cleaning an environment polluted by heavy metals is phytoextraction. It builds on the uptake of pollutants from the soil by the plants, which are able to grow under conditions of high concentrations of toxic metals. The aim of this work was to assess the possibility of growing and phytoextraction potential of Miscanthus x giganteus and Sida hermaphrodita cultivated on two different soils contaminated with five heavy metals simultaneously: Cd, Cu, Ni, Pb, and Zn. A 3-year microplot experiment with two perennial energy crops, M. x giganteus and S. hermaphrodita, was conducted in the experimental station of IUNG-PIB in Poland (5° 25' N, 21° 58 'E), in the years of 2008-2010. Miscanthus was found more tolerant to concomitant soil contamination with heavy metals and produced almost double biomass than Sida in all three tested years, independent of soil type. Miscanthus collected greater amount of heavy metals (except for cadmium) in the biomass than Sida. Both energy crops absorb high levels of zinc, lower levels of lead, copper, and nickel, and absorbed cadmium at least, generally more metals were taken from the sandy soil, where plants also yielded better. Photosynthesis net rate of Miscanthus was on average 40% higher compared to Sida. Obtained results indicate that M. x giganteus and S. hermaphrodita can successfully be grown on moderately contaminated soil with heavy metals.

Vigas de concreto reforçadas com bambu Dendrocalamus giganteus. I: análise experimental

OpenAIRE

Lima Júnior,Humberto C.; Mesquita,Ligia P.; Fabro,Gilmar; Willrich,Fábio L.; Czarnieski,Cleber J.

2005-01-01

Neste trabalho, apresenta-se e se discute um estudo experimental sobre o comportamento estrutural de vigas de concreto reforçadas com bambu. Ensaiaram-se dez vigas de concreto armado, sendo oito vigas armadas longitudinalmente com varas de bambu Dendrocalamus giganteus e duas vigas de referência, armadas com barras de aço. Duas variáveis foram estudadas: a taxa de armadura longitudinal (1,6 e 3,2%) e a relação área/perímetro das varas de bambu (0,25 e 0,33 cm). Para cada combinação de variáve...

Randomised controlled trial of a secondary prevention program for myocardial infarction patients ('ProActive Heart': study protocol. Secondary prevention program for myocardial infarction patients

Directory of Open Access Journals (Sweden)

Taylor C Barr

2009-05-01

Full Text Available Abstract Background Coronary heart disease (CHD is a significant cause of health and economic burden. Secondary prevention programs play a pivotal role in the treatment and management of those affected by CHD although participation rates are poor due to patient, provider, health system and societal-level barriers. As such, there is a need to develop innovative secondary prevention programs to address the treatment gap. Telephone-delivered care is convenient, flexible and has been shown to improve behavioural and clinical outcomes following myocardial infarction (MI. This paper presents the design of a randomised controlled trial to evaluate the efficacy of a six-month telephone-delivered secondary prevention program for MI patients (ProActive Heart. Methods 550 adult MI patients have been recruited over a 14 month period (December 2007 to January 2009 through two Brisbane metropolitan hospitals, and randomised to an intervention or control group (n = 225 per group. The intervention commences within two weeks of hospital discharge delivered by study-trained health professionals ('health coaches' during up to 10 × 30 minute scripted telephone health coaching sessions. Participants also receive a ProActive Heart handbook and an educational resource to use during the health coaching sessions. The intervention focuses on appropriate modification of CHD risk factors, compliance with pharmacological management, and management of psychosocial issues. Data collection occurs at baseline or prior to commencement of the intervention (Time 1, six months follow-up or the completion of the intervention (Time 2, and at 12 months follow-up for longer term outcomes (Time 3. Primary outcome measures include quality of life (Short Form-36 and physical activity (Active Australia Survey. A cost-effective analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the

Ultraestructura de bambúes del género Dendrocalamus (Poaceae: Bambusoideae cultivados en Costa Rica III: Dendrocalamus giganteus

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Mayra Montiel

2006-06-01

Full Text Available Dendrocalamus giganteus es una de las especies de bambú más grandes y fuertes, y es ampliamente utilizada con propósitos varios. Se llevó a cabo un análisis ultraestructural de una población costarricense, determinando tres formas de acumulación de la cera cuticular en forma de papilas céricas. En la zona abaxial de la lámina foliar se aprecian estructuras cuadradas, constituidas por dos células de sílice en los extremos y en las partes laterales papilas céricas dobles, en el centro hay papilas céricas esféricas. Estas estructuras son únicas para este especie, por lo que tienen alto valor taxonómico.Dendrocalamus giganteus is one of the biggest, strongest and most used bamboos. An ultrastructural analysis of samples from a Costa Rican population showed that there are three forms of cuticular wax accumulations, shaped like ceric papillae. In the abaxial zone of the leaf lamina there are square structures composed by two silica cells in the boundaries and double ceric papillae in the lateral parts; in the center there are spherical papillae. These structures are unique for this species. Rev. Biol. Trop. 54(Suppl. 2: 59-63. Epub 2006 Dec. 01.

Regulation of Hypertension for Secondary Prevention of Stroke: The Possible 'Bridging Function' of Acupuncture.

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Zheng, Haizhen; Han, Yuhui; Du, Yuzheng; Shi, Xuemin; Huang, Huiyuan; Yu, Xiaoyang; Tan, Xiaochan; Hu, Chunxiao; Wang, Yue; Zhou, Shiyuan

2018-01-01

Worldwide, stroke is the leading cause of mortality and disability, with hypertension being an independent risk factor for a secondary stroke. Acupuncture for the treatment of hypertension gains more attention in alternative and complementary medicine, but the results are inconsistent. Few studies regarding the secondary prevention of stroke by managing hypertension with acupuncture have been carried out as there are some problems regarding the antihypertensive drug status in the secondary prevention of stroke. Still, the potential of acupuncture in regulating the blood pressure for secondary stroke prevention deserves our focus. This review is based on papers recorded in the PubMed, Embase, and Web of Science databases, from their inception until March 28, 2017, and retrieved with the following search terms: hypertension and acupuncture, limited in spontaneously hypertensive rats (SHRs), stress-induced (or cold-induced) hypertensive or pre-hypertensive models. We find that, in these hypertensive animals, acupuncture could mainly influence factors related to the nervous system, oxidative stress, the endocrine system, cardiovascular function, and hemorheology, which are closely associated with the stroke outcome. This trend may give us a hint that acupuncture might well participate in the secondary prevention of stroke through these pathways when used in the management of hypertension. © 2018 S. Karger GmbH, Freiburg.

Role of depression in secondary prevention of Chinese coronary heart disease patients receiving percutaneous coronary intervention.

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Can Feng

Full Text Available Coronary heart disease (CHD patients who have undergone percutaneous coronary intervention (PCI have higher rates of depression than the general population. However, few researchers have assessed the impact of depression on the secondary prevention of CHD in China.The main purpose of this investigation was to explore the relationship between depression and secondary prevention of CHD in Chinese patients after PCI.This descriptive, cross-sectional one-site study recruited both elective and emergency PCI patients one year after discharge. Data from 1934 patients were collected in the clinic using questionnaires and medical history records between August 2013 and September 2015. Depression was evaluated by the 9-item Patient Health Questionnaire. Secondary prevention of CHD was compared between depression and non-depression groups.We found that depression affected secondary prevention of CHD in the following aspects: lipid levels, blood glucose levels, smoking status, physical activity, BMI, and rates of medication use.Depressive patients with CHD are at increased risk of not achieving the lifestyle and risk factor control goals recommended in the 2006 AHA guidelines. Screening should focus on patients after PCI because treating depression can improve outcomes by improving secondary prevention of CHD.

Arthromitus (Bacillus cereus) symbionts in the cockroach Blaberus giganteus: dietary influences on bacterial development and population density

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Feinberg, L.; Jorgensen, J.; Haselton, A.; Pitt, A.; Rudner, R.; Margulis, L.

1999-01-01

The filamentous spore-forming bacterium Arthromitus, discovered in termites, millipedes, sow bugs and other soil-dwelling arthropods by Leidy (1850), is the intestinal stage of Bacillus cereus. We extend the range of Arthromitus habitats to include the hindgut of Blaberus giganteus, the large tropical American cockroach. The occurrence and morphology of the intestinal form of the bacillus were compared in individual cockroaches (n=24) placed on four different diet regimes: diurnally maintained insects fed (1) dog food, (2) soy protein only, (3)purified cellulose only, and (4) a dog food-fed group maintained in continuous darkness. Food quality exerted strong influence on population densities and developmental stages of the filamentous bacterium and on fecal pellet composition. The most dramatic rise in Arthromitus populations, defined as the spore-forming filament intestinal stage, occurred in adult cockroaches kept in the dark on a dog food diet. Limited intake of cellulose or protein alone reduced both the frequency of Arthromitus filaments and the rate of weight gain of the insects. Spores isolated from termites, sow bugs, cockroaches and moths, grown on various hard surfaces display a branching mobility and resistance to antibiotics characteristic to group I Bacilli whose members include B. cereus, B. circulans, B. alvei and B. macerans. DNA isolated from pure cultures of these bacilli taken from the guts of Blaberus giganteus (cockroach), Junonia coenia (moth), Porcellio scaber (sow bug) and Cryptotermes brevis (termite) and subjected to Southern hybridization with a 23S-5S B. subtilis ribosomal sequence probe verified that they are indistinguishable from laboratory strains of Bacillus cereus.

Platelet aggregation inhibitors in primary and secondary prevention of ischemic stroke

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von der Schulenburg, Johann-Matthias

2006-04-01

Full Text Available Background: The ischaemic stroke (IS is one of the most frequent cause of death in Germany. Besides of non-drug many drug-based interventions are used in primary or secondary prevention of IS, among them the thrombocyte aggregation inhibitors (TAI. Objectives: The evaluation addresses the questions on medical efficacy and cost-effectiveness of the TAI administration in the prevention of IS as compared to the management of risk factors alone as well as to the use of anticoagulant drugs. Methods: The literature search for articles published after 1997 was conducted in December 2003 in the most important medical and economic databases. The medical analysis was performed on the basis of the most up-to date meta-analyses of randomised controlled trials (RCT as well as of new published RCT. The data from the studies for stroke, bleeding complications as well as for the combined endpoint "severe vascular events" (SVE: death or stroke or myocardial infarction were summarised in meta-analyses.In order to include grey literature contact has been taken up with the pharmaceutical manufacturers of TAI. Results are presented in a descriptive way. Results: The medical analysis included data from 184 RCT (vs. placebo and from 22 RCT (vs. anticoagulant drugs. The absolute reduction of IS (4.8% vs. 6.6%; p<0,00001 and SVE (10.0% vs. 12.4%; p<0,00001 were definitely higher than the absolute increase of bleeding complications (1.6% vs. 0.9%; p<0,00001, but relatively similar to this absolute increase in a subpopulation with a low risk for SVE. With regard to the stroke prevention, evidence of efficacy could be yielded for acetylsalicil acid (ASA, dipyridamole, cilostazol, ridogrel and the combination ASA with dipyridamole. ASA is less effective than anticoagulants in the prevention of ischaemic stroke in atrial fibrillation, however, it causes fewer bleeding complications.Low dosed ASA can be considered cost-effective in secondary prevention of ischemic stroke

Current issues of preventing tobacco use in secondary school graduates

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Florova N.B.

2013-09-01

Full Text Available Here is identified the tendency to reduce the effectiveness of anti-tobacco prevention work among graduating students of secondary school. This decline may be due to psychological and social reasons. It is shown that risk factors of involving in chemical dependency are meaningfully disclosed in longitudinal studies, whereas the dynamics of personal change during the formation of anti-addictive prevention skills are more fully disclosed in the comparative age sections. The typical phenomena, accompanying the downward trend in prevention, are the growth of problem behavior and the crisis of mass dropout. Such phenomena are so great that they are recognized as a crisis at a state level.

Dabigatran experience in primary and secondary prevention of cardioembolic stroke

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Maksim Alekseyevich Domashenko

2013-01-01

Full Text Available The review of novel oral anticoagulants (dabigatran, rivaroxaban and apixaban in stroke prevention and also own data of administration of dabigatran in primary and secondary prevention of ischemic stroke in 45 patients with cerebrovascular diseases are presented. Most patients received dabigatran 14 days after the first stroke associated with nonvalvular atrial fibrillation. In other cases dabigatran was used for primary prevention of stroke in patients with chronic forms of cerebrovascular diseases and nonvalvular atrial fibrillation. Dabigatran shows good tolerability and efficacy. Recurrent strokes were diagnosed in 2 patients. The reasons for these events were arterial hypertension in one case and symptomatic atherosclerotic plaque in the other case.

Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population

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There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demo...

Optimising secondary prevention in the acute period following a TIA of ischaemic origin.

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Heron, Neil

2016-01-01

Transient ischaemic attacks (TIAs) are highly prevalent conditions, with at least 46 000 people per year in the UK having a TIA for the first time. TIAs are a warning that the patient is at risk of further vascular events and the 90-day risk of vascular events following a TIA, excluding events within the first week after diagnosis when the risk is highest, can be as high as 18%. Immediate assessment of patients with TIA, either at accident and emergency, general practice and/or TIA clinics, is therefore required to address secondary prevention and prevent further vascular events. This article addresses the need for optimising secondary prevention in the acute period following a TIA of ischaemic origin to reduce the risk of further vascular events as per recent Cochrane review advice and presents a novel project, Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE), to do this. One novel way to tackle vascular risk factors and promote secondary prevention in patients with TIA could be to adapt a cardiac rehabilitation programme for these patients. SPRITE, a feasibility and pilot study (ClinicalTrials.gov Identifier: NCT02712385) funded by the National Institute for Health Research, is attempting to adapt a home-based cardiac rehabilitation programme, 'The Healthy Brain Rehabilitation Manual', for use in the acute period following a TIA. The use of cardiac rehabilitation programmes post-TIA requires further research, particularly within the primary care setting.

Effectiveness of recommended drug classes in secondary prevention of acute coronary syndrome in France

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf; Ali, Sanni; Lassalle, Régis; De Boer, Anthonius; Moore, Nicholas; Klungel, Olaf; Pariente, Antoine

Background: Guidelines for cardiovascular secondary prevention are based on evidence from relatively old clinical trials and need to be evaluated in daily clinical practice. Objectives: To evaluate effectiveness of the recommended drug classes after an acute coronary syndrome (ACS) for secondary

Arbuscular mycorrhizal fungal inoculation protects Miscanthus × giganteus against trace element toxicity in a highly metal-contaminated site.

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Firmin, Stéphane; Labidi, Sonia; Fontaine, Joël; Laruelle, Frédéric; Tisserant, Benoit; Nsanganwimana, Florian; Pourrut, Bertrand; Dalpé, Yolande; Grandmougin, Anne; Douay, Francis; Shirali, Pirouz; Verdin, Anthony; Lounès-Hadj Sahraoui, Anissa

2015-09-15

Arbuscular mycorrhizal fungus (AMF)-assisted phytoremediation could constitute an ecological and economic method in polluted soil rehabilitation programs. The aim of this work was to characterize the trace element (TE) phytoremediation potential of mycorrhizal Miscanthus × giganteus. To understand the mechanisms involved in arbuscular mycorrhizal symbiosis tolerance to TE toxicity, the fatty acid compositions and several stress oxidative biomarkers were compared in the roots and leaves of Miscanthus × giganteus cultivated under field conditions in either TE-contaminated or control soils. TEs were accumulated in greater amounts in roots, but the leaves were the organ most affected by TE contamination and were characterized by a strong decrease in fatty acid contents. TE-induced oxidative stress in leaves was confirmed by an increase in the lipid peroxidation biomarker malondialdehyde (MDA). TE contamination decreased the GSSG/GSH ratio in the leaves of exposed plants, while peroxidase (PO) and superoxide dismutase (SOD) activities were increased in leaves and in whole plants, respectively. AMF inoculation also increased root colonization in the presence of TE contamination. The mycorrhizal colonization determined a decrease in SOD activity in the whole plant and PO activities in leaves and induced a significant increase in the fatty acid content in leaves and a decrease in MDA formation in whole plants. These results suggested that mycorrhization is able to confer protection against oxidative stress induced by soil pollution. Our findings suggest that mycorrhizal inoculation could be used as a bioaugmentation technique, facilitating Miscanthus cultivation on highly TE-contaminated soil. Copyright © 2015. Published by Elsevier B.V.

Nitrogen Reserve Pools in Two Miscanthus × giganteus Genotypes under Contrasting N Managements

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Ryan M. Dierking

2017-09-01

Full Text Available Nitrogen (N reserves in vegetative tissues contribute N to regrowth of Miscanthus × giganteus shoots in spring, but our understanding of how N fertilization and plant genotype affect this process is incomplete. Our specific objectives were to: (1 determine how N fertilizer management impacts accumulation of dry matter and N among aboveground and belowground tissues and organs; (2 understand how changes in N management and tissue N concentration influence seasonal fluctuations in concentrations of buffer-soluble proteins and amino acids in putative storage organs including rhizomes and roots; and (3 characterize genotypic variability and genotype × N interactions for N reserve accumulation and use among Miscanthus × giganteus genotypes. Established plots of the IL Clone and Nagara-sib population were fertilized with 0–0, 0–150, 75–75, 150–0, and 150–150 kg N ha-1 where the first numeral denotes the N rate applied in 2011 (Year 1 and the second number denotes the N rate applied in 2012 (Year 2. Rhizomes, roots, stembases, and shoots were sampled at 6-week intervals between March and August and then in November at dormancy. Concentrations of N, soluble protein and amino-N increased in all tissues with fertilizer N application. With the exception of rhizome amino-N, concentrations of these N pools in roots and rhizomes declined as plants resumed growth in spring and increased sharply between August and November as growth slowed. Losses in shoot and stembase N mass between August and November were similar to total N accumulation in roots and rhizomes during this interval. Compared to the unfertilized control, specific N managements enhanced growth of above- and belowground tissues. The IL Clone generally had greater biomass yield of all organs than the Nagara-sib; the exception being shoot biomass in November when extensive leaf senescence reduce yield of the IL Clone. High biomass yields were obtained with 75 kg N ha-1 applied annually

Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality.

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Maxwell, Giliana M; Radzilani-Makatu, Makondelele; Takalani, James F

2016-04-01

Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education) suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP) in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. The conclusion drawn was that learners are aware of the measures for preventing TP.

Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality

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Giliana M. Maxwell

2016-04-01

Full Text Available Background: Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. Aim: The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Setting: The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. Methodology: A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Results: Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. Conclusion: The conclusion drawn was that learners are aware of the measures for preventing TP. Keywords

Ultraestructura de bambúes del género Dendrocalamus (Poaceae: Bambusoideae) cultivados en Costa Rica III: Dendrocalamus giganteus

OpenAIRE

Mayra Montiel; Ethel Sánchez

2006-01-01

Dendrocalamus giganteus es una de las especies de bambú más grandes y fuertes, y es ampliamente utilizada con propósitos varios. Se llevó a cabo un análisis ultraestructural de una población costarricense, determinando tres formas de acumulación de la cera cuticular en forma de papilas céricas. En la zona abaxial de la lámina foliar se aprecian estructuras cuadradas, constituidas por dos células de sílice en los extremos y en las partes laterales papilas céricas dobles, en el centro hay papil...

HIV, other STD, and pregnancy prevention education in public secondary schools -- 45 states, 2008-2010.

Science.gov (United States)

2012-04-06

In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy. The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection. The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents. To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF, CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.

Cytotoxicity and modes of action of four Cameroonian dietary spices ethno-medically used to treat cancers: Echinops giganteus, Xylopia aethiopica, Imperata cylindrica and Piper capense.

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Kuete, Victor; Sandjo, Louis P; Wiench, Benjamin; Efferth, Thomas

2013-08-26

Echinops giganteus, Imperata cylindrica, Piper capense and Xylopia aethiopica are four medicinal spices used in Cameroon to treat cancers. The above plants previously displayed cytotoxicity against leukemia CCRF-CEM and CEM/ADR5000 cell lines as well as human pancreatic MiaPaCa-2 cells. The present study aims at emphasizing the study of the cytotoxicity and the modes of action of the above plants on a panel of ten cancer cell lines including various sensitive and drug-resistant phenotypes. The study has been extended to the isolation of the bioactive constituents from Echinops giganteus. The cytotoxicity of the extracts was determined using a resazurin reduction assay, whereas the caspase-Glo assay was used to detect the activation of caspases 3/7, caspase 8 and caspase 9 in cells treated with the four extracts. Flow cytometry was used for cell cycle analysis and detection of apoptotic cells, analysis of mitochondrial membrane potential (MMP) as well as measurement of reactive oxygen species (ROS). The four tested extracts inhibited the proliferation of all tested cancer cell lines including sensitive and drug-resistant phenotypes. Collateral sensitivity of cancer cells to the extract of Echinops giganteus was generally better than to doxorubicin. The recorded IC50 ranges were 3.29 µg/mL [against human knockout clones HCT116 (p53(-/-)) colon cancer cells] to 14.32 µg/mL (against human liver hepatocellular carcinoma HepG2 cells) for the crude extract from Echinops giganteus, 4.17 µg/mL (against breast cancer cells transduced with control vector MDA-MB231 cells) to 19.45 µg/mL (against MDA-MB-231 BCRP cells) for that of Piper capense, 4.11 µg/mL (against leukemia CCRF-CEM cells) to 30.60 µg/mL (against leukemia HL60AR cells) for Xylopia aethiopica, 3.28 µg/mL [against HCT116 (p53(-/-)) cells] to 33.43 µg/mL (against HepG2 cells) for Imperata cylindica and 0.11 µg/mL (against CCRF-CEM cells) to 132.47 µg/mL (against HL60AR cells) for doxorubicin. The four

Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.

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Tan, Eng Keong; Loh, Kah Poh; Goff, Sarah L

2017-12-01

Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.

Use of secondary prevention pharmacotherapy after first myocardial infarction in patients with diabetes mellitus

DEFF Research Database (Denmark)

Jørgensen, Casper H.; Gislason, Gunnar H.; Ahlehoff, Ole

2014-01-01

BACKGROUND: Despite recommended pharmacotherapies the use of secondary prevention therapy after myocardial infarction (MI) remains suboptimal. Patients with diabetes mellitus (DM) have worse prognosis after MI compared to patients without DM and aggressive secondary prevention pharmacotherapy......-blockers, and clopidogrel within 90 days, and statins within 180 days of discharge, respectively. RESULTS: A total of 78,230 patients were included, the mean age was 68.3 years (SD 13.0), 63.5% were men and 9,797 (12.5%) had diabetes. Comparison of claimed prescriptions in the period 1997-2002 and 2003-2006 showed...

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2016-01-01

-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2017-01-01

-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

ERECTA-family receptor kinase genes redundantly prevent premature progression of secondary growth in the Arabidopsis hypocotyl.

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Ikematsu, Shuka; Tasaka, Masao; Torii, Keiko U; Uchida, Naoyuki

2017-03-01

Secondary growth is driven by continuous cell proliferation and differentiation of the cambium that acts as vascular stem cells, producing xylem and phloem to expand vascular tissues laterally. During secondary growth of hypocotyls in Arabidopsis thaliana, the xylem undergoes a drastic phase transition from a parenchyma-producing phase to a fiber-producing phase at the appropriate time. However, it remains to be fully elucidated how progression of secondary growth is properly controlled. We focused on phenotypes of hypocotyl vasculatures caused by double mutation in ERECTA (ER) and ER-LIKE1 (ERL1) receptor-kinase genes to elucidate their roles in secondary growth. ER and ERL1 redundantly suppressed excessive radial growth of the hypocotyl vasculature during secondary growth. ER and ERL1 also prevented premature initiation of the fiber differentiation process mediated by the NAC SECONDARY WALL THICKENING PROMOTING FACTORs in the hypocotyl xylem. Upon floral transition, the hypocotyl xylem gained a competency to respond to GA in a BREVIPEDICELLUS-dependent manner, which was a prerequisite for fiber differentiation. However, even after the floral transition, ER and ERL1 prevented precocious initiation of the GA-mediated fiber formation. Collectively, our findings reveal that ER and ERL1 redundantly prevent premature progression of sequential events in secondary growth. © 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.

Challenges and opportunities for primary, secondary, and tertiary prevention of Chagas' disease.

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Rassi, A; Dias, J C P; Marin-Neto, J A; Rassi, A

2009-04-01

A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.

Risk of misclassification with a non-fasting lipid profile in secondary cardiovascular prevention.

Science.gov (United States)

Klop, Boudewijn; Hartong, Simone C C; Vermeer, Henricus J; Schoofs, Mariette W C J; Kofflard, Marcel J M

2017-09-01

Routinely fasting is not necessary for measuring the lipid profile according to the latest European consensus. However, LDL-C tends to be lower in the non-fasting state with risk of misclassification. The extent of misclassification in secondary cardiovascular prevention with a non-fasting lipid profile was investigated. 329 patients on lipid lowering therapy for secondary cardiovascular prevention measured a fasting and non-fasting lipid profile. Cut-off values for LDL-C, non-HDL-C and apolipoprotein B were set at fasting LDL-C (calculated using the Friedewald formula), direct LDL-C, non-HDL-C and apolipoprotein B. Net misclassification fasting measurements resulted in lower LDL-C (-0.2±0.4mmol/l, Pfasting LDL-C target of fasting state. In the non-fasting state net misclassification with direct LDL-C was 5.7% (95% CI 2.1-9.2%), 4.0% (95% CI 1.0-7.4%) with non-HDL-C and 4.1% (95% CI 1.1-9.1%) with apolipoprotein B. Use of non-fasting LDL-C as treatment target in secondary cardiovascular prevention resulted in significant misclassification with subsequent risk of undertreatment, whereas non-fasting direct LDL-C, non-HDL-C and apolipoprotein B are reliable parameters. Copyright © 2017 Elsevier B.V. All rights reserved.

Primary and Secondary Prevention Trials in Alzheimer Disease: Looking Back, Moving Forward

Science.gov (United States)

Hsu, David C.; Marshall, Gad A.

2015-01-01

The field of Alzheimer disease (AD) prevention has been a culmination of basic science, clinical, and translational research. In the past three years since the new 2011 AD diagnostic guidelines, large-scale collaborative efforts have embarked on new clinical trials with the hope of someday preventing AD. This review will shed light on the historical and scientific contexts in which these trials were based on, as well as discuss potential challenges these trials may face in the coming years. Primary preventive measures, such as lifestyle, multidomain, medication, and supplemental interventions, will be analyzed. Secondary prevention as represented by disease-modifying interventions, such as anti-amyloid therapy and pioglitazone, will also be reviewed. Finally, hypotheses on future directions for AD prevention trials will be proposed. PMID:27697063

New insights into secondary prevention in post-traumatic stress disorder

Science.gov (United States)

Zohar, Joseph; Juven-Wetzler, Alzbeta; Sonnino, Rachel; Cwikel-Hamzany, Shlomit; Balaban, Evgenya; Cohen, Hagit

2011-01-01

Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies. PMID:22033784

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

Science.gov (United States)

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

2003-10-01

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

Secondary prevention after minor stroke and TIA - usual care and development of a support program.

Directory of Open Access Journals (Sweden)

Stefanie Leistner

Full Text Available Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program.Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU. Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed.168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP: 155/84 mmHg and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg were assessed at 6 months. Proportions of patients with BP according to guidelines were 50% in usual-care and 77% in the support program (p<0.01. LDL<100 mg/dl was measured in 62 versus 71% (p = 0.12. Proportions of patients who stopped smoking were 50 versus 79% (p<0.01. 72 versus 89% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09.Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-vascular recurrence rates are going to be assessed in a multicenter randomized trial.

Decline in Coronary Mortality in Sweden between 1986 and 2002: Comparing Contributions from Primary and Secondary Prevention.

Directory of Open Access Journals (Sweden)

Lena Björck

Full Text Available The relative importance of risk factor reduction in healthy people (primary prevention versus that in patients with coronary heart disease (secondary prevention has been debated. We aimed to quantify the contribution of the two.We used the previously validated IMPACT model to estimate contributions from primary prevention (reducing risk factors in the population, particularly smoking, cholesterol and systolic blood pressure and from secondary prevention (reducing risk factors in coronary heart disease patients in the Swedish population.Between 1986 and 2002, about 8,690 fewer deaths were related to changes in the three major risk factors. Population cholesterol fell by 0.64 mmol/L, with approximately 5,210 fewer deaths attributable to diet changes (4,470 in healthy people740 in patients. plus 810 to statin treatment (200 in healthy people, 610 in patients. Overall smoking prevalence decreased by 10.3%, resulting in 1,195 fewer deaths, attributable to smoking cessation (595 in healthy people, 600 in patients. Mean population systolic blood pressure fell by 2.6 mmHg, resulting in 900 fewer deaths (865 in healthy people, 35 in patients, plus 575 fewer deaths attributable to antihypertensive medication in healthy people. The majority of falls in deaths attributable to risk factors occurred in people without known heart disease: 6,705 fewer deaths compared with 1,985 fewer deaths in patients (secondary prevention, emphasizing the importance of promoting health interventions in the general population.The largest effects on mortality came from primary prevention, giving markedly larger mortality reductions than secondary prevention.

Cranialization of the frontal sinus for secondary mucocele prevention following open surgery for benign frontal lesions.

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Gilad Horowitz

Full Text Available OBJECTIVE: To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus. STUDY DESIGN: Retrospective case series. SETTING: Tertiary academic medical center. PATIENTS: Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011. INTERVENTIONS: Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59% or frontal cranialization (n = 28, 41%. MAIN OUTCOME MEASURES: The prevalence of post-surgical complications and secondary mucocele formation were compiled. RESULTS: Pathologies included osteoma (n = 34, 49%, mucocele (n = 27, 39%, fibrous dysplasia (n = 6, 9%, and encephalocele (n = 2, 3%. Complications included skin infections (n = 6, postoperative cutaneous fistula (n = 1, telecanthus (n = 4, diplopia (n = 3, nasal deformity (n = 2 and epiphora (n = 1. None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001. CONCLUSION: Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions.

Cymbopogon citratus and Cymbopogon giganteus essential oils have cytotoxic effects on tumor cell cultures. Identification of citral as a new putative anti-proliferative molecule.

Science.gov (United States)

Bayala, Bagora; Bassole, Imaël H N; Maqdasy, Salwan; Baron, Silvère; Simpore, Jacques; Lobaccaro, Jean-Marc A

2018-03-06

Cymbopogon species are used as traditional remedies in Burkina Faso for treating several diseases. We aimed to study the effects of their essential oils on cancer cell lines. For that purpose, Cymbopogon citratus (DC.) Stapf. and Cymbopogon giganteus Chiov. were studied for their essential oils after various chemical extractions. Antioxidant, potential anti-inflammatory action (inhibition of lipoxygenase) and cytotoxic activities were also tested on various prostate cancer and glioblastoma cell lines. Thirty-three compounds were identified in the essential oil of C. giganteus: Limonene (19.33%), Mentha-1(7),8-dien-2-ol cis (17.34%), Mentha-1(7),8-dien-2-ol trans (13.95%), trans-Mentha-2,8-diene-para-ol 1 (13.91%) and Mentha-2,8-diene-1-ol, cis-para (8.10%) were the most abundant. C. citratus essential oil contained 15 compounds and the major ones were geranial/citral A (48.18%) and neral/citral B (34.37%). Essential oil of C. citratus showed the highest ability to scavenge DPPH + radicals (approximately 68% at 8 mg/mL) while C. giganteus exhibited the highest capability to reduce ABTS + (0.59μmolET/g). The essential oil of C. citratus was the most effective on prostate cell lines LNCaP (IC 50  = 6.36 μg/ml) and PC-3 (IC 50  = 32.1 μg/ml), and on glioblastoma cell lines (SF-767 (IC 50  = 45.13 μg/ml) and SF-763 (IC 50  = 172.05 μg/ml). Interestingly, the activity of essential oil of C. citratus was statistically equal to that of its major component, citral. Combination of both oils showed antagonist, additive, indifferent and synergistic effects on LNCaP, PC-3, SF-767 and SF-763 cell lines, respectively. In conclusion, plants from the traditional medicine in Burkina Faso could be of interest for identifying new compounds, such as citral, for the treatment of prostate cancer and glioblastoma. Copyright © 2018 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review

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Lynne V. McFarland

2015-04-01

Full Text Available Clostridium difficile infections are a global clinical concern and are one of the leading causes of nosocomial outbreaks. Preventing these infections has benefited from multidisciplinary infection control strategies and new antibiotics, but the problem persists. Probiotics are effective in preventing antibiotic-associated diarrhea and may also be a beneficial strategy for C. difficile infections, but randomized controlled trials are scarce. This meta-analysis pools 21 randomized, controlled trials for primary prevention of C. difficile infections (CDI and four trials for secondary prevention of C. difficile recurrences and assesses the efficacy of specific probiotic strains. Four probiotics significantly improved primary CDI prevention: (Saccharomyces boulardii, Lactobacillus casei DN114001, a mixture of L. acidophilus and Bifidobacterium bifidum, and a mixture of L. acidophilus, L. casei and L. rhamnosus. None of the tested probiotics significantly improved secondary prevention of CDI. More confirmatory randomized trials are needed to establish if probiotics are useful for preventing C. difficile infections. v

In vitro Propagation of Giant Bamboo (Dendrocalamus giganteus) and Arudinaria alpina

International Nuclear Information System (INIS)

Machua, J.; Sigu, G. Gathura M.; Nyingi, J

2007-01-01

The giant bamboo (Dendrocalamus giganteus) is a multipurpose tree with uses and it has been widely cultivated in Asia while the indigenous bamboo (Arudinaria alpina) has a very low rate of domestication. The propagation and establishment of bamboo species is hampered by infrequent flowering, insufficient and irregular supply of seeds and inadequate knowledge of propagation technologies. The study aimed at developing in vitro techniques for mass propagation of the bamboo. Bamboo explant material was collected and and sterilized in a permutation of sterilizers over varying durations. The explants were further inoculated into matrix of hormonal concentrations. Successful sterilization of both Dendrocalamous giganteous and Arudinaria alpina was achieved in 25% v/v formaldehyde for 20 minutes resulting in a 75% survival. On the other hand sterilization with sodium hypochlorite was found to be ineffective for both species. Root initiation was not achieved after six weeks in varying concentrations of IBA (indolebutyric acid), NAA (+ n aphthalene acetic acid) and a blanket application of 0.3mgl -1 BAP, by which time most microshoots had overgrown the culture tubes. In conclusion, 25% v/v formaldehyde for 20 minutes is adequate for bamboo explant sterilization while microshoots induction could be achieved though varying BAP concentrations while the culture conditions were optimal for toot initiation

The effects of a three-year smoking prevention programme in secondary schools in Helsinki.

Science.gov (United States)

Vartiainen, Erkki; Pennanen, Marjaana; Haukkala, Ari; Dijk, Froukje; Lehtovuori, Riku; De Vries, Hein

2007-06-01

This study evaluates the effects of a 3-year smoking prevention programme in secondary schools in Helsinki. The study is part of the European Smoking prevention Framework Approach (ESFA), in which Denmark, Finland, the Netherlands, Portugal, Spain and the UK participated. A total of 27 secondary schools in Finland participated in the programme (n = 1821). Schools were randomised into experimental (13) and control groups (14). The programme included 14 information lessons about smoking and refusal skills training. The 3-year smoking prevention programme was also integrated into the standard curriculum. The community-element of the programme included parents, parish confirmation camps and dentists. The schools in the experimental group received the prevention programme and the schools in the control group received the standard health education curriculum. Among baseline never smokers (60.8%), the programme had a significant effect on the onset of weekly smoking in the experimental group [OR = 0.63 (0.45-0.90) P = 0.009] when compared with the control group. Being female, doing poorly at school, having parents and best friends who smoke and more pocket money to spend compared with others were associated with an increased likelihood of daily and weekly smoking onset. These predictors did not have an interaction effect with the experimental condition. This study shows that a school- and community-based smoking prevention programme can prevent smoking onset among adolescents.

Pharmacoepidemiological analysis of the drugs used for secondary prevention of brain infarction on dispensary stage

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Miheyeva N.V.

2014-03-01

Full Text Available Aim. The secondary prevention of cerebral infarction on dispensary stage to current clinical guidelines was analyzed. Adherence of patients to prescribe medications was evaluated. Material and methods. 106 patients of hospital neurologic department with brain infarction were included in prospective pharmacoepidemiological study of the drugs used for secondary prevention of brain infarction on dispensary stage since 1 January 2009 to 31 December 2009. Duration of outpatient observation was 3 years. Results. All of the patients were of 64,9 ± 10,3 years old. Hypertension was diagnosed in 102 of them (96.2%, atrial fibrillation — in 33 (31.1% patients. 39 (36.8% patients died during 3 years after discharge from the hospital. ACE inhibitors/angiotensin II receptor antagonist were prescribed for 83 (78.3% patients, antiplatelet- 76 (71,7%, statins — 16 (15,1% patients in discharge from hospital. Warfarin was prescribed only for 1 (3.05% patient with atrial fibrillation and ischemic stroke.consumption of drugs with evidence efficiency were diminished already after one year of observation in outpatient clinics. Conclusion.Therapy for secondary stroke prevention is not fully comply with current clinical guidelines

Availability of human immunodeficiency virus prevention services in secondary schools in Kabarole District, Uganda

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Jane Namuddu

2015-08-01

Full Text Available The aim of this study was to assess the level of availability of HIV prevention strategies in secondary schools in Kabarole district, Uganda in order to inform the design of interventions to strengthen HIV Prevention and psychosocial support. Quantitative and qualitative research methods were used in eight secondary schools in Kabarole district to establish available HIV prevention and psychosocial support services. Questionnaires were administered to 355 students 12-24 years old. In addition, 20 Key Informant interviews were held with education service providers. Quantitative data was analyzed using Epi-data and qualitative data were analyzed by thematic content analysis. Seven of the eight schools had at least one HIV prevention strategy. Two teachers in each of the five schools had been trained in HIV prevention. No school had a nurse trained in HIV prevention, care and support. Education service providers had limited knowledge of HIV prevention support and care of students living with HIV. We found out that students had knowledge on how one can acquire HIV. HIV prevention services reported by students in schools included: talks from teachers and guests (19%, drama with HIV prevention related messages (16%, peer education clubs (15%, workshops and seminars on HIV (8%, sensitization about HIV/AIDS (7%, guidance and counseling (6%, talking compounds- (5%, abstinence talks (6%, keeping students busy in sports (4%, straight talk (4%. Sixty three percent reported receiving HIV reading materials from various sources. Preventing HIV infection among students in schools is still demanding with limited interventions for students. Efforts to support school interventions should focus on including HIV Prevention in the school curriculum, working with peer educators as well as education service providers who spend much of the time with the students while at school.

Achieving secondary prevention low-density lipoprotein particle concentration goals using lipoprotein cholesterol-based data.

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Simon C Mathews

Full Text Available BACKGROUND: Epidemiologic studies suggest that LDL particle concentration (LDL-P may remain elevated at guideline recommended LDL cholesterol goals, representing a source of residual risk. We examined the following seven separate lipid parameters in achieving the LDL-P goal of <1000 nmol/L goal for very high risk secondary prevention: total cholesterol to HDL cholesterol ratio, TC/HDL, <3; a composite of ATP-III very high risk targets, LDL-C<70 mg/dL, non-HDL-C<100 mg/dL and TG<150 mg/dL; a composite of standard secondary risk targets, LDL-C<100, non-HDL-C<130, TG<150; LDL phenotype; HDL-C ≥ 40; TG<150; and TG/HDL-C<3. METHODS: We measured ApoB, ApoAI, ultracentrifugation lipoprotein cholesterol and NMR lipoprotein particle concentration in 148 unselected primary and secondary prevention patients. RESULTS: TC/HDL-C<3 effectively discriminated subjects by LDL-P goal (F = 84.1, p<10(-6. The ATP-III very high risk composite target (LDL-C<70, nonHDL-C<100, TG<150 was also effective (F = 42.8, p<10(-5. However, the standard secondary prevention composite (LDL-C<100, non-HDL-C<130, TG<150 was also effective but yielded higher LDL-P than the very high risk composite (F = 42.0, p<10(-5 with upper 95% confidence interval of LDL-P less than 1000 nmol/L. TG<150 and TG/HDL-C<3 cutpoints both significantly discriminated subjects but the LDL-P upper 95% confidence intervals fell above goal of 1000 nmol/L (F = 15.8, p = 0.0001 and F = 9.7, p = 0.002 respectively. LDL density phenotype neared significance (F = 2.85, p = 0.094 and the HDL-C cutpoint of 40 mg/dL did not discriminate (F = 0.53, p = 0.47 alone or add discriminatory power to ATP-III targets. CONCLUSIONS: A simple composite of ATP-III very high risk lipoprotein cholesterol based treatment targets or TC/HDL-C ratio <3 most effectively identified subjects meeting the secondary prevention target level of LDL-P<1000 nmol/L, providing a potential alternative to advanced lipid testing in many clinical

Obstacles to the Primary and Secondary Prevention of Breast Cancer in African-American Women

National Research Council Canada - National Science Library

Hargreaves, Margaret

1997-01-01

Study objectives are to develop a quantitative assessment tool to describe barriers to primary and secondary prevention of breast cancer, to use this tool to establish preliminary norms in an urban...

The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.

OpenAIRE

Houk, V N; Thacker, S B

1989-01-01

The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increa...

Fibrates for secondary prevention of cardiovascular disease and stroke.

Science.gov (United States)

Wang, Deren; Liu, Bian; Tao, Wendan; Hao, Zilong; Liu, Ming

2015-10-25

Fibrates are a class of drugs characterised by mainly lowering high triglyceride, raising high-density lipoprotein (HDL) cholesterol, and lowering the small dense fraction of low-density lipoprotein (LDL) cholesterol. Their efficacy for secondary prevention of serious vascular events is unclear, and to date no systematic review focusing on secondary prevention has been undertaken. To assess the efficacy and safety of fibrates for the prevention of serious vascular events in people with previous cardiovascular disease (CVD), including coronary heart disease and stroke. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 9, 2014) on the Cochrane Library, MEDLINE (OVID, 1946 to October week 1 2014), EMBASE (OVID, 1980 to 2014 week 41), the China Biological Medicine Database (CBM) (1978 to 2014), the Chinese National Knowledge Infrastructure (CNKI) (1979 to 2014), Chinese Science and Technique Journals Database (VIP) (1989 to 2014). We also searched other resources, such as ongoing trials registers and databases of conference abstracts, to identify further published, unpublished, and ongoing studies. We included randomised controlled trials (RCTs) in which a fibrate (for example gemfibrozil, fenofibrate) was compared with placebo or no treatment. We excluded RCTs with only laboratory outcomes. We also excluded trials comparing two different fibrates without a placebo or no-treatment control. Two review authors independently selected trials for inclusion, assessed risk of bias, and extracted the data. We contacted authors of trials for missing data. We included 13 trials involving a total of 16,112 participants. Eleven trials recruited participants with history of coronary heart disease, two trials recruited participants with history of stroke, and one trial recruited participants with a mix of people with CVD. We judged overall risk of bias to be moderate. The meta-analysis (including all fibrate trials) showed evidence for a protective

Secondary prevention at 360°: the important role of diagnostic imaging.

Science.gov (United States)

Ciarrapico, Anna Micaela; Manenti, Guglielmo; Pistolese, Chiara; Fabiano, Sebastiano; Fiori, Roberto; Romagnoli, Andrea; Sergiacomi, Gianluigi; Stefanini, Matteo; Simonetti, Giovanni

2015-06-01

The aim of this paper is to underline the importance of the role of general practitioners (GPs) in distributing vital information about prevention to citizens, to highlight the importance of the so-called voluntary prevention programmes, both for conditions for which no organised screening programmes exist and for those for which they do exist but may well be obsolete or inefficient. Nowadays, voluntary prevention is made more effective thanks to the new sophisticated diagnostic technologies applied worldwide by diagnostic imaging. Epidemiological data about the incidence and causes of death among the Italian population have shown that screening programmes should be aimed first at fighting the following diseases: prostatic carcinoma, lung cancer, colorectal carcinoma, breast cancer, cardiovascular disease, cerebrovascular disease, aortic and peripheral vascular disease. GPs do not generally give good or adequate instructions concerning voluntary prevention programmes; GPs may not even be aware of this type of prevention which could represent a valuable option together with the existing mass screening programmes. Therefore, in the following analysis, we aim to outline the correct diagnostic pathway for the prevention of diseases having the highest incidence in our country and which represent the most frequent causes of death. If used correctly, these screening programmes may contribute to the success of secondary prevention, limiting the use of tertiary prevention and thus producing savings for the Italian National Health System.

Measuring Promotion and Prevention Orientations of Secondary School Students: It Is More Than Meets the Eye

Science.gov (United States)

Hodis, Flaviu A.; Hattie, John A. C.; Hodis, Georgeta M.

2016-01-01

The General Regulatory Focus Measure has been used extensively in psychological research to gauge promotion and prevention orientations. Findings of this research show that for New Zealand secondary school students, the General Regulatory Focus Measure does not measure promotion and prevention as theoretically independent constructs.

The effect of daytime rain on the Indian Flying Fox (Mammalia: Chiroptera: Pteropodidae Pteropus giganteus

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S. Baskaran

2016-02-01

Full Text Available Excessive water loss during the day due to heat stress in bats of the genus Pteropus appears to be inevitable, because these bats are exposed to direct sunlight.  Rain also affects the rest pattern of the Indian Flying Fox Pteropus giganteus during the day.  When rain occurred during the day, most of the bats hung in a slanting position and did not exhibit any movements.  After rain, they licked both ventral and dorsal surfaces of the wing membrane and scratched their body with their thumb claws.  They also licked the water droplets that remained on the leaves and branches of the tree.  Even though their rest had been affected by the rain the bats utilized the water droplets to quench their thirst, cool their body and clean their fur.  The construction of water reservoirs near Pteropus roosts will help to assure their long-term conservation. 

Primary and Secondary Prevention of Colorectal Cancer

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Pedro J. Tárraga López

2014-07-01

Full Text Available Introduction Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. Colorectal cancer (CRC is the third most frequent cancer in men, after lung and prostate cancer, and is the second most frequent cancer in women after breast cancer. It is also the third cause of death in men and women separately, and is the second most frequent cause of death by cancer if both genders are considered together. CRC represents approximately 10% of deaths by cancer. Modifiable risk factors of CRC include smoking, physical inactivity, being overweight and obesity, eating processed meat, and drinking alcohol excessively. CRC screening programs are possible only in economically developed countries. However, attention should be paid in the future to geographical areas with ageing populations and a western lifestyle. 19 , 20 Sigmoidoscopy screening done with people aged 55-64 years has been demonstrated to reduce the incidence of CRC by 33% and mortality by CRC by 43%. Objective To assess the effect on the incidence and mortality of CRC diet and lifestyle and to determine the effect of secondary prevention through early diagnosis of CRC. Methodology A comprehensive search of Medline and Pubmed articles related to primary and secondary prevention of CRC and subsequently, a meta-analysis of the same blocks are performed. Results 225 articles related to primary or secondary prevention of CRC were retrieved. Of these 145 were considered valid on meta-analysis: 12 on epidemiology, 56 on diet and lifestyle, and over 77 different screenings for early detection of CRC. Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. There is no doubt whatsoever which environmental factors, probably diet, may account for these cancer rates. Excessive alcohol consumption and cholesterol-rich diet are associated with a high risk of colon cancer. A diet poor in folic acid and vitamin

[Preventive dentistry 5. Secondary caries].

NARCIS (Netherlands)

Hollanders, A.C.C.; Kuper, N.K.; Opdam, N.J.M.; Huysmans, M.C.D.N.J.M.

2017-01-01

Secondary caries is reported as one of the most important reasons for replacing restorations. The patient's general caries risk plays an important role in the development of secondary caries. The connection, at the patient level, between various factors, the risk of caries and restoration factors,

Primary and secondary prevention of skin cancer in mountain guides: attitude and motivation for or against participation.

Science.gov (United States)

Zink, Alexander; Thome, Frank; Schielein, Maximilian; Spinner, Christoph D; Biedermann, Tilo; Tizek, Linda

2018-05-30

Outdoor professionals such as mountain guides are at a substantial risk of developing non-melanoma skin cancer (NMSC) due to solar ultraviolet radiation (UVR) exposure. Despite major recent primary prevention efforts, studies on secondary skin cancer prevention efforts are limited and corresponding data on outdoor workers scarce. To assess the sun-protective behavior and individual motivations for or against skin cancer screening examinations in the German mountain guide population to aid in the development of effective awareness and prevention strategies. A cross-sectional study among all registered mountain guides in Germany was conducted using a 35-item online questionnaire on primary and secondary prevention of NMSC as well as perceived barriers for prevention. A total of 145 mountain guides participated in the study in January 2017. Of these, 86.2% reported using sunscreen often or always, 62.1% with a sun protection factor (SPF) of 30-50; and 60.7% had undergone dermatological examination by a medical professional. The most common reasons for using secondary prevention efforts were hope of an early diagnosis (77.3%), fear of skin cancer (73.9%), and the intention to be aware of one's own health (70.5%). The main reasons for not doing so were absence of conspicuous skin conditions (63.2%), and feeling healthy (59.6%). Awareness of prevention strategies recommended by the scientific community is low among affected occupationally high-risk mountain guide populations. Understanding the specific needs of this high-risk group is essential for the development of sustainable awareness and prevention strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A qualitative assessment of program characteristics for preventing secondary conditions in individuals with fetal alcohol spectrum disorders.

Science.gov (United States)

Patrenko, Christie L M; Tahir, Naira; Mahoney, Erin C; Chin, Nancy P

2014-01-01

Fetal alcohol spectrum disorders (FASD) are a major public health problem that affects 2 to 5 percent of the population. Individuals with FASD are at high risk for secondary conditions, such as mental health problems, school disruptions, and trouble with the law. Evidence-based intervention programs are needed to prevent and treat secondary conditions in this population. The purpose of this study was to identify intervention program characteristics for preventing secondary conditions in individuals with FASD from the perspectives of parents and service providers. This qualitative study utilized a phenomenological approach to identify program characteristics for preventing secondary conditions. Twenty-five parents of children (ages 3 to 33) with FASD and 18 service providers participated in focus groups or individual interviews. Data was systematically analyzed using a framework approach. Themes did not differ by participant type. Participants emphasized five primary characteristics of intervention programs for individuals with FASD. Programs need to 1) be available to individuals across the lifespan, 2) have a prevention focus, 3) be individualized, 4) be comprehensive, and 5) be coordinated across systems and developmental stages. Participants discussed a variety of specific intervention strategies for each developmental stage and setting. Program characteristics identified in this study are consistent with a positive behavior support framework. This framework is discussed in the context of research on existing interventions for individuals with FASD, and recommendations for future intervention development and evaluation are highlighted.

Gasification of torrefied Miscanthus × giganteus in an air-blown bubbling fluidized bed gasifier.

Science.gov (United States)

Xue, G; Kwapinska, M; Horvat, A; Kwapinski, W; Rabou, L P L M; Dooley, S; Czajka, K M; Leahy, J J

2014-05-01

Torrefaction is suggested to be an effective method to improve the fuel properties of biomass and gasification of torrefied biomass should provide a higher quality product gas than that from unprocessed biomass. In this study, both raw and torrefied Miscanthus × giganteus (M×G) were gasified in an air-blown bubbling fluidized bed (BFB) gasifier using olivine as the bed material. The effects of equivalence ratio (ER) (0.18-0.32) and bed temperature (660-850°C) on the gasification performance were investigated. The results obtained suggest the optimum gasification conditions for the torrefied M × G are ER 0.21 and 800°C. The product gas from these process conditions had a higher heating value (HHV) of 6.70 MJ/m(3), gas yield 2m(3)/kg biomass (H2 8.6%, CO 16.4% and CH4 4.4%) and cold gas efficiency 62.7%. The comparison between raw and torrefied M × G indicates that the torrefied M × G is more suitable BFB gasification. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fire hazard analysis at the first unit of the Ignalina nuclear power plant: 1. Analysis of fire prevention and ventilation systems and secondary effects

International Nuclear Information System (INIS)

Poskas, P.; Simonis, V.; Zujus, R. and others

2004-01-01

Evaluation of the fire prevention and ventilation systems and the secondary effects on safety at the Ignalina NPP from the point of view of fire hazard using computerized system is presented. Simplified screening algorithms for fire prevention, ventilation and the evaluation of secondary effects are developed, which allow accelerating fire hazard analysis at the Ignalina NPP. The analysis indicated that the fire prevention systems practically meet the national requirements and international recommendations for fire prevention. But it is necessary to introduce in separate rooms the measures improving fire prevention to guarantee the effective functioning of the ventilation systems and the reduction of the influence of secondary effects on safety. Computerized system of fire prevention and ventilation systems and evaluation of secondary effects on safety can be easily applied for fire hazard analysis at different big plants. (author)

Economic Evaluation of Lipid-Lowering Therapy in the Secondary Prevention Setting in the Philippines.

Science.gov (United States)

Tumanan-Mendoza, Bernadette A; Mendoza, Victor L

2013-05-01

To determine the cost-effectiveness of lipid-lowering therapy in the secondary prevention of cardiovascular events in the Philippines. A cost-utility analysis was performed by using Markov modeling in the secondary prevention setting. The models incorporated efficacy of lipid-lowering therapy demonstrated in randomized controlled trials and mortality rates obtained from local life tables. Average and incremental cost-effectiveness ratios were obtained for simvastatin, atorvastatin, pravastatin, and gemfibrozil. The costs of the following were included: medications, laboratory examinations, consultation and related expenses, and production losses. The costs were expressed in current or nominal prices as of the first quarter of 2010 (Philippine peso). Utility was expressed in quality-adjusted life-years gained. Sensitivity analyses were performed by using variations in the cost centers, discount rates, starting age, and differences in utility weights for stroke. In the analysis using the lower-priced generic counterparts, therapy using 40 mg simvastatin daily was the most cost-effective option compared with the other therapies, while pravastatin 40 mg daily was the most cost-effective alternative if the higher-priced innovator drugs were used. In all sensitivity analyses, gemfibrozil was strongly dominated by the statins. In secondary prevention, simvastatin or pravastatin were the most cost-effective options compared with atorvastatin and gemfibrozil in the Philippines. Gemfibrozil was strongly dominated by the statins. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The diet of the Indian Flying Fox Pteropus giganteus (Brünnich. 1782 (Chiroptera: Pteropodidae in Myanmar - conflicts with local people?

Directory of Open Access Journals (Sweden)

Sein Sein Win

2015-07-01

Full Text Available The diet of Pteropus giganteus from three roosts in Mandalay Region, central Myanmar was investigated for over two years by examining feeding remains in and around two villages.  It consists of 24 species of fruits, six species of flowers and three of leaves.  Of these, 13 species of fruits are eaten by the local people, three of which are also marketed.  Two are used in traditional medicine and one for stuffing pillows. Most dietary plants are native, mangoes are seasonally superabundant and are eaten in large numbers.  Interviews revealed no evidence of conflict between bats and villagers. 

Final Report DE-SC0006634. Quantifying phenotypic and genetic diversity of Miscanthus sinensis as a resource for knowledge-based improvement of M. ×giganteus (M. sinensis × M. sacchariflorus)

Energy Technology Data Exchange (ETDEWEB)

Sacks, Erik [Univ. of Illinois, Urbana, IL (United States)

2016-02-08

Miscanthus is especially attractive as a bioenergy crop for temperate environments because it produces high yields, needs few inputs, and grows well during the cool weather of early spring and late fall when few warm-season grasses can. However, Miscanthus feedstock production for the emerging U.S. bioenergy industry and for existing demand in Europe is based on a single sterile, vegetatively propagated variety of M. ×giganteus. M. ×giganteus is an interspecific hybrid of the parental species M. sinensis and M. sacchariflorus. Prior to the current study, little information existed about the genetic diversity and breeding potential of either M. ×giganteus parental species. In the current project, we studied more than 600 accessions of M. sinensis from throughout its native range in China, Japan, and Korea, in addition to ornamental cultivars and U.S. naturalized populations. Using thousands of DNA markers, we identified seven geographically distinct genetic groups of M. sinensis. Notably, we found that the ornamental cultivars and U.S. naturalized populations were derived from only a subset of the Southern Japan group, indicating that our study greatly increased the genetic diversity available for breeding new biomass cultivars. Additionally, this new understanding of M. sinensis population structure could be used to predict which crosses may produce progeny with the greatest hybrid vigor. Replicated field trials were also established at multiple locations in North America and Asia. Data on traits of importance for biomass productivity, such as flowering time, yield and height, were taken. Analyses of the phenotypic data from the field trials along with the DNA markers allowed us to identify many marker-trait associations. These results will enable marker-assisted breeding, which will allow selection at the seedling stage rather than waiting two to three years to obtain phenotypic data. Thus, this study is expected to greatly increase the efficiency of breeding

Developing County-level Water Footprints of Biofuel Produced from Switchgrass and Miscanthus x Giganteus in the United States

Energy Technology Data Exchange (ETDEWEB)

Wu, May M. [Argonne National Lab. (ANL), Argonne, IL (United States); Chiu, Yi-Wen [Argonne National Lab. (ANL), Argonne, IL (United States)

2014-09-30

Perennial grass has been proposed as a potential candidate for producing cellulosic biofuel because of its promising productivity and benefits to water quality, and because it is a non-food feedstock. While extensive research focuses on selecting and developing species and conversion technologies, the impact of grass-based biofuel production on water resources remains less clear. As feedstock growth requires water and the type of water consumed may vary considerably from region to region, water use must be characterized with spatial resolution and on a fuel production basis. This report summarizes a study that assesses the impact of biofuel production on water resource use and water quality at county, state, and regional scales by developing a water footprint of biofuel produced from switchgrass and Miscanthus × giganteus via biochemical conversion.

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

Science.gov (United States)

Womack, Sarah K; Armstrong, Thomas J

2005-09-01

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

Comparing primary prevention with secondary prevention to explain decreasing coronary heart disease death rates in Ireland, 1985-2000.

LENUS (Irish Health Repository)

Kabir, Zubair

2007-01-01

BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking.

Partnership for fragility bone fracture care provision and prevention program (P4Bones: study protocol for a secondary fracture prevention pragmatic controlled trial

Directory of Open Access Journals (Sweden)

Gaboury Isabelle

2013-01-01

Full Text Available Abstract Background Fractures associated with bone fragility in older adults signal the potential for secondary fracture. Fragility fractures often precipitate further decline in health and loss of mobility, with high associated costs for patients, families, society and the healthcare system. Promptly initiating a coordinated, comprehensive pharmacological bone health and falls prevention program post-fracture may improve osteoporosis treatment compliance; and reduce rates of falls and secondary fractures, and associated morbidity, mortality and costs. Methods/design This pragmatic, controlled trial at 11 hospital sites in eight regions in Quebec, Canada, will recruit community-dwelling patients over age 50 who have sustained a fragility fracture to an intervention coordinated program or to standard care, according to the site. Site study coordinators will identify and recruit 1,596 participants for each study arm. Coordinators at intervention sites will facilitate continuity of care for bone health, and arrange fall prevention programs including physical exercise. The intervention teams include medical bone specialists, primary care physicians, pharmacists, nurses, rehabilitation clinicians, and community program organizers. The primary outcome of this study is the incidence of secondary fragility fractures within an 18-month follow-up period. Secondary outcomes include initiation and compliance with bone health medication; time to first fall and number of clinically significant falls; fall-related hospitalization and mortality; physical activity; quality of life; fragility fracture-related costs; admission to a long term care facility; participants’ perceptions of care integration, expectations and satisfaction with the program; and participants’ compliance with the fall prevention program. Finally, professionals at intervention sites will participate in focus groups to identify barriers and facilitating factors for the integrated

Improving secondary prevention screening in clinical encounters using mhealth among prelicensure master's entry clinical nursing students.

Science.gov (United States)

FitzGerald, Leah Z; Rorie, Anne; Salem, Benissa E

2015-04-01

To determine the feasibility and acceptability of a mHealth application among nursing students for health promotion and secondary prevention health recommendations for hospitalized adult patients. A pretest-posttest design with a convenience sample of 169 prelicensure master's entry clinical nursing students in a large urban public university. Survey questions assessed intention to use, perceived usefulness, perceived ease of use, subjective norm, voluntariness, clinical area relevance, output quality, and result demonstrability of the United States Preventive Services Task Force (USPSTF) evidence-based practice guidelines via the mHealth application. Descriptive statistics and frequencies were used to explore sociodemographics; paired t-tests were used to evaluate pre- and posttest differences. Pre- and posttest significant differences (p technology among prelicensure master's entry clinical nursing students in order to engage and foster translational learning and improve dissemination of secondary prevention screening guidelines among hospitalized patients. © 2015 Sigma Theta Tau International.

Cutaneous and diphtheritic avian poxvirus infection in a nestling Southern Giant Petrel (Macronectes giganteus) from Antarctica

Science.gov (United States)

Shearn-Bochsler, Valerie; Green, David Earl; Converse, K.A.; Docherty, D.E.; Thiel, T.; Geisz, H.N.; Fraser, William R.; Patterson-Fraser, Donna L.

2008-01-01

The Southern giant petrel (Macronectes giganteus) is declining over much of its range and currently is listed as vulnerable to extinction by the International Union for the Conservation of Nature (IUCN). Island-specific breeding colonies near Palmer Station, Antarctica, have been monitored for over 30 years, and because this population continues to increase, it is critically important to conservation. In austral summer 2004, six diseased giant petrel chicks were observed in four of these colonies. Diseased chicks were 6a??9 weeks old and had multiple proliferative nodules on their bills and skin. One severely affected chick was found dead on the nest and was salvaged for necropsy. Histopathological examination of nodules from the dead chick revealed epithelial cell hyperplasia and hypertrophy with numerous eosinophilic intracytoplasmic inclusions (B??llinger bodies). A poxvirus was isolated from multiple nodules. Poxviral infection has not been reported in this species, and the reason for its emergence and its potential impact on the population are not yet known.

How do stroke survivors and their carers use practitioners' advice on secondary prevention medications? Qualitative study of an online forum.

Science.gov (United States)

Izuka, Nkeonye J; Alexander, Matthew A W; Balasooriya-Smeekens, Chantal; Mant, Jonathan; De Simoni, Anna

2017-09-01

Secondary prevention medications reduce risk of stroke recurrence, yet many people do not receive recommended treatment, nor take medications optimally. Exploring how patients report making use of practitioners' advice on secondary prevention medicines on an online forum and what feedback was received from other participants. Thematic analysis of the archive of Talkstroke (2004-2011), UK. Posts including any secondary prevention medication terms, General Practitioner (GP) and their replies were identified. Fifity participants talked about practitioners' advice on secondary prevention medications in 43 discussion threads. Patients consulted practitioners for reassurance and dealing with side effects. Practitioners' advice varied from altering to maintaining current treatment. Three main themes emerged from the use of practitioners' advice: patients following advice (reassured, happy when side effects made tolerable, or still retaining anxiety about treatment); patients not following advice (admitting adherence on-off or stopping medications as side effects still not tolerable); asking other participants for feedback on advice received. Practitioners' advice was disregarded mainly when related to dealing with statin side effects, after one or two consultations. Themes for feedback involved sharing experience, directing back to practitioners, or to external evidence. Side effects of secondary prevention medications and statins in particular, cause anxiety and resentment in some patients, and their concerns are not always addressed by practitioners. Practitioners could consider more proactive strategies to manage such side effects. Forum feedback was appropriate and supportive of the practitioners' advice received. Our findings from peer-to-peer online conversations confirm and widen previous research. © The Author 2017. Published by Oxford University Press.

Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk

OpenAIRE

Halkes, P.H.A.; Gray, Laura J.; Bath, Philip M.W.; Diener, Hans-Christoph; Guiraud-Chaumeil, B.

2008-01-01

Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient \\ud ischemic attack or minor stroke of presumed arterial origin and to perform subgroup analyses to identify patients that might benefit most from secondary prevention with A+D.\\ud Data sources: The previously published meta-analysis of individual patient data was updated with data from ESPRIT (N=2,739); trials without data on ...

[Nurse involvement in primary care: it is the key to improve the outcomes in primary and secondary prevention?].

Science.gov (United States)

Scardi, Sabino; Gori, Pierpaolo; Umari, Paolo

2010-06-01

Difficulties in management of risk factors, lifestyle and medications adherence to achieve secondary prevention of ischemic heart disease were described. Many studies indicate that the benefit of cardiac rehabilitation therapy after acute coronary events is only partially maintained during the following year. Thereafter, new strategies of medical care are needed to improve the long-term outcomes in coronary patients. Nurse co-ordinated, multidisciplinary cardiac rehabilitative programme could help patients to improve their lifestyle, to control their risk factors and to achieve their therapeutic goals for secondary prevention of ischemic heart disease.

Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin).

Science.gov (United States)

Pagidipati, Neha J; Navar, Ann Marie; Pieper, Karen S; Green, Jennifer B; Bethel, M Angelyn; Armstrong, Paul W; Josse, Robert G; McGuire, Darren K; Lokhnygina, Yuliya; Cornel, Jan H; Halvorsen, Sigrun; Strandberg, Timo E; Delibasi, Tuncay; Holman, Rury R; Peterson, Eric D

2017-09-26

Intensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol diabetes mellitus and known cardiovascular disease at entry into TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Logistic regression was used to evaluate the association between individual and regional factors and secondary prevention achievement at baseline. Cox proportional hazards regression analysis was used to determine the association between baseline secondary prevention achievement and cardiovascular death, myocardial infarction, or stroke. Overall, 29.9% of patients with diabetes mellitus and cardiovascular disease achieved all 5 secondary prevention parameters at baseline, although 71.8% achieved at least 4 parameters. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of ≈25%. Individually, blood pressure control (57.9%) had the lowest overall attainment, whereas nonsmoking status had the highest (89%). Over a median 3.0 years of follow-up, a higher baseline secondary prevention score was associated with improved outcomes in a step-wise graded relationship (adjusted hazard ratio, 0.60; 95% confidence interval, 0.47-0.77 for those patients achieving all 5 measures versus those achieving ≤2). In an international trial population, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes mellitus and cardiovascular disease, which in turn could lead to reduced risk of downstream cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00790205. © 2017 American Heart Association, Inc.

School Violence in Secondary Education in the Governorate of Mafraq: Forms, Causes and Prevention--A Case Study

Science.gov (United States)

Khaled, Mohammad S. Bani

2014-01-01

This study considers school violence. It was investigated in secondary schools in the governorate of Mafraq. The aim is to identify the forms and causes of the phenomenon; hence to come out with the preventive and remedial measures, accordingly. The study was conducted in one of the secondary schools selected randomly in the city of Mafraq in the…

Implementation of Telephone-Based Secondary Preventive Intervention after Stroke and Transient Ischemic Attack - Participation Rate, Reasons for Nonparticipation and One-Year Mortality

Directory of Open Access Journals (Sweden)

Anna-Lotta Irewall

2014-02-01

Full Text Available Background and Purpose: Patients who experience a stroke or transient ischemic attack (TIA are known to be at high risk of subsequent vascular events, underscoring the need for secondary preventive intervention. However, previous studies have indicated insufficiency in the implementation of secondary prevention, emphasizing the need to develop effective methods of follow-up. In the present study, we examined the potential of implementing a telephone-based, nurse-led, secondary preventive follow-up in stroke and TIA patients on a population level by analyzing the participation rate, reasons for nonparticipation, and one-year mortality. Methods: Between January 1, 2010 and December 31, 2011, all patients admitted to Östersund hospital, Sweden, and diagnosed with either stroke or TIA were considered for inclusion into the secondary preventive follow-up. Baseline data were collected at the hospital, and reasons for nonparticipation were documented. Multivariate logistic regression was performed to identify predictors of the patient decision not to participate and to explore independent associations between baseline characteristics and exclusion. A one-year follow-up of mortality was also performed; the survival functions of the three groups (included, excluded, declining participation was calculated using the Kaplan-Meier estimator. Results: From a total of 810 identified patients, 430 (53.1% were included in the secondary preventive follow-up, 289 (35.7% were excluded mainly due to physical or cognitive disability, and 91 (11.2% declined participation. Age ≥85 years, ischemic and hemorrhagic stroke, modified Rankin scale score >3, body mass index ≥25, congestive heart failure, and lower education level were independently associated with exclusion, whereas lower education level was the only factor independently associated with the patient decision not to participate. Exclusion was associated with a more than 12 times higher risk of mortality

[Primary and secondary prevention procedures of temporo-mandibular joint disease in the evolutive age].

Science.gov (United States)

Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Campisi, G; Di Cosola, M; Suriano, M; Lo Muzio, L

2009-02-01

In the last years prevention of temporomandiboular joint (TMJ) disease had acquired great importance. According to the neuro-occlusal rehabilitation (RNO) it is possible to say that TMJ disease starts since first years of life. So it is important both for dentist and for pediatric know what are the conditions and the atypical functions which predispose to this pathology. The aim of this work was to show how it is possible to intercept since primary teeth and the correct norms of primary and secondary prevention.

New developments in secondary stroke prevention: impact of the European/Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT) on clinical management.

Science.gov (United States)

Lutsep, Helmi L

2007-01-01

Secondary stroke prevention is an important goal of poststroke patient treatment. Various pharmacologic approaches have been advocated, but the relative efficacy and safety of these regimens has remained the subject of much debate. Recently released data from the European/Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT) indicated that combination therapy with aspirin and extended-release dipyridamole was more effective than aspirin monotherapy, and probably more effective than anticoagulants, for the prevention of cerebrovascular events after a stroke or transient ischemic attack. When viewed in light of results of earlier trials, these findings confirmed that combination aspirin plus extended-release dipyridamole therapy improved outcomes in these patients and is a recommended option for poststroke patient treatment.

Relationships between soil parameters and physiological status of Miscanthus x giganteus cultivated on soil contaminated with trace elements under NPK fertilisation vs. microbial inoculation.

Science.gov (United States)

Pogrzeba, Marta; Rusinowski, Szymon; Sitko, Krzysztof; Krzyżak, Jacek; Skalska, Aleksandra; Małkowski, Eugeniusz; Ciszek, Dorota; Werle, Sebastian; McCalmont, Jon Paul; Mos, Michal; Kalaji, Hazem M

2017-06-01

Crop growth and development can be influenced by a range of parameters, soil health, cultivation and nutrient status all play a major role. Nutrient status of plants can be enhanced both through chemical fertiliser additions (e.g. N, P, K supplementation) or microbial fixation and mobilisation of naturally occurring nutrients. With current EU priorities discouraging the production of biomass on high quality soils there is a need to investigate the potential of more marginal soils to produce these feedstocks and the impacts of soil amendments on crop yields within them. This study investigated the potential for Miscanthus x giganteus to be grown in trace element (TE)-contaminated soils, ideally offering a mechanism to (phyto)manage these contaminated lands. Comprehensive surveys are needed to understand plant-soil interactions under these conditions. Here we studied the impacts of two fertiliser treatments on soil physico-chemical properties under Miscanthus x giganteus cultivated on Pb, Cd and Zn contaminated arable land. Results covered a range of parameters, including soil rhizosphere activity, arbuscular mycorrhization (AM), as well as plant physiological parameters associated with photosynthesis, TE leaf concentrations and growth performance. Fertilization increased growth and gas exchange capacity, enhanced rhizosphere microbial activity and increased Zn, Mg and N leaf concentration. Fertilization reduced root colonisation by AMF and caused higher chlorophyll concentration in plant leaves. Microbial inoculation seems to be a promising alternative for chemical fertilizers, especially due to an insignificant influence on the mobility of toxic trace elements (particularly Cd and Zn). Copyright © 2017 Elsevier Ltd. All rights reserved.

Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

Science.gov (United States)

Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D

2014-05-02

People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence

Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy

NARCIS (Netherlands)

Boveé, Lian; Whelan, Jane; Sonder, Gerard J. B.; van Dam, Alje P.; van den Hoek, Anneke

2012-01-01

Background: Internationally, guidelines to prevent secondary transmission of Shigella infection vary widely. Cases, their contacts with diarrhoea, and those in certain occupational groups are frequently excluded from work, school, or daycare. In the Netherlands, all contacts attending pre-school

Cunnilingus apparently increases duration of copulation in the Indian flying fox, Pteropus giganteus.

Directory of Open Access Journals (Sweden)

Jayabalan Maruthupandian

Full Text Available We observed a total of 57 incidences of copulation in a colony of the Indian flying fox, Pteropus giganteus, over 13 months under natural conditions. The colony consisted of about 420 individuals, roosting in a Ficus religiosa tree. Copulations occurred between 07.00 h and 09.30 h from July to January, with more occurring in October and November. Initially males groomed their penis before approaching a nearby female. Females typically moved away and males followed. When the female stopped moving, the male started licking her vagina (cunnilingus. Typically each bout of cunnilingus lasted for about 50 s. In 57 out of 69 observations, the male mounted the female and copulated. The duration of copulation varied from 10 to 20 sec. After completion of copulation, the male continued cunnilingus for 94 to 188 sec. The duration of pre-copulatory cunnilingus and copulation was positively correlated whereas, the duration of pre- and post-copulatory cunnilingus was negatively correlated. Apart from humans, oral sex as foreplay prior to copulation is uncommon in mammals. Another pteropodid bat, Cynopterus sphinx exhibits fellatio with females licking the penis of males during copulation. It appears that bats, especially pteropodids perform oral sex, either cunnilingus or fellatio, possibly for achieving longer copulation.

Variation in CAD Secondary Prevention Prescription among Outpatient Cardiology Practices: Insights from the NCDR®

Science.gov (United States)

Maddox, Thomas M.; Chan, Paul S.; Spertus, John A.; Tang, Fengming; Jones, Phil; Ho, P. Michael; Bradley, Steven M.; Tsai, Thomas T.; Bhatt, Deepak L.; Peterson, Pamela N.

2014-01-01

Objectives This study assesses practice variation of secondary prevention medication prescription among coronary artery disease (CAD) patients treated in outpatient practices participating in the NCDR® PINNACLE Registry®. Background Among patients with CAD, secondary prevention with a combination of beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and statins reduces cardiac mortality and myocardial infarction (MI). Accordingly, every CAD patient should receive the combination of these medications for which they are eligible. However, little is known about current prescription patterns of these medications and the variation in use among outpatient cardiology clinics. Methods Using data from NCDR® PINNACLE Registry®, a national outpatient cardiology practice registry, we assessed medication prescription patterns among eligible CAD patients between July 2008 and December 2010. Overall rates of prescription and variation by practice were calculated, adjusting for patient characteristics. Results Among 156,145 CAD patients in 58 practices, 103,830 (66.5%) were prescribed the optimal combination of medications for which they were eligible. The median rate of optimal combined prescription by practice was 73.5% and varied from 28.8% to 100%. After adjustment for patient factors, the practice median rate ratio for prescription was 1.25 (95% CI 1.2,1.32), indicating a 25% likelihood that 2 random practices would differ in treating identical CAD patients. Conclusions Among a national registry of CAD patients treated in outpatient cardiology practices, over one-third of patients failed to receive their optimal combination of secondary prevention medications. Significant variation was observed across practices, even after adjusting for patient characteristics, suggesting that quality improvement efforts may be needed to support more uniform practice. PMID:24184238

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)

Corrà, Ugo; Piepoli, Massimo F; Carré, François

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...... 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...... and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling...

What imaging techniques should be used in primary versus secondary prevention for further risk stratification?

Science.gov (United States)

Schiele, François; Navarese, Eliano Pio; Visoná, Adriana; Ray, Kausik

2017-04-01

An accurate assessment of the cardiovascular (CV) risk of an individual is key for guiding the appropriate treatment strategy for cardiovascular disease (CVD). Although conventional risk factors for CVD are well established, there can be substantial variation in the extent of atherosclerosis between patients. The use of a variety of imaging modalities can be beneficial in the primary prevention stage and in the classification of an individual's CV risk. Therefore, appropriate implementation of these imaging techniques for risk assessment purposes, in line with clinical guidelines, can influence the outcomes of CVD prevention. The expert working group collaborated to review current invasive and non-invasive imaging techniques available to healthcare practitioners and how they can be used in the measurement of preclinical vascular damage and CV risk assessment. After evaluation of the current guideline recommendations and clinical data available, the expert working group collaborated to produce recommendations regarding the use of imaging in the risk stratification in primary prevention, CV risk in peri-acute coronary syndrome and CV risk assessment in secondary prevention. Overall, a variety of both invasive and non-invasive imaging modalities were highlighted by the expert working group as having the potential to assist in the risk assessments of patients at risk of CVD. These imaging techniques can be utilised in both primary and secondary prevention strategies and have the potential to be important risk modifiers, improving the outcome of CV risk assessment. Copyright © 2017 Elsevier B.V. All rights reserved.

An Analysis of Family-School Collaboration in Preventing Adolescent Violence in Urban Secondary Schools

Science.gov (United States)

Bender, C. J. Gerda; Emslie, Annemarie

2010-01-01

The purpose of this article is to describe how school staff members, learners and parents collaborate to prevent adolescent learner violence in two different urban secondary schools. The increase in acts of interpersonal learner violence has a destructive effect on the safe and positive development of young people. Empirical evidence indicates…

Combustion and kinetic parameters estimation of torrefied pine, acacia and Miscanthus giganteus using experimental and modelling techniques.

Science.gov (United States)

Wilk, Małgorzata; Magdziarz, Aneta; Gajek, Marcin; Zajemska, Monika; Jayaraman, Kandasamy; Gokalp, Iskender

2017-11-01

A novel approach, linking both experiments and modelling, was applied to obtain a better understanding of combustion characteristics of torrefied biomass. Therefore, Pine, Acacia and Miscanthus giganteus have been investigated under 260°C, 1h residence time and argon atmosphere. A higher heating value and carbon content corresponding to a higher fixed carbon, lower volatile matter, moisture content, and ratio O/C were obtained for all torrefied biomass. TGA analysis was used in order to proceed with the kinetics study and Chemkin calculations. The kinetics analysis demonstrated that the torrefaction process led to a decrease in Ea compared to raw biomass. The average Ea of pine using the KAS method changed from 169.42 to 122.88kJ/mol. The changes in gaseous products of combustion were calculated by Chemkin, which corresponded with the TGA results. The general conclusion based on these investigations is that torrefaction improves the physical and chemical properties of biomass. Copyright © 2017 Elsevier Ltd. All rights reserved.

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......) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic...... makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all...

Endoscopic therapy and beta-blockers for secondary prevention in adults with cirrhosis and oesophageal varices

DEFF Research Database (Denmark)

Gluud, Lise Lotte; Morgan, Marsha Y.

2017-01-01

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the beneficial and harmful effects of endoscopic therapy and beta-blockers used as a combination therapy versus monotherapy with either endoscopic therapy or beta-blockers for secondary prevention...

Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials.

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Katsanos, Aristeidis H; Filippatou, Angeliki; Manios, Efstathios; Deftereos, Spyridon; Parissis, John; Frogoudaki, Alexandra; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Pikilidou, Maria; Kargiotis, Odysseas; Voumvourakis, Konstantinos; Alexandrov, Anne W; Alexandrov, Andrei V; Tsivgoulis, Georgios

2017-01-01

Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo. On the basis of the reported BP values, we performed univariate metaregression analyses according to the achieved BP values under the random-effects model (Method of Moments) for those adverse events reported in ≥10 total subgroups of included randomized controlled clinical trials. In pairwise meta-analyses, antihypertensive treatment lowered the risk for recurrent stroke (risk ratio, 0.73; 95% confidence interval, 0.62-0.87; Psecondary stroke prevention. © 2016 American Heart Association, Inc.

Toxoplasmosis in the Eastern Grey Kangaroo, Macropus giganteus and the Cape Hyrax, Procavis capensis in Japan

Directory of Open Access Journals (Sweden)

Khaled Mohamed El-Dakhly1,4, Nagwan El-Habashi2, El-Shaymaa El-Nahass3,4, Hiroki Sakai4 and Tokuma Yanai4,*

2013-11-01

Full Text Available Toxoplasmosis was investigated in an eastern grey kangaroo, Macropus giganteus, and four cape hyraxes, Procavia capensis, in a Japanese zoo. Clinically, the kangaroo showed neurological signs, emaciation, diarrhea, elevated AST and CK, and subjected to coma before death. One young cape hyrax had severe anorexia, while the other three died without exhibiting clinical signs. Grossly, lungs of the kangaroo were dark red in color, while hyraxes, besides, showed hepatic multifocal white foci, and intestinal multifocal hemorrhages. Histologically, the kangaroo had frequent Toxoplasma gondii pseudocysts in brain, heart and skeletal muscles. All hyraxes had multifocal necrosis with cysts containing numerous bradyzoites in liver and spleen, along with necrotic gastroenteritis and intestinal hemorrhages. Immunohistochemically, cysts showed positive reaction to anti-T. gondii antibodies. These findings indicate possible outbreaks of toxoplasmosis in eastern grey kangaroos and cape hyraxes, zoo habitants; therefore, they could be susceptible intermediate hosts for T. gondii in terms of zoonosis. This is the first report of toxoplasmosis in eastern grey kangaroos and cape hyraxes in Japanese zoos.

Outcome of Secondary Stroke Prevention in Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants.

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Nakase, Taizen; Moroi, Junta; Ishikawa, Tatsuya

2018-05-01

Since non-vitamin K antagonist oral anticoagulants (NOACs) were released for clinical use, many studies have investigated its effectiveness in stroke prevention. In this study, to determine whether or not there is a difference in outcome in secondary stroke prevention between warfarin and NOACs, patients with embolic stroke with newly prescribed anticoagulants were prospectively analyzed. Patients with acute ischemic stroke, who newly started anticoagulant therapy, were consecutively asked to participate in this study. Enrolled patients (76.3 ± 11.0 years old) were classified into warfarin (n = 48), dabigatran (n = 73), rivaroxaban (n = 49), and apixaban (n = 65). The outcome in 1 year was prospectively investigated at outpatient clinic or telephone interview. Recurrence of stroke and death was considered as the critical incidence. The prevalence of risk factors was not different among all medicines. Patients with dabigatran showed significantly younger onset age (P incident rates were 7.1%, 15.3%, 19.0%, and 29.7% for dabigatran, apixaban, rivaroxaban, and warfarin, respectively. Dabigatran showed relatively better outcome compared with warfarin (P = .069) and rivaroxaban (P = .055). All patients on NOACs presented lower cumulative stroke recurrence compared with warfarin. Even in the situation of secondary stroke prevention, noninferiority of NOACs to warfarin might be demonstrated. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Stroke Care 1 Medical treatment in acute and long-term secondary prevention after transient ischaemic attack and ischaemic stroke

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Rothwell, Peter M.; Algra, Ale; Amarenco, Pierre

2011-01-01

Stroke is a major cause of death and disability worldwide. Without improvements in prevention, the burden will increase during the next 20 years because of the ageing population, especially in developing countries. Major advances have occurred in secondary prevention during the past three decades,

Effectiveness of secondary and tertiary prevention for violence against women in low and low-middle income countries: a systematic review.

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Kirk, Lucy; Terry, Samantha; Lokuge, Kamalini; Watterson, Jessica L

2017-07-04

Violence against women (VAW) is a major problem worldwide, with one in three women experiencing violence in their lifetime. While interventions to prevent violence (primary prevention) are extremely important, they can take many years. This review focuses on secondary and tertiary prevention interventions that address the needs of survivors of violence and aim to prevent recurrence. This review also focuses on studies taking place in low and low-middle income countries, where rates of VAW are highest. Searches of peer-reviewed and grey literature took place from March-June 2016 through databases (Embase, CINAHL, WHO Global Index Medicus, Medline, PsychINFO, Web of Science, Cochrane Library, Applied Social Sciences Index and Abstracts and Sociological Abstracts) and by consulting experts in the field. Only primary research was eligible for inclusion and studies had to focus on secondary or tertiary prevention for survivors of VAW in low or low-middle income countries. All study designs were eligible, as long as the study examined client-related outcome measures (e.g., incidence of violence, health outcomes or client satisfaction). Data were extracted and quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and a qualitative quality assessment tool developed by Mays and Pope. Due to the low number of results and heterogeneity of the study populations and outcomes, a narrative synthesis was conducted and evidence was summarized. One thousand two hundred fifteen studies were identified through the search strategy and 22 of these met the eligibility criteria. Overall, the evidence for interventions is weak and study limitations prevent definitive conclusions on what works. There is some evidence that interventions targeting alcohol use, both among perpetrators and survivors, may be effective at reducing VAW through secondary prevention, and that psychotherapy might be effective for

Comparative effectiveness of recommended versus less intensive drug combinations in secondary prevention of acute coronary syndrome

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf; Ali, M Sanni; Lassalle, Régis; Robinson, Philip; de Boer, Anthonius; Moore, Nicholas; Klungel, Olaf H; Pariente, Antoine

2017-01-01

PURPOSE: The secondary prevention treatment for acute coronary syndrome (ACS) is based on the combined use of drugs from four therapeutic classes (beta-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). The objective of this study

Comparative effectiveness of recommended versus less intensive drug combinations in secondary prevention of acute coronary syndrome

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf H H; Ali, M. Sanni; Lassalle, Régis; Robinson, Philip; de Boer, A.; Moore, Nicholas; Klungel, Olaf H.; Pariente, Antoine

Purpose: The secondary prevention treatment for acute coronary syndrome (ACS) is based on the combined use of drugs from four therapeutic classes (beta-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). The objective of this study

Examining the Effectiveness of the Smoking Prevention Program "I Do Not Smoke, I Exercise" in Elementary and Secondary School Settings.

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Kolovelonis, Athanasios; Goudas, Marios; Theodorakis, Yannis

2016-11-01

The aim of the study was to examine the effectiveness of the smoking prevention program "I do not smoke, I exercise" implemented with elementary and secondary school students. "I do not smoke, I exercise" is a theory-based smoking prevention program that promotes exercise as an alternative of smoking. The program consists of eight sessions implemented weekly. Participants were 338 Greek students (135 elementary and 203 secondary students) who were pre- and posttested in smoking, program, and exercise-related measures. The results showed that the program had significant effects on elementary students' attitudes toward smoking, intention to smoke, subjective norms, attitudes toward the application of the program, and knowledge about the health consequences of smoking. For secondary students, significant effects were found on students' perceived behavioral control and knowledge about the health consequences of smoking, while very few students reported a smoking experience before and after the intervention. Therefore the program "I do not smoke, I exercise" may have positive effects on variables related with smoking behavior. Differences in the program's impact on elementary and secondary students were identified. All these are discussed with reference to the need of implementing smoking prevention programs in schools contexts. © 2016 Society for Public Health Education.

Ventilatory accommodation of oxygen demand and respiratory water loss in kangaroos from mesic and arid environments, the eastern grey kangaroo (Macropus giganteus) and the red kangaroo (Macropus rufus).

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Dawson, T J; Munn, A J; Blaney, C E; Krockenberger, A; Maloney, S K

2000-01-01

We studied ventilation in kangaroos from mesic and arid environments, the eastern grey kangaroo (Macropus giganteus) and the red kangaroo (Macropus rufus), respectively, within the range of ambient temperatures (T(a)) from -5 degrees to 45 degrees C. At thermoneutral temperatures (Ta=25 degrees C), there were no differences between the species in respiratory frequency, tidal volume, total ventilation, or oxygen extraction. The ventilatory patterns of the kangaroos were markedly different from those predicted from the allometric equation derived for placentals. The kangaroos had low respiratory frequencies and higher tidal volumes, even when adjustment was made for their lower basal metabolism. At Ta>25 degrees C, ventilation was increased in the kangaroos to facilitate respiratory water loss, with percent oxygen extraction being markedly lowered. Ventilation was via the nares; the mouth was closed. Differences in ventilation between the two species occurred at higher temperatures, and at 45 degrees C were associated with differences in respiratory evaporative heat loss, with that of M. giganteus being higher. Panting in kangaroos occurred as a graded increase in respiratory frequency, during which tidal volume was lowered. When panting, the desert red kangaroo had larger tidal volumes and lower respiratory frequencies at equivalent T(a) than the eastern grey kangaroo, which generally inhabits mesic forests. The inference made from this pattern is that the red kangaroo has the potential to increase respiratory evaporative heat loss to a greater level.

Secondary stroke prevention: challenges and solutions.

Science.gov (United States)

Esenwa, Charles; Gutierrez, Jose

2015-01-01

Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.

Barriers to medication adherence for the secondary prevention of stroke: a qualitative interview study in primary care.

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Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

2016-08-01

Medications are highly effective at reducing risk of recurrent stroke, but success is influenced by adherence to treatment. Among survivors of stroke and transient ischaemic attack (TIA), adherence to medication is known to be suboptimal. To identify and report barriers to medication adherence for the secondary prevention of stroke/TIA. A qualitative interview study was conducted within general practice surgeries in the East of England, UK. Patients were approached by letter and invited to take part in a qualitative research study. Semi-structured interviews were undertaken with survivors of stroke, caregivers, and GPs to explore their perspectives and views around secondary prevention and perceived barriers to medication adherence. Key themes were identified using a grounded theory approach. Verbatim quotes describing the themes are presented here. In total, 28 survivors of stroke, including 14 accompanying caregivers and five GPs, were interviewed. Two key themes were identified. Patient level barriers included ability to self-care, the importance people attach to a stroke event, and knowledge of stroke and medication. Medication level barriers included beliefs about medication and beliefs about how pills work, medication routines, changing medications, and regimen complexity and burden of treatment. Patients who have had a stroke are faced with multiple barriers to taking secondary prevention medications in UK general practice. This research suggests that a collaborative approach between caregivers, survivors, and healthcare professionals is needed to address these barriers and facilitate medication-taking behaviour. © British Journal of General Practice 2016.

Incorporating Primary and Secondary Prevention Approaches To Address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study

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Butte, Nancy F.; Barlow, Sarah; Vandewater, Elizabeth A.; Sharma, Shreela V.; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O.; Durand, Casey; Li, Linlin; Kelder, Steven H.

2015-01-01

Abstract Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2–12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3–83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Conclusions: Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity. PMID:25555188

Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study.

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Hoelscher, Deanna M; Butte, Nancy F; Barlow, Sarah; Vandewater, Elizabeth A; Sharma, Shreela V; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O; Durand, Casey; Li, Linlin; Kelder, Steven H

2015-02-01

There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.

Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy.

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van Schaik, T M; Jørstad, H T; Twickler, T B; Peters, R J G; Tijssen, J P G; Essink-Bot, M L; Fransen, M P

2017-07-01

To explore the association between health literacy and the risk of cardiovascular disease (CVD), and to assess the differential effects by health literacy level of a nurse-coordinated secondary prevention program (NCPP) in patients with coronary artery disease (CAD). Data were collected in two medical centres participating in the RESPONSE trial (Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists). CVD risk profiles were assessed at baseline and 12-month follow-up using the Systematic Coronary Risk Evaluation (SCORE). Health literacy was assessed by the short Rapid Estimate of Adult Literacy in Medicine (REALM-D) and the Newest Vital Sign (NVS-D); self-reported health literacy was evaluated by the Set of Brief Screening Questions (SBSQ-D). Among 201 CAD patients, 18% exhibited reading difficulties, 52% had difficulty understanding and applying written information, and 5% scored low on self-reported health literacy. Patients with low NVS-D scores had a higher CVD risk [mean SCORE 5.2 (SD 4.8) versus 3.3 (SD 4.1), p literacy levels without significant differences. Inadequate health literacy is prevalent in CAD patients in the Netherlands, and is associated with less favourable CVD risk profiles. Where many other forms of CVD prevention fail, nurse-coordinated care seems to be effective among patients with inadequate health literacy.

Secondary Prevention of Chronic PTSD by Early and Short-Term Administration of Escitalopram: A Prospective Randomized, Placebo-Controlled, Double-Blind Trial.

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Zohar, Joseph; Fostick, Leah; Juven-Wetzler, Alzabeta; Kaplan, Zeev; Shalev, Hadar; Schreiber, Gavriel; Miroshnik, Natalie; Shalev, Arieh Y; Stein, Dan J; Seedat, Soraya; Suliman, Sharain; Klein, Ehud

Prospective studies have not identified a viable pharmacologic strategy for secondary prevention of posttraumatic stress disorder (PTSD). The authors examined whether preventive intervention via early and short-term administration of a selective serotonin reuptake inhibitor (SSRI), within 1 month of exposure to a traumatic event (before diagnosis of PTSD could be made), may reduce the severity of PTSD symptoms according to DSM-IV at 13 months' follow-up. Over 25,000 screening calls to patients referred to an emergency department for a traumatic event performed between June 2006 and December 2008 yielded 353 participants who were recruited within the month following a traumatic event . Participants were randomly assigned in a double-blind design to escitalopram (n = 176) or placebo (n = 177). The per-protocol analysis comprised 198 participants (escitalopram, n = 102; placebo, n = 96) who received treatment for 12 to 24 weeks and were available for follow-up at week 56. The primary outcome measure, the Clinician Administered PTSD Scale (CAPS), revealed no prevention effect. However, a secondary outcome, the Pittsburgh Sleep Quality Inventory (PSQI), showed better results for the SSRI group than for the placebo group. For a subset of participants who experienced intentional trauma (missile attacks, rape, or physical assault; n = 50), the prevention effect was found on both primary and secondary measures (CAPS, PSQI and measures of depression and global illness severity). Early and short-term administration of escitalopram was not shown to prevent PTSD, although it did improve sleep quality. In a subgroup of participants who experienced intentional trauma, however, this early-treatment approach may be effective as secondary prevention. This large study is the first to investigate the preventive effect of early administration of escitalopram on PTSD. It highlights the relevance of the type of trauma (intentional vs unintentional) to the outcome. Clinical

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study.

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Murphy, Adrianna; Palafox, Benjamin; O'Donnell, Owen; Stuckler, David; Perel, Pablo; AlHabib, Khalid F; Avezum, Alvaro; Bai, Xiulin; Chifamba, Jephat; Chow, Clara K; Corsi, Daniel J; Dagenais, Gilles R; Dans, Antonio L; Diaz, Rafael; Erbakan, Ayse N; Ismail, Noorhassim; Iqbal, Romaina; Kelishadi, Roya; Khatib, Rasha; Lanas, Fernando; Lear, Scott A; Li, Wei; Liu, Jia; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Monsef, Nahed; Mony, Prem K; Puoane, Thandi; Rangarajan, Sumathy; Rosengren, Annika; Schutte, Aletta E; Sintaha, Mariz; Teo, Koon K; Wielgosz, Andreas; Yeates, Karen; Yin, Lu; Yusoff, Khalid; Zatońska, Katarzyna; Yusuf, Salim; McKee, Martin

2018-03-01

There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated. The proportion of patients with cardiovascular disease on three medications ranged from 0% in South Africa (95% CI 0-1·7), Tanzania (0-3·6), and Zimbabwe (0-5·1), to 49·3% in Canada (44·4-54·3). Proportions receiving at least one drug varied from 2·0% (95% CI 0·5-6·9) in Tanzania to 91·4% (86·6-94·6) in Sweden. There was significant (pSaudi Arabia, China, Colombia, India, Pakistan, and Zimbabwe. Pro-poor distributions were observed in Sweden, Brazil, Chile, Poland, and the occupied Palestinian territory. The strongest predictors of inequality were public expenditure on health and overall use of secondary prevention medicines. Use of medication for secondary prevention of cardiovascular disease is alarmingly low. In many countries with the lowest use, pro-rich inequality is greatest. Policies associated with an equal or pro-poor distribution include free medications and community health programmes to support adherence to medications. Full funding sources listed at the end of the paper (see Acknowledgments). Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0. license. Published by Elsevier Ltd.. All rights reserved.

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study

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Adrianna Murphy, PhD

2018-03-01

Full Text Available Summary: Background: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. Methods: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from −1 (pro-poor to 1 (pro-rich, standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated. Findings: The proportion of patients with cardiovascular disease on three medications ranged from 0% in South Africa (95% CI 0–1·7, Tanzania (0–3·6, and Zimbabwe (0–5·1, to 49·3% in Canada (44·4–54·3. Proportions receiving at least one drug varied from 2·0% (95% CI 0·5–6·9 in Tanzania to 91·4% (86·6–94·6 in Sweden. There was significant (p<0·05 pro-rich inequality in Saudi Arabia, China, Colombia, India, Pakistan, and Zimbabwe. Pro-poor distributions were observed in Sweden, Brazil, Chile, Poland, and the occupied Palestinian territory. The strongest predictors of inequality were public expenditure on health and overall use of secondary prevention medicines. Interpretation: Use of medication for secondary prevention of cardiovascular disease is alarmingly low. In many countries with the lowest use, pro-rich inequality is greatest. Policies associated with an equal or pro-poor distribution include free medications and community health programmes to support adherence to medications. Funding: Full funding sources listed at the end of the paper (see Acknowledgments.

The Office Guidelines Applied to Practice program improves secondary prevention of heart disease in Federally Qualified Healthcare Centers

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Adesuwa Olomu

2016-12-01

Office-GAP resulted in increased use of guideline-based medications for secondary CVD prevention in underserved populations. The Office-GAP program could serve as a model for implementing guideline-based care for other chronic diseases.

Primary care organisational interventions for secondary prevention of ischaemic heart disease: a systematic review and meta-analysis.

Science.gov (United States)

Murphy, Edel; Vellinga, Akke; Byrne, Molly; Cupples, Margaret E; Murphy, Andrew W; Buckley, Brian; Smith, Susan M

2015-07-01

Ischaemic heart disease (IHD) is the most common cause of death worldwide. To determine the long-term impact of organisational interventions for secondary prevention of IHD. Systematic review and meta-analysis of studies from CENTRAL, MEDLINE(®), Embase, and CINAHL published January 2007 to January 2013. Searches were conducted for randomised controlled trials of patients with established IHD, with long-term follow-up, of cardiac secondary prevention programmes targeting organisational change in primary care or community settings. A random-effects model was used and risk ratios were calculated. Five studies were included with 4005 participants. Meta-analysis of four studies with mortality data at 4.7-6 years showed that organisational interventions were associated with approximately 20% reduced mortality, with a risk ratio (RR) for all-cause mortality of 0.79 (95% confidence interval [CI] = 0.66 to 0.93), and a RR for cardiac-related mortality of 0.74 (95% CI = 0.58 to 0.94). Two studies reported mortality data at 10 years. Analysis of these data showed no significant differences between groups. There were insufficient data to conduct a meta-analysis on the effect of interventions on hospital admissions. Additional analyses showed no significant association between organisational interventions and risk factor management or appropriate prescribing at 4.7-6 years. Cardiac secondary prevention programmes targeting organisational change are associated with a reduced risk of death for at least 4-6 years. There is insufficient evidence to conclude whether this beneficial effect is maintained indefinitely. © British Journal of General Practice 2015.

Mass media and marketing communication promoting primary and secondary cancer prevention.

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Hannon, Peggy; Lloyd, Gareth P; Viswanath, K; Smith, Tenbroeck; Basen-Engquist, Karen; Vernon, Sally W; Turner, Gina; Hesse, Bradford W; Crammer, Corinne; von Wagner, Christian; Backinger, Cathy L

2009-01-01

People often seek and receive cancer information from mass media (including television, radio, print media, and the Internet), and marketing strategies often inform cancer information needs assessment, message development, and channel selection. In this article, we present the discussion of a 2-hour working group convened for a cancer communications workshop held at the 2008 Society of Behavioral Medicine meeting in San Diego, CA. During the session, an interdisciplinary group of investigators discussed the current state of the science for mass media and marketing communication promoting primary and secondary cancer prevention. We discussed current research, new research areas, methodologies and theories needed to move the field forward, and critical areas and disciplines for future research.

Is clopidogrel superior to aspirin in secondary prevention of vascular disease?

Directory of Open Access Journals (Sweden)

Algra Ale

2000-11-01

Full Text Available Abstract The cornerstone in clinical evidence of the relative efficacy of thienopyridines (clopidogrel, ticlopidine versus aspirin in the secondary prevention of vascular disease is the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events trial. This trial showed a modest benefit in the reduction of vascular events by clopidogrel. The results differed according to qualifying disorder: myocardial infarction, -3.7%; ischaemic stroke, +7.3%; and peripheral arterial disease, +23.8% (P = 0.042. Similar results were found for ticlopidine after brain ischaemia. The safety of clopidogrel appears to be similar to that of aspirin and better than that of ticlopidine. However, the recent report of thrombotic thrombocytopenic purpura in association with clopidogrel causes concern.

Preventing Dropout in Secondary Schools. Educator's Practice Guide. What Works Clearinghouse. NCEE 2017-4028

Science.gov (United States)

Rumberger, Russell W.; Addis, Howard; Allensworth, Elaine; Balfanz, Robert; Bruch, Julie; Dillon, Erin; Duardo, Debra; Dynarski, Mark; Furgeson, Joshua; Jayanthi, Madhavi; Newman-Gonchar, Rebecca; Place, Kate; Tuttle, Christina

2017-01-01

The goal of this practice guide is to offer educators specific, evidence-based recommendations that address the challenges of preventing dropout in secondary schools. This guide synthesizes the best publicly available research and shares practices that are supported by evidence. It is intended to be practical and easy for teachers and school…

HIV/AIDS prevention: knowledge, attitudes and education practices of secondary school health personnel in 14 cities of China.

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Chen, J Q; Dunne, M P; Zhao, D C

2004-01-01

This study assessed the preparedness of school health personnel to develop and deliver HIV/AIDS prevention education programmes for young people in China. A survey of 653 personnel working in secondary schools in 14 cities was conducted. More than 90% had basic knowledge of ways in which HIV can be transmitted, but knowledge of ways in which the virus is not transmitted needs improvement. Substantial numbers of teachers were not sure whether there was an effective preventive vaccine (42%) or did not know whether AIDS was a curable illness or not (32%). The great majority approved of AIDS prevention programmes in universities (98%) and secondary schools (91%), although fewer (58%) agreed that the topic was appropriate for primary schools. Currently, most classroom activities focuses on teaching facts about HIV/AIDS transmission, while less than half are taught about HIV/AIDS related discrimination and life skills to reduce peer pressure. Personnel with some prior training on HIV/ AIDS education (53%) had better factual knowledge, more tolerant attitudes and more confidence in teaching about HIV/AIDS than those without training. The majority of teachers indicated a need for more resource books, audiovisual products, expert guidance, school principal support and dissemination of national AIDS prevention education guidelines to schools.

Dual Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke: A Ghost from the Past or a New Frontier?

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Clotilde Balucani

2010-01-01

Full Text Available With majority of ischemic strokes attributable to atherothrombosis and many being predictable after transient ischemic attacks (TIA, the role of early secondary prevention with antiplatelet agents is under renewed investigation. Prior major clinical trials of various secondary stroke prevention regimens pointed to a greater efficacy of dual antiplatelet agents if initiated early from symptom onset. This paper examines data and rationale behind dual antiplatelet regimens across the completed clinical trials. The safety of dual antiplatelets approach is of concern, but it could be outweighed, at least in early management, by a greater reduction in recurrence of ischemic events since this risk is “front loaded” after minor stroke or TIA. Aspirin monotherapy, though considered standard of care, is compared to aspirin-extended release dipiridamole and its combination with clopidogrel in early-phase completed and efficacy-phase ongoing clinical trials.

Effectiveness of nurse-led patient-centered care behavioral risk modification on secondary prevention of coronary heart disease: A systematic review.

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Chiang, Chung-Yan; Choi, Kai-Chow; Ho, Ka-Ming; Yu, Sau-Fung

2018-04-22

Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease. A systematic review of randomized controlled trials focusing on nurse-led patient-centered care for secondary cardiac prevention was conducted. Primary outcomes were behavioral risks (e.g. smoking, physical activity), secondary outcomes were clinically relevant physiological parameters (e.g. body weight, blood pressure, blood glucose, blood lipoproteins), health-related quality of life, mortality, and self efficacy. Twenty-three English and seven Chinese electronic databases were searched to identify the trials. The studies' eligibility and methodological quality were assessed by two reviewers independently according to the Joanna Briggs Institute guidelines. Statistical heterogeneities of the included studies were assessed by Higgins I2 and quantitative pooling was performed when studies showed sufficient comparability. 15 articles on 12 randomized controlled trials were included in this review. Methodological quality of the included studies was fair. Based on the Joanna Briggs Institute critical appraisal tool for experimental studies, the included studies had met a mean of six criteria out the ten in this appraisal tool. The meta-analyses of the included studies revealed that nurse-led patient-centered care had significantly improved patients' smoking habits, adherence toward physical activity advices, and total cholesterol level with medical regime optimization, in short- to medium-term. The intervention was also favorable in improving the patients' health-related quality of life in several domains of

A systematic review of published interventions for primary and secondary prevention of ischaemic heart disease (IHD in rural populations of Australia

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Laura V. Alston

2016-08-01

Full Text Available Abstract Background Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred specifically in rural Australia in terms of IHD. A summary of this evidence could have implications for future action and research in improving the health of rural communities. The aim of this study was to review all published interventions conducted in rural Australia that were aimed at the primary and/or secondary prevention of ischaemic heart disease (IHD in adults. Methods Systematic review of the peer-reviewed literature published between January 1990 and December 2015. Search terms were derived from four major topics: (1 rural; (2 ischaemic heart disease; (3 Australia and; (4 intervention/prevention. Terms were adapted for six databases and three independent researchers screened results. Studies were included if the published work described an intervention focussed on the prevention or reduction of IHD or risk factors, specifically in a rural population of Australia, with outcomes specific to participants including, but not limited to, changes in diet, exercise, cholesterol or blood pressure levels. Results Of 791 papers identified in the search, seven studies met the inclusion criteria, and one further study was retrieved from searching reference lists of screened abstracts. Typically, excluded studies focused on cardiovascular diseases without specific reference to IHD, or presented intervention results without stratification by rurality. Larger trials that included metropolitan residents without stratification were excluded due to differences in the specific needs, characteristics and health service access challenges of rural populations. Six interventions were primary prevention studies, one was secondary prevention only and one included both

Evaluation of medical and health economic effectiveness of non-pharmacological secondary prevention of coronary heart disease

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Greiner, Wolfgang

2009-12-01

Full Text Available Background: Coronary heart disease (CHD is a common and potentially fatal malady with a life time prevalence of over 20%. For Germany, the mortality attributable to chronic ischemic heart disease or acute myocardial infarction is estimated at 140,000 deaths per year. An association between prognosis of CHD and lifestyle risk factors has been consistently shown. To positively influence lifestyle risk factors in patients with CHD, non-pharmaceutical secondary prevention strategies are frequently recommended and implemented. Objectives: The aim of this HTA (HTA = Health Technology Assessment is to summarise the current literature on strategies for non-pharmaceutical secondary prevention in patients with CHD and to evaluate their medical effectiveness/efficacy and cost-effectiveness as well as the ethical, social and legal implications. In addition, this report aims to compare the effectiveness and efficacy of different intervention components and to evaluate the generalisability with regard to the German context. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information (DIMDI. In addition, a manual search of identified reference lists was conducted. The present report includes German and English literature published between January 2003 and September 2008 targeting adults with CHD. The methodological quality of included studies was assessed according to pre-defined quality criteria, based on the criteria of evidence based medicine. Results: Among 9,074 publications 43 medical publications met the inclusion criteria. Overall study quality is satisfactory, but only half the studies report overall mortality or cardiac mortality as an outcome, while the remaining studies report less reliable outcome parameters. The follow-up duration varies between twelve and 120 months. Although overall effectiveness of non-pharmaceutical secondary

SECONDARY PREVENTION OF STROKE IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION: THE CLINICIANS’ VIEWPOINT

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E. A. Drozdova

2015-09-01

Full Text Available Atrial fibrillation is one of the main risk factor of ischemic stroke. Current problems of the management of patients with stroke due to non-valvular atrial fibrillation and secondary stroke prevention in these patients are considered. Data of own author’s observation for patients of this type during 6 months after discharge from the hospital are presented. The problems which patients faced with are analyzed. Comparative assessment of warfarin and dabigatran therapies is given.

Utility of electronic patient records in primary care for stroke secondary prevention trials

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Ashworth Mark

2011-02-01

Full Text Available Abstract Background This study aimed to inform the design of a pragmatic trial of stroke prevention in primary care by evaluating data recorded in electronic patient records (EPRs as potential outcome measures. The study also evaluated achievement of recommended standards of care; variation between family practices; and changes in risk factor values from before to after stroke. Methods Data from the UK General Practice Research Database (GPRD were analysed for 22,730 participants with an index first stroke between 2003 and 2006 from 414 family practices. For each subject, the EPR was evaluated for the 12 months before and after stroke. Measures relevant to stroke secondary prevention were analysed including blood pressure (BP, cholesterol, smoking, alcohol use, body mass index (BMI, atrial fibrillation, utilisation of antihypertensive, antiplatelet and cholesterol lowering drugs. Intraclass correlation coefficients (ICC were estimated by family practice. Random effects models were fitted to evaluate changes in risk factor values over time. Results In the 12 months following stroke, BP was recorded for 90%, cholesterol for 70% and body mass index (BMI for 47%. ICCs by family practice ranged from 0.02 for BP and BMI to 0.05 for LDL and HDL cholesterol. For subjects with records available both before and after stroke, the mean reductions from before to after stroke were: mean systolic BP, 6.02 mm Hg; diastolic BP, 2.78 mm Hg; total cholesterol, 0.60 mmol/l; BMI, 0.34 Kg/m2. There was an absolute reduction in smokers of 5% and heavy drinkers of 4%. The proportion of stroke patients within the recommended guidelines varied from less than a third (29% for systolic BP, just over half for BMI (54%, and over 90% (92% on alcohol consumption. Conclusions Electronic patient records have potential for evaluation of outcomes in pragmatic trials of stroke secondary prevention. Stroke prevention interventions in primary care remain suboptimal but important

Preventing secondary cases of invasive meningococcal capsular group B (MenB) disease using a recently-licensed, multi-component, protein-based vaccine (Bexsero(®)).

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Ladhani, Shamez N; Cordery, Rebecca; Mandal, Sema; Christensen, Hannah; Campbell, Helen; Borrow, Ray; Ramsay, Mary E

2014-11-01

To assess the potential use of a protein-based meningococcal group B (MenB) vaccine (Bexsero(®)) in addition to antibiotic chemoprophylaxis for preventing secondary cases. Published studies on the risk of secondary meningococcal infections were used to estimate the numbers needed to vaccinate (NNV) with Bexsero(®) to prevent a secondary case in household and educational settings. Most secondary cases occur within a few days of diagnosis in the index case. Unlike conjugate vaccines, early protection offered after a single dose of Bexsero(®) is likely to be low, particularly in young children, who are at higher risk of secondary infection. NNV was dependent on predicted meningococcal strain coverage, estimated onset of protection after one Bexsero(®) dose and estimated vaccine efficacy. Even in the most favourable scenario where we assume the vaccine is administered within 4 days of the index case and prevents 90% of cases occurring after 14 days, the NNV for household contacts was >1000. NNV in educational settings was much higher. The estimated NNV should be taken into account when deciding policy to recommend Bexsero(®) for close contacts of single cases in household or educational settings. Bexsero(®) may have a protective role in clusters and outbreaks. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Secondary stroke prevention: challenges and solutions

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Esenwa C

2015-08-01

Full Text Available Charles Esenwa, Jose GutierrezDepartment of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USAAbstract: Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke, the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies.Keywords: stroke mechanisms, stroke risk, hypertension, diabetes, dyslipidemia

Environmental hazards related to Miscanthus x giganteus cultivation on heavy metal contaminated soil

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Pogrzeba M.

2013-04-01

Full Text Available According to recent estimates reaching the target of a 20% share of renewable energy sources (RES in the final energy balance in Poland by 2020 will result in the demand for more than 8 million tons of biomass, which, in turn, will entail the necessity of creating large-scale energy crop plantations. According to EU assumptions the most effective way to produce biomass for energy purposes is cultivation of energy crops in agricultural areas. It is particularly vital for Poland, because these areas constitute a relatively large part of the country (59%, 76% of them being used as farmlands. In Silesia, the most industrialized region of the country, 5-10% of agricultural soils are contaminated with cadmium, lead and zinc. The main objective of the presented study was to estimate the accumulation of heavy metals in the tissues of Miscanthus x giganteus grown on contaminated soils and calculate concentrations of Pb, Cd and Zn in crops. It was shown that the large intake of heavy metals by that species could cause high emissions of pollutants into the atmosphere during its improper combustion. As a side effect, winter harvesting led to the loss of even 30% of biomass. Plant residues (leaves can be the source of pollution after decomposing and releasing metals back into the soil. Moreover, miscanthus leaves can be transferred by wind to the surrounding areas. It is very likely that ash coming from the combustion of contaminated biomass cannot be used as a fertilizer.

Phylogeography of Eastern Grey Kangaroos, Macropus giganteus, Suggests a Mesic Refugium in Eastern Australia.

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Brett A Coghlan

Full Text Available Phylogeographic studies around the world have identified refugia where fauna were able to persist during unsuitable climatic periods, particularly during times of glaciation. In Australia the effects of Pleistocene climate oscillations on rainforest taxa have been well studied but less is known about the effects on mesic-habitat fauna, such as the eastern grey kangaroo (Macropus giganteus. The eastern grey kangaroo is a large mammal that is common and widespread throughout eastern Australia, preferring dry mesic habitat, rather than rainforest. As pollen evidence suggests that the central-eastern part of Australia (southeast Queensland and northern New South Wales experienced cycles of expansion in mesic habitat with contraction in rainforests, and vice versa during glacial and interglacial periods, respectively, we hypothesise that the distribution of the eastern grey kangaroo was affected by these climate oscillations and may have contracted to mesic habitat refugia. From 375 mitochondrial DNA control region sequences from across the distribution of eastern grey kangaroos we obtained 108 unique haplotypes. Phylogenetic analysis identified two clades in Queensland, one of which is newly identified and restricted to a small coastal region in southern Queensland north of Brisbane, known as the Sunshine Coast. The relatively limited geographic range of this genetically isolated clade suggests the possibility of a mesic habitat refugium forming during rainforest expansion during wetter climate cycles. Other potential, although less likely, reasons for the genetic isolation of the highly distinct clade include geographic barriers, separate northward expansions, and strong local adaptation.

Phylogeography of Eastern Grey Kangaroos, Macropus giganteus, Suggests a Mesic Refugium in Eastern Australia.

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Coghlan, Brett A; Goldizen, Anne W; Thomson, Vicki A; Seddon, Jennifer M

2015-01-01

Phylogeographic studies around the world have identified refugia where fauna were able to persist during unsuitable climatic periods, particularly during times of glaciation. In Australia the effects of Pleistocene climate oscillations on rainforest taxa have been well studied but less is known about the effects on mesic-habitat fauna, such as the eastern grey kangaroo (Macropus giganteus). The eastern grey kangaroo is a large mammal that is common and widespread throughout eastern Australia, preferring dry mesic habitat, rather than rainforest. As pollen evidence suggests that the central-eastern part of Australia (southeast Queensland and northern New South Wales) experienced cycles of expansion in mesic habitat with contraction in rainforests, and vice versa during glacial and interglacial periods, respectively, we hypothesise that the distribution of the eastern grey kangaroo was affected by these climate oscillations and may have contracted to mesic habitat refugia. From 375 mitochondrial DNA control region sequences from across the distribution of eastern grey kangaroos we obtained 108 unique haplotypes. Phylogenetic analysis identified two clades in Queensland, one of which is newly identified and restricted to a small coastal region in southern Queensland north of Brisbane, known as the Sunshine Coast. The relatively limited geographic range of this genetically isolated clade suggests the possibility of a mesic habitat refugium forming during rainforest expansion during wetter climate cycles. Other potential, although less likely, reasons for the genetic isolation of the highly distinct clade include geographic barriers, separate northward expansions, and strong local adaptation.

Challenges in secondary prevention after acute myocardial infarction: A call for action.

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Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul; Frederix, Ines; Prescott, Eva; Schmid, Jean Paul; Cupples, Margaret; Deaton, Christi; Doherty, Patrick; Giannuzzi, Pantaleo; Graham, Ian; Hansen, Tina Birgitte; Jennings, Catriona; Landmesser, Ulf; Marques-Vidal, Pedro; Vrints, Christiaan; Walker, David; Bueno, Héctor; Fitzsimons, Donna; Pelliccia, Antonio

2016-12-01

Worldwide, each year more than 7 million people experience myocardial infarction, in which one-year mortality rates are now in the range of 10%, but vary with patient characteristics. The consequences are even more dramatic: among patients who survive, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings are endorsed.

Effect of ginkgo capsules combined with secondary preventive drugs on the endothelial injury and plaque properties of patients with hypertension complicated by carotid atherosclerosis

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Wei Li

2017-10-01

Full Text Available Objective: To study the effect of ginkgo capsules combined with secondary preventive drugs on the endothelial injury and plaque properties of patients with hypertension complicated by carotid atherosclerosis. Methods: A total of 178 patients with hypertension complicated by carotid atherosclerosis who were treated in Chengyue Community Health Service Center of Xisaishan District Huangshi City Hubei Province between February 2015 and January 2017 were collected and randomly divided into two groups. Control group were treated with conventional secondary preventive drugs, and observation group were treated with ginkgo capsules combined with secondary preventive drugs. The differences in serum endothelial injury indexes and lipid metabolism indexes as well as carotid artery ultrasound parameters were compared between the two groups before and after treatment. Results: Before treatment, endothelial injury indexes and lipid metabolism indexes as well as carotid artery ultrasound parameters were not significantly different between two groups. After treatment, serum ET, AngⅡ, TC, LDL-C and LpA contents as well as carotid artery ultrasound parameters DS and AS levels of observation group were lower than those of control group while serum NO and HDL-C contents as well as carotid artery ultrasound parameter MLD level were higher than those of control group. Conclusion: Ginkgo capsule combined with secondary preventive drugs can effectively reduce the endothelial injury and stabilize the plaques in patients with hypertension complicated by carotid atherosclerosis.

Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population

NARCIS (Netherlands)

Kaasenbrood, Lotte; Boekholdt, S. Matthijs; van der Graaf, Yolanda; Ray, Kausik K.; Peters, Ron J. G.; Kastelein, John J. P.; Amarenco, Pierre; LaRosa, John C.; Cramer, Maarten J. M.; Westerink, Jan; Kappelle, L. Jaap; de Borst, Gert J.; Visseren, Frank L. J.

2016-01-01

Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction and residual

Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population

NARCIS (Netherlands)

Kaasenbrood, Lotte; Boekholdt, S. Matthijs; Van Der Graaf, Yolanda; Ray, Kausik K.; Peters, Ron J G; Kastelein, John J P; Amarenco, Pierre; Larosa, John C.; Cramer, Maarten J M; Westerink, Jan; Kappelle, L. Jaap; De Borst, Gert J.; Visseren, Frank L J

2016-01-01

Background: Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction and

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

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DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

2013-06-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.

Gender roles, physical and sexual violence prevention in primary extend to secondary school in Samutsakorn Province, Thailand.

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Chamroonsawasdi, Kanittha; Suparp, Jarueyporn; Kittipichai, Wirin; Khajornchaikul, Piyathida

2010-03-01

To enhance positive attitude and life skills on gender roles to prevent physical and sexual violence. A whole school-based participatory learning program using a quasi-experimental study with pre and post test design was conducted among 2 schools during June-September, 2005. The experimental group, were 134 students in a primary school and 179 students in a secondary school. While the control group, were 122 students in a primary school and 95 students in a secondary school. Means score of attitude toward gender roles before implementation in the experimental group was significantly lower than the control group (p 0.05). Means paired different score (after-before) between the two groups was significantly different (p = 0.002). A whole school-based program on gender roles and violence prevention is suitable for youths and should be merged as school curricula and expanded as a nationwide program at all level of education. Gender equity should be taught at an early childhood. Parental involvement in school-based activities should be negotiated.

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study

NARCIS (Netherlands)

A. Murphy (Adrianna); Palafox, B. (Benjamin); O.A. O'Donnell (Owen); D. Stuckler (David); P. Perel (Pablo); AlHabib, K.F. (Khalid F); Avezum, A. (Alvaro); Bai, X. (Xiulin); Chifamba, J. (Jephat); Chow, C.K. (Clara K); Corsi, D.J. (Daniel J); G.R. Dagenais (Gilles R); Dans, A.L. (Antonio L); R. Díaz (Rafael); Erbakan, A.N. (Ayse N); Ismail, N. (Noorhassim); Iqbal, R. (Romaina); Kelishadi, R. (Roya); Khatib, R. (Rasha); Lanas, F. (Fernando); Lear, S.A. (Scott A); Li, W. (Wei); Liu, J. (Jia); Lopez-Jaramillo, P. (Patricio); Mohan, V. (Viswanathan); Monsef, N. (Nahed); Mony, P.K. (Prem K); Puoane, T. (Thandi); Rangarajan, S. (Sumathy); A. Rosengren (Annika); Schutte, A.E. (Aletta E); Sintaha, M. (Mariz); Teo, K.K. (Koon K); Wielgosz, A. (Andreas); Yeates, K. (Karen); Yin, L. (Lu); Yusoff, K. (Khalid); Zatońska, K. (Katarzyna); S. Yusuf (Salim); M. McKee (Martin)

2018-01-01

textabstractBackground: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. Methods: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492

Secondary prevention lifestyle interventions initiated within 90 days after TIA or 'minor' stroke: a systematic review and meta-analysis of rehabilitation programmes.

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Heron, Neil; Kee, Frank; Cardwell, Christopher; Tully, Mark A; Donnelly, Michael; Cupples, Margaret E

2017-01-01

Strokes are often preceded by a transient ischaemic attack (TIA) or 'minor' stroke. The immediate period after a TIA/minor stroke is a crucial time to initiate secondary prevention. However, the optimal approach to prevention, including non-pharmacological measures, after TIA is not clear. To systematically review evidence about the effectiveness of delivering secondary prevention, with lifestyle interventions, in comprehensive rehabilitation programmes, initiated within 90 days of a TIA/minor stroke. Also, to categorise the specific behaviour change techniques used. The review identified randomised controlled trials by searching the Cochrane Library, Ovid MEDLINE, Ovid EMBASE, Web of Science, EBSCO CINAHL and Ovid PsycINFO. Two review authors independently screened titles and abstracts for eligibility (programmes initiated within 90 days of event; outcomes reported for TIA/minor stroke) and extracted relevant data from appraised studies; a meta-analysis was used to synthesise the results. A total of 31 potentially eligible papers were identified and four studies, comprising 774 patients post-TIA or minor stroke, met the inclusion criteria; two had poor methodological quality. Individual studies reported increased aerobic capacity but meta-analysis found no significant change in resting and peak systolic blood pressure, resting heart rate, aerobic capacity, falls, or mortality. The main behaviour change techniques were goal setting and instructions about how to perform given behaviours. There is limited evidence of the effectiveness of early post-TIA rehabilitation programmes with preventive lifestyle interventions. Further robust randomised controlled trials of comprehensive rehabilitation programmes that promote secondary prevention and lifestyle modification immediately after a TIA are needed. © British Journal of General Practice 2017.

Microcapsule-Type Self-Healing Protective Coating for Cementitious Composites with Secondary Crack Preventing Ability.

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Kim, Dong-Min; Yu, Hwan-Chul; Yang, Hye-In; Cho, Yu-Jin; Lee, Kwang-Myong; Chung, Chan-Moon

2017-01-26

A microcapsule-type self-healing protective coating with secondary crack preventing capability has been developed using a silanol-terminated polydimethylsiloxane (STP)/dibutyltin dilaurate (DD) healing agent. STP undergoes condensation reaction in the presence of DD to give a viscoelastic substance. STP- and DD-containing microcapsules were prepared by in-situ polymerization and interfacial polymerization methods, respectively. The microcapsules were characterized by Fourier-transform infrared (FT-IR) spectroscopy, optical microscopy, and scanning electron microscopy (SEM). The microcapsules were integrated into commercial enamel paint or epoxy coating formulations, which were applied on silicon wafers, steel panels, and mortar specimens to make dual-capsule self-healing protective coatings. When the STP/DD-based coating was scratched, self-healing of the damaged region occurred, which was demonstrated by SEM, electrochemical test, and water permeability test. It was also confirmed that secondary crack did not occur in the healed region upon application of vigorous vibration to the self-healing coating.

Microcapsule-Type Self-Healing Protective Coating for Cementitious Composites with Secondary Crack Preventing Ability

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Dong-Min Kim

2017-01-01

Full Text Available A microcapsule-type self-healing protective coating with secondary crack preventing capability has been developed using a silanol-terminated polydimethylsiloxane (STP/dibutyltin dilaurate (DD healing agent. STP undergoes condensation reaction in the presence of DD to give a viscoelastic substance. STP- and DD-containing microcapsules were prepared by in-situ polymerization and interfacial polymerization methods, respectively. The microcapsules were characterized by Fourier-transform infrared (FT-IR spectroscopy, optical microscopy, and scanning electron microscopy (SEM. The microcapsules were integrated into commercial enamel paint or epoxy coating formulations, which were applied on silicon wafers, steel panels, and mortar specimens to make dual-capsule self-healing protective coatings. When the STP/DD-based coating was scratched, self-healing of the damaged region occurred, which was demonstrated by SEM, electrochemical test, and water permeability test. It was also confirmed that secondary crack did not occur in the healed region upon application of vigorous vibration to the self-healing coating.

Level of knowledge the teenagers in secondary schools about addiction, and its prevention

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Dorota Maciąg

2012-12-01

Full Text Available Background: Narcotics have been present in the world for thousands of years. People have been trying to change their psyche by means of psychoactive drugs. At the very beginning drugs were used as the element of religious cult, helpful in varying social meetings. With time, they were used as medicinal substances. The phenomenon of narcosis among children and teenagers by means of various narcotics is one of the most serious aspects of social aberration and it is a very difficult educational problem all over the world. Drug abuse among teenagers is becoming more and more serious and is increasing, which puts health and life in danger. There are as many reasons of drug abuse as narcotics. Young people do not appreciate their health, as in their opinion illnesses are directly related to an old age. They do not understand the consequences of drug abuse which is just a good fun for them. The aim of drug prevention strategy is, first of all, the reduction of drugs availability. The prevention strategies concentrated on costs aim at helping the individuals to develop and keep the healthy way of life. The strategies concentrated on society should include the environmental factors, such as legal, economical, family, cultural, political and religious aspects. The aim of this work was to specify the awareness of secondary school students concerning drug abuse, its reasons, health effects and prevention. Materials and methods: The research was conducted among 80 students of 1–3 grade of secondary schools from Opatów province. The questionnaire was the research tool, which consisted of 21 questions concerning the students’ knowledge about the reasons for reaching for drugs, the possibilities of getting drugs at school, the health reasons of drug abuse as well as the drug prevention conducted by the teachers and school educationalists. Results: Only 25% of the students believed drug abuse to be a socially pathological phenomenon. 65% claimed that lately

Cost-Effectiveness Analysis of Atorvastatin versus Rosuvastatin in Primary and Secondary Cardiovascular Prevention Populations in Brazil and Columbia.

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Mould-Quevedo, Joaquín F; Gutiérrez-Ardila, Magda Vianey; Ordóñez Molina, Jaime Eduardo; Pinsky, Brett; Vargas Zea, Nicolás

2014-12-01

Latin America has witnessed a marked increase in cardiovascular (CV) disease, the leading cause of death in many countries. The benefits of lipid-lowering therapy to reduce CV-related events are widely accepted. Clinical evidence suggests that rosuvastatin is associated with slightly greater reductions in low-density lipoprotein cholesterol levels than is atorvastatin at comparable doses. Rosuvastatin, however, is often priced at a premium. Our objective was to examine the cost-effectiveness of using atorvastatin versus rosuvastatin in reducing CV events in Brazil and Colombia using real-world prices. A global Markov cohort model of primary and secondary CV prevention was developed and adapted to Brazilian and Colombian settings. The risks and costs of major CV events and efficacy, adherence, and costs of statins were considered. Total gains in life-years, quality-adjusted life-years, major CV events avoided, and costs over the lifetime horizon were estimated. Several dose comparisons were considered. In the Colombian analyses, differences in drug costs between therapies were considerable while outcomes were similar. The incremental cost per quality-adjusted life-year gained for rosuvastatin versus atorvastatin was more than $700,000 and $200,000 in primary and secondary prevention, respectively. Brazilian analyses found lower incremental cost-effectiveness ratios for rosuvastatin at some dose comparisons due to similar pricing between statins. Sensitivity analyses revealed that changes in treatment efficacy and adherence had the largest impact on results. In primary and secondary CV prevention, the efficacy advantage of rosuvastatin was minimal, while its acquisition cost was higher, particularly in Colombia. The incremental cost-effectiveness ratios were, therefore, generally in favor of atorvastatin being the cost-effective option. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights

Helpers in Distress: Preventing Secondary Trauma

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Whitfield, Natasha; Kanter, Deborah

2014-01-01

Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

Secondary prevention of work-related upper extremity disorders: recommendations from the Annapolis conference.

Science.gov (United States)

Feuerstein, Michael; Harrington, Cherise B

2006-09-01

Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical knowledge. A working conference was held in Annapolis, Maryland on September 23rd and 24th, 2005 with leaders in research and application related to upper extremity disorders to address this challenge. The intent of the meeting was to review "state of the art" evidence in epidemiology and intervention research in order to develop suggestions regarding next steps in intervention research and application. On day 2 a number of stakeholders were present to discuss what they perceived as the missing pieces in both epidemiological research and applied intervention research in order to generate more effective workplace interventions. The papers in this series of the Journal of Occupational Rehabilitation indicate that scientifically sound progress has been made over the past decade in identifying ergonomic, workplace psychosocial, and individual factors in both the etiology and exacerbation of these symptoms/disorders. However, there is a gap between this knowledge and the development and practical implementation of comprehensive interventions for these problems. The conference also highlighted the paucity of economic analyses of the impact of these disorders as well as the economic study of the impact of intervention. Approaches for such evaluations were presented and are included in this special section of the journal. This series of papers and the summary of the invited group's discussions provided in this paper clearly emphasize the need for innovative ways to think about these problems and specific research topics that can help

Pharmacotherapy in Patients after Acute Myocardial Infarction - the Basis for Effective Secondary Prevention. Data from a Pilot Registry in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Grünfeldová, H.; Tomečková, Marie; Monhart, Z.; Faltus, Václav; Peleška, Jan

2007-01-01

Roč. 30 (2007), s. 372-372 ISSN 1420-4096. [Central European Meeting on Hypertension and Cardiovascular Disease Prevention. 11.10.2007-13.10.2007, Kraków] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : acute myocardial ifraction * pilot registry * secondary prevention Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery

Usage of the Heterologous Expression of the Antimicrobial Gene afp From Aspergillus giganteus for Increasing Fungal Resistance in Olive

Science.gov (United States)

Narvaez, Isabel; Khayreddine, Titouh; Pliego, Clara; Cerezo, Sergio; Jiménez-Díaz, Rafael M.; Trapero-Casas, José L.; López-Herrera, Carlos; Arjona-Girona, Isabel; Martín, Carmen; Mercado, José A.; Pliego-Alfaro, Fernando

2018-01-01

The antifungal protein (AFP) produced by Aspergillus giganteus, encoded by the afp gene, has been used to confer resistance against a broad range of fungal pathogens in several crops. In this research, transgenic olive plants expressing the afp gene under the control of the constitutive promoter CaMV35S were generated and their disease response against two root infecting fungal pathogens, Verticillium dahliae and Rosellinia necatrix, was evaluated. Embryogenic cultures derived from a mature zygotic embryo of cv. ‘Picual’ were used for A. tumefaciens transformation. Five independent transgenic lines were obtained, showing a variable level of afp expression in leaves and roots. None of these transgenic lines showed enhanced resistance to Verticillium wilt. However, some of the lines displayed a degree of incomplete resistance to white root rot caused by R. necatrix compared with disease reaction of non-transformed plants or transgenic plants expressing only the GUS gene. The level of resistance to this pathogen correlated with that of the afp expression in root and leaves. Our results indicate that the afp gene can be useful for enhanced partial resistance to R. necatrix in olive, but this gene does not protect against V. dahliae. PMID:29875785

Purification and Characterization of a Unique Pectin Lyase from Aspergillus giganteus Able to Release Unsaturated Monogalacturonate during Pectin Degradation

Directory of Open Access Journals (Sweden)

Danielle Biscaro Pedrolli

2014-01-01

Full Text Available A pectin lyase, named PLIII, was purified to homogeneity from the culture filtrate of Aspergillus giganteus grown in submerged culture containing orange peel waste as carbon source. PLIII was able to digest apple pectin and citrus pectins with different degrees of methyl esterification. Interestingly, the PLIII activity was stimulated in the presence of some divalent cations including Pb2+ and was not significantly affected by Hg2+. Like other pectin lyases, PLIII is stimulated by but is not dependent on Ca2+. The main soluble product released during the degradation of pectic substances promoted by the PLIII is compatible with an unsaturated monogalacturonate. PLIII is a unique enzyme able to release unsaturated monogalacturonate as the only soluble product during the degradation of pectic substances; therefore, PLIII was classified as an exo-pectin lyase. To our knowledge, this is the first characterization of an exo-pectin lyase. The PLIII described in this work is potentially useful for ethanol production from pectin-rich biomass, besides other common applications for alkaline pectinases like preparation of textile fibers, coffee and tea fermentation, vegetable oil extraction, and the treatment of pulp in papermaking.

[Compliance with recommendations in secondary prevention of stroke in primary care].

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Tamayo-Ojeda, Carmen; Parellada-Esquius, Neus; Salvador-González, Betlem; Oriol-Torón, Pilar Ángeles; Rodríguez-Garrido, M Dolores; Muñoz-Segura, Dolores

Knowing compliance with secondary prevention recommendations of stroke in primary care and to identify factors associated with compliance. Multi-centre cross-sectional. Health primary care centres in a metropolitan area (944,280 inhabitants). Patients aged 18years and over with ischemic brain disease diagnosis prior to 6months before the study. Clinical history records of demographic variables, risk factors and cardiovascular comorbidity, drugs, blood pressure values (BP), LDL-cholesterol and medical visits by doctor and nurses after the event. Good adherence was considered when BP <140/90 mmHg, LDL-cholesterol <100 mg/dL, smoking abstention and preventive drugs prescription (anti-platelet/anticoagulants, statins and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-antagonists or diuretics) during the last 18months. A total of 21,976 patients, mean age 73.12 years (SD: 12.13), 48% women, 72.7% with stroke. Co-morbidity: hypertension 70.8%, dyslipidemia 55.1%, DM 30.9%, atrial fibrillation 14.1%, ischemic heart disease 13.5%, chronic renal failure 12.5%, heart failure 8.8%, peripheral arterial disease 6.2%, dementia 7.8%. No record was found for smoking in 3.7%, for BP in 3.5% and for LDL in 6.5%. Optimal control: abstention smoking in 3.7%, BP <140/90 in 65.7% and LDL <100 mg/dL in 41.0%. 86.2% anti-platelet/anticoagulants, 61.3% statins and 61.8% angiotensin-converting-enzyme inhibitors, angiotensin-receptor-antagonists or diuretic. Registration and risk factors control was higher in 66-79years aged and lower in 18-40years aged. The implementation of clinical guidelines recommendations for stroke prevention in primary care must be improved, especially among younger population. Organizational changes and more active involvement by professionals and strategies against therapeutic inertia must be taken. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Nutrient requirements of Miscanthus x giganteus: Conclusions from a review of published studies

International Nuclear Information System (INIS)

Cadoux, Stéphane; Riche, Andrew B.; Yates, Nicola E.; Machet, Jean-Marie

2012-01-01

Miscanthus x giganteus is a perennial biomass crop particularly suited to substituting fossil fuel resources in bioenergy production, in order to reduce greenhouse gas (GHG) emissions. The area of miscanthus grown in the EU is likely to increase in the future. However, the exact nutrient and fertiliser requirements of the crop are still under debate, which leads to uncertainties when making global assessments of GHG reductions and economics. The aim of our study was to review and analyse published data, in order to determine a consensus view on the nutrient requirements of the crop, and to identify where further research is needed. The findings of this study highlight the nutrient requirements of miscanthus are low compared to other crops. This is due to: i) high nutrient absorption efficiency through extensive rooting, ii) high absorbed nutrient use efficiency, iii) significant nutrient cycling between the rhizome and aerial biomass, iv) nutrient recycling before harvest through leaf fall, and v) possible contribution of N fixation by bacteria. Due to the low yield in the establishment phase of the crop, it is not recommended to apply any fertiliser during the two first years after planting, unless planted on poor soils. From the third year, typically 4.9, 0.45 and 7.0, grams per kilogram of dry matter, of N, P and K respectively are removed at harvest, and this should be a maximum to be replaced by fertilisers. Uncertainties in the exact requirements are due i) to a lack of data, in the different studies, on the nitrogen provided by soils, ii) to a lack of knowledge on the actual contribution of the rhizome to the plant nutrition, and iii) to the inexistence of tools for the diagnosis of the plant N status.

[Secondary prevention of coronary heart disease is less agressive in patients over 64 years].

Science.gov (United States)

Muñoz, Miguel A; Marrugat, Jaume

2003-06-01

Although elderly people has a higher incidence of coronary heart disease, this group is seldom included in clinical trials. Studies performed in Spain on elderly coronary heart disease patients have been conducted in hospital settings. The aim of our study was to analyse wether the management of coronary heart disease patients over 64 years of age cared by family physicians differed from that of the rest. Cross-sectional multicentre study embedded in a clinical trial on 1,022 patients with stable coronary heart disease in which socio-demographic variables, comorbidity, treatment and cardiovascular risk- factor control were collected. Mean age was 64 10, 74.0% were men and 53.8% of subjects were over 64 years. Patients over 64 years had a greater cardiovascular comorbidity (87.7 vs 82.6%; p = 0.002) and received lower number of drugs than the rest in the prevention of recurrences (60.4 vs 70.9%; p < 0.001). Probability to receive less than two drugs on secondary prevention by subjects over 64 years was 0.45 (95% CI, 0.30-0.68) despite comorbidity, sex and cardiovascular risk profile.Conclusions. Coronary heart disease patients over 64 years receive less drugs for coronary event recurrence prevention than their younger counterparts despite their worse cardiovascular risk profile.

Differences in the diurnal pattern of soil respiration under adjacent Miscanthus x giganteus and barley crops reveal potential flaws in accepted sampling strategies

Science.gov (United States)

Keane, James; Ineson, Phil

2017-04-01

Soil respiration (Rs) plays an important role in the global carbon cycle and contributes ca. 30% of global ecosystem respiration.However, for convenience, measurements used to compare Rs from different land uses, crops or management practices are often made between 09:00 and 16:00, with an implicit assumption that Rs is largely controlled by temperature. Three months' continuous data presented here show distinctly different diurnal patterns of Rs between barley (Hordeum vulgare) and Miscanthus x giganteus (Miscanthus) grown on adjacent fields. Maximum Rs in barley occurred during the afternoon and correlated with soil temperature, whereas Rs peaked in Miscanthus during the night and was significantly correlated with earlier levels of solar radiation, probably due to delays in translocation of recent photosynthate. Since daily mean Rs in Miscanthus coincided with levels 40% greater than the mean in barley, it is vital to select appropriate times to measure Rs if only single daily measurements are to be made.

Pleurotus giganteus (Berk. Karun & Hyde), the giant oyster mushroom inhibits NO production in LPS/H2O2 stimulated RAW 264.7 cells via STAT 3 and COX-2 pathways.

Science.gov (United States)

Baskaran, Asweni; Chua, Kek Heng; Sabaratnam, Vikineswary; Ravishankar Ram, Mani; Kuppusamy, Umah Rani

2017-01-13

Pleurotus giganteus (Berk. Karunarathna and K.D. Hyde), has been used as a culinary mushroom and is known to have medicinal properties but its potential as an anti-inflammatory agent to mitigate inflammation triggered diseases is untapped. In this study, the molecular mechanism underlying the protective effect of ethanol extract of P. giganteus (EPG) against lipopolysaccharide (LPS) and combination of LPS and hydrogen peroxide (H 2 O 2 )-induced inflammation on RAW 264.7 macrophages was investigated. The effect of EPG on nitric oxide (NO) production as an indicator of inflammation in RAW 264.7 macrophages was estimated based on Griess reaction that measures nitrite level. The expressions of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), NF-kB activating protein (NKAP), signal transducer and activator of transcription 3 protein (STAT 3) and glutathione peroxidase (GPx) genes were assessed using real time reverse transcription polymerase chain reaction (RT-PCR) approach. EPG (10 μg/ml) showed the highest reduction in the LPS-induced NO production in RAW 264.7 macrophages and significantly suppressed (p < 0.05) the expression iNOS, STAT 3 and COX-2. There was a significant increase (p < 0.05) in combination of LPS and H 2 O 2 - induced iNOS production when compared to the LPS-induced iNOS production in RAW 264.7 macrophages and this concurred with the NO production which was attenuated by EPG at 10 μg/ml. A significant (p < 0.05) down regulation was observed in the combination of LPS and H 2 O 2 -induced iNOS and GPx expression by EPG. Our data suggest that the anti-inflammatory activity of EPG is mediated via the suppression of the STAT 3 and COX-2 pathways and can serve as potential endogenous antioxidant stimulant.

Growth and fecundity of fertile Miscanthus × giganteus ("PowerCane") compared to feral and ornamental Miscanthus sinensis in a common garden experiment: Implications for invasion.

Science.gov (United States)

Miriti, Maria N; Ibrahim, Tahir; Palik, Destiny; Bonin, Catherine; Heaton, Emily; Mutegi, Evans; Snow, Allison A

2017-08-01

Perennial grasses are promising candidates for bioenergy crops, but species that can escape cultivation and establish self-sustaining naturalized populations (feral) may have the potential to become invasive. Fertile Miscanthus  ×  giganteus , known as "PowerCane," is a new potential biofuel crop. Its parent species are ornamental, non-native Miscanthus species that establish feral populations and are sometimes invasive in the USA. As a first step toward assessing the potential for "PowerCane" to become invasive, we documented its growth and fecundity relative to one of its parent species ( Miscanthus sinensis ) in competition with native and invasive grasses in common garden experiments located in Columbus, Ohio and Ames, Iowa, within the targeted range of biofuel cultivation. We conducted a 2-year experiment to compare growth and reproduction among three Miscanthus biotypes-"PowerCane," ornamental M. sinensis , and feral M. sinensis -at two locations. Single Miscanthus plants were subjected to competition with a native grass ( Panicum virgatum ), a weedy grass ( Bromus inermis ), or no competition. Response variables were aboveground biomass, number of shoots, basal area, and seed set. In Iowa, all Miscanthus plants died after the first winter, which was unusually cold, so no further results are reported from the Iowa site. In Ohio, we found significant differences among biotypes in growth and fecundity, as well as significant effects of competition. Interactions between these treatments were not significant. "PowerCane" performed as well or better than ornamental or feral M. sinensis in vegetative traits, but had much lower seed production, perhaps due to pollen limitation. In general, ornamental M. sinensis performed somewhat better than feral M. sinensis . Our findings suggest that feral populations of "PowerCane" could become established adjacent to biofuel production areas. Fertile Miscanthus  ×  giganteus should be studied further to assess its

Pre-exercise screening and health coaching in CHD secondary prevention: a qualitative study of the patient experience.

Science.gov (United States)

Shaw, R; Gillies, M; Barber, J; MacIntyre, K; Harkins, C; Findlay, I N; McCloy, K; Gillie, A; Scoular, A; MacIntyre, P D

2012-06-01

Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly variable. In order to explore patients' experiences of a pre-exercise screening and health coaching programme (involving one-to-one consultations to support exercise behaviour change), semi-structured telephone interviews were undertaken with 84 CHD patients recruited from primary care. The interviews focused on patients' experiences of the intervention including referral and any recommendations for improvement. A thematic analysis of transcribed interviews showed that the majority of patients were positive about referral. However, patients also identified a number of barriers to attending and completing the programme, including a belief they were sufficiently active already, the existence of other health problems, feeling unsupported in community-based exercise classes and competing demands. Our findings highlight important issues around the choice of an appropriate point of intervention for programmes of this kind as well as the importance of appropriate patient selection, suggesting that the effectiveness of health coaching may be under-reported as a result of including patients who are not yet ready to change their behaviours.

DOGMAS AND UPDATES ON THE USE OF BETA-BLOCKERS IN SECONDARY PREVENTION. FIRST PART.

Directory of Open Access Journals (Sweden)

Alberto Morales Salinas

2011-08-01

Full Text Available There is consensus on clinical guidelines that beta-blockers (BB provide unquestionable benefits in several environments of secondary prevention, such as heart failure and myocardial infarction. However, in everyday practice they are underused in contexts where they are not contraindicated. Such is the case of heart failure with ejection fraction. This article presents an analysis on the available evidence of beta blockers’ effectiveness in heart failure with ejection fraction. It is concluded that overwhelming evidence favours the use of beta-blockers in chronic heart failure with ejection fraction, whereas in episodes of acute decompensated heart failure, their suspension should be avoided whenever it is possible.

Compliance of an elderly hip fracture population with secondary preventative measures. Efficacy of a simple clinical practice intervention.

LENUS (Irish Health Repository)

Street, John

2012-02-03

Secondary pharmaceutical measures are effective in all age groups for the prevention of osteoporotic fractures. This prospective study determines the demographics of 566 consecutive osteoporotic hip fractures presenting to a Level 1 Trauma Center. We examine the efficacy of simple treatment recommendations for pharmaceutical treatment of osteoporosis and the factors determining general practitioner and patient compliance with these recommendations in a community setting. One out of four patients (24.5%) had sustained a previous fragility fracture. Mean age was 80 years. Twenty five percent were resident in a nursing home and only 10% were taking anti-resorptive therapy preoperatively. In hospital mortality was 6%, and 39% of recruited patients were dead at 12 months. By this time more than half the survivors were resident in a nursing home. The compliance with anti-resorptive therapy had increased to over 70% consequent to our simple recommendations. Significant differences in GP and patient compliance were observed between nursing home and own residence dwellers. This study demonstrates the efficacy of a simple clinical practice intervention in increasing patient and GP compliance with secondary fracture prevention measures. We also discuss many of the confounding issues determining this compliance.

Edetate Disodium-Based Treatment for Secondary Prevention in Post-Myocardial Infarction Patients.

Science.gov (United States)

Lamas, Gervasio A; Issa, Omar M

2016-02-01

An abundance of data, known for decades, is available linking metals, such as lead and cadmium, with cardiovascular disease. However, the idea that these toxic metals could be a modifiable risk factor for atherosclerosis did not become apparent clinically until the completion of the Trial to Assess Chelation Therapy in 2012. This pivotal study was the first double-blind, randomized, controlled trial of its kind to demonstrate a clear improvement in cardiovascular outcomes with edetate disodium therapy in a secondary prevention, post-myocardial infarction population. This effect size was most striking in diabetic patients, where the efficacy of edetate disodium was comparable, if not superior, to that of current guideline-based therapies. Given the economic burden of diabetes and cardiovascular disease, the potential impact of this therapy could be enormous if the results of this study are replicated.

Risk factors and prognostic role of an electrical storm in patients after myocardial infarction with an implanted ICD for secondary prevention.

Science.gov (United States)

Kwaśniewski, Wojciech; Filipecki, Artur; Orszulak, Michał; Orszulak, Witold; Urbańczyk, Dagmara; Roczniok, Robert; Trusz-Gluza, Maria; Mizia-Stec, Katarzyna

2018-04-01

The aim of our study was to determine the risk factors for electrical storm (ES) and to assess the impact of ES on the long-term prognosis in patients after myocardial infarction (MI) with an implantable cardioverter-defibrillator (ICD) for secondary prevention of sudden cardiac death (SCD). We retrospectively analyzed 416 patients with coronary artery disease after MI who had an implanted ICD for secondary prevention of SCD. Fifty (12%) patients had one or more incidents of an electrical storm - the ES (+) group. We matched the reference group of 47 patients from 366 ES (-) patients. We analyzed 3,408 episodes of ventricular arrhythmias: 3,148 ventricular tachyarrhythmic episodes in the ES (+) group (including 187 episodes of ES) and 260 in the ES (-) group. Multivariate logistic regression showed that inferior wall MI (RR = 3.98, 95% CI: 1.52-10.41) and the absence of coronary revascularization (RR = 2.92, 95% CI: 1.18-7.21) were independent predictors of ES ( p = 0.0014). During 6-year observation of 97 patients, there were 39 (40%) deaths: 25 (50%) subjects in the ES (+) group and 14 (30%) in the ES (-) group ( p = 0.036). Independent predictors of death were: the occurrence of ES (HR = 1.93), older age (HR = 1.06), and lower left ventricular ejection fraction (HR = 0.95) (for all p storm in patients after MI with ICD for secondary prevention is a relatively common phenomenon and has a negative prognostic significance. Myocardial infarction of the inferior wall and the absence of coronary revascularization are predisposing factors for the occurrence of an ES.

Gaining Insight from Flexible Models - Assessment of the Secondary Prevention Trial of CHD in the Czech Male Population with MI History

Czech Academy of Sciences Publication Activity Database

Valenta, Zdeněk; Pitha, J.; Podrapská, I.; Poledne, R.

2006-01-01

Roč. 45, č. 2 (2006), s. 186-190 ISSN 0026-1270 R&D Projects: GA MŠk LN00B107 Keywords : coronary heart disease * non-proportional hazards * secondary prevention * survival Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.684, year: 2006

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol.

Science.gov (United States)

Sharif Ishak, Sharifah Intan Zainun; Chin, Yit Siew; Mohd Taib, Mohd Nasir; Mohd Shariff, Zalilah

2016-10-20

Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old. Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).

Theoretical Risk and Prevention Model for Secondary Health Conditions and Mortality After SCI: 15 Years of Research

Science.gov (United States)

Krause, James S.; Saunders, Lee L.; DiPiro, Nicole D.; Reed, Karla S.

2013-01-01

Background: To successfully prevent secondary health conditions (SHCs) and promote longevity after spinal cord injury (SCI), we must first understand the risk factors precipitating their occurrence and develop strategies to address these risk factors. Conceptual models may aid in identifying the nature of SHCs and guide research, clinical practice, and the development of prevention strategies. Objective: Our purpose is to review and refine an existing theoretical risk and prevention model (TRPM) as a means of classifying risk and protective factors for SHCs and mortality after SCI and for identifying points of intervention. Methods: We describe conceptual work within the field of SCI research and SHCs, including a description of the TRPM, a review of research using the TRPM, and conceptual enhancements to the TRPM based on previous research. Conclusions: The enhanced TRPM directs research to the timing and chronicity of the SHCs and their relationship with overall health and physiologic decline. Future research should identify differences in the nature of SHCs, the extent to which they relate to risk and protective factors, and the degree to which they may be prevented with appropriate research-based strategies. PMID:23459002

Secondary benefit of maintaining normal transcranial Doppler velocities when using hydroxyurea for prevention of severe sickle cell anemia.

Science.gov (United States)

Ghafuri, Djamila Labib; Chaturvedi, Shruti; Rodeghier, Mark; Stimpson, Sarah-Jo; McClain, Brandi; Byrd, Jeannie; DeBaun, Michael R

2017-07-01

In a retrospective cohort study, we tested the hypothesis that when prescribing hydroxyurea (HU) to children with sickle cell anemia (SCA) to prevent vaso-occlusive events, there will be a secondary benefit of maintaining low transcranial Doppler (TCD) velocity, measured by imaging technique (TCDi). HU was prescribed for 90.9% (110 of 120) of children with SCA ≥5 years of age and followed for a median of 4.4 years, with 70% (n = 77) receiving at least one TCDi evaluation after starting HU. No child prescribed HU had a conditional or abnormal TCDi measurement. HU initiation for disease severity prevention decreases the prevalence of abnormal TCDi velocities. © 2016 Wiley Periodicals, Inc.

Effective secondary fracture prevention: implementation of a global benchmarking of clinical quality using the IOF Capture the Fracture® Best Practice Framework tool.

Science.gov (United States)

Javaid, M K; Kyer, C; Mitchell, P J; Chana, J; Moss, C; Edwards, M H; McLellan, A R; Stenmark, J; Pierroz, D D; Schneider, M C; Kanis, J A; Akesson, K; Cooper, C

2015-11-01

Fracture Liaison Services are the best model to prevent secondary fractures. The International Osteoporosis Foundation developed a Best Practice Framework to provide a quality benchmark. After a year of implementation, we confirmed that a single framework with set criteria is able to benchmark services across healthcare systems worldwide. Despite evidence for the clinical effectiveness of secondary fracture prevention, translation in the real-world setting remains disappointing. Where implemented, a wide variety of service models are used to deliver effective secondary fracture prevention. To support use of effective models of care across the globe, the International Osteoporosis Foundation's Capture the Fracture® programme developed a Best Practice Framework (BPF) tool of criteria and standards to provide a quality benchmark. We now report findings after the first 12 months of implementation. A questionnaire for the BPF was created and made available to institutions on the Capture the Fracture website. Responses from institutions were used to assign gold, silver, bronze or black (insufficient) level of achievements mapped across five domains. Through an interactive process with the institution, a final score was determined and published on the Capture the Fracture website Fracture Liaison Service (FLS) map. Sixty hospitals across six continents submitted their questionnaires. The hospitals served populations from 20,000 to 15 million and were a mix of private and publicly funded. Each FLS managed 146 to 6200 fragility fracture patients per year with a total of 55,160 patients across all sites. Overall, 27 hospitals scored gold, 23 silver and 10 bronze. The pathway for the hip fracture patients had the highest proportion of gold grading while vertebral fracture the lowest. In the first 12 months, we have successfully tested the BPF tool in a range of health settings across the globe. Initial findings confirm a significant heterogeneity in service provision and

High prevalence of missed opportunities for secondary fracture prevention in a regional general hospital setting in Singapore.

Science.gov (United States)

Gani, Linsey; Reddy, Saripalli K; Alsuwaigh, Rayan; Khoo, Joan; King, Thomas F J

2017-12-01

This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population. Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients. We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed. There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%, p = 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%, p Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups.

Adherence to oral anticoagulant therapy in secondary stroke prevention – impact of the novel oral anticoagulants

Directory of Open Access Journals (Sweden)

Luger S

2015-11-01

Full Text Available Sebastian Luger,1 Carina Hohmann,2 Daniela Niemann,1 Peter Kraft,3 Ignaz Gunreben,3 Tobias Neumann-Haefelin,2 Christoph Kleinschnitz,3 Helmuth Steinmetz,1 Christian Foerch,1 Waltraud Pfeilschifter1 1Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, 2Department of Neurology, Klinikum Fulda gAG, Fulda, 3Department of Neurology, University Hospital Würzburg, Würzburg, Germany Background: Oral anticoagulant therapy (OAT potently prevents strokes in patients with atrial fibrillation. Vitamin K antagonists (VKA have been the standard of care for long-term OAT for decades, but non-VKA oral anticoagulants (NOAC have recently been approved for this indication, and raised many questions, among them their influence on medication adherence. We assessed adherence to VKA and NOAC in secondary stroke prevention. Methods: All patients treated from October 2011 to September 2012 for ischemic stroke or transient ischemic attack with a subsequent indication for OAT, at three academic hospitals were entered into a prospective registry, and baseline data and antithrombotic treatment at discharge were recorded. At the 1-year follow-up, we assessed the adherence to different OAT strategies and patients’ adherence to their respective OAT. We noted OAT changes, reasons to change treatment, and factors that influence persistence to the prescribed OAT. Results: In patients discharged on OAT, we achieved a fatality corrected response rate of 73.3% (n=209. A total of 92% of these patients received OAT at the 1-year follow-up. We observed good adherence to both VKA and NOAC (VKA, 80.9%; NOAC, 74.8%; P=0.243 with a statistically nonsignificant tendency toward a weaker adherence to dabigatran. Disability at 1-year follow-up was an independent predictor of lower adherence to any OAT after multivariate analysis, whereas the choice of OAT did not have a relevant influence. Conclusion: One-year adherence to OAT after stroke is strong (>90% and patients

Prevention Of Stroke

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Nagaraja D

2005-01-01

Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS: a protocol for a randomised controlled trial

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Leistner Stefanie

2013-01-01

Full Text Available Abstract Background Patients with recent stroke or TIA are at high risk for new vascular events. Several evidence based strategies in secondary prevention of stroke are available but frequently underused. Support programs with multifactorial risk factor modifications after stroke or TIA have not been investigated in large-scale prospective controlled trials so far. INSPiRE-TMS is a prospective, multi-center, randomized open intervention trial for intensified secondary prevention after minor stroke and TIA. Methods/design Patients with acute TIA or minor stroke admitted to the participating stroke centers are screened and recruited during in-hospital stay. Patients are randomised in a 1:1 ratio to intervention (support program and control (usual care arms. Inclusion of 2.082 patients is planned. The support program includes cardiovascular risk factor measurement and feedback, monitoring of medication adherence, coaching in lifestyle modifications, and active involvement of relatives. Standardized motivational interviewing is used to assess and enhance patients’ motivation. Primary objective is a reduction of new major vascular events defined as nonfatal stroke and myocardial infarction or vascular death. Recruitment time is planned for 3.5 years, follow up time is at least 2 years for every patient resulting in a total study time of 5 years (first patient in to last patient out. Discussion Given the high risk for vascular re-events in acute stroke and the available effective strategies in secondary prevention, the INSPIRE-TMS support program has the potential to lead to a relevant reduction of recurrent events and a prolongation of the event-free survival time. The trial will provide the basis for the decision whether an intensified secondary prevention program after stroke should be implemented into regular care. A cost-effectiveness evaluation will be performed. Trial registration clinicaltrials.gov: 01586702

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems.

LENUS (Irish Health Repository)

Corrrigan, Mairead

2006-01-01

BACKGROUND: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. METHODS: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. RESULTS: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

Directory of Open Access Journals (Sweden)

Leathem Claire S

2006-07-01

Full Text Available Abstract Background Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD. It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. Methods In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23 and four with staff (N = 29 informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients and 10 interviews (staff. The data were analysed using thematic analysis. Results Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems.

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Corrrigan, Mairead; Cupples, Margaret E; Smith, Susan M; Byrne, Molly; Leathem, Claire S; Clerkin, Pauline; Murphy, Andrew W

2006-07-18

Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour

Efficacy of standard and intensive statin treatment for the secondary prevention of cardiovascular and cerebrovascular events in diabetes patients : A meta-analysis

NARCIS (Netherlands)

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

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,

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol

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Sharifah Intan Zainun Sharif Ishak

2016-10-01

Full Text Available Abstract Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL, a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old. Methods/Design Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity, body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. Discussion It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. Trial registration UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016

The SPHERE Study. Secondary prevention of heart disease in general practice: protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative, economic and policy analyses. [ISRCTN24081411].

LENUS (Irish Health Repository)

Murphy, Andrew W

2005-07-29

BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to

Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease

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Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

2017-01-01

Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation. This is an update of a Cochrane Review first published in 2002, and last updated in 2013. Objectives To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). Search methods We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Selection criteria Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease. Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion. Two trials compared the drug

Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.

Science.gov (United States)

Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

2017-01-17

Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation.This is an update of a Cochrane Review first published in 2002, and last updated in 2013. To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Two authors independently assessed trial eligibility and the risk of bias and extracted data. We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease.Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion.Two trials compared the drug hydroxyurea (hydroxycarbamide) and phlebotomy to long-term transfusions and iron chelation therapy: one in

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

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Woller, Scott C; Stevens, Scott M; Kaplan, David A; Branch, D Ware; Aston, Valerie T; Wilson, Emily L; Gallo, Heather M; Johnson, Eric G; Rondina, Matthew T; Lloyd, James F; Evans, R Scott; Elliott, C Gregory

2016-04-01

Antiphospholipid syndrome (APS) is an acquired thrombophilia characterized by thrombosis, pregnancy morbidity, and the presence of characteristic antibodies. Current therapy for patients having APS with a history of thrombosis necessitates anticoagulation with the vitamin K antagonist warfarin, a challenging drug to manage. Apixaban, approved for the treatment and prevention of venous thrombosis with a low rate of bleeding observed, has never been studied among patients with APS. We report study rationale and design of Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome (ASTRO-APS), a prospective randomized open-label blinded event pilot study that will randomize patients with a clinical diagnosis of APS receiving therapeutic anticoagulation to either adjusted-dose warfarin or apixaban 2.5 mg twice a day. We aim to report our ability to identify, recruit, randomize, and retain patients with APS randomized to apixaban compared with warfarin. We will report clinically important outcomes of thrombosis and bleeding. All clinical outcomes will be adjudicated by a panel blinded to the treatment arm. A unique aspect of this study is the enrollment of patients with an established clinical diagnosis of APS. Also unique is our use of electronic medical record interrogation techniques to identify patients who would likely meet our inclusion criteria and use of an electronic portal for follow-up visit data capture. ASTRO-APS will be the largest prospective study to date comparing a direct oral anticoagulant with warfarin among patients with APS for the secondary prevention of thrombosis. Our inclusion criteria assure that outcomes obtained will be clinically applicable to the routine management of patients with APS receiving indefinite anticoagulation. © The Author(s) 2015.

Multimodal secondary prevention behavioral interventions for TIA and stroke: a systematic review and meta-analysis.

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Maggie Lawrence

Full Text Available Guidelines recommend implementation of multimodal interventions to help prevent recurrent TIA/stroke. We undertook a systematic review to assess the effectiveness of behavioral secondary prevention interventions.Searches were conducted in 14 databases, including MEDLINE (1980-January 2014. We included randomized controlled trials (RCTs testing multimodal interventions against usual care/modified usual care. All review processes were conducted in accordance with Cochrane guidelines.Twenty-three papers reporting 20 RCTs (6,373 participants of a range of multimodal behavioral interventions were included. Methodological quality was generally low. Meta-analyses were possible for physiological, lifestyle, psychosocial and mortality/recurrence outcomes. Note: all reported confidence intervals are 95%. Systolic blood pressure was reduced by 4.21 mmHg (mean (-6.24 to -2.18, P = 0.01 I2 = 58%, 1,407 participants; diastolic blood pressure by 2.03 mmHg (mean (-3.19 to -0.87, P = 0.004, I2 = 52%, 1,407 participants. No significant changes were found for HDL, LDL, total cholesterol, fasting blood glucose, high sensitivity-CR, BMI, weight or waist:hip ratio, although there was a significant reduction in waist circumference (-6.69 cm, -11.44 to -1.93, P = 0.006, I2 = 0%, 96 participants. There was no significant difference in smoking continuance, or improved fruit and vegetable consumption. There was a significant difference in compliance with antithrombotic medication (OR 1.45, 1.21 to 1.75, P<0.0001, I2 = 0%, 2,792 participants and with statins (OR 2.53, 2.15 to 2.97, P< 0.00001, I2 = 0%, 2,636 participants; however, there was no significant difference in compliance with antihypertensives. There was a significant reduction in anxiety (-1.20, -1.77 to -0.63, P<0.0001, I2 = 85%, 143 participants. Although there was no significant difference in odds of death or recurrent TIA/stroke, there was a significant reduction in the odds of cardiac events (OR 0.38, 0

Prevention of Graves' ophthalmopathy.

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Bartalena, Luigi

2012-06-01

Smoking is the most important risk factor for the occurrence/progression of Graves' ophthalmopathy (GO), as well as for its lower/slower response to immunosuppression. Accordingly, refrain from smoking should be urged, both as primary prevention (removal of risk factors in Graves' patients without GO), secondary prevention (early detection and treatment of asymptomatic/very mild GO) and tertiary prevention (reduction of complications/disability of overt GO). A 6-month course of 200 μg/day sodium selenite can prevent progression of mild GO to more severe GO and is, therefore, a form of secondary prevention and, probably, primary prevention. Correction of thyroid dysfunction and stable maintenance of euthyroidism are important preventive measures. The optimal treatment for hyperthyroidism in patients with GO is uncertain, because evidence demonstrating the superiority of antithyroid drugs over thyroid ablation (radioiodine, thyroidectomy, or both) is lacking. If radioiodine is used, low-dose steroid prophylaxis is recommended, particularly in smokers, to prevent radioiodine-associated GO progression. Copyright © 2011 Elsevier Ltd. All rights reserved.

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology.

Science.gov (United States)

Piepoli, Massimo F; Corrà, Ugo; Adamopoulos, Stamatis; Benzer, Werner; Bjarnason-Wehrens, Birna; Cupples, Margaret; Dendale, Paul; Doherty, Patrick; Gaita, Dan; Höfer, Stefan; McGee, Hannah; Mendes, Miguel; Niebauer, Josef; Pogosova, Nana; Garcia-Porrero, Esteban; Rauch, Bernhard; Schmid, Jean Paul; Giannuzzi, Pantaleo

2014-06-01

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice. © The European Society of Cardiology 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Use of Low-dose Aspirin as Secondary Prevention of Atherosclerotic Cardiovascular Disease Among US Adults (From the National Health Interview Survey, 2012)

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Fang, Jing; George, Mary G.; Gindi, Renee M.; Hong, Yuling; Yang, Quanhe; Ayala, Carma; Ward, Brian W.; Loustalot, Fleetwood

2015-01-01

Current guidelines recommend that adults with atherosclerotic cardiovascular disease take low-dose aspirin or other antiplatelet medications as secondary prevention of recurrent cardiovascular events. Yet, no national level assessment of low-dose aspirin use for secondary prevention of cardiovascular disease has been reported among a community-based population. Using data from the 2012 National Health Interview Survey, we assessed low-dose aspirin use among those with atherosclerotic cardiovascular disease. We estimated the prevalence ratios of low-dose aspirin use, adjusting for sociodemographic status, health insurance, and cardiovascular risk factors. Among those with atherosclerotic cardiovascular disease (n=3,068), 76% had been instructed to take aspirin, and 88% of those were following this advice. Of those not advised, 11% took aspirin on this own. Overall, 70% were taking aspirin (including those who followed their health care provider's advice and those who were not advised but took aspirin on their own). Logistic regression models showed that women, non-Hispanic blacks and Hispanics, those aged 40–64 years, with a high school education or with some college, or with fewer cardiovascular disease risk factors were less likely to take aspirin than men, non-Hispanic whites, those aged ≥65 years, with a college education or higher, or with all four selected cardiovascular disease risk factors, respectively. Additional analyses conducted among those with coronary heart disease only (n=2,007) showed similar patterns. In conclusion, use of low-dose aspirin for secondary prevention was 70%, with high reported adherence to health care providers' advice to take low-dose aspirin (88%), and significant variability within subgroups. PMID:25670639

[Control of major cardiovascular risk factors of ischemic heart disease in secondary prevention in Aragón: COCINA study].

Science.gov (United States)

Cucalon Arenal, J M; Buisac Ramón, C; Marin Ibáñez, A; Castan Ruiz, S; Blay Cortes, M G; Barrasa Villar, J I

2016-01-01

Ischemic heart disease remains a leading cause of death in Spain. According to the American Heart Association/American College of Cardiology (AHA/ACC) and European national societies, secondary prevention for these patients consists of control of major cardiovascular risk factors (CVRF) and suitable lifestyle habits. To determine the degree of control of CVRF in the Aragonese population in secondary prevention. Cross-sectional study of a sample of 705 patients of Aragon who had suffered a cardiac event, selected opportunistically in consultations of family physicians participating in the 3 provinces of Aragon. The study was conducted in the second half of 2012. To measure the degree of control of different FRVC and lifestyle habits in this population. Anthropometric, different cardiovascular risk factors, treatment and lifestyle. 58% of men and 52% of women met criteria for monitoring of measured variables. The best result was obtained with smoking cessation and the worst with BMI. Hypertension, Dyslipidemia and Diabetes Mellitus achieve poor control results. The results show that the degree of control of CVRF is still low, especially in variables such as dyslipidemia and Diabetes Mellitus. Only 16.5% of control patients met criteria given the pharmacologically-modifiable cardiovascular risk factors. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

Using Intervention Mapping to Develop an Oral Health e-Curriculum for Secondary Prevention of Eating Disorders.

Science.gov (United States)

DeBate, Rita D; Bleck, Jennifer R; Raven, Jessica; Severson, Herb

2017-06-01

Preventing oral-systemic health issues relies on evidence-based interventions across various system-level target groups. Although the use of theory- and evidence-based approaches has been encouraged in developing oral health behavior change programs, the translation of theoretical constructs and principles to behavior change interventions has not been well described. Based on a series of six systematic steps, Intervention Mapping provides a framework for effective decision making with regard to developing, implementing, and evaluating theory- and evidence-informed, system-based behavior change programs. This article describes the application of the Intervention Mapping framework to develop the EAT (evaluating, assessing, and treating) evidence-based intervention with the goal of increasing the capacity of oral health providers to engage in secondary prevention of oral-systemic issues associated with disordered eating behaviors. Examples of data and deliverables for each step are described. In addition, results from evaluation of the intervention via randomized control trial are described, with statistically significant differences observed in behavioral outcomes in the intervention group with effect sizes ranging from r=0.62 to 0.83. These results suggest that intervention mapping, via the six systematic steps, can be useful as a framework for continued development of preventive interventions.

Ankles back in randomized controlled trial (ABrCt): braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial.

Science.gov (United States)

Janssen, Kasper W; van Mechelen, Willem; Verhagen, Evert Alm

2011-09-27

Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training) against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training

Prevalence, risk factors and secondary prevention of stroke recurrence in eight countries from south, east and southeast asia: a scoping review.

Science.gov (United States)

Chin, Y Y; Sakinah, H; Aryati, A; Hassan, B M

2018-04-01

In most Asian countries, stroke is one of the major causes of mortality. A stroke event is life-changing for stroke survivors, which results in either mortality or disability. Therefore, this study comprehensively focuses on prevalence, risk factors, and secondary prevention for stroke recurrence identified in South, East, and Southeast Asian countries. This scoping review uses the methodological framework of Arksey and O'Malley. A comprehensive search of academic journals (English) on this topic published from 2007 to 2017 was conducted. A total of 22 studies were selected from 585 studies screened from the electronic databases. First-year stroke recurrence rates are in the range of 2.2% to 25.4%. Besides that, modifiable risk factors are significantly associated with pathophysiological factors (hypertension, ankle-brachial pressure index, atherogenic dyslipidaemia, diabetes mellitus, metabolic syndrome, and atrial fibrillation) and lifestyle factors (obesity, smoking, physical inactivity, and high salt intake). Furthermore, age, previous history of cerebrovascular events, and stroke subtype are also significant influence risk factors for recurrence. A strategic secondary prevention method for recurrent stroke is health education along with managing risk factors through a combination of appropriate lifestyle intervention and pharmacological therapy. To prevent recurrent stroke, health intervention should be geared towards changing lifestyle to embody a healthier approach to life. This is of great importance to public health and stroke survivors' quality of life.

Risk factors for secondary substance use disorders in people with childhood and adolescent-onset bipolar disorder: opportunities for prevention.

Science.gov (United States)

Kenneson, Aileen; Funderburk, Jennifer S; Maisto, Stephen A

2013-07-01

Compared to other mental illnesses, bipolar disorder is associated with a disproportionately high rate of substance use disorders (SUDs), and the co-occurrence is associated with significant morbidity and mortality. Early diagnosis of primary bipolar disorder may provide opportunities for SUD prevention, but little is known about the risk factors for secondary SUD among individuals with bipolar disorder. The purposes of this study were to describe the population of people with childhood and adolescent-onset primary bipolar disorder, and to identify risk factors for secondary SUD in this population. Using data collected from the National Comorbidity Survey Replication study, we identified 158 individuals with childhood-onset (adolescent-onset (13-18 years) primary bipolar disorder (I, II or subthreshold). Survival analysis was used to identify risk factors for SUD. Compared to adolescent-onset, people with childhood-onset bipolar disorder had increased likelihoods of attention deficit hyperactivity disorder (ADHD) (adjusted odds ratio=2.81) and suicide attempt (aOR=3.61). Males were more likely than females to develop SUD, and did so at a faster rate. Hazard ratios of risk factors for SUD were: lifetime oppositional defiant disorder (2.048), any lifetime anxiety disorder (3.077), adolescent-onset bipolar disorder (1.653), and suicide attempt (15.424). SUD was not predicted by bipolar disorder type, family history of bipolar disorder, hospitalization for a mood episode, ADHD or conduct disorder. As clinicians struggle to help individuals with bipolar disorder, this study provides information that might be useful in identifying individuals at higher risk for SUD. Future research can examine whether targeting these risk factors may help prevent secondary SUD. Published by Elsevier Inc.

[Secondary glaucoma in Paraguay. Etiology and incidence].

Science.gov (United States)

Strohl, A; Pozzi, S; Wattiez, R; Roesen, B; Miño de Kaspar, H; Klauss, V

1999-06-01

Glaucoma is the third-most-frequent cause of blindness in the world, with a total of 5.2 million blind people as a result of this disease; 80% live in developing countries. In Paraguay, after cataract it is the second-most-frequent-cause. Early detection of the risk factors and groups can help to avoid progress of this disease. Trauma, cataract and infectious uveitis represent special risks for developing secondary glaucoma, which is a more frequent cause of blindness in third-world countries than in industrialized nations. Until now there has been little data regarding the causes, disease course, and options for therapy. Therefore, secondary glaucoma was examined in Paraguay to obtain information on the situation in Latin America. The aim of the study was to explore the causes of secondary glaucoma for programs concerning prevention and therapy. From November 1996 to February 1997 patients with secondary glaucoma were examined at the University Hospital of Asunción, Paraguay. After the clinical examination the secondary glaucomas were classified. Patients with primary glaucoma were included in the same period of time as well in order to get the rate of secondary glaucoma. Altogether 293 patients were examined: 61 with secondary and 232 with primary glaucoma. The causes of secondary glaucoma in 73 eyes were: 20 (27%) with pseudoexfoliation glaucoma, 19 (26%) with post-traumatic glaucoma, 16 (22%) with neovascular glaucoma, 4 (5%) with lens-related glaucoma, 3 (4%) with glaucoma associated with ocular surgery, 2 (3%) with pigmentary and 2 (3%) with corticoid-induced glaucoma. A ratio of 4:1 primary glaucomas to secondary glaucomas was found. The development of special measures for prevention and early therapy is only possible if the causes of this severe disease are explored. The results of this study represent basic information and could help to introduce of prevention programs.

Use of cardiovascular polypills for the secondary prevention of cerebrovascular disease.

Science.gov (United States)

Masjuan, J; Gállego, J; Aguilera, J M; Arenillas, J F; Castellanos, M; Díaz, F; Portilla, J C; Purroy, F

2018-01-08

There is little control of cardiovascular (CV) risk factors in secondary prevention after an ischaemic stroke, in part due to a lack of adherence to treatment. The CV polypill may contribute to proper treatment adherence, which is necessary for CV disease prevention. This study aimed to establish how and in what cases the CV polypill should be administered. A group of 8 neurologists drafted consensus recommendations using structured brainstorming and based on their experience and a literature review. These recommendations are based on the opinion of the participating experts. The use of the CV polypill is beneficial for patients, healthcare professionals, and the health system. Its use is most appropriate for atherothrombotic stroke, lacunar stroke, stroke associated with cognitive impairment, cryptogenic stroke with CV risk factors, and silent cerebrovascular disease. It is the preferred treatment in cases of suspected poor adherence, polymedicated patients, elderly people, patients with polyvascular disease or severe atherothrombosis, young patients in active work, and patients who express a preference for the CV polypill. Administration options include switching from individual drugs to the CV polypill, starting treatment with the CV polypill in the acute phase in particular cases, use in patients receiving another statin or an angiotensin ii receptor antagonist, or de novo use if there is suspicion of poor adherence. Nevertheless, use of the CV polypill requires follow-up on the achievement of the therapeutic objectives to make dose adjustments. This document is the first to establish recommendations for the use of the CV polypill in cerebrovascular disease, beyond its advantages in terms of treatment adherence. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Secondary Prevention of Esophageal Squamous Cell Carcinoma in Areas Where Smoking, Alcohol, and Betel Quid Chewing are Prevalent

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Chen-Shuan Chung

2010-06-01

Full Text Available Esophageal cancer is ranked as the sixth most common cause of cancer death worldwide and has a substantial effect on public health. In contrast to adenocarcinoma arising from Barrett's esophagus in Western countries, the major disease phenotype in the Asia-Pacific region is esophageal squamous cell carcinoma which is attributed to the prevalence of smoking, alcohol, and betel quid chewing. Despite a multidisciplinary approach to treating esophageal cancer, the outcome remains poor. Moreover, field cancerization reveals that esophageal squamous cell carcinoma is closely linked with the development of head and neck cancers that further sub-optimize the treatment of patients. Therefore, preventive strategies are of paramount importance to improve the prognosis of this dismal disease. Since obstacles exist for primary prevention via risk factor elimination, the current rationale for esophageal cancer prevention is to identify high-risk groups at earlier stages of the disease, and encourage them to get a confirmatory diagnosis, prompt treatment, and intensive surveillance for secondary prevention. Novel biomarkers for identifying specific at-risk populations are under extensive investigation. Advances in image-enhanced endoscopy do not just substantially improve our ability to identify small precancerous or cancerous foci, but can also accurately predict their invasiveness. Research input from the basic sciences should be translated into preventive measures in order to decrease the disease burden of esophageal cancer.

Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a multinational medical-student-delivered smoking prevention programme for secondary schools in Germany.

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Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Klingelhöfer, Doris; Groneberg, David A

2015-09-18

To evaluate the multinational medical-student-delivered tobacco prevention programme for secondary schools for its effectiveness to reduce the smoking prevalence among adolescents aged 11-15 years in Germany at half year follow-up. We used a prospective quasi-experimental study design with measurements at baseline (t1) and 6 months postintervention (t2) to investigate an intervention in 8 German secondary schools. The participants were split into intervention and control classes in the same schools and grades. A total of 1474 eligible participants of both genders at the age of 11-15 years were involved within the survey for baseline assessment of which 1200 completed the questionnaire at 6-month follow-up (=longitudinal sample). The schools participated voluntarily. The inclusion criteria were age (10-15 years), grade (6-8) and school type (regular secondary schools). Two 60 min school-based modules delivered by medical students. The primary end point was the difference from t1 to t2 of the smoking prevalence in the control group versus the difference from t1 to t2 in the intervention group (difference of differences approach). The percentage of former smokers and new smokers in the two groups were studied as secondary outcome measures. In the control group, the percentage of students who claimed to be smokers doubled from 4.2% (t1) to 8.1% (t2), whereas it remained almost the same in the intervention group (7.1% (t1) to 7.4% (t2); p=0.01). The likelihood of quitting smoking was almost six times higher in the intervention group (total of 67 smokers at t1; 27 (4.6%) and 7 (1.1%) in the control group; OR 5.63; 95% CI 2.01 to 15.79; p<0.01). However, no primary preventive effect was found. We report a significant secondary preventive (smoking cessation) effect at 6-month follow-up. Long-term evaluation is planned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cluster randomized trial in the general practice research database: 2. Secondary prevention after first stroke (eCRT study: study protocol for a randomized controlled trial

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Dregan Alex

2012-10-01

Full Text Available Abstract Background The purpose of this research is to develop and evaluate methods for conducting pragmatic cluster randomized trials in a primary care electronic database. The proposal describes one application, in a less frequent chronic condition of public health importance, secondary prevention of stroke. A related protocol in antibiotic prescribing was reported previously. Methods/Design The study aims to implement a cluster randomized trial (CRT using the electronic patient records of the General Practice Research Database (GPRD as a sampling frame and data source. The specific objective of the trial is to evaluate the effectiveness of a computer-delivered intervention at enhancing the delivery of stroke secondary prevention in primary care. GPRD family practices will be allocated to the intervention or usual care. The intervention promotes the use of electronic prompts to support adherence with the recommendations of the UK Intercollegiate Stroke Working Party and NICE guidelines for the secondary prevention of stroke in primary care. Primary outcome measure will be the difference in systolic blood pressure between intervention and control trial arms at 12-month follow-up. Secondary outcomes will be differences in serum cholesterol, prescribing of antihypertensive drugs, statins, and antiplatelet therapy. The intervention will continue for 12 months. Information on the utilization of the decision-support tools will also be analyzed. Discussion The CRT will investigate the effectiveness of using a computer-delivered intervention to reduce the risk of stroke recurrence following a first stroke event. The study will provide methodological guidance on the implementation of CRTs in electronic databases in primary care. Trial registration Current Controlled Trials ISRCTN35701810

The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

NARCIS (Netherlands)

Overbeek, M.M.; de Schipper, J.C.; Lamers-Winkelman, F.; Schuengel, C.

2012-01-01

Background: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has

The 'diet heart' hypothesis in secondary prevention of coronary heart disease.

Science.gov (United States)

de Lorgeril, M; Salen, P; Monjaud, I; Delaye, J

1997-01-01

From this detailed analysis of the main dietary trials conducted over the last 30 years in the secondary prevention of coronary heart disease, it can be said that the older trials were conducted on low risk patients and used high fat diets (about 40% of energy as lipids), comprising low saturated fat and cholesterol intake but very high (15 to 20% of energy) polyunsaturated fat intake, particularly from the omega-6 fatty acid family. These experimental diets were designed to reduce blood cholesterol and failed to improve prognosis. By contrast, recent trials were not primarily designed to reduce cholesterol, were conducted in medium- and high-risk patients and used low fat diets supplemented by omega-3 fatty acids from various sources. In two of these trials, the consumption of natural antioxidants, oligoelements and vegetable proteins was increased. Recurrence rate was reduced in the range of 30 to 70%. One conclusion from these well-conducted recent experiments on more than 3000 patients is that new and more specific dietary recommendations are clearly warranted in secondary prevention of coronary heart disease. They should be more specific and more clearly defined and therefore different from those generally provided in the U.S.A. and Europe at present. In a recent Consensus Panel statement, authors wrote less than one line to describe a cardioprotective diet in patients with coronary heart disease, summarized as diet and coronary heart disease is more complex than the current cholesterol hypothesis. They identified at least seven major dietary factors, including fibres, although the evidence of an effect on coronary heart disease is weak. However, they did not mention vegetable and fish proteins which are rich in arginine and L-glutamine, major regulators of cardiovascular function. Thus, new dietary advice should include: reduce intake of total (not more than 30% of energy) and saturated (less than 10%) fats maintain intake at least minimally, of the essential

Differentiated Approach to the Treatment and Secondary Prevention of Asthma on the Background of Persistent Infections in Children

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O.Ye. Chernyshova

2016-11-01

Full Text Available Thе article describes a differentiated approach to the treatment and secondary prevention of asthma occurring on the background of intracellular infections caused by the herpes simplex virus types I and II, cytomegalovirus, Epstein-Barr virus in children. The results confirmed the need for addition to the basic therapy of asthma the etiopathogenetic treatment, in particular, administration of acyclic nucleosides or macrolides depending on diagnosed infection, immunomodulators and alpha-2b-interferon (Laferobion to decrease the severity of disease and to reduce disability.

Exploring resilience and mindfulness as preventative factors for psychological distress burnout and secondary traumatic stress among human service professionals.

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Harker, Rachel; Pidgeon, Aileen M; Klaassen, Frances; King, Steven

2016-06-08

Human service professionals are concerned with the intervention and empowerment of vulnerable social populations. The human service industry is laden with employment-related stressors and emotionally demanding interactions, which can lead to deleterious effects, such as burnout and secondary traumatic stress. Little attention has been given to developing knowledge of what might enable human service workers to persist and thrive. Cultivating and sustaining resilience can buffer the impact of occupational stressors on human service professionals. One of the psychological factors associated with cultivating resilience is mindfulness. The aim of this current research is to improve our understanding of the relationship between resilience, mindfulness, burnout, secondary traumatic stress, and psychological distress among human service professionals. The current study surveyed 133 human service professionals working in the fields of psychology, social work, counseling, youth and foster care work to explore the predictive relationship between resilience, mindfulness, and psychological distress. The results showed that higher levels of resilience were a significant predictor of lower levels of psychological distress, burnout and secondary traumatic stress. In addition, higher levels of mindfulness were a significant predictor of lower levels of psychological distress and burnout. The findings suggest that cultivating resilience and mindfulness in human service professionals may assist in preventing psychological distress burnout and secondary traumatic stress. Limitations of this study are discussed together with implications for future research.

Melatonin prevents secondary intra-abdominal hypertension in rats possibly through inhibition of the p38 MAPK pathway.

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Chang, Mingtao; Li, Yang; Liu, Dong; Zhang, Lianyang; Zhang, Hongguang; Tang, Hao; Zhang, Huayu

2016-08-01

Exogenous administration of melatonin has been demonstrated to down-regulate inflammatory responses and attenuate organ damage in various models. However, the salutary effect of melatonin against secondary intra-abdominal hypertension (IAH) remains unclear. This study sought to test the influence of melatonin on secondary IAH in a pathophysiological rat model and the underlying mechanisms involved. Before resuscitation, male rats underwent a combination of induced portal hypertension, applying an abdominal restraint device, and hemorrhaging to mean arterial pressure (MAP) of 40mmHg for 2h. After blood reinfusion, the rats were treated with lactated Ringer solution (LR) (30mL/h), melatonin (50mg/kg) +LR, and SB-203580 (10μmol/kg)+LR. LR was continuously infused for 6h. MAP, the inferior vena cava pressure and urine output were monitored. Histopathological examination, immunofluorescence of tight junction proteins, and transmission electron microscopy were administered. Intestinal permeability, myeloperoxidase activity, malondialdehyde, glutathione peroxidase, and levels of TNF-a, IL-2, and IL-6, were assessed. The expression of extracellular signal-regulated kinase, p38, c-Jun NH2-terminal kinase, translocation of nuclear factor kappa B subunit, signal transducers and activators of transcription and tight junction proteins were detected by Western blot. We found that melatonin inhibited the inflammatory responses, decreased expression of p38 MAPK, attenuated intestinal injury, and prevented secondary IAH. Moreover, administration of SB203580 abolished the increase in p38 MAPK and also attenuated intestinal injury. These data indicate that melatonin exerts a protective effect in intestine in secondary IAH primarily by attenuating the inflammatory responses which are in part attributable to p38 MAPK inhibition. Copyright © 2016 Elsevier Inc. All rights reserved.

The national clinical audit of falls and bone health-secondary prevention of falls and fractures: a physiotherapy perspective.

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Goodwin, Victoria; Martin, Finbarr C; Husk, Janet; Lowe, Derek; Grant, Robert; Potter, Jonathan

2010-03-01

To establish current physiotherapy practice in the secondary management of falls and fragility fractures compared with national guidance. Web-based national clinical audit. Acute trusts (n=157) and primary care trusts (n=146) in England, Wales and Northern Ireland. Data were collected on 5642 patients with non-hip fragility fractures and 3184 patients with a hip fracture. Those patients who were bedbound or who declined assessment or rehabilitation were excluded from the analysis. Results indicate that of those with non-hip fractures, 28% received a gait and balance assessment, 22% participated in an exercise programme, and 3% were shown how to get up from the floor. For those with a hip fracture, the results were 68%, 44% and 7%, respectively. Physiotherapists have a significant role to play in the secondary prevention of falls and fractures. However, along with managers and professional bodies, more must be done to ensure that clinical practice reflects the evidence base and professional standards.

Technical note: Differences in the diurnal pattern of soil respiration under adjacent Miscanthus × giganteus and barley crops reveal potential flaws in accepted sampling strategies

Science.gov (United States)

Ben Keane, J.; Ineson, Phil

2017-03-01

For convenience, measurements used to compare soil respiration (Rs) from different land uses, crops or management practices are often made between 09:00 and 16:00 UTC, convenience which is justified by an implicit assumption that Rs is largely controlled by temperature. Three months of continuous data presented here show distinctly different diurnal patterns of Rs between barley (Hordeum vulgare) and Miscanthus × giganteus (Miscanthus) grown on adjacent fields. Maximum Rs in barley occurred during the afternoon and correlated with soil temperature, whereas in Miscanthus after an initial early evening decline, Rs increased above the daily average during the night and in July maximum daily rates of Rs were seen at 22:00 and was significantly correlated with earlier levels of solar radiation, probably due to delays in translocation of recent photosynthate. Since the time of the daily mean Rs in Miscanthus occurred when Rs in the barley was 40 % greater than the daily mean, it is vital to select appropriate times to measure Rs especially if only single daily measurements are to be made.

Ankles back in randomized controlled trial (ABrCt: braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial

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Verhagen Evert ALM

2011-09-01

Full Text Available Abstract Background Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. Methods/Design This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. Discussion The ABrCt is the first randomized controlled trial to directly compare the secondary preventive

Caracterização físico-mecânica do laminado colado de bambu (Dendrocalamus giganteus.

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Juarez Benigno Paes

2009-09-01

Full Text Available Normal 0 21 MicrosoftInternetExplorer4 Esta pesquisa teve como objetivo avaliar a influência do tratamento preservativo e do tipo de adesivo nas propriedades físico-mecânicas do laminado colado, confeccionado com o bambu Dendrocalamus giganteus. Para tanto, colmos de bambu foram tratados pelo método de imersão em produto químico (solução de 1% de ingredientes ativos de borato de cobre cromatado - CCB e em água, durante 15 dias. Dos colmos tratados, foram retiradas as camadas externa e interna, obtendo-se lâminas com espessuras de 4 mm, comprimento de 45 cm e largura de 5 cm. Para a colagem das lâminas, utilizaram-se os adesivos "Cascophen RS" (resorcinol-formol e "Cascorez-Extra" (acetato polivinílico. O adesivo à base de resorcinol-formol proporcionou maior resistência à umidade ao BLC, quando comparado àquele à base de acetato polivinílico, tendo as amostras provenientes de peças tratadas com CCB sido mais estáveis que as tratadas com água. Dentre as propriedades mecânicas testadas, o adesivo apresentou resultado significativo para o cisalhamento na linha de cola e o tratamento preservativo para o MOE. A interação dos fatores adesivo e tratamento foi significativa para o MOE, resistência a compressão paralela ao cisalhamento na linha de cola, tendo as peças tratadas com água e aderidas com resorcinol-formol apresentado melhores resultados para o MOE e compressão paralela às fibras e aquelas tratadas com CCB, para o cisalhamento na linha de cola.

Contemporary Reflections on the Safety of Long-Term Aspirin Treatment for the Secondary Prevention of Cardiovascular Disease

Science.gov (United States)

Fanaroff, Alexander C.; Roe, Matthew T.

2018-01-01

Aspirin has been the cornerstone of therapy for the secondary prevention treatment of patients with cardiovascular disease since landmark trials were completed in the late 1970s and early 1980s that demonstrated the efficacy of aspirin for reducing the risk of ischemic events. Notwithstanding the consistent benefits demonstrated with apirin for both acute and chronic cardiovascular disease, there are a number of toxicities associated with aspirin that have been showcased by recent long-term clinical trials that have included an aspirin monotherapy arm. As an inhibitor of cyclooxygenase, aspirin impairs gastric mucosal protective mechanisms. Prior trials have shown that up to 15–20% of patients developed gastrointestinal symptoms with aspirin monotherapy and roughly 1% of patients per year had a clinically significant bleeding event, including 1 in 1000 patients who suffered an intracranial or fatal bleed. These risks have been shown to be compounded for patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention (PCI), who are also treated with other anti-thrombotic agents during the acute care/procedural period, as well as for an extended time period afterwards. Given observations of substantial increases in bleeding rates from many prior long-term clinical trials that have evaluated aspirin together with other oral platelet inhibitors or oral anti-coagulants, the focus of contemporary research has pivoted towards tailored anti-thrombotic regimens that attempt to either shorten the duration of exposure to aspirin or replace aspirin with an alternative anti-thrombotic agent. While these shifts are occurring, the safety profile of aspirin when used for the secondary prevention treatment of patients with established cardiovascular disease deserves further consideration. PMID:27028617

Traditional preventive treatment options

DEFF Research Database (Denmark)

Longbottom, C; Ekstrand, K; Zero, D

2009-01-01

Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient...... options....

Eating Disorders: Prevention through Education.

Science.gov (United States)

Nagel, K. L.; Jones, Karen H.

1993-01-01

School prevention programs for teenage eating disorders should emphasize nutrition education (knowledge, attitudes, behavior) and living skills (self-concept, coping). Secondary prevention involves identifying early warning signs and places for referral; tertiary prevention creates a supportive school environment for recoverers with teachers as…

Cultural values and secondary prevention of breast cancer in african american women.

Science.gov (United States)

Beckjord, Ellen Burke; Klassen, Ann C

2008-01-01

Improving mammography initiation and maintenance among African American women has been suggested as a strategy for reducing breast cancer mortality in this population. We examined cultural values in relation to self-reported breast cancer screening among 572 low-income, urban, African American women. Cultural values examined included time orientation, family authority, employment aspirations, value of past vs modern life, and reliance on medical professionals. Also, implications for continued development of culturally tailored health interventions and opportunities for the consideration of cultural values in health communication are discussed. Bivariate analyses showed that more traditional values were associated with worse screening histories and lower intentions for future screening. In multivariate analyses, two interactions were observed between cultural values and age: for younger women, more traditional values were associated with lower odds of having ever received a mammogram, and for older women, more traditional values were associated with lower odds of intentions to receive a mammogram in the next 2 years. This study adds to the evidence that cultural constructs, such as values, are associated with secondary prevention of breast cancer and supports the consideration of cultural constructs as important in increasing mammography and reducing breast cancer disparities for African American women.

Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

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Byeon HJ

2016-02-01

Full Text Available Hee Ja Byeon,1,* Young-Mo Yang,2,* Eun Joo Choi21Department of Pharmacy, Chosun University Hospital, 2Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, South Korea*These authors contributed equally to this workBackground: Acute coronary syndrome (ACS is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.Methods: This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.Results: Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71% patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69% unstable angina patients, 44 (70.97% non-ST-segment elevation myocardial infarction patients, and 153 (85.96% ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21% and 18 (n=105, 21.26% months after discharge tended to be gradually

Technical specifications for PWR secondary water chemistry

International Nuclear Information System (INIS)

Weeks, J.R.; van Rooyen, D.

1977-08-01

The bases for establishing Technical Specifications for PWR secondary water chemistry are reviewed. Whereas extremely stringent control of secondary water needs to be maintained to prevent denting in some units, sound bases for establishing limits that will prevent stress corrosion, wastage, and denting do not exist at the present time. This area is being examined very thoroughly by industry-sponsored research programs. Based on the evidence available to date, short term control limits are suggested; establishment of these or other limits as Technical Specifications is not recommended until the results of the research programs have been obtained and evaluated

Stroke Prevention: Managing Modifiable Risk Factors

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Silvia Di Legge

2012-01-01

Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.

Secondary prevention of epidemic gastric cancer in the model of Helicobacter pylori-associated gastritis.

Science.gov (United States)

Pizzi, Marco; Saraggi, Deborah; Fassan, Matteo; Megraud, Francis; Di Mario, Francesco; Rugge, Massimo

2014-01-01

Irrespective of its etiology, long-standing, non-self-limiting gastric inflammation (mostly in Helicobacter pylori-associated cases) is the cancerization ground on which epidemic (intestinal-type) gastric carcinoma (GC) can develop. The natural history of invasive gastric adenocarcinoma encompasses gastritis, atrophic mucosal changes, and intraepithelial neoplasia (IEN). The topography, the extent and the severity of the atrophic changes significantly correlate with the risk of developing both IEN and GC. In recent years, both noninvasive (serological) tests and invasive (endoscopy/biopsy) procedures have been proposed to stratify patients according to different classes of GC risk. As a consequence, different patient-tailored GC secondary prevention strategies have been put forward. This review summarizes the histological features of H. pylori-related gastritis and the natural history of the disease. Histological and serological strategies to assess GC risk as well as the clinical management of atrophic gastritis patients are also discussed. © 2014 S. Karger AG, Basel.

Web-Based Prevention of Parenting Difficulties in Young, Urban Mothers Enrolled in Post-Secondary Education.

Science.gov (United States)

Ehrensaft, Miriam K; Knous-Westfall, Heather M; Alonso, Thailyn Lopez

2016-12-01

Research consistently indicates that young mothers are at elevated risk for adverse social and economic risks. Recent attention has been paid to the value of maternal educational attainment for their children's economic and social outcomes. Pursuit of post-secondary education requires mothers to balance multiple roles, potentially stressing the parent-child relationship. Yet, almost no studies have addressed parenting and associated stress in young mothers enrolled in post-secondary education, and no preventive intervention trials have been conducted. We screened young mothers (parenting stress, and participated in a randomized controlled trial to assess the efficacy of a web-based parenting intervention (Triple P Online) in reducing parenting stress and dysfunctional discipline (N = 52). Mothers were randomly assigned to the web-based parenting program condition or to a waitlist control condition. Mothers who completed at least the first four core modules of the online program had lower scores on the Parenting Scale's subscales (Overreactivity, Verbosity, and Laxness), compared to those who did not complete four or more modules. No intervention effects were obtained for parenting stress. The current study provides preliminary evidence of the efficacy of this online parenting program for reducing risk for dysfunctional discipline in student mothers. Future research is warranted to replicate these findings, and to test whether provision of supplemental support for implementation, or briefer program formats may promote both program compliance and outcomes related to reducing parenting stress.

Internet-based interventions for the secondary prevention of coronary heart disease.

Science.gov (United States)

Devi, Reena; Singh, Sally J; Powell, John; Fulton, Emily A; Igbinedion, Ewemade; Rees, Karen

2015-12-22

The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease (CHD). To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, in December 2014. We also searched six other databases in October 2014, and three trials registers in January 2015 together with reference checking and handsearching to identify additional studies. Randomised controlled trials (RCTs) evaluating Internet-delivered secondary prevention interventions aimed at people with CHD. Two review authors independently assessed risk of bias and extracted data according to the Cochrane Handbook for Systematic Reviews of Interventions. We assessed evidence quality using the GRADE approach and presented this in a 'Summary of findings' table. Eighteen trials met our inclusion criteria. Eleven studies are complete (1392 participants), and seven are ongoing. Of the completed studies, seven interventions are broad, targeting the lifestyle management of CHD, and four focused on physical activity promotion. The comparison group in trials was usual care (n = 6), minimal intervention (n = 3), or traditional cardiac rehabilitation (n = 2).We found no effects of Internet-based interventions for all-cause mortality (odds ratio (OR) 0.27, 95% confidence interval (CI) 0.04 to 1.63; participants = 895; studies = 6; low-quality evidence). There was only one case of cardiovascular mortality in a control group (participants = 895; studies = 6). No incidences of non-fatal re-infarction were reported across any of the studies. We found no effects for revascularisation (OR 0.69, 95% CI 0.37 to 1.27; participants = 895; studies = 6; low-quality evidence).We found no effects for total cholesterol (mean difference (MD) 0.00, 95% CI -0.27 to 0.28; participants = 439; studies = 4; low

Carbon steel corrosion prevention during chemical cleaning of steam generator secondary side components

International Nuclear Information System (INIS)

Fulger, M.; Lucan, D.; Velciu, L.

2009-01-01

During operation of a nuclear power plant, many contaminants, such as solid particles or dissolved species are formed in the secondary circuit, go into steam generator and deposit as scales on heat transfer tubing, support plate or as sludge on tube sheet. By accumulation of these impurities, heat transfer is reduced and the integrity of the steam generator tubing is influenced. Chemical cleaning is a qualified, efficient measure to improve steam generator corrosion performance. The corrosion mechanism can be counteracted by the chemical cleaning of the deposits on the tube sheet and the scales on the heat transfer tubing. The major component of the scales is magnetite, which can be dissolved using an organic chelating agent (ethylenediaminetetraacetic acid, EDTA) in combination with a complexing agent such as citric acid in an alkaline reducing environment. As the secondary side of SG is a conglomerate of alloys it is necessary to choose an optimal chemical cleaning solution for an efficient cleaning properties and at the same time with capability of corrosion prevention of carbon steel components during the process. The paper presents laboratory tests initiated to confirm the ability of this process to clean the SG components. The experiments followed two paths: - first, carbon steel samples have been autoclavized in specific secondary circuit solutions of steam generator to simulate the deposits constituted during operation of this equipment; - secondly, autoclavized samples have been cleaned with a solvent composed of EDTA citric acid, hydrazine of pH = 5 and temperature of 85 deg. C. Before chemical cleaning, the oxide films were characterized by surface analysis techniques including optical microscopy, scanning electron microscopy (SEM) and electrochemical impedance spectroscopy (EIS). Applied to dissolve corrosion products formed in a steam generator, the solvents based on chelating agents are aggressive toward carbon steels and corrosion inhibitors are

Lifetime sedentary living accelerates some aspects of secondary aging

DEFF Research Database (Denmark)

Booth, Frank W; Laye, Matthew J; Roberts, Michael D

2011-01-01

accelerates secondary aging (e.g., speeding the reduction in bone mineral density, maximal oxygen consumption, and skeletal muscle strength and power), but does not alter the primary aging of these systems. Third, a lifetime of physical activity to the age of ∼60-70 yr old totally prevents decrements in some...... role in the secondary aging of many essential physiological functions, and this aging can be prevented through a lifetime of physical activity.......Lifetime physical inactivity interacts with secondary aging (i.e., aging caused by diseases and environmental factors) in three patterns of response. First, lifetime physical inactivity confers no apparent effects on a given set of physiological functions. Second, lifetime physical inactivity...

Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia.

Science.gov (United States)

Hamilton, Sandra; Mills, Belynda; McRae, Shelley; Thompson, Sandra

2018-01-30

Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations. CR and Aboriginal Community Controlled Health Services were identified through the Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Structured interviews with CR coordinators included questions specific to program delivery, content, referral and attendance. Of the 38 CR services identified, 23 (61%) were located in rural (n = 11, 29%) and remote (n = 12, 32%) regions. Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) found 77% of rural/remote services were hospital-based, with no service providing a comprehensive home-based or alternative method of program delivery. The majority of rural (60%) and remote (80%) services provided CR through chronic condition exercise programs compared with 17% of metropolitan services; only 27% of rural/remote programs provided education classes. Rural/remote coordinators were overwhelmingly physiotherapists, and only 50% of rural and 33% of remote programs had face-to-face access to multidisciplinary support. Patient referral and attendance rates differed greatly across WA and referrals to rural/remote services generally numbered less than 5 per month. Program evaluation was reported by 33% of rural/remote coordinators. Geography, population density and service availability limits patient access to CR services in rural/remote WA. Current

SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES AMONG PATIENTS OF DIFFERENT AGE GROUPS WITH A HISTORY OF MYOCARDIAL INFARCTION BY THE EXAMPLE OF OUTPATIENT CARDIOLOGY INSTITUTION

Directory of Open Access Journals (Sweden)

S. B. Fitilev

2017-01-01

Full Text Available Aim. To study secondary prevention of cardiovascular diseases among patients of different age groups with a history of myocardial infarction by the example of outpatient cardiology institution.Material and methods. Retrospective pharmacoepidemiological study was conducted by analyzing the medical records of 825 patients with a history of myocardial infarction, who visited the outpatient cardiology institution for the first time in 2011. Patients were divided into two groups according to their age: younger than 60 years (n=308, and 60 years and older (n=517.Results. The population of elderly patients was more severe: significantly more often patients had disability and comorbidities. The prevalence of the main modifiable risk factors could not be assessed fully due to the lack of information in patients’ medical records. Elderly patients were significantly less likely to receive β-blockers (80.3% and statins (63.8%. No significant differences were found in daily doses of the main prescribed preventive drugs between two groups.Conclusion. Secondary prevention of cardiovascular diseases among patients of different age groups could not be considered proper, as there is low level of attention to the modifiable risk factors and recommendation on their correction. A tendency to under-prescription of angiotensin converting enzyme inhibitors was revealed, as well as significantly lower number of recommendations for taking statins and β-adrenoblockers in the group of elderly patients.

A Survey about Protective Effect of Echinococcus Granulosus Protoscolices Surface Antigens in Preventing Secondary Hydatid Cyst

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H Yousofi

2006-10-01

Full Text Available ABSTRACT: Introduction & Objective: Hydatid cyst is located in human and some animal visceral organs such as liver and lung. The disease is considered as a medical, veterinary and economical problem in endemic area. When the hydatid cyst is ruptured, protoscolices from inside the cyst may spread out to other parts of the body and develops a new cyst named secondary hydatid cyst. In this research in an attempt to prevent secondary hydatid cyst, protective potential of protoscolices surface antigens extracted with different detergents has been investigated in animal model. Materials & Methods: In this experimental study, groups of Balb/c mice were immunized intra-peritoneally with protoscolices homogenate and three detergent (SDS, Tween and Triton x–100 extracted protoscolices surface antigens and alum as adjuvant. These mice were then boosted two times with the same antigens fortnightly. Control mice were simultaneously injected with alum alone. Two weeks following the last injection all the mice in cases and control groups were challenged with live protoscolices. Three months afterward all the mice in case and control groups were sacrificed and their peritoneal cavities were explored for hydatid cysts. Results: The mean of developed cyst number in mice injected with protoscolices homogenate was 3±2, while in control group the mean of developed cysts number was 5.8 ± 1.7 (p< 0.02. The mean of developed cyst number in mice injected with SDS, Tween and Triton x–100 extracted protoscolices surface antigens was 3, 3.6 and 3.4, respectively, while the mean of developed cyst number in control group was 5.8. Conclusion: The mean of cyst number in cases and control groups was different and this difference was statistically significant. Results of this investigation revealed that protoscolices homogenate antigens and some detergent extracted antigens are protective against secondary hydatid cyst infection

Hypokalemic periodic paralysis: Three rare secondary causes

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Prasanna Eswaradass Venkatesan

2015-01-01

Full Text Available Periodic paralysis is a rare neuromuscular disorder, related to a defect in muscle ion channels, characterized by episodes of painless muscle weakness, which may be precipitated by heavy exercise, fasting, or high-carbohydrate meals. Hypokalemic periodic paralysis may be familial (primary or secondary. Here, we report three cases of secondary causes of hypokalemic periodic paralysis. On evaluation, case 1 had distal renal tubular acidosis (RTA due to Sjogren′s syndrome, case 2 had drug induced proximal RTA (Fanconi′s syndrome and case 3 had thyrotoxicosis. Clinician must be aware of causes of secondary PP as recognition and diagnosis can completely prevent further attacks of periodic paralysis. Each of the above case is rare, but completely treatable if diagnosed. Low dose steroids with bicarbonate replacement in case 1, stopping tenofovir in case 2 and carbimazole therapy in case 3 prevented further attacks of periodic paralysis and cardiopulmonary complications.

Transcatheter closure of patent foramen ovale for secondary prevention of ischemic stroke: Quantitative synthesis of pooled randomized trial data.

Science.gov (United States)

Hakeem, Abdul; Cilingiroglu, Mehmet; Katramados, Angelos; Boudoulas, Konstantinos Dean; Iliescu, Cezar; Gundogdu, Betul; Marmagkiolis, Konstantinos

2018-01-14

To evaluate the safety and efficacy of percutaneous device closure of patent foramen ovale (PFO) for secondary prevention of ischemic stroke BACKGROUND: Stroke remains the leading cause of serious long-term disability in the United States. The effectiveness of a percutaneous PFO closure in the prevention of recurrent cryptogenic strokes has not been established. We performed a literature search using PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Internet-based sources from January 2003 to September 2017. Randomized controlled trails (RCTs) comparing percutaneous PFO closure to medical therapy alone. Five RCTs (CLOSURE I, PC Trial, REDUCE, RESPECT, and CLOSE) with 1,829 patients in the device group and 1,611 patients in the medical group met inclusion criteria. The cumulative incidence of recurrent stroke was 2.02% in the PFO closure arm and 4.4% in the medical therapy group (RR 0.42, 95%CI 0.20, 0.91; P = 0.03). There was no difference in the incidence of death [0.7% vs. 0.9%; RR 0.76 (95% CI 0.35, 1.64), P = 0.49] or adverse events during the follow-up period [24.6% vs. 23.7% (RR 1.03; 95% CI 0.91, 1.16), P = 0.65] between the closure and medical therapy groups. Incidence of atrial fibrillation was significantly higher in closure group compared to medical therapy [4% vs. 0.6% (RR 4.73; 95% CI 2.09, 10.70), P = 0.0002]. The comparative effectiveness of PFO closure (compared to medical therapy) was significantly more pronounced in those younger than 45 years, males, larger shunts and disc design platforms (P < 0.05). Based on the results of this analysis of randomized trial data, percutaneous PFO closure appears to be a safe and effective therapeutic option for the secondary prevention of ischemic stroke in patients with PFO and cryptogenic stroke. © 2018 Wiley Periodicals, Inc.

Principal Results of a Prospective Randomised Controlled Study: Morbidity and Mortality after Stroke — Eprosartan Compared with Nitrendipine for Secondary Prevention (MOSES

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Stephan Lüders

2005-03-01

Full Text Available The morbidity and mortality after stroke — eprosartan compared with nitrendipine for secondary prevention (MOSES trial compared the effects of two antihypertensive agents in secondary prevention of stroke. The hypothesis of the trial was that in hypertensive stroke patients, for the same level of blood pressure (BP control, eprosartan would be more effective than nitrendipine in reducing cerebrovascular and cardiovascular morbidity and mortality.A total of 710 patients were assigned to an eprosartan-based regimen and 695 to a nitrendipine-based regimen.These patients had hypertension requiring treatment and documented cerebral ischaemia or haemorrhage. They were well matched at baseline in general characteristics, BP and concomitant disease. BP was lowered to the same extent in both treatment arms, with a very similar timeframe. A high proportion of patients in both treatment arms achieved target BP.The combined primary endpoint was a composite of total mortality and total number of cardiovascular and cerebrovascular events, including recurrent events.There were 206 endpoints in the eprosartan group and 255 endpoints in the nitrendipine group.This represents a statistically significant 21% risk reduction in favour of eprosartan. Eprosartan also had advantages over nitrendipine in respect of all cerebrovascular events and first cardiovascular events.

Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke: I: feasibility and risk factors.

Science.gov (United States)

Prior, Peter L; Hachinski, Vladimir; Unsworth, Karen; Chan, Richard; Mytka, Sharon; O'Callaghan, Christina; Suskin, Neville

2011-11-01

Comprehensive cardiac rehabilitation (CCR), which integrates structured lifestyle interventions and medications, reduces morbidity and mortality among cardiac patients. CCR has not typically been used with cerebrovascular populations, despite important commonalities with heart patients. We tested feasibility and effectiveness of 6-month outpatient CCR for secondary prevention after transient ischemic attack or mild, nondisabling stroke. This article presents risk factors. A future article will discuss psychological outcomes. Consecutive consenting subjects having sustained a transient ischemic attack or mild, nondisabling stroke within the previous 12 months (mean, 11.5 weeks; event-to-CCR entry) with ≥1 vascular risk factor, were recruited from a stroke prevention clinic providing usual care. We measured 6-month CCR outcomes following a prospective cohort design. Of 110 subjects recruited from January 2005 to April 2006, 100 subjects (mean age, 64.9 years; 46 women) entered and 80 subjects completed CCR. We obtained favorable, significant intake-to-exit changes in: aerobic capacity (+31.4%; Pstroke, offering a promising model for vascular protection across chronic disease entities. We know of no similar previous investigation, and are now conducting a randomized trial.

Costs of secondary prevention of stroke by carotid endarterectomy

DEFF Research Database (Denmark)

Hædersdal, Carsten; Sørensen, Mette; Olsen, Tom Skyhøj

2012-01-01

We estimated the costs to the Danish National Health Service of preventing stroke due to carotid artery stenosis by carotid endarterectomy (CEA), including costs of identifying patients, Doppler ultrasound (DUS) examination and CEA.......We estimated the costs to the Danish National Health Service of preventing stroke due to carotid artery stenosis by carotid endarterectomy (CEA), including costs of identifying patients, Doppler ultrasound (DUS) examination and CEA....

Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline.

Science.gov (United States)

Jeronimo, Jose; Castle, Philip E; Temin, Sarah; Denny, Lynette; Gupta, Vandana; Kim, Jane J; Luciani, Silvana; Murokora, Daniel; Ngoma, Twalib; Qiao, Youlin; Quinn, Michael; Sankaranarayanan, Rengaswamy; Sasieni, Peter; Schmeler, Kathleen M; Shastri, Surendra S

2017-10-01

To provide resource-stratified, evidence-based recommendations on the secondary prevention of cervical cancer globally. ASCO convened a multidisciplinary, multinational panel of oncology, primary care, epidemiology, health economic, cancer control, public health, and patient advocacy experts to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, a formal consensus-based process, and a modified ADAPTE process to adapt existing guidelines were conducted. Other experts participated in formal consensus. Seven existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Four systematic reviews plus cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement. Human papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies by setting are as follows: maximal: ages 25 to 65, every 5 years; enhanced: ages 30 to 65, if two consecutive negative tests at 5-year intervals, then every 10 years; limited: ages 30 to 49, every 10 years; and basic: ages 30 to 49, one to three times per lifetime. For basic settings, visual assessment is recommended as triage; in other settings, genotyping and/or cytology are recommended. For basic settings, treatment is recommended if abnormal triage results are present; in other settings, colposcopy is recommended for abnormal triage results. For basic settings, treatment options are cryotherapy or loop electrosurgical excision procedure; for other settings, loop electrosurgical excision procedure (or ablation) is recommended. Twelve-month post-treatment follow-up is recommended in all settings. Women who are HIV positive should be screened with HPV testing after diagnosis and screened twice as many times per lifetime as the general population. Screening is recommended at 6 weeks postpartum in

Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline

Directory of Open Access Journals (Sweden)

Jose Jeronimo

2017-10-01

Full Text Available Purpose: To provide resource-stratified, evidence-based recommendations on the secondary prevention of cervical cancer globally. Methods: ASCO convened a multidisciplinary, multinational panel of oncology, primary care, epidemiology, health economic, cancer control, public health, and patient advocacy experts to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, a formal consensus-based process, and a modified ADAPTE process to adapt existing guidelines were conducted. Other experts participated in formal consensus. Results: Seven existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Four systematic reviews plus cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement. Recommendations: Human papillomavirus (HPV DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies by setting are as follows: maximal: ages 25 to 65, every 5 years; enhanced: ages 30 to 65, if two consecutive negative tests at 5-year intervals, then every 10 years; limited: ages 30 to 49, every 10 years; and basic: ages 30 to 49, one to three times per lifetime. For basic settings, visual assessment is recommended as triage; in other settings, genotyping and/or cytology are recommended. For basic settings, treatment is recommended if abnormal triage results are present; in other settings, colposcopy is recommended for abnormal triage results. For basic settings, treatment options are cryotherapy or loop electrosurgical excision procedure; for other settings, loop electrosurgical excision procedure (or ablation is recommended. Twelve-month post-treatment follow-up is recommended in all settings. Women who are HIV positive should be screened with HPV testing after diagnosis and screened twice as many times per lifetime as the general

Alendronate for fracture prevention in postmenopause.

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Holder, Kathryn K; Kerley, Sara Shelton

2008-09-01

Osteoporosis is an abnormal reduction in bone mass and bone deterioration leading to increased fracture risk. Alendronate (Fosamax) belongs to the bisphosphonate class of drugs, which act to inhibit bone resorption by interfering with the activity of osteoclasts. To assess the effectiveness of alendronate in the primary and secondary prevention of osteoporotic fractures in postmenopausal women. The authors searched Central, Medline, and EMBASE for relevant randomized controlled trials published from 1966 to 2007. The authors undertook study selection and data abstraction in duplicate. The authors performed meta-analysis of fracture outcomes using relative risks, and a relative change greater than 15 percent was considered clinically important. The authors assessed study quality through reporting of allocation concealment, blinding, and withdrawals. Eleven trials representing 12,068 women were included in the review. Relative and absolute risk reductions for the 10-mg dose were as follows. For vertebral fractures, a 45 percent relative risk reduction was found (relative risk [RR] = 0.55; 95% confidence interval [CI], 0.45 to 0.67). This was significant for primary prevention, with a 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.38 to 0.80) and 2 percent absolute risk reduction; and for secondary prevention, with 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.43 to 0.69) and 6 percent absolute risk reduction. For nonvertebral fractures, a 16 percent relative risk reduction was found (RR = 0.84; 95% CI, 0.74 to 0.94). This was significant for secondary prevention, with a 23 percent relative risk reduction (RR = 0.77; 95% CI, 0.64 to 0.92) and a 2 percent absolute risk reduction, but not for primary prevention (RR = 0.89; 95% CI, 0.76 to 1.04). There was a 40 percent relative risk reduction in hip fractures (RR = 0.60; 95% CI, 0.40 to 0.92), but only secondary prevention was significant, with a 53 percent relative risk reduction (RR = 0.47; 95% CI

Analysis of the Cochrane Review: Fibrates for secondary prevention of cardiovascular disease and stroke.

Science.gov (United States)

Pires da Rosa, Gilberto; Libânio, Diogo; Filipe Azevedo, Luís

2017-01-01

The influence of fibrates on cardiovascular risk has been the focus of several clinical trials. This Cochrane Collaboration Systematic Review evaluated the efficacy of fibrates for secondary prevention of cardiovascular events and stroke, analyzing 13 randomized controlled trials, in a total of 16 112 participants with a history of cardiovascular disease. Fibrates showed a protective effect for the composite outcome of non-fatal stroke, non-fatal myocardial infarction (MI) and vascular death, mainly due to reduction in the risk of non-fatal or fatal MI. Nonetheless, these results largely relied on studies including clofibrate, a drug withdrawn from the market in 2002. No statistically significant differences regarding adverse events were found between fibrates and placebo. Although insufficient to support the routine prescription of fibrates in this setting, this evidence should be taken into account when deciding on lipid-modifying therapy in dyslipidemic patients with a history of cardiovascular disease. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Is there an app for that? Mobile phones and secondary prevention of cardiovascular disease.

Science.gov (United States)

Neubeck, Lis; Cartledge, Susie; Dawkes, Susan; Gallagher, Robyn

2017-09-01

Advances in technology coupled with increased penetration of mobile phones and smart devices are rapidly changing healthcare delivery. Mobile phone applications ('apps'), text messages, and Internet platforms used alone or in combination are now providing interventions targeting people with multiple cardiovascular risk factors. The present article will review the emerging evidence regarding apps and discuss their potential role in providing secondary prevention interventions via mobile phones. Seven recent randomized controlled trials used text messages or apps for six to 12 months, with or without differing combinations of other technology platforms. All studies, involved cardiac and diabetes populations, and demonstrated at least one positive improvement to cardiovascular risk factor profiles. When measured, acceptability of the intervention was high. Mobile apps and technology can deliver positive outcomes in the management of cardiovascular risk factors. However, because of the complexity of combination interventions, it is difficult to determine the 'active' ingredient. A future challenge for researchers and clinicians will be to respond quickly to these rapidly evolving interventions in order to ensure the delivery of effective, evidence-based outcomes.

Secondary emission electron gun using external primaries

Science.gov (United States)

Srinivasan-Rao, Triveni [Shoreham, NY; Ben-Zvi, Ilan [Setauket, NY

2009-10-13

An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.

Mortality and Reinfarction among Patients Using Different Beta-Blockers for Secondary Prevention after a Myocardial Infarction

DEFF Research Database (Denmark)

Andersen, Søren Skøtt; Hansen, Morten Lock; Gislason, Gunnar H

2009-01-01

Objectives: To study differences in the clinical efficacy of various brands of beta-blocker in secondary prevention after a myocardial infarction (MI). Methods: All patients hospitalized with a first MI between 1995 and 2002 who were still alive 30 days after discharge and had had at least one...... prescription for a beta-blocker filled were identified by individual-level linkage of nationwide registries of hospitalizations and drugs dispensed from pharmacies. A total of 32,259 MI patients were included in the study. Multivariable Cox proportional hazard models were used to analyze the risks of death...... and recurrent MI related to treatment with different beta-blockers. Results: The risks for death and recurrent MI were similar in patients using different beta-blockers, except that mortality from all causes among patients with a prescription for sotalol was higher. Subgroup analyses of high-risk patients...

Trial for the Prevention of Depression (TriPoD) in final-year secondary students: study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Perry, Yael; Calear, Alison L; Mackinnon, Andrew; Batterham, Philip J; Licinio, Julio; King, Catherine; Thomsen, Noel; Scott, Jan; Donker, Tara; Merry, Sally; Fleming, Theresa; Stasiak, Karolina; Werner-Seidler, Aliza; Christensen, Helen

2015-10-12

Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations. Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using

Secondary effects of radiotherapy on the orofacial sphere

International Nuclear Information System (INIS)

Guillaume, Nicolas

2012-01-01

The objective of this research is to determine the role of the dental surgeon in the taking into care of patients treated by head and neck radiotherapy. It also aims at giving information to the patient on secondary effects which radiotherapy may induce, and at determining which therapeutic behaviour to adopt to prevent or at least mitigate the appearance of complications. The author first presents some generalities on radiotherapy: presentation of upper aero-digestive tract cancers (surgery, radiotherapy, and chemotherapy), description of the different radiotherapy techniques (external radiotherapy, brachytherapy), discussion of factors influencing local secondary effects of radiotherapy. The second part addresses the specific case of early orofacial secondary effects, discusses their origin, clinic signs and prevention means: cutaneous effect, mucositis, xerostomia, candidiasis, taste disorders, relationship between early local reactions and anti-tumour treatment efficiency. The third part addresses late orofacial secondary effects: cervix sclerosis, limitation of mouth opening, dental effects, periodontal diseases, osteoradionecrosis. The last part discusses the evolution of radiotherapy: intensity modulated conformational radiotherapy, targeted therapeutics [fr

Just Do It! Reducing Academic Procrastination of Secondary Students

Science.gov (United States)

Xu, Ziwei

2016-01-01

Academic procrastination is a common problem among secondary students. This paper provides secondary teachers with evidence-based strategies to reduce or prevent academic procrastination in their classrooms. Given that reducing academic procrastination is a responsibility for teachers as well as students, the paper describes teacher-administered…

The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

OpenAIRE

Overbeek, M.M.; de Schipper, J.C.; Lamers-Winkelman, F.; Schuengel, C.

2012-01-01

Abstract Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies...

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial.

Science.gov (United States)

Brinker, Titus Josef; Owczarek, Andreas Dawid; Seeger, Werner; Groneberg, David Alexander; Brieske, Christian Martin; Jansen, Philipp; Klode, Joachim; Stoffels, Ingo; Schadendorf, Dirk; Izar, Benjamin; Fries, Fabian Norbert; Hofmann, Felix Johannes

2017-06-06

More than 8.5 million Germans suffer from chronic diseases attributable to smoking. Education Against Tobacco (EAT) is a multinational network of medical students who volunteer for school-based prevention in the classroom setting, amongst other activities. EAT has been implemented in 28 medical schools in Germany and is present in 13 additional countries around the globe. A recent quasi-experimental study showed significant short-term smoking cessation effects on 11-to-15-year-old adolescents. The aim of this study was to provide the first randomized long-term evaluation of the optimized 2014 EAT curriculum involving a photoaging software for its effectiveness in reducing the smoking prevalence among 11-to-15-year-old pupils in German secondary schools. A randomized controlled trial was undertaken with 1504 adolescents from 9 German secondary schools, aged 11-15 years in grades 6-8, of which 718 (47.74%) were identifiable for the prospective sample at the 12-month follow-up. The experimental study design included measurements at baseline (t1), 6 months (t2), and 12 months postintervention (t3), via questionnaire. The study groups consisted of 40 randomized classes that received the standardized EAT intervention (two medical student-led interactive modules taking 120 minutes total) and 34 control classes within the same schools (no intervention). The primary endpoint was the difference in smoking prevalence from t1 to t3 in the control group versus the difference from t1 to t3 in the intervention group. The differences in smoking behavior (smoking onset, quitting) between the two groups, as well as gender-specific effects, were studied as secondary outcomes. None of the effects were significant due to a high loss-to-follow-up effect (52.26%, 786/1504). From baseline to the two follow-up time points, the prevalence of smoking increased from 3.1% to 5.2% to 7.2% in the control group and from 3.0% to 5.4% to 5.8% in the intervention group (number needed to treat [NNT

Secondary HIV prevention among kothi-identified MSM in Chennai, India.

Science.gov (United States)

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali

2008-05-01

This study explored experiences and contexts of HIV risk and prevention among HIV-positive kothi-identified men in Chennai, India. In-depth, semi-structured interviews were conducted with 10 HIV-positive men and three service providers, recruited using purposive sampling. Interviews were audio-taped, transcribed in Tamil and translated into English. Data were analysed using a narrative thematic approach and constant comparative method. Misconceptions about HIV transmission; cultural taboos around discussing sexual behaviour and HIV; stigma related to same-sex behaviour; harassment; and the criminalization of consensual sex between men present formidable challenges to HIV prevention. Frank and open discussion about male-to-male sexual behaviour and living with HIV, which may support health and HIV prevention, may be dangerous in the context of pervasive risks due to stigmatization, violence and criminalization. Instead, culturally appropriate, multi-level interventions developed in collaboration with community stakeholders are needed to support HIV prevention among kothi-identified men in South India.

A Web-based, computer-tailored smoking prevention program to prevent children from starting to smoke after transferring to secondary school: randomized controlled trial.

Science.gov (United States)

Cremers, Henricus-Paul; Mercken, Liesbeth; Candel, Math; de Vries, Hein; Oenema, Anke

2015-03-09

Smoking prevalence rates among Dutch children increase rapidly after they transit to secondary school, in particular among children with a low socioeconomic status (SES). Web-based, computer-tailored programs supplemented with prompt messages may be able to empower children to prevent them from starting to smoke when they transit to secondary school. The main aim of this study is to evaluate whether computer-tailored feedback messages, with and without prompt messages, are effective in decreasing children's smoking intentions and smoking behavior after 12 and 25 months of follow-up. Data were gathered at baseline (T0), and after 12 months (T1) and 25 months (T2) of follow-up of a smoking prevention intervention program called Fun without Smokes. A total of 162 schools were randomly allocated to a no-intervention control group, an intervention prompt group, or an intervention no-prompt group. A total of 3213 children aged 10 to 12 years old participated in the study and completed a Web-based questionnaire assessing their smoking intention, smoking behavior, and sociocognitive factors, such as attitude, social influence, and self-efficacy, related to smoking. After completion, children in the intervention groups received computer-tailored feedback messages in their own email inbox and those messages could be accessed on the intervention website. Children in the prompt group received prompt messages, via email and short message service (SMS) text messaging, to stimulate them to reuse the intervention website with nonsmoking content. Multilevel logistic regression analyses were performed using multiple imputations to assess the program effects on smoking intention and smoking behavior at T1 and T2. A total of 3213 children participated in the Fun without Smokes study at T0. Between T0 and T1 a total of 1067 children out of the original 3213 (33.21%) dropped out of the study. Between T0 and T2 the number of children that did not participate in the final measurement was

Organizing your practice for screening and secondary prevention among adults.

Science.gov (United States)

Knierim, Kyle E; Fernald, Douglas H; Staton, Elizabeth W; Nease, Donald E

2014-06-01

Prevention plays an important role in achieving the triple aim of decreasing per capita health care costs, improving the health of populations, and bettering the patient experience. Primary care is uniquely positioned to provide preventive services. External forces are aligning to support the transition of primary care from traditional models focused on disease-specific, acute episodes of care to new ways of organizing that are more patient centered, team based, and quality driven. By aligning leadership, building change capacity, and selectively choosing relevant processes to change, those practicing primary care can successfully organize their practice environment to deliver preventive services. Copyright © 2014 Elsevier Inc. All rights reserved.

A retrospective study of Babesia macropus associated with morbidity and mortality in eastern grey kangaroos (Macropus giganteus and agile wallabies (Macropus agilis

Directory of Open Access Journals (Sweden)

Shannon L. Donahoe

2015-08-01

Full Text Available This is a retrospective study of 38 cases of infection by Babesia macropus, associated with a syndrome of anaemia and debility in hand-reared or free-ranging juvenile eastern grey kangaroos (Macropus giganteus from coastal New South Wales and south-eastern Queensland between 1995 and 2013. Infection with B. macropus is recorded for the first time in agile wallabies (Macropus agilis from far north Queensland. Animals in which B. macropus infection was considered to be the primary cause of morbidity had marked anaemia, lethargy and neurological signs, and often died. In these cases, parasitised erythrocytes were few or undetectable in peripheral blood samples but were sequestered in large numbers within small vessels of visceral organs, particularly in the kidney and brain, associated with distinctive clusters of extraerythrocytic organisms. Initial identification of this piroplasm in peripheral blood smears and in tissue impression smears and histological sections was confirmed using transmission electron microscopy and molecular analysis. Samples of kidney, brain or blood were tested using PCR and DNA sequencing of the 18S ribosomal RNA and heat shock protein 70 gene using primers specific for piroplasms. The piroplasm detected in these samples had 100% sequence identity in the 18S rRNA region with the recently described Babesia macropus in two eastern grey kangaroos from New South Wales and Queensland, and a high degree of similarity to an unnamed Babesia sp. recently detected in three woylies (Bettongia penicillata ogilbyi in Western Australia.

Establishment, Growth, and Yield Potential of the Perennial Grass Miscanthus × Giganteus on Degraded Coal Mine Soils

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Stanisław Jeżowski

2017-06-01

Full Text Available Miscanthus × giganteus is a giant C4 grass native to Asia. Unlike most C4 species, it is relatively cold tolerant due to adaptations across a wide range of altitudes. These grasses are characterized by high productivity and low input requirements, making them excellent candidates for bioenergy feedstock production. The aim of this study was to investigate the potential for growing Miscanthus on extremely marginal soils, degraded by open lignite (brown coal mining. Field experiments were established within three blocks situated on waste heaps originating from the lignite mine. Analyses were conducted over the first 3 years following Miscanthus cultivation, focusing on the effect of organic and mineral fertilization on crop growth, development and yield in this extreme environment. The following levels of fertilization were implemented between the blocks: the control plot with no fertilization (D0, a plot with sewage sludge (D1, a plot with an identical amount of sewage sludge plus one dose of mineral fertilizer (D2 and a plot with an identical amount of sewage sludge plus a double dose of mineral fertilizer (D3. Crop development and characteristics (plant height, tillering, and biomass yield [dry matter] were measured throughout the study period and analyzed using Analysis of Variance (ANOVA. Significant differences were apparent between plant development and 3rd year biomass production over the course of the study (0.964 kg plant-1 for DO compared to 1.503 kg plant-1 for D1. Soil analyses conducted over the course of the experiment showed that organic carbon levels within the soil increased significantly following the cultivation of Miscanthus, and overall, pH decreased. With the exception of iron, macronutrient concentrations remained stable throughout. The promising yields and positive effects of Miscanthus on the degraded soil suggests that long term plantations on land otherwise unsuitable for agriculture may prove to be of great

Novel preventive treatment options

DEFF Research Database (Denmark)

Longbottom, C; Ekstrand, K; Zero, D

2009-01-01

A number of novel preventive treatment options which, as with traditional methods, can be differentiated into 3 categories of prevention (primary, secondary and tertiary), have been and are being currently investigated. Those reviewed are either commercially available or appear relatively close...... of these techniques show considerable promise and dentists should be aware of these developments and follow their progress, the evidence for each of these novel preventive treatment options is currently insufficient to make widespread recommendations. Changes in dental practice should be explored to see how oral...

Knowledge of Sexually Transmitted Diseases among Secondary ...

African Journals Online (AJOL)

The study was carried out in three public secondary schools in Ogbondoroko and Laduba .... population live in the rural areas where information on sexually transmitted ..... Centers for Disease Control and Prevention (2009) Diagnoses of HIV ...

[Reduction of in-hospital mortality and improved secondary prevention after acute myocardial infarction. First results from the registry of secondary prevention after acute myocardial infarction (SAMI)].

Science.gov (United States)

Tebbe, U; Messer, C; Stammwitz, E; The, G S; Dietl, J; Bischoff, K-O; Schulten-Baumer, U; Tebbenjohanns, J; Gohlke, H; Bramlage, P

2007-07-30

In hospital mortality of acute myocardial infarction (AMI) has been reduced due to the availability of better therapeutic strategies. But there is still a gap between mortality rates in randomised trials and daily clinical practice. Thus, it was aim of the present registry to document the course and outcome of patients with AMI and to improve patient care by implementing recent guidelines. In a nationwide registry study in hospitals in Germany with a cardiology unit or an internal medicine department data on consecutive patients were recorded for six to twelve months at admission, discharge and during a follow-up of one year. From 02/2003 until 10/2004 a total of 5,353 patients with acute myocardial infarction (65.7 % male, mean age of 67.6 +/- 17.7 years; 55.1 % of them with ST elevation myocardial infarction (STEMI) were included in the registry. Of the patients with STEMI, 76.6 % underwent acute intervention, 37.1 % had thrombolysis, 69.7 % percutaneous transluminal coronary angioplasty (PTCA). 40.0 % of those with non-Stemi (NSTEMI) had an acute intervention, 6.6 % thrombolysis, 73.5 % PTCA. Recommended secondary prevention consisted of ASS (93.2 %), beta-blockers (93.0 %), CSE-inhibitors (83.5 %), ACE-inhibitors (80.9 %) and clopidogrel (74.0 %). In-hospital mortality was 10.5 % (STEMI) and 7.4 % (NSTEMI). The 9 % mortality among patients with acute myocardial infarction treated in the hospitals participating in the SAMI registry is low compared to that in similar collectives. The high number of patients who had thrombofibrinolysis and coronary interventions as well as the early initiation of drug therapy contributed to these results. Medical treatment in the prehospital phase of these patients remains still insufficient and to a substantial extent contributes to the mortality of acute myocardial infarction.

Secondary containment systems for bulk oil storage facilities

International Nuclear Information System (INIS)

Carr, B.A.

1996-01-01

The United States Environmental Protection Agency has conducted site inspections at several onshore bulk oil above ground storage facilities, to ensure that owners follow the spill prevention, control and countermeasure regulations. The four violations which were most frequently cited at these facilities were: (1) lack of a spill prevention plan, (2) lack of appropriate containment equipment to prevent discharged oil from reaching a navigable water course, (3) inadequate secondary containment structures, and (4) lack of an adequate quick drainage system in the facility tank loading/unloading area. Suggestions for feasible designs which would improve the impermeability of secondary containment for above ground storage tanks (AST) included the addition of a liner, retrofitting the bottom of an AST with a second steel plate, using a geosynthetic liner on top of the original bottom, installing a leak detection system in the interstitial space between the steel plates, or installing an under-tank liner with a leak detection system during construction of a new AST. 2 refs

Barriers to healthy-lifestyle participation in stroke: consumer participation in secondary prevention design.

Science.gov (United States)

Lennon, Olive C; Doody, Catherine; Ni Choisdealbh, Cliodhna; Blake, Catherine

2013-12-01

The aim of the study was to explore community-dwelling stroke patients' perceived barriers to healthy-lifestyle participation for secondary disease prevention, as well as their preferred means for risk-reduction information dissemination and motivators to participation in healthy-lifestyle interventions. Four focus groups (5-6 stroke survivors per group) were defined from community support groups. Key questions addressed barriers to healthy-lifestyle adoption, preferred methods for receiving information and factors that would engage participants in a risk-reduction programme. Groups were audiotaped, transcribed verbatim and analysed for thematic content using a framework approach. Twenty-two participants, 12 men, 10 women, mean age 71.4 (53-87) years, were included in the study. Three overarching themes emerged as barriers to healthy-lifestyle participation: physical, mental and environmental. Exercise participation difficulties spread across all three themes; healthy eating and smoking cessation concentrated in environmental and mental dimensions. Talks (discussions) were noted as participants' preferred method of information provision. Risk-reduction programmes considered attractive were stroke specific, convenient and delivered by healthcare professionals and involved both social and exercise components. Many stroke patients appear unable to adopt healthy-lifestyle changes through advice alone because of physical, mental and environmental barriers. Risk-reduction programmes including interactive education should be specifically tailored to address barriers currently experienced and extend beyond the stroke survivor to others in their environment who influence lifestyle choices.

Lumbar supports to prevent recurrent low back pain among home care workers: a randomized trial

NARCIS (Netherlands)

Roelofs, Pepijn D. D. M.; Bierma-Zeinstra, Sita M. A.; van Poppel, Mireille N. M.; Jellema, Petra; Willemsen, Sten P.; van Tulder, Maurits W.; van Mechelen, Willem; Koes, Bart W.

2007-01-01

People use lumbar supports to prevent low back pain. Secondary analyses from primary preventive studies suggest benefit among workers with previous low back pain, but definitive studies on the effectiveness of supports for the secondary prevention of low back pain are lacking. To determine the

The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

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Overbeek Mathilde M

2012-02-01

Full Text Available Abstract Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!' has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. Methods/design This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140 are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program

A small-scale study investigating staff and student perceptions of the barriers to a preventative approach for adolescent self-harm in secondary schools in Wales-a grounded theory model of stigma.

Science.gov (United States)

Parker, Rachel

2018-06-01

Grounded theory analysis of secondary school staff and pupil perceptions about the barriers to preventative work for adolescent self-harm within the secondary school setting in Wales. Qualitative and grounded theory. Two secondary schools in Wales were purposefully sampled for variation. Four group interviews took place using qualitative research methods (Participatory Rapid Appraisal) with six school-based professionals and six students aged more than 16 years. Three pupil participants had long-term experience themselves of self-harming behaviours; all the remaining participants had encountered pupils who self-harmed. The research interviews were transcribed verbatim, generating school context-dependent information. This was analysed through the logic of abduction using the constant comparative grounded theory method because of its ability to focus on axial coding for context. The ontology that shaped this work was critical realism within a public health paradigm. A theoretical model of stigma resulted from the grounded theory analytical process, specifically in relation to staff and student perceptions about adolescent self-harm within the institutional context. This meant that social-based behaviours in the secondary school setting centred on the topic and behaviour of adolescent self-harm were structured by stigma. The findings of this study offer an explanation on the exclusion of adolescent self-harm from preventative work in secondary schools. The stigma model demonstrates that adolescent self-harm is excluded from the socio-cultural norms of the institutional setting. Applying the UK Equality Act (2010), this is discrimination. Further research on the institutional-level factors impacting adolescent self-harm in the secondary school context in England and Wales is now urgently needed. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[German Prevention Programs for Eating Disorders - A Systematic Review].

Science.gov (United States)

Pickhardt, Mara; Adametz, Luise; Richter, Felicitas; Strauß, Bernhard; Berger, Uwe

2018-02-13

In the past years a considerable amount of primary and secondary prevention programs for eating disorders was developed in German speaking countries. However, up to now there has been no systematic review of contents and evaluation studies. The main objective of the present systematic review is to identify and outline German prevention programs for eating disorders. This should facilitate the selection of appropriate and effective interventions for medical experts, other professionals and teachers. A systematic literature research was conducted and 22 German-language primary and secondary prevention programs were identified. Half of them were evaluated. The programs were conducted either in school, on the internet or in a group setting. The findings show that throughout almost all programs a reduction in weight and shape concerns and drive for thinness as well as an increase of (body) self-esteem could be observed in either the total sample or the high-risk sample. However, programs were inconsistently effective in reducing disordered eating behavior in the target population. All studies were effective in reducing at least one risk factor. Overall, higher effect sizes were found for secondary prevention programs than for primary prevention programs. Lastly, limitations of the studies and suggestions for future prevention efforts are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

PECULIARITIES OF ARTERIAL HYPERTENSION DIAGNOSIS AND SECONDARY PREVENTION ACCORDING TO PHYSICIANS INTERVIEWING

Directory of Open Access Journals (Sweden)

N. S. Oganisyan

2006-01-01

Full Text Available Aim. To reveal peculiarities of arterial hypertension (AH diagnosis and therapy and their matching with international and national guidelines on AH. Material and Methods. An interview among Moscow physicians dealing with hypertensive patients was conducted in April-June 2005. Interview was taken with specially worked out forms containing 15 questions about hypertensive patient management. 102 physicians took part in interviewing, among them 65 internists and 37 cardiologists. Among interviewed physicians 56 ones were from outpatient clinics, 19 - from diagnostic centers, 14 - from hospitals, 5 - from commercial medical centers, 4 - from research center and 3 physicians had private practice.  Results. 80,4% of interviewed physicians correctly determined the main goals of AH therapy. 16% of doctors did not indicate blood pressure level below 140/90 mm Hg as target level of secondary prevention. Mainly antihypertensive therapy was presented by four classes of medicines, their shares were as follow: ACE inhibitors - 35%, beta-blockers – 28%, diuretics – 26% and calcium antagonists – 10%. Other classes of antihypertensive medicines (antagonists of angiotensin-II receptors, central acting medicines made about 1% of share. When choosing original medicine among several suggested trade marks, only 22% of doctors defined the medicine correctly. Original medicines made only 29,4% prescriptions in real medical practice. Conclusion. Real practice of AH diagnosis and therapy considerably differs from international and national guidelines on AH. It is possibly related with lack of appropriate knowledge among physicians as well as problems in public health service.   

A novel cost-effectiveness model of prescription eicosapentaenoic acid extrapolated to secondary prevention of cardiovascular diseases in the United States.

Science.gov (United States)

Philip, Sephy; Chowdhury, Sumita; Nelson, John R; Benjamin Everett, P; Hulme-Lowe, Carolyn K; Schmier, Jordana K

2016-10-01

Given the substantial economic and health burden of cardiovascular disease and the residual cardiovascular risk that remains despite statin therapy, adjunctive therapies are needed. The purpose of this model was to estimate the cost-effectiveness of high-purity prescription eicosapentaenoic acid (EPA) omega-3 fatty acid intervention in secondary prevention of cardiovascular diseases in statin-treated patient populations extrapolated to the US. The deterministic model utilized inputs for cardiovascular events, costs, and utilities from published sources. Expert opinion was used when assumptions were required. The model takes the perspective of a US commercial, third-party payer with costs presented in 2014 US dollars. The model extends to 5 years and applies a 3% discount rate to costs and benefits. Sensitivity analyses were conducted to explore the influence of various input parameters on costs and outcomes. Using base case parameters, EPA-plus-statin therapy compared with statin monotherapy resulted in cost savings (total 5-year costs $29,393 vs $30,587 per person, respectively) and improved utilities (average 3.627 vs 3.575, respectively). The results were not sensitive to multiple variations in model inputs and consistently identified EPA-plus-statin therapy to be the economically dominant strategy, with both lower costs and better patient utilities over the modeled 5-year period. The model is only an approximation of reality and does not capture all complexities of a real-world scenario without further inputs from ongoing trials. The model may under-estimate the cost-effectiveness of EPA-plus-statin therapy because it allows only a single event per patient. This novel model suggests that combining EPA with statin therapy for secondary prevention of cardiovascular disease in the US may be a cost-saving and more compelling intervention than statin monotherapy.

Life skills training as HIV/AIDS preventive strategy in secondary ...

African Journals Online (AJOL)

A life skills and HIV/AIDS education programme was implemented in secondary schools as a strategy to combat the spread of HIV/AIDS among school-going young people in South Africa. As part of a joint effort of the Departments of Health and Education, two teachers per school were trained to implement life skills training ...

The PRESLO study: evaluation of a global secondary low back pain prevention program for health care personnel in a hospital setting. Multicenter, randomized intervention trial

Directory of Open Access Journals (Sweden)

Denis Angélique

2012-11-01

Full Text Available Abstract Background Common low back pain represents a major public health problem in terms of its direct cost to health care and its socio-economic repercussions. Ten percent of individuals who suffer from low back pain evolve toward a chronic case and as such are responsible for 75 to 80% of the direct cost of low back pain. It is therefore imperative to highlight the predictive factors of low back pain chronification in order to lighten the economic burden of low back pain-related invalidity. Despite being particularly affected by low back pain, Hospices Civils de Lyon (HCL personnel have never been offered a specific, tailor-made treatment plan. The PRESLO study (with PRESLO referring to Secondary Low Back Pain Prevention, or in French, PREvention Secondaire de la LOmbalgie, proposed by HCL occupational health services and the Centre Médico-Chirurgical et de Réadaptation des Massues – Croix Rouge Française, is a randomized trial that aims to evaluate the feasibility and efficiency of a global secondary low back pain prevention program for the low back pain sufferers among HCL hospital personnel, a population at risk for recurrence and chronification. This program, which is based on the concept of physical retraining, employs a multidisciplinary approach uniting physical activity, cognitive education about low back pain and lumbopelvic morphotype analysis. No study targeting populations at risk for low back pain chronification has as yet evaluated the efficiency of lighter secondary prevention programs. Methods/Design This study is a two-arm parallel randomized controlled trial proposed to all low back pain sufferers among HCL workers, included between October 2008 and July 2011 and followed over two years. The personnel following their usual treatment (control group and those following the global prevention program in addition to their usual treatment (intervention group are compared in terms of low back pain recurrence and the

Changing Pattern of Bacteriuria among Asymptomatic Secondary ...

African Journals Online (AJOL)

Subjects and Methods: A survey of 628 adolescents attending secondary schools in Enugu was ... females in whom asymptomatic bacteriuria needs to be treated in pregnancy in order to prevent the attendant risks to the fetus. Thus, there is a ...

EFFICACY AND SAFETY OF LIPID-LOWERING DRUGS IN PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES IN THE ELDERLY

Directory of Open Access Journals (Sweden)

E. A. Ushkalova

2016-01-01

Full Text Available Effect of hyperlipidemia on morbidity and mortality in elderly patients is considered. Authors also cover issues of efficacy and safety of lipid-lowering therapy in primary and secondary prevention of cardiovascular diseases in patients ≥80 years of age who are the most quickly growing group of population and have the highest cardiovascular risk. They stress the need to take into account polymorbidity and polypharmacy that increase the risk of adverse reactions due to the use of both statins and their drug-drug interactions, which requires an assessment of risk/benefit ratio. In addition, there is a need for development of reliable prognostic tools to predict relevant outcomes (e.g., stroke, decrease in functionality/independence, quality of life reduction and rationales for lipid-lowering therapy in the elderly and also their adherence to treatment.

Knowledge, Attitudes and Perceptions of Secondary School Teenagers towards HIV Transmission and Prevention in Rural and Urban Areas of Central Uganda.

Science.gov (United States)

Rukundo, Annamaria; Muwonge, Mathias M; Mugisha, Danny; Aturwanaho, Dickens; Kasangaki, Arabat; Bbosa, Godfrey S

2016-01-01

HIV/AIDS has remained a challenge in Uganda among adolescent despite the ABC strategy used globally to prevent HIV infection. The study assessed the knowledge, attitudes and perceptions of secondary school teenagers towards HIV transmission and prevention in rural and urban schools of central Uganda. A cross sectional study using self-administered questionnaires and structured interviews was used to collect data from adolescents in secondary schools in Kampala and Buikwe districts. Eight schools were randomly selected with 4 schools in each district. A total of 245 students from schools were recruited in the study with 120 and 125 students from urban Kampala and rural Buikwe district schools respectively. Data were analyzed using SPSS version 11. The results were expressed as percentages in a 2 × 2 tables. The mean age of the participants was 15.9 ± 2.5 years. Results showed that 95.1% participants had knowledge on HIV/AIDS in both urban and rural schools and 27.4% knew all the modes of HIV transmission. About 83.7% knew the ABC strategy for HIV prevention and 37.6% would talk about HIV/AIDS mainly with friends. For HIV cure, 62.0% of study participants reported non-cure and 24.9% were not sure. The remaining 13.1% of the study participants in both urban and rural schools reported that HIV can be cured. And the modes of curing HIV that were mentioned by participants included spiritual healing, transmitting it to others through sexual intercourse and that antiretroviral (ARVs) drugs can cure it as well as that it can be cured abroad. About 65.7% of participants reported recognition of one with HIV/ AIDS and by having red lips, being sickly; weight loss, skin rash and being very rich were mentioned. About 39.2% of the study participants mentioned that they cannot get infected with HIV and can't contract HIV at all and 18.4% believed that chances of getting HIV infection were high. On perception and attitude on condoms and their use, participants reported that it is

Mobile phone text messaging to improve medication adherence in secondary prevention of cardiovascular disease.

Science.gov (United States)

Adler, Alma J; Martin, Nicole; Mariani, Javier; Tajer, Carlos D; Owolabi, Onikepe O; Free, Caroline; Serrano, Norma C; Casas, Juan P; Perel, Pablo

2017-04-29

Worldwide at least 100 million people are thought to have prevalent cardiovascular disease (CVD). This population has a five times greater chance of suffering a recurrent cardiovascular event than people without known CVD. Secondary CVD prevention is defined as action aimed to reduce the probability of recurrence of such events. Drug interventions have been shown to be cost-effective in reducing this risk and are recommended in international guidelines. However, adherence to recommended treatments remains sub-optimal. In order to influence non-adherence, there is a need to develop scalable and cost-effective behaviour-change interventions. To assess the effects of mobile phone text messaging in patients with established arterial occlusive events on adherence to treatment, fatal and non-fatal cardiovascular events, and adverse effects. We searched CENTRAL, MEDLINE, Embase, the Conference Proceedings Citation Index - Science on Web of Science on 7 November 2016, and two clinical trial registers on 12 November 2016. We contacted authors of included studies for missing information and searched reference lists of relevant papers. We applied no language or date restrictions. We included randomised trials with at least 50% of the participants with established arterial occlusive events. We included trials investigating interventions using short message service (SMS) or multimedia messaging service (MMS) with the aim to improve adherence to medication for the secondary prevention of cardiovascular events. Eligible comparators were no intervention or other modes of communication. We used standard methodological procedures expected by Cochrane. In addition, we attempted to contact all authors on how the SMS were developed. We included seven trials (reported in 13 reports) with 1310 participants randomised. Follow-up ranged from one month to 12 months. Due to heterogeneity in the methods, population and outcome measures, we were unable to conduct meta-analysis on these studies

[Violence prevention in secondary schools: the Faustlos-curriculum for middle school].

Science.gov (United States)

Schick, Andreas; Cierpka, Manfred

2009-01-01

Schools and kindergartens are particularly suitable for the implementation of violence prevention programs. Many German schools and kindergartens have securely established the violence prevention curriculum Faustlos. The Faustlos programs for kindergartens and elementary schools are now complemented with the version for middle schools. As the kindergarten- and elementary school versions the middle school program too focuses on the theoretically profound, age group-tailored promotion of empathy, impulse control and anger management. These dimensions are subdivided into the five themes "understanding the problem" "training for empathy"; "anger management", "problem solving" and "applying skills" and taught stepwise, highly structured and based on several video sequences in 31 lessons. US-American evaluation studies proof the effectiveness and the violence prevention potential of the program. With the curriculum for middle schools a comprehensive Faustlos program package is now made available to sustainably promote core violence prevention competences of children and adolescents on a developmentally appropriate level and with a consistent didactic approach.

Piloting the use of indigenous methods to prevent Nipah virus infection by interrupting bats' access to date palm sap in Bangladesh.

Science.gov (United States)

Nahar, Nazmun; Mondal, Utpal Kumar; Sultana, Rebeca; Hossain, M Jahangir; Khan, M Salah Uddin; Gurley, Emily S; Oliveras, Elizabeth; Luby, Stephen P

2013-09-01

People in Bangladesh frequently drink fresh date palm sap. Fruit bats (Pteropus giganteus) also drink raw sap and may contaminate the sap by shedding Nipah virus through saliva and urine. In a previous study we identified two indigenous methods to prevent bats accessing the sap, bamboo skirts and lime (calcium carbonate). We conducted a pilot study to assess the acceptability of these two methods among sap harvesters. We used interactive community meetings and group discussions to encourage all the sap harvesters (n = 12) from a village to use either bamboo skirts or lime smear that some of them (n = 4) prepared and applied. We measured the preparation and application time and calculated the cost of bamboo skirts. We conducted interviews after the use of each method. The sap harvesters found skirts effective in preventing bats from accessing sap. They were sceptical that lime would be effective as the lime was washed away by the sap flow. Preparation of the skirt took ∼105 min. The application of each method took ∼1 min. The cost of the bamboo skirt is minimal because bamboo is widely available and they made the skirts with pieces of used bamboo. The bamboo skirt method appeared practical and affordable to the sap harvesters. Further studies should explore its ability to prevent bats from accessing date palm sap and assess if its use produces more or better quality sap, which would provide further incentives to make it more acceptable for its regular use.

Prevention, not just treatment.

Science.gov (United States)

Connors, G L; Hilling, L

1998-03-01

A tragic burden of disease, disability, and death has resulted from smoking. The role of pulmonary rehabilitation is not only in treatment and rehabilitation of lung disease but in the prevention of lung disease. The skills of the pulmonary rehabilitation specialist should be used in the earlier detection and prevention of lung disease through primary and secondary prevention. The spirometer must gain acceptance in the medical community as the early tool to evaluate lung health, not the chest radiograph or the stethoscope. The lung age formula and sputum pap smears are just a few of the evaluation tools used to detect and motivate susceptible individuals. Prevention is the key to enhancing lung health.

Alzheimer's disease prevention: from risk factors to early intervention.

Science.gov (United States)

Crous-Bou, Marta; Minguillón, Carolina; Gramunt, Nina; Molinuevo, José Luis

2017-09-12

Due to the progressive aging of the population, Alzheimer's disease (AD) is becoming a healthcare burden of epidemic proportions for which there is currently no cure. Disappointing results from clinical trials performed in mild-moderate AD dementia combined with clear epidemiological evidence on AD risk factors are contributing to the development of primary prevention initiatives. In addition, the characterization of the long asymptomatic stage of AD is allowing the development of intervention studies and secondary prevention programmes on asymptomatic at-risk individuals, before substantial irreversible neuronal dysfunction and loss have occurred, an approach that emerges as highly relevant.In this manuscript, we review current strategies for AD prevention, from primary prevention strategies based on identifying risk factors and risk reduction, to secondary prevention initiatives based on the early detection of the pathophysiological hallmarks and intervention at the preclinical stage of the disease. Firstly, we summarize the evidence on several AD risk factors, which are the rationale for the establishment of primary prevention programmes as well as revising current primary prevention strategies. Secondly, we review the development of public-private partnerships for disease prevention that aim to characterize the AD continuum as well as serving as platforms for secondary prevention trials. Finally, we summarize currently ongoing clinical trials recruiting participants with preclinical AD or a higher risk for the onset of AD-related cognitive impairment.The growing body of research on the risk factors for AD and its preclinical stage is favouring the development of AD prevention programmes that, by delaying the onset of Alzheimer's dementia for only a few years, would have a huge impact on public health.

Can prevention classification be improved by considering the function of prevention?

Science.gov (United States)

Foxcroft, David R

2014-12-01

Universal, selective and indicated forms of prevention have been adopted as improvements on previous notions of primary and secondary prevention. However, some conceptual confusion remains concerning the placing of environmental, community-based or mass media preventive interventions within this typology. It is suggested that a new dimension of functional types of prevention, namely environmental, developmental and informational prevention should be specified alongside the forms of prevention in a taxonomy matrix. The main advantage of this new taxonomy is that a matrix combining the form and function dimensions of prevention can be used to identify and map out prevention strategies, to consider where research evidence is present and where more is needed, and to evaluate the relative effectiveness of different categories and components of prevention for specific health and social issues. Such evaluations would provide empirical evidence as to whether the different categories of prevention are related to outcomes or processes of prevention in ways that suggest the value of the taxonomy for understanding and increasing the impact of prevention science. This new prevention taxonomy has been useful for conceptualising and planning prevention activities in a case study involving the Swedish National Institute for Public Health. Future work should assess (1) the robustness of this new taxonomy and (2) the theoretical and empirical basis for profiling prevention investments across the various forms and functions of prevention.

Dicty_cDB: Contig-U16302-1 [Dicty_cDB

Lifescience Database Archive (English)

Full Text Available 9523, 5' end, exp... 117 5e-28 3 ( EU020782 ) Mastigoproctus giganteus clone Mga3136f1 putative... 113 8e-28...clone Stu3... 210 1e-60 EU020782_1( EU020782 |pid:none) Mastigoproctus giganteus

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

Science.gov (United States)

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

2018-02-01

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

State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics.

Science.gov (United States)

Adams, William M; Scarneo, Samantha E; Casa, Douglas J

2017-09-01

Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States. Descriptive epidemiology study. A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved. The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43.93% to 39.80%) were Ohio, Delaware, Alaska, Vermont

Análise química do bambu-gigante (Dendrocalamus giganteus Wall. ex Munro em diferentes idades

Directory of Open Access Journals (Sweden)

Nelson Potenciano Marinho

2012-06-01

Full Text Available http://dx.doi.org/10.5902/198050985749O bambu é uma planta monocotiledônea de origem tropical, de rápido crescimento, sendo considerado um importante regenerador ambiental devido ao seu sistema radicular. O Dendrocalamus giganteus é popularmente conhecido por bambu-gigante, sendo uma espécie entouceirante de grande porte, cujos colmos podem variar de 24 a 40 metros de altura, com diâmetros entre 10 e 20 cm. Esse trabalho teve como objetivo analisar quimicamente os colmos do bambu-gigante visando fornecer informações sobre a sua composição química nas idades de 2 a 6 anos. Os colmos do bambu foram coletados na área Experimental Agrícola do Departamento de Engenharia Mecânica da UNESP-Bauru, onde é realizado o manejo sistemático de diversas espécies de bambu para fins de pesquisas e divulgação dessa planta. Foram retiradas amostras da base entre bambus com idade de 2 a 6 anos de uma mesma touceira, totalizando 5 amostras, com 2 metros de altura cada, colhidas na lua minguante no mês de março. As análises químicas foram feitas com os entrenós, utilizando as normas e procedimentos da TAPPI. A porcentagem média de extrativos em água quente, extrativos em água fria, extrativos totais e teor de cinzas não apresentaram relação direta com a idade. A maior porcentagem de extrativos em água quente, com valor de 12,04%, extrativos em água fria, com 10,25%, e extrativos totais, com 12,91%, foi observada aos 2 anos de idade. A maior porcentagem de cinzas foi obtida aos três anos, com valores de 1,09%. O teor médio de extrativos em NaOH diminui de 25,72% aos dois anos para 20,17% aos seis anos de idade. O mesmo comportamento foi observado para os extrativos em etanol tolueno, diminuindo de 10,91% para 4,61%. O teor médio de lignina não sofreu influência da idade, variando de 22,66 a 24,11%.

Shroud cutting techniques and collection systems for secondary radioactivity release

International Nuclear Information System (INIS)

Yokoi, H.; Watanabe, A.; Uetake, N.; Shimura, T.; Omote, T.; Adachi, H.; Murakami, S.; Kobayashi, H.; Gotoh, M.

2001-01-01

Replacement of in-core shroud has been conducted as part of the preventive maintenance program in Tsuruga-1. The EDM (electric discharged machining) and plasma cutting methods were applied to in-core shroud cutting and secondary cutting in the DSP (dryer/separator pool), respectively. The cutting systems were improved in order to decrease radioactive secondary products. 1) Fundamental EDM cutting tests: fundamental EDM cutting tests were carried out in order to study secondary products. It could be presumed that volatile Co-carbonyl compound was generated by using a carbon electrode. The Ag/W electrode was effective as EDM electrode for in-core shroud cutting to prevent generation of Co-carbonyl compound and to decrease the total amount of secondary products. 2) In-core shroud cutting in RPV (reactor pressure vessel): EDM cutting system with the Ag/W electrode and collection system could keep a good environment during in-core shroud cutting in Tsuruga-1. Activity concentration was lower value than limitation of mask charge level, 4E-6 Bq/cm 3 , even near the water surface. 3) Secondary plasma cutting in DSP: the secondary cutting work was successful in the point of reduction of working period and radiation exposure. The amount of radiation exposure was reduced to 60% of the planned value, because of adequate decontamination of the working environment and reduction of number of torch maintenance tasks by improvements of the underwater cutting device

Techniques for Primary-to-Secondary Leak Monitoring in PWR Plants

International Nuclear Information System (INIS)

Sohn, Wook; Chi, Jun Hwa; Kang, Duck Won; Tae, Jeong Woo

2006-01-01

Historically, corrosion and mechanical damage have made steam generator tubes in PWR plants see various types of degradation from both the primary and secondary sides of the tubes. Since the tube degradation can lead to through-wall failure, the plant personnel should make efforts to prevent the failure. One of such preventive efforts is to monitor primary-to-secondary leakage (PSL) that usually precedes the tube rupture. Thus the objective of PSL monitoring is to make operators to determine when to shutdown the plant in order to minimize the likelihood of propagation of leaks to tube rupture under normal and faulted conditions This paper addresses briefly the status of techniques for PSL monitoring used in PWR plants

Refuge or reservoir? The potential impacts of the biofuel crop Miscanthus x giganteus on a major pest of maize.

Directory of Open Access Journals (Sweden)

Joseph L Spencer

Full Text Available BACKGROUND: Interest in the cultivation of biomass crops like the C4 grass Miscanthus x giganteus (Miscanthus is increasing as global demand for biofuel grows. In the US, Miscanthus is promoted as a crop well-suited to the Corn Belt where it could be cultivated on marginal land interposed with maize and soybean. Interactions (direct and indirect of Miscanthus, maize, and the major Corn Belt pest of maize, the western corn rootworm, (Diabrotica virgifera virgifera LeConte, WCR are unknown. Adding a perennial grass/biomass crop to this system is concerning since WCR is adapted to the continuous availability of its grass host, maize (Zea mays. METHODOLOGY/PRINCIPAL FINDINGS: In a greenhouse and field study, we investigated WCR development and oviposition on Miscanthus. The suitability of Miscanthus for WCR development varied across different WCR populations. Data trends indicate that WCR populations that express behavioural resistance to crop rotation performed as well on Miscanthus as on maize. Over the entire study, total adult WCR emergence from Miscanthus (212 WCR was 29.6% of that from maize (717 WCR. Adult dry weight was 75-80% that of WCR from maize; female emergence patterns on Miscanthus were similar to females developing on maize. There was no difference in the mean no. of WCR eggs laid at the base of Miscanthus and maize in the field. CONCLUSIONS/SIGNIFICANCE: Field oviposition and significant WCR emergence from Miscanthus raises many questions about the nature of likely interactions between Miscanthus, maize and WCR and the potential for Miscanthus to act as a refuge or reservoir for Corn Belt WCR. Responsible consideration of the benefits and risks associated with Corn Belt Miscanthus are critical to protecting an agroecosystem that we depend on for food, feed, and increasingly, fuel. Implications for European agroecosystems in which Miscanthus is being proposed are also discussed in light of the WCR's recent invasion into Europe.

Improvements to secondary coolant circuits of a liquid metal cooled nuclear reactor

International Nuclear Information System (INIS)

Brachet, Alain.

1981-01-01

This invention concerns improvements to secondary coolant-systems for sodium cooled nuclear reactors. It further concerns a protective device for a free level mechanical pump which prevents any gas bubbles due to leaks of the working gas of the pump from entering the secondary system of the nuclear reactor [fr

Secondary poisoning of owls by anticoagulant rodenticides

Science.gov (United States)

Mendenhall, Vivian M.; Pank, L.F.

1980-01-01

Anticoagulants-compounds that prevent clotting of the blood-are extensively used for control of small mammal pests. The potential secondary hazards of 6 anticoagulant rodenticides to birds of prey were examined in this study. Whole rats or mice were killed with each anticoagulant and were fed to 1-3 species of owls. Owls died of hemorrhaging after feeding on rats killed with bromadiolone, brodifacoum, or diphacinone; sublethal hemorrhaging occurred in owls fed rats killed with difenacoum. These results demonstrate potential secondary hazards of 4 anticoagulants to avian predators. No abnormalities were observed in owls fed rats killed with fumarin and chlorophacinone

Blood Pressure Control: Stroke and Stroke Prevention

Directory of Open Access Journals (Sweden)

Hans-Christoph Diener

2005-03-01

Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

The Role of Aspirin in the Prevention of Cardiovascular Disease

Science.gov (United States)

Ittaman, Sunitha V.; VanWormer, Jeffrey J.; Rezkalla, Shereif H.

2014-01-01

Aspirin therapy is well-accepted as an agent for the secondary prevention of cardiovascular events and current guidelines also define a role for aspirin in primary prevention. In this review, we describe the seminal trials of aspirin use in the context of current guidelines, discuss factors that may influence the effectiveness of aspirin therapy for cardiovascular disease prevention, and briefly examine patterns of use. The body of evidence supports a role for aspirin in both secondary and primary prevention of cardiovascular events in selected population groups, but practice patterns may be suboptimal. As a simple and inexpensive prophylactic measure for cardiovascular disease, aspirin use should be carefully considered in all at-risk adult patients, and further measures, including patient education, are necessary to ensure its proper use. PMID:24573704

Prevention of preterm birth.

LENUS (Irish Health Repository)

Flood, Karen

2012-02-01

Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

Differing approaches to falls and fracture prevention between Australia and Colombia

Science.gov (United States)

Gomez, Fernando; Curcio, Carmen Lucia; Suriyaarachchi, Pushpa; Demontiero, Oddom; Duque, Gustavo

2013-01-01

Falls and fractures are major causes of morbidity and mortality in older people. More importantly, previous falls and/or fractures are the most important predictors of further events. Therefore, secondary prevention programs for falls and fractures are highly needed. However, the question is whether a secondary prevention model should focus on falls prevention alone or should be implemented in combination with fracture prevention. By comparing a falls prevention clinic in Manizales (Colombia) versus a falls and fracture prevention clinic in Sydney (Australia), the objective was to identify similarities and differences between these two programs and to propose an integrated model of care for secondary prevention of fall and fractures. A comparative study of services was performed using an internationally agreed taxonomy. Service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE) and previous reports in the literature. Comparison included organization, administration, client characteristics, and interventions. Several similarities and a number of differences that could be easily unified into a single model are reported here. Similarities included population, a multidisciplinary team, and a multifactorial assessment and intervention. Differences were eligibility criteria, a bone health assessment component, and the therapeutic interventions most commonly used at each site. In Australia, bone health assessment is reinforced whereas in Colombia dizziness assessment and management is pivotal. The authors propose that falls clinic services should be operationally linked to osteoporosis services such as a “falls and fracture prevention clinic,” which would facilitate a comprehensive intervention to prevent falls and fractures in older persons. PMID:23378748

A secondary meta-synthesis of qualitative studies of gender and access to cardiac rehabilitation.

Science.gov (United States)

Angus, Jan E; King-Shier, Kathryn M; Spaling, Melisa A; Duncan, Amanda S; Jaglal, Susan B; Stone, James A; Clark, Alexander M

2015-08-01

To discuss issues in the theorization and study of gender observed during a qualitative meta-synthesis of influences on uptake of secondary prevention and cardiac rehabilitation services. Women and men can equally benefit from secondary prevention/cardiac rehabilitation and there is a need to understand gender barriers to uptake. Meta-method analysis secondary to meta-synthesis. For the meta-synthesis, a systematic search was performed to identify and retrieve studies published as full papers during or after 1995 and contained: a qualitative research component wholly or in a mixed method design, extractable population specific data or themes for referral to secondary prevention programmes and adults ≥18 years. Databases searched between January 1995-31 October 2011 included: CSA Sociological Abstracts, EBSCOhost CINAHL, EBSCOhost Gender Studies, EBSCOhost Health Source Nursing: Academic Edition, EBSCOhost SPORTDiscus, EBSCOhost SocINDEX. Studies were reviewed against inclusion/exclusion criteria. Included studies were subject to quality appraisal and standardized data extraction. Of 2264 screened articles, 69 were included in the meta-method analysis. Only four studies defined gender or used gender theories. Findings were mostly presented as inherently the characteristic of gendered worldviews of participants. The major themes suggest a mismatch between secondary prevention/cardiac rehabilitation services and consumers' needs, which are usually portrayed as differing according to gender but may also be subject to intersecting influences such as age or socioeconomic status. There is a persistent lack of theoretically informed gender analysis in qualitative literature in this field. Theory-driven gender analysis will improve the conceptual clarity of the evidence base for gender-sensitive cardiac rehabilitation programme development. © 2015 John Wiley & Sons Ltd.

Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American Society of Clinical Oncology clinical practice guideline endorsement.

Science.gov (United States)

Meyerhardt, Jeffrey A; Mangu, Pamela B; Flynn, Patrick J; Korde, Larissa; Loprinzi, Charles L; Minsky, Bruce D; Petrelli, Nicholas J; Ryan, Kim; Schrag, Deborah H; Wong, Sandra L; Benson, Al B

2013-12-10

The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing recent clinical practice guidelines that have been developed by other professional organizations. The Cancer Care Ontario (CCO) Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer was reviewed by ASCO for methodologic rigor and considered for endorsement. The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements. Surveillance should be guided by presumed risk of recurrence and functional status of the patient (important within the first 2 to 4 years). Medical history, physical examination, and carcinoembryonic antigen testing should be performed every 3 to 6 months for 5 years. Patients at higher risk of recurrence should be considered for testing in the more frequent end of the range. A computed tomography scan (abdominal and chest) is recommended annually for 3 years, in most cases. Positron emission tomography scans should not be used for surveillance outside of a clinical trial. A surveillance colonoscopy should be performed 1 year after the initial surgery and then every 5 years, dictated by the findings of the previous one. If a colonoscopy was not preformed before diagnosis, it should be done after completion of adjuvant therapy (before 1 year). Secondary prevention (maintaining a healthy body weight and active lifestyle) is recommended. If a patient is not a candidate for surgery or systemic therapy because of severe comorbid conditions, surveillance tests should not be performed. A treatment plan from the specialist should have clear directions on appropriate follow-up by a nonspecialist.

Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study.

Science.gov (United States)

Jhaveri, Mansi M; Benjamin-Garner, Ruby; Rianon, Nahid; Sherer, Mark; Francisco, Gerard; Vahidy, Farhaan; Kobayashi, Kayta; Gaber, Mary; Shoemake, Paige; Vu, Kim; Trevino, Alyssa; Grotta, James; Savitz, Sean

2017-09-03

The aftermath of stroke leaves many consequences including cognitive deficits and falls due to imbalance. Stroke survivors and families struggle to navigate the complex healthcare system with little assistance posthospital discharge, often leading to early hospital readmission and worse stroke outcomes. Telemedicine Guided Education on Secondary Stroke and Fall Prevention Following Inpatient Rehabilitation feasibility study examines whether stroke survivors and their caregivers find value in telerehabilitation (TR) home visits that provide individualised care and education by a multidisciplinary team after discharge from inpatient rehabilitation. A prospective, single arm, pilot study is designed to evaluate the feasibility of weekly TR home visits initiated postdischarge from inpatient rehabilitation. Newly diagnosed patients with stroke are recruited from a Houston-based comprehensive stroke centre inpatient rehabilitation unit, loaned an iPad with data plan and trained to use information technology security-approved videoconferencing application. After hospital discharge, six weekly TR home visits are led by rotating specialists (pharmacist, physical/occupational therapist, speech therapist, rehabilitation physician, social worker, geriatrician specialised in fracture prevention) followed by satisfaction survey on week 7. Specialists visually assess patients in real time, educate them on secondary stroke and fall prevention and suggest ways to improve function including direct medical interventions when indicated. Primary outcomes are proportion of eligible patients consenting to the study, participation rate in all six TR home visits and satisfaction score. The study started 31 December 2015 with plan to enrol up to 50 patients over 24 months. Feasibility study results will inform us as to whether a randomised controlled trial is warranted to determine efficacy of TR home visit intervention in improving stroke outcomes. Ethics approval obtained by the

Medicinal formulations of a Kanda tribal healer – a tribe on the verge ...

African Journals Online (AJOL)

Besides medicinal plants, the Kanda healer also used the body hairs of the Asiatic black bear (Ursus thibetanus) and bats (Pteropus giganteus giganteus) in one of his formulation for treatment of fever with shivering. The ailments treated by the Kanda healer were fairly common ailments like cuts and wounds, skin diseases, ...

Advances in pharmacotherapy for secondary hyperparathyroidism.

Science.gov (United States)

Rodríguez, Mariano; Rodríguez-Ortiz, María E

2015-01-01

Secondary hyperparathyroidism is a frequent complication of chronic kidney disease. This review will discuss the various therapeutic options available for the management of hyperparathyroidism. The main therapeutic strategies available to prevent or slow down the progression of hyperparathyroidism will be detailed here. Reductions in phosphatemia may be achieved by controlling dietary phosphorus, administering phosphorus binders, or increasing the frequency of dialysis sessions. Vitamin D sterols reduce parathyroid hormone (PTH) secretion while normalizing calcium (Ca) and vitamin D levels. Calcimimetics decrease PTH levels, probably with an additional effect on hyperplasia. Percutaneous injections in parathyroids represent an option useful in cases of hyperparathyroidism resistant to pharmacological therapy. Pubmed was searched by combining the terms 'secondary hyperparathyroidism' and the name of each one of the drugs reported in this review. PTH increases from early stages of renal disease. One of the goals in pre-dialysis is the prevention of hyperphosphatemia and the maintenance of Ca levels in the normal range. The management of hyperparathyroidism in dialysis requires control of phosphorus level. In this stage, the decision to use calcimimetics and vitamin D derivatives should be made according to serum levels of Ca and phosphorus.

Impact of the Prevention Plan on Employee Health Risk Reduction

OpenAIRE

Loeppke, Ronald; Edington, Dee W.; Bég, Sami

2010-01-01

This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

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

Science.gov (United States)

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

2016-01-01

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

Lumbar supports for prevention and treatment of low back pain

DEFF Research Database (Denmark)

Van Tulder, M W; Jellema, P; van Poppel, M N

2000-01-01

BACKGROUND: Lumbar supports are used in the treatment of low back pain patients to make the impairment and disability vanish or decrease. Lumbar supports are also used to prevent the onset of low back pain (primary prevention) or to prevent recurrences of a low back pain episode (secondary...... 1999, and the Embase database up to September 1998. We also screened references given in relevant reviews and identified controlled trials, and used Science Citation Index to identify additional controlled trials. SELECTION CRITERIA: Controlled clinical trials that reported on any type of lumbar...... types of treatment or no intervention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, while it is still unclear if lumbar...

Self-Management Interventions to Prevent the Secondary Condition of Pain in People with Disability Due to Mobility Limitations

Directory of Open Access Journals (Sweden)

Katherine Froehlich-Grobe

2016-01-01

Full Text Available Introduction This focused review examines the use and effectiveness of self-management strategies in preventing or managing pain, which is among the most common secondary conditions faced by individuals with a mobility disability. Methods This focused review was part of a two-phase comprehensive scoping review. Phase I was a comprehensive scoping review of the literature targeting multiple outcomes of self-management interventions for those with mobility impairment, and Phase II was a focused review of the literature on self-management interventions that target pain as a primary or secondary outcome. Two authors searched CINAHL, PubMed, and PsyclNFO for papers published from January 1988 through August 2014 using specified search terms. Following the scoping review, the authors independently screened and selected the studies and reviewed the eligible studies, and the first author extracted data from the included studies. Results The scoping review yielded 40 studies that addressed pain self-management interventions for those living with mobility impairment. These 40 accumulated papers revealed a heterogeneous evidence base in terms of setting (clinic, community, and online, target populations, intervention duration (3 weeks to 24 months, and mode (health-care providers and lay leaders. Most of the reviewed studies reported that the self-management intervention led to significant reduction of pain over time, suggesting that self-management may be a promising approach for addressing pain experienced by people who live with mobility limitations. Discussion This review also reveals moderate-to-high bias across studies, and findings indicate that future research should enhance the methodological quality to provide stronger evidence about the effectiveness of self-management strategies for reducing pain among those with mobility impairments.

Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy

Directory of Open Access Journals (Sweden)

Boveé Lian

2012-12-01

Full Text Available Abstract Background Internationally, guidelines to prevent secondary transmission of Shigella infection vary widely. Cases, their contacts with diarrhoea, and those in certain occupational groups are frequently excluded from work, school, or daycare. In the Netherlands, all contacts attending pre-school (age 0–3 and junior classes in primary school (age 4–5, irrespective of symptoms, are also excluded pending microbiological clearance. We identified risk factors for secondary Shigella infection (SSI within households and evaluated infection control policy in this regard. Methods This retrospective cohort study of households where a laboratory confirmed Shigella case was reported in Amsterdam (2002–2009 included all households at high risk for SSI (i.e. any household member under 16 years. Cases were classified as primary, co-primary or SSIs. Using univariable and multivariable binomial regression with clustered robust standard errors to account for household clustering, we examined case and contact factors (Shigella serotype, ethnicity, age, sex, household size, symptoms associated with SSI in contacts within households. Results SSI occurred in 25/ 337 contacts (7.4%: 20% were asymptomatic, 68% were female, and median age was 14 years (IQR: 4–38. In a multivariable model adjusted for case and household factors, only diarrhoea in contacts was associated with SSI (IRR 8.0, 95% CI:2.7-23.8. In a second model, factors predictive of SSI in contacts were the age of case (0–3 years (IRRcase≥6 years:2.5, 95% CI:1.1-5.5 and 4–5 years (IRRcase≥6 years:2.2, 95% CI:1.1-4.3 and household size (>6 persons (IRR2-4 persons 3.4, 95% CI:1.2-9.5. Conclusions To identify symptomatic and asymptomatic SSI, faecal screening should be targeted at all household contacts of preschool cases (0–3 years and cases attending junior class in primary school (4–5 years and any household contact with diarrhoea. If screening was limited to these groups, only

Allergy and asthma prevention 2014

DEFF Research Database (Denmark)

Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht

2014-01-01

Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy....... This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas...... that antiviral vaccines could be useful in the future. Allergen-specific immunotherapy is effective for the treatment of allergic patients with symptoms; the study of its value for primary and secondary prevention of asthma and allergy is in its very preliminary phases. The lack of success in the prevention...

Secondary combined suicide pact.

Science.gov (United States)

Jayanth, S H; Girish Chandra, Y P; Hugar, Basappa S; Kainoor, Sunilkumar

2014-03-01

This article reports a combined suicide pact, where in a young couple; a 26 year old male and a 20 year old female committed suicide by using two methods. The couple had resorted to hanging and self-immolation to prevent failure of single method alone. In secondary combined suicides, several other methods of suicide are tried after the first method chosen has failed. It is primary combined suicide only when two or more methods are used simultaneously. Both types of combined suicide by one individual is well reported in the literature whereas the same by two persons together is rare. In this report, the deceased were disappointed lovers, poor and the family members were against their marriage. The investigation of scene, methods employed to commit suicide, autopsy findings and the interview with their relatives altogether suggested that it was a secondary combined suicide pact. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Factors predicting the development of pressure ulcers in an at-risk population who receive standardized preventive care: secondary analyses of a multicentre randomised controlled trial.

Science.gov (United States)

Demarre, Liesbet; Verhaeghe, Sofie; Van Hecke, Ann; Clays, Els; Grypdonck, Maria; Beeckman, Dimitri

2015-02-01

To identify predictive factors associated with the development of pressure ulcers in patients at risk who receive standardized preventive care. Numerous studies have examined factors that predict risk for pressure ulcer development. Only a few studies identified risk factors associated with pressure ulcer development in hospitalized patients receiving standardized preventive care. Secondary analyses of data collected in a multicentre randomized controlled trial. The sample consisted of 610 consecutive patients at risk for pressure ulcer development (Braden Score Pressure ulcers in category II-IV were significantly associated with non-blanchable erythema, urogenital disorders and higher body temperature. Predictive factors significantly associated with superficial pressure ulcers were admission to an internal medicine ward, incontinence-associated dermatitis, non-blanchable erythema and a lower Braden score. Superficial sacral pressure ulcers were significantly associated with incontinence-associated dermatitis. Despite the standardized preventive measures they received, hospitalized patients with non-blanchable erythema, urogenital disorders and a higher body temperature were at increased risk for developing pressure ulcers. Improved identification of at-risk patients can be achieved by taking into account specific predictive factors. Even if preventive measures are in place, continuous assessment and tailoring of interventions is necessary in all patients at risk. Daily skin observation can be used to continuously monitor the effectiveness of the intervention. © 2014 John Wiley & Sons Ltd.

Core competencies for cardiac rehabilitation/secondary prevention professionals: 2010 update: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation.

Science.gov (United States)

Hamm, Larry F; Sanderson, Bonnie K; Ades, Philip A; Berra, Kathy; Kaminsky, Leonard A; Roitman, Jeffrey L; Williams, Mark A

2011-01-01

Cardiac rehabilitation/secondary prevention (CR/SP) services are typically delivered by a multidisciplinary team of health care professionals. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognizes that to provide high-quality services, it is important for these health care professionals to possess certain core competencies. This update to the previous statement identifies 10 areas of core competencies for CR/SP health care professionals and identifies specific knowledge and skills for each core competency. These core competency areas are consistent with the current list of core components for CR/SP programs published by the AACVPR and the American Heart Association and include comprehensive cardiovascular patient assessment; management of blood pressure, lipids, diabetes, tobacco cessation, weight, and psychological issues; exercise training; and counseling for psychosocial, nutritional, and physical activity issues.

Oral damages in radiotherapy: dentistry prevention and treating

International Nuclear Information System (INIS)

Caielli, Cibelle; Martha, Patricia M.; Dib, Luciano L.

1995-01-01

The authors show the importance of the multidisciplinary participation in treatment of oncologic patients about the prevention and treatment of oral damage induced by head and neck irradiation. The main secondary effects are: xerostomy, mucositis, irradiation caries and osteoradionecrosis. The dentistry has to perform preventively to avoid the appearance of this sequel or reduce its effects. (author)

A comprehensive fracture prevention strategy in older adults

DEFF Research Database (Denmark)

Blain, H.; Masud, T.; Dargent-Molina, P.

2016-01-01

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS...... of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people....

School Administrator Perceptions of Cyberbullying Facilitators and Barriers to Preventive Action: A Qualitative Study.

Science.gov (United States)

Young, Rachel; Tully, Melissa; Ramirez, Marizen

2017-06-01

Schools are often held responsible for preventing or addressing cyberbullying, yet little is known about school administrator perceptions of cyberbullying and the challenges they face in addressing this public health issue. The goal of this study is to examine school administrators' perceptions of the facilitators of cyberbullying and barriers to primary and secondary prevention strategies. Public school administrators ( N = 36) participated in in-depth interviews about bullying and discussed their experiences with cyberbullying and their perceptions of cyberbullying facilitators and barriers to prevention. Three main themes arose from the analysis: (1) cyberbullying as a major challenge; (2) facilitators of cyberbullying and barriers to preventive action, including parents and technology; and (3) prevention efforts, including unclear jurisdiction for action, primary versus secondary prevention efforts, and technology attributes that facilitate school response to bullying. Although administrators perceive cyberbullying as a major challenge facing their schools, they are often unsure about appropriate primary and secondary prevention efforts. Relationships with parents and police complicate response and prevention as schools attempt to navigate unclear jurisdiction. Additionally, technology presents a challenge to schools because it is seen as an enabler of cyberbullying, a facilitator of prevention, and a necessary part of education efforts. Lack of research on prevention strategies, parents' knowledge and attitudes, and confusion about responsibility for addressing cyberbullying are barriers to action. Findings suggest administrators could benefit from additional clarity on which strategies are most effective for primary prevention of cyberbullying, and that prevention strategies should proactively involve parents to promote effective collaboration with schools.

Factors Influencing Stress, Burnout, and Retention of Secondary Teachers

Science.gov (United States)

Fisher, Molly H.

2011-01-01

This study examines the stress, burnout, satisfaction, and preventive coping skills of nearly 400 secondary teachers to determine variables contributing to these major factors influencing teachers. Analysis of Variance (ANOVA) statistics were conducted that found the burnout levels between new and experienced teachers are significantly different,…

SODEXPERT: help to PWR plant management to prevent secondary circuit corrosion

International Nuclear Information System (INIS)

Eon-Duval, P.; Fiquet, J.M.; Langlet, J.P.

1996-01-01

Since about 10 years, problems of secondary circuit corrosion have raised for PWR plant management. The watch staff can't be asked the physicochemical knowledge requested for a proper interpretation of the various probes outputs. So an expert-system has been performed to help the identification of dangerous situation from a corrosion point of view, and immediately start the PWR managing action. This software has been successfully tested and validated. (D.L.). 5 figs., 4 photos

Prevention of nonsteroidal anti-inflammatory drug-induced gastropathy.

Science.gov (United States)

Schlansky, Barry; Hwang, Joo Ha

2009-01-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for their analgesic, antipyretic, and antiinflammatory properties, and aspirin is increasingly employed in the primary and secondary prevention of cardiovascular disease and ischemic stroke. Despite undisputed therapeutic efficacy for these indications, all NSAIDs impart a considerable risk of peptic ulcer disease and upper gastrointestinal hemorrhage. A growing body of evidence supports an association between non-aspirin NSAIDs and acute coronary syndromes, and an expanding understanding of the gastroduodenal effects of aspirin, COX-2 selective agents, clopidogrel, and Helicobacter pylori synergism fuel controversies in NSAID use. In this review, we discuss risk stratification of patients taking NSAIDs and the appropriate application of proven gastro-protective strategies to decrease the incidence of gastrointestinal hemorrhage based upon an individualized assessment of risk for potential toxicities. Prevention of NSAID-related gastropathy is an important clinical issue, and therapeutic strategies for both the primary and secondary prevention of adverse events are continually evolving.

Acupuncture lowering blood pressure for secondary prevention of stroke: a study protocol for a multicenter randomized controlled trial.

Science.gov (United States)

Du, Yu-Zheng; Gao, Xin-Xin; Wang, Cheng-Ting; Zheng, Hai-Zhen; Lei, Yun; Wu, Meng-Han; Shi, Xue-Min; Ban, Hai-Peng; Gu, Wen-Long; Meng, Xiang-Gang; Wei, Mao-Ti; Hu, Chun-Xiao

2017-09-15

Stroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke. This is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group. The experimental group will receive "HuoXueSanFeng" acupuncture combined with one antihypertensive medication in addition to routine ischemic stroke treatment. The control group will only receive one antihypertensive medication and basic treatments for ischemic stroke. HuoXueSanFeng acupuncture will be given for six sessions weekly for the first 6 weeks and three times weekly for the next 6 weeks. A 9-month follow-up will, thereafter, be conducted. Antihypertensive medication will be adjusted based on BP levels. The primary outcome will be the recurrence of stroke. The secondary outcomes including 24-h ambulatory BP, the TCM syndrome score, the Short Form 36-item Health Survey (SF-36), the National Institute of Health Stroke Scale (NIHSS), as well as the Barthel Index (BI) scale will be assessed at baseline, 6 weeks and 12 weeks post initiating treatments; cardiac ultrasound, carotid artery ultrasound, transcranial Doppler, and lower extremity ultrasound will be evaluated at baseline and 12 weeks after treatment. The safety of acupuncture will also be assessed. We aim to determine the clinical effects of controlling BP for secondary prevention of stroke with acupuncture add-on treatment. ClinicalTrials.gov, ID: NCT02967484 . Registered on 13 February 2017; last updated on 27 June 2017.

Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials.

Science.gov (United States)

Mega, J L; Stitziel, N O; Smith, J G; Chasman, D I; Caulfield, M; Devlin, J J; Nordio, F; Hyde, C; Cannon, C P; Sacks, F; Poulter, N; Sever, P; Ridker, P M; Braunwald, E; Melander, O; Kathiresan, S; Sabatine, M S

2015-06-06

Genetic variants have been associated with the risk of coronary heart disease. In this study, we tested whether or not a composite of these variants could ascertain the risk of both incident and recurrent coronary heart disease events and identify those individuals who derive greater clinical benefit from statin therapy. A community-based cohort study (the Malmo Diet and Cancer Study) and four randomised controlled trials of both primary prevention (JUPITER and ASCOT) and secondary prevention (CARE and PROVE IT-TIMI 22) with statin therapy, comprising a total of 48,421 individuals and 3477 events, were included in these analyses. We studied the association of a genetic risk score based on 27 genetic variants with incident or recurrent coronary heart disease, adjusting for traditional clinical risk factors. We then investigated the relative and absolute risk reductions in coronary heart disease events with statin therapy stratified by genetic risk. We combined data from the different studies using a meta-analysis. When individuals were divided into low (quintile 1), intermediate (quintiles 2-4), and high (quintile 5) genetic risk categories, a significant gradient in risk for incident or recurrent coronary heart disease was shown. Compared with the low genetic risk category, the multivariable-adjusted hazard ratio for coronary heart disease for the intermediate genetic risk category was 1·34 (95% CI 1·22-1·47, pgenetic risk category was 1·72 (1·55-1·92, pgenetic risk categories. Similarly, we noted greater absolute risk reductions in those individuals in higher genetic risk categories (p=0·0101), resulting in a roughly threefold decrease in the number needed to treat to prevent one coronary heart disease event in the primary prevention trials. Specifically, in the primary prevention trials, the number needed to treat to prevent one such event in 10 years was 66 in people at low genetic risk, 42 in those at intermediate genetic risk, and 25 in those at high

Breast cancer prevention across the cancer care continuum.

Science.gov (United States)

Klemp, Jennifer R

2015-05-01

To review the current state of breast cancer prevention from primary prevention through survivorship, highlight cross-cutting issues, and discuss strategies for clinical integration and future research. Published articles between 1985 and 2015 and original research. Cancer risk persists across the lifespan. Interprofessional strategies to reduce morbidity and mortality from cancer include primary, secondary, and tertiary prevention (survivorship). Prevention strategies across the cancer care continuum are cross-cutting and focus on measures to: prevent the onset of disease, identify and treat asymptomatic persons who have already developed risk factors or preclinical disease, and restore function, minimize the negative effects of disease, and prevent disease-related complications. Oncology nurses and advanced practice nurses are vital in the delivery of breast cancer prevention strategies. Published by Elsevier Inc.

Preventing and managing challenging behaviour.

Science.gov (United States)

Hallett, Nutmeg

2018-02-21

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

[Impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome].

Science.gov (United States)

Liu, J; Wang, W; Liu, J; Wang, Y; Qi, Y; Sun, J Y; Zhao, D

2018-02-24

Objective: To evaluate the impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome (ACS). Methods: This multi-center cross-sectional study collected data from 34 hospitals covering 22 provinces in China. Hospitals were randomly divided into four groups: control group(routine treatment and care), promotional calendar group (routine treatment and care plus giving propaganda desk calendar to patients), education group (routine treatment and care add patients education by nurses) and combined intervention group (promotional calendar and education).At least 90 patients with ACS were consecutively enrolled from each involved hospital from April 15, 2012 to June 30, 2013. To reduce the impact of uneven distribution of inter-group variables on the results, 1∶1∶1∶1 propensity score matching method was used. The drug usage for secondary prevention and prognosis wasobtainedat 6 months after hospital discharge. Results: (1) A total of 3 391 patients were selected and 2 244 patients were included for the final analysisafter propensity score analysis. (2) At 6 months after discharge, the adherence rates of antiplatelet, statins, angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB), β-blocker and the combination of 4 medications were similar between control group and promotional calendar group (all P> 0.016).The adherence rates of antiplatelet and statins were 97.0% (526/542) and 91.0% (493/542) in the education group, 3.7% and 5.5% higher than in the control group (both Ppromotional calendar group, and the statins adherence rate was 5.5%( OR= 1.055, 95% CI 1.012-1.101, Ppromotional calendar group, respectively, and statin adherence was 6.1% ( OR= 1.061, 95% CI 1.017-1.107, Ppromotional calendar group and education group. The adherence rates of combined medication in combined intervention group were respectively 21.6%( OR= 1.216, 95% CI 1.079-1.371, Ppromotional calendar

Bullying in Secondary Schools: Action Planning Using a Positive Behavior Intervention and Support Framework

Science.gov (United States)

Lawrence, Tory De Shannon

2017-01-01

Bullying behavior is not a new issue, but despite the efforts of many, the problem continues to plague our students and schools, particularly in secondary schools. Secondary school leaders need a school-wide strategic plan for bullying prevention. Students need to be engaged in learning how to resolve conflicts and in understanding how bullying…

Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

DEFF Research Database (Denmark)

Callahan, Alfred; Amarenco, Pierre; Goldstein, Larry B

2011-01-01

To perform a secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial, which tested the effect of treatment with atorvastatin in reducing stroke in subjects with a recent stroke or transient ischemic attack, to explore the effects of treatment...

Comparison of antiplatelet regimens in secondary stroke prevention

DEFF Research Database (Denmark)

Christiansen, Christine Benn; Pallisgaard, Jannik; Gerds, Thomas Alexander

2015-01-01

BACKGROUND: In patients with ischemic stroke of non-cardioembolic origin, acetylsalicylic acid, clopidogrel, or a combination of acetylsalicylic acid and dipyridamole are recommended for the prevention of a recurrent stroke. The purpose of this study was to examine the risk of bleeding or recurrent...... stroke associated with these three treatments. METHODS: Patients who were discharged with first-time ischemic stroke from 2007-2010, with no history of atrial fibrillation were identified from Danish nationwide registries. Hazard ratios (HRs) and 1-year risks of recurrent ischemic stroke and bleeding...... were calculated for each antiplatelet regimen. RESULTS: Among patients discharged after first-time ischemic stroke, 3043 patients were treated with acetylsalicylic acid, 12,295 with a combination of acetylsalicylic acid and dipyridamole, and 3885 with clopidogrel. Adjusted HRs for clopidogrel versus...

Can atopic dermatitis be prevented?

Science.gov (United States)

Gómez-de la Fuente, E

2015-05-01

Atopic dermatitis has become a health problem in our setting due to its rising prevalence, impact on quality of life, associated costs, and role in the progression to other atopic diseases. Furthermore, atopic dermatitis has no definitive cure and therefore preventive measures are important. In this article, we review the latest advances in both primary prevention (reduction of the incidence of atopic dermatitis) and secondary prevention (reduction of associated morbidity and reduction of the atopic march). We analyze the different preventive strategies available, including modification of the immune system through microbial exposure, induction of immune tolerance through antigen exposure, and restoration of skin barrier function to halt the atopic march. Dermatologists need to be familiar with these strategies in order to apply them where necessary and to accurately inform patients and their relatives to prevent misguided or inappropriate actions. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

Therapeutic potential of culinary-medicinal mushrooms for the management of neurodegenerative diseases: diversity, metabolite, and mechanism.

Science.gov (United States)

Phan, Chia-Wei; David, Pamela; Naidu, Murali; Wong, Kah-Hui; Sabaratnam, Vikineswary

2015-01-01

Mushrooms have long been used not only as food but also for the treatment of various ailments. Although at its infancy, accumulated evidence suggested that culinary-medicinal mushrooms may play an important role in the prevention of many age-associated neurological dysfunctions, including Alzheimer's and Parkinson's diseases. Therefore, efforts have been devoted to a search for more mushroom species that may improve memory and cognition functions. Such mushrooms include Hericium erinaceus, Ganoderma lucidum, Sarcodon spp., Antrodia camphorata, Pleurotus giganteus, Lignosus rhinocerotis, Grifola frondosa, and many more. Here, we review over 20 different brain-improving culinary-medicinal mushrooms and at least 80 different bioactive secondary metabolites isolated from them. The mushrooms (either extracts from basidiocarps/mycelia or isolated compounds) reduced beta amyloid-induced neurotoxicity and had anti-acetylcholinesterase, neurite outgrowth stimulation, nerve growth factor (NGF) synthesis, neuroprotective, antioxidant, and anti-(neuro)inflammatory effects. The in vitro and in vivo studies on the molecular mechanisms responsible for the bioactive effects of mushrooms are also discussed. Mushrooms can be considered as useful therapeutic agents in the management and/or treatment of neurodegeneration diseases. However, this review focuses on in vitro evidence and clinical trials with humans are needed.

[Secondary osteoporosis in gynecology].

Science.gov (United States)

Taguchi, Y; Gorai, I

1998-06-01

Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

How successful is secondary prevention for coronary artery disease (CAD) in the real world

International Nuclear Information System (INIS)

Rauf, M.A.; Khan, N.; Khan, N.; Khan, I.; Hafizullah, M.; Mahmood, N.

2012-01-01

Objective: To document the effects of secondary prevention on different risk factors in the real world situation. Methodology: It was a cross sectional comparative study carried out at a referral cardiac clinic in Peshawar from January 2010 to December 2010. Study subjects presenting with at least 6 months follow up were included from different parts of Khyber Pukhtunkhawa. All patients with positive history or objective evidence of CAD were enrolled. Study subjects were divided in two groups based on the fact that either taking or had stopped medication for the duration of the study period. Study variables were levels of lipids, glucose, blood pressure (BP), smoking and obesity. Results: A total of 843 patients were included in the study. Males were 70.4 % (593). Mean age was 58.74 +- 10.6 years. Patients taking regular medicine were 69.03% while 30.97% had stopped their medicine for at least three months. Diabetics, hypertensive and positive family history for CAD were 33.4%, 50.25% and 24% respectively. When compared to patient who had stopped medicine, mean systolic BP (p= 0.014), diastolic BP (p= 0.05), mean Cholesterol (p=0.000), mean LDL (p=0.000), mean HDL (p=0.000) and HbA1c% (p=0.049), was well controlled in patients who were taking medicine regularly. Mean BMI (p=0.786), triglycerides and smoking (p=0.761) had no significant difference between the two groups. Conclusion: Blood pressure, serum cholesterol, LDL, HDL, as well as HbA1c% were reduced with little effect on serum TGs, BMI and smoking in those who were taking medicine regularly compared to those who had stopped. (author)

Activity syndromes and metabolism in giant deep-sea isopods

Science.gov (United States)

Wilson, Alexander D. M.; Szekeres, Petra; Violich, Mackellar; Gutowsky, Lee F. G.; Eliason, Erika J.; Cooke, Steven J.

2017-03-01

Despite growing interest, the behavioural ecology of deep-sea organisms is largely unknown. Much of this scarcity in knowledge can be attributed to deepwater animals being secretive or comparatively 'rare', as well as technical difficulties associated with accessing such remote habitats. Here we tested whether two species of giant marine isopod (Bathynomus giganteus, Booralana tricarinata) captured from 653 to 875 m in the Caribbean Sea near Eleuthera, The Bahamas, exhibited an activity behavioural syndrome across two environmental contexts (presence/absence of food stimulus) and further whether this syndrome carried over consistently between sexes. We also measured routine metabolic rate and oxygen consumption in response to a food stimulus in B. giganteus to assess whether these variables are related to individual differences in personality. We found that both species show an activity syndrome across environmental contexts, but the underlying mechanistic basis of this syndrome, particularly in B. giganteus, is unclear. Contrary to our initial predictions, neither B. giganteus nor B. tricarinata showed any differences between mean expression of behavioural traits between sexes. Both sexes of B. tricarinata showed strong evidence of an activity syndrome underlying movement and foraging ecology, whereas only male B. giganteus showed evidence of an activity syndrome. Generally, individuals that were more active and bolder, in a standard open arena test were also more active when a food stimulus was present. Interestingly, individual differences in metabolism were not related to individual differences in behaviour based on present data. Our study provides the first measurements of behavioural syndromes and metabolism in giant deep-sea isopods.

Phylogeny in Defining Model Plants for Lignocellulosic Ethanol Production: A Comparative Study of Brachypodium distachyon, Wheat, Maize, and Miscanthus x giganteus Leaf and Stem Biomass

Science.gov (United States)

Meineke, Till; Manisseri, Chithra; Voigt, Christian A.

2014-01-01

The production of ethanol from pretreated plant biomass during fermentation is a strategy to mitigate climate change by substituting fossil fuels. However, biomass conversion is mainly limited by the recalcitrant nature of the plant cell wall. To overcome recalcitrance, the optimization of the plant cell wall for subsequent processing is a promising approach. Based on their phylogenetic proximity to existing and emerging energy crops, model plants have been proposed to study bioenergy-related cell wall biochemistry. One example is Brachypodium distachyon, which has been considered as a general model plant for cell wall analysis in grasses. To test whether relative phylogenetic proximity would be sufficient to qualify as a model plant not only for cell wall composition but also for the complete process leading to bioethanol production, we compared the processing of leaf and stem biomass from the C3 grasses B. distachyon and Triticum aestivum (wheat) with the C4 grasses Zea mays (maize) and Miscanthus x giganteus, a perennial energy crop. Lambda scanning with a confocal laser-scanning microscope allowed a rapid qualitative analysis of biomass saccharification. A maximum of 108–117 mg ethanol·g−1 dry biomass was yielded from thermo-chemically and enzymatically pretreated stem biomass of the tested plant species. Principal component analysis revealed that a relatively strong correlation between similarities in lignocellulosic ethanol production and phylogenetic relation was only given for stem and leaf biomass of the two tested C4 grasses. Our results suggest that suitability of B. distachyon as a model plant for biomass conversion of energy crops has to be specifically tested based on applied processing parameters and biomass tissue type. PMID:25133818

Comparison of Arundo donax L. and Miscanthus x giganteus in a long-term field experiment in Central Italy: Analysis of productive characteristics and energy balance

International Nuclear Information System (INIS)

Angelini, Luciana G.; Ceccarini, Lucia; Nassi o Di Nasso, Nicoletta; Bonari, Enrico

2009-01-01

Miscanthus x giganteus (miscanthus) and Arundo donax L. (giant reed) are two perennial crops which have been received particular attention during the last decade as bioenergy crops. The main aim of the present study was to compare the above-ground biomass production and the energy balance of these perennial rhizomatous grasses in a long-term field experiment. The crops were cultivated from 1992 to 2003 in the temperate climate of Central Italy with 20,000 plants ha -1 , 100-100-100 kg N, P 2 O 5 , K 2 O per hectare, and without irrigation supply. For each year of trial, biomass was harvested in autumn to estimate biometric characteristics and productive parameters. Besides, energy analysis of biomass production was carried out determining energy output, energy input, energy efficiency (output/input) and net energy yield (output-input). Results showed high above-ground biomass yields over a period of 10 years for both species, with better productive performances in giant reed than in miscanthus (37.7 t DM ha -1 year -1 vs 28.7 t DM ha -1 year -1 averaged from 2 to 12 years of growth). Such high yields resulted positively correlated to number of stalks (miscanthus), plant height and stalk diameter (giant reed). Moreover, these perennial species are characterised by a favourable energy balance with a net energy yield of 467 and 637 GJ ha -1 (1-12 year mean) for miscanthus and giant reed respectively. With such characteristics, both grasses could be proposed as biomass energy crops in Southern Europe with a significant and environmentally compatible contribution to energy needs

Comparison of Arundo donax L. and Miscanthus x giganteus in a long-term field experiment in Central Italy: Analysis of productive characteristics and energy balance

Energy Technology Data Exchange (ETDEWEB)

Angelini, Luciana G.; Ceccarini, Lucia; Nassi o Di Nasso, Nicoletta [University of Pisa, Dipartimento di Agronomia e Gestione dell' Agroecosistema, Via S. Michele degli Scalzi 2, 56100 Pisa (Italy); Bonari, Enrico [Scuola Superiore Sant' Anna, Piazza Martiri della Liberta, 33, 56100 Pisa (Italy)

2009-04-15

Miscanthus x giganteus (miscanthus) and Arundo donax L. (giant reed) are two perennial crops which have been received particular attention during the last decade as bioenergy crops. The main aim of the present study was to compare the above-ground biomass production and the energy balance of these perennial rhizomatous grasses in a long-term field experiment. The crops were cultivated from 1992 to 2003 in the temperate climate of Central Italy with 20,000 plants ha{sup -1}, 100-100-100 kg N, P{sub 2}O{sub 5}, K{sub 2}O per hectare, and without irrigation supply. For each year of trial, biomass was harvested in autumn to estimate biometric characteristics and productive parameters. Besides, energy analysis of biomass production was carried out determining energy output, energy input, energy efficiency (output/input) and net energy yield (output-input). Results showed high above-ground biomass yields over a period of 10 years for both species, with better productive performances in giant reed than in miscanthus (37.7 t DM ha{sup -1} year{sup -1}vs 28.7 t DM ha{sup -1} year{sup -1} averaged from 2 to 12 years of growth). Such high yields resulted positively correlated to number of stalks (miscanthus), plant height and stalk diameter (giant reed). Moreover, these perennial species are characterised by a favourable energy balance with a net energy yield of 467 and 637 GJ ha{sup -1} (1-12 year mean) for miscanthus and giant reed respectively. With such characteristics, both grasses could be proposed as biomass energy crops in Southern Europe with a significant and environmentally compatible contribution to energy needs. (author)

New visions for basic research and primary prevention of pediatric allergy

DEFF Research Database (Denmark)

Hamelman, E.; Herz, U.; Holt, P.

2008-01-01

, resources need to be focused on better understanding of the early allergic events and on interventional studies to investigate new strategies of primary and secondary prevention. Accordingly, this review summarizes the state-of-the-art of genetic, immunological and clinical aspects of primary prevention...

Prevention of suicide among adolescents and young people: reflecting on the experience of Western models

Directory of Open Access Journals (Sweden)

I.B. Bovina

2013-07-01

Full Text Available We analyze various preventive and proactive suicide programs, which operate in a number of Western countries. We consider various measures implemented under the auspices of the WHO, as well as in the framework of the European Alliance Against Depression. Following J. Henden, wediscuss three types of suicide prevention: primary, secondary and tertiary. Primary prevention covers the population as a whole – suicide prevention is to promote the value of health and life. This type of prevention is addressed to a wide audience, including teenagers and young adults groups. Secondary prevention is aimed at those who have attempted to commit suicide, because the presence of attempts is a significant feature that allows to predict next attempts. Tertiary prevention is addressed to suicider’s close circle, it aims at help the suicider’s relatives to survive this event, use the appropriate ways of coping with the tragic situation.

Domestic violence: recognition, intervention, and prevention.

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Smith, M; Martin, F

1995-02-01

Domestic violence is a significant social and health problem that has received intensive recent publicity in the lay media. Nurses should play a major role in primary, secondary, and tertiary prevention interventions. Intensified health promotion and public policy initiatives can reduce the incidence of domestic violence in the future.

A review on prevention and treatment of post-orthodontic white spot lesions - evidence-based methods and emerging technologies

DEFF Research Database (Denmark)

Bergstrand, Fredrik; Twetman, Svante

2011-01-01

The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances.......The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances....

Simulation of fatigue damagesin secondary truss of crane

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Eremin Konstantin Ivanovich

2014-02-01

Full Text Available Basing on the damaging statistics obtained during the on-site inspections of industrial multi-span building structures with under-crane secondary trusses which have continuous lower plinth, we simulated the scenario of the most likely damage development of under-crane secondary trusses.The first scenario is the development of cracks along the total cross section of plinth. In the process of calculations we defined a real deformation scheme of plinth of under-crane secondary trusses with damage and its stress condition.The second scenario is the destruction of a support or support mounting unit to the lower plinth of under-crane secondary trusses. The destruction of this kind can occur as a result of a crack in a support or as a result of destruction of high-strength fasteners of a support to plinth. We discovered that a system with such damage is geometrically unchanged; there is no possibility of sudden destruction of both the under-crane secondary trusses and the entire building frame.The third scenario is the upper plinth separation from one of the walls of lower plinth of under-crane secondary trusses.The scenario is developed to define the viability of under-crane secondary trusses as a result of cracks in the area of wall junction with the upper shelf of lower plinth, their further development and the appearance of discrete cracks developing into a backbone along the entire span length of under-crane secondary trusses.Based on the calculations of the stress strain state of under-crane secondary trusses with damages in the emergency nature in a separate span of the lower plinth and a truss member, we estimated the viability of structure. The analysis of viability limits makes it possible to find the measures of collapse preventing and avoid possible victims.

Automotive Mechanics Curriculum Outline for Secondary Schools. Vocational Education Curriculum Guide.

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Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

This curriculum outline for secondary automotive mechanics is structured around Louisiana's Vocational-Technical Automotive Mechanics Curriculum. The curriculum is composed of 16 units of instruction, covering the following topics: benchwork, fundamentals of automotive engines, preventive maintenance, automotive brakes, steering and front…

A Secondary Analysis of Longitudinal Prevalence Data to Determine the Use of Pressure Ulcer Preventive Measures in Dutch Nursing Homes, 2005-2014.

Science.gov (United States)

van Leen, Martin Wf; Schols, Joseph Mga; Hovius, Steven Er; Halfens, Ruud Jg

2017-09-01

Pressure ulcers (PUs) are an important and distressing problem in Dutch nursing homes. A secondary analysis of longitudinal data from the Dutch National Prevalence Measurement of Care Problems (LPZ) - an annual, multicenter, point-prevalence survey - was conducted for the years 2005-2014 to determine the use of specific recommended PU preventive measures from the European Pressure Ulcer Advisory Panel 1998, the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel 2009, and the 2002 and 2011 Dutch PU guidelines. Preventive care was investigated among nursing home residents at risk for PUs and included skin care (moisturization); nutritional and hydration status assessment and optimization; and pressure redistribution involving mattresses, cushions, and heel pressure-relieving strategies and devices. Following abstraction from the study database, data for 3 at-risk groups were distinguished: 1) residents with a Braden score of 17, 18, or 19; 2) residents with a Braden score below 17; and 3) residents with a PU. Data were aggregated at the institutional level. Differences were tested with multiple regression analyses. The mean number of residents over the study period was 5435, the mean age was 82.8 years, and the mean Braden score was 15.3. None of the recommended preventive measures from the guidelines consulted was applied 100% of the time: preventive skin care measures were used in 25.1% to 63.8% of cases and dehydration and/or malnutrition were identified and managed in 27.8% to 65.6% of patients. Pressure redistribution with special types of mattresses was used in 85.2% of patients, cushions in (wheel)chairs were used in 64.8% of patients, and heels were offloaded in 57.8% of patients. The results regarding repositioning for the 3 groups, respectively, showed a maximum use of 9.7%, 30.3%, and 65.6%; the higher the PU risk, the more preventive measures were used. Although the results show a decrease in the percent of category 2 through

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

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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.

Effectiveness of McKenzie Method-Based Self-Management Approach for the Secondary Prevention of a Recurrence of Low Back Pain (SAFE Trial): Protocol for a Pragmatic Randomized Controlled Trial.

Science.gov (United States)

de Campos, Tarcisio F; Maher, Chris G; Clare, Helen A; da Silva, Tatiane M; Hancock, Mark J

2017-08-01

Although many people recover quickly from an episode of low back pain (LBP), recurrence is very common. There is limited evidence on effective prevention strategies for recurrences of LBP. The purpose of this study was to determine the effectiveness of a McKenzie method-based self-management approach in the secondary prevention of LBP. This will be a pragmatic randomized controlled trial. Participants will be recruited from the community and primary care, with the intervention delivered in a number of physical therapist practices in Sydney, Australia. The study will have 396 participants, all of whom are at least 18 years old. Participants will be randomly assigned to either the McKenzie method-based self-management approach group or a minimal intervention control group. The primary outcome will be days to first self-reported recurrence of an episode of activity-limiting LBP. The secondary outcomes will include: days to first self-reported recurrence of an episode of LBP, days to first self-reported recurrence of an episode of LBP leading to care seeking, and the impact of LBP over a 12-month period. All participants will be followed up monthly for a minimum of 12 months or until they have a recurrence of activity-limiting LBP. All participants will also be followed-up at 3, 6, 9, and 12 months to assess the impact of back pain, physical activity levels, study program adherence, credibility, and adverse events. Participants and therapists will not be masked to the interventions. To our knowledge, this will be the first large, high-quality randomized controlled trial investigating the effectiveness of a McKenzie method-based self-management approach for preventing recurrences of LBP. If this approach is found to be effective, it will offer a low-cost, simple method for reducing the personal and societal burdens of LBP. © 2017 American Physical Therapy Association

Uterine prolapse prevention in Eastern Nepal

DEFF Research Database (Denmark)

Radl, Christina Mathilde; Rajwar, Ranjita; Aro, Arja R.

2012-01-01

are working well or the attitudes toward them. This paper presents the findings of a qualitative study on primary and secondary prevention of uterine prolapse in Eastern Nepal. Method: The study involved eight focus group discussions with 71 women in six villages of the eastern districts of Siraha and Saptari......: It was found that patriarchy, gender discrimination, and cultural traditions such as early marriage and pregnancy make it difficult for people to discontinue uterine prolapse risk behaviors. Women are aware of risk factors, prevention, and treatment, but are powerless to change their situations. Health...

Secondary cycle water chemistry for 500 MWe pressurised heavy water reactor (PHWR) plant: a case study

International Nuclear Information System (INIS)

Bhandakkar, A.; Subbarao, A.; Agarwal, N.K.

1995-01-01

In turbine and secondary cycle system of 500 MWe PHWR, chemistry of steam and water is controlled in secondary cycle for prevention of corrosion in steam generators (SGs), feedwater system and steam system, scale and deposit formation on heat transfer surfaces and carry-over of solids by steam and deposition on steam turbine blades. Water chemistry of secondary side of SGs and turbine cycle is discussed. (author). 8 refs., 2 tabs., 1 fig

Let's prevent diabetes

DEFF Research Database (Denmark)

Gray, Laura J.; Khunti, Kamlesh; Williams, Sian

2012-01-01

Background: The prevention of type 2 diabetes is a globally recognised health care priority, but there is a lack of rigorous research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. The aim...... of the study is to establish whether a pragmatic structured education programme targeting lifestyle and behaviour change in conjunction with motivational maintenance via the telephone can reduce the incidence of type 2 diabetes in people with impaired glucose regulation (a composite of impaired glucose...... of type 2 diabetes. Secondary outcomes include changes in HbA1c, blood glucose levels, cardiovascular risk, the presence of the Metabolic Syndrome and the cost-effectiveness of the intervention.Methods: The study consists of screening and intervention phases within 44 general practices coordinated from...

Exercise for prevention of cardiovascular disease: Evidence-based recommendations

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Geevar Zachariah

2017-01-01

Full Text Available Sedentary lifestyle is one of the major risk factors for cardiovascular disease (CVD. In India, a large percentage of the people are physically inactive with fewer than 10% engaging in recreational physical activity. Physical activity has many beneficial effects on the risk factors for CVD. Apart from improving fitness level, it decreases myocardial oxygen demand and improves myocardial perfusion. There is an inverse association between physical activity and all-cause mortality. In primary prevention, physical inactivity is associated with a two-fold increase in the risk for coronary events. In secondary prevention, data confirm the existence of an inverse dose–response relationship between cardiovascular fitness and the all-cause mortality in large populations of cardiovascular patients. Guidelines from the American authorities as well as the European Society of Cardiology provide specific recommendations for exercise depending on the clinical setting (primary or secondary prevention of CVD and the patient-specific factors (the patient's physical activity level and the perceived CVD risk. The present review summarizes the clinical evidence regarding the role of exercise in CVD prevention and the exercise recommendations from the leading Cardiac societies.

Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial.

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Odden, Michelle C; McClure, Leslie A; Sawaya, B Peter; White, Carole L; Peralta, Carmen A; Field, Thalia S; Hart, Robert G; Benavente, Oscar R; Pergola, Pablo E

2016-01-01

Studies suggest a J-shaped association between blood pressure and cardiovascular events in the setting of intensive systolic blood pressure control; whether there is a similar association with stroke remains less well established. The Secondary Prevention of Small Subcortical Strokes was a randomized trial to evaluate higher (130-149 mm Hg) versus lower (blood pressure targets in participants with recent lacunar infarcts. We evaluated the association of mean achieved blood pressure, 6 months after randomization, and recurrent stroke, major vascular events, and all-cause mortality. After a mean follow up of 3.7 years, there was a J-shaped association between achieved blood pressure and outcomes; the lowest risk was at ≈124 and 67 mm Hg systolic and diastolic blood pressure, respectively. For example, above a systolic blood pressure of 124 mm Hg, 1 standard deviation higher (11.1 mm Hg) was associated with increased mortality (adjusted hazard ratio: 1.9; 95% confidence interval: 1.4, 2.7), whereas below this level, this relationship was inverted (0.29; 0.10, 0.79), Pblood pressure of 67 mm Hg, a 1 standard deviation higher (8.2 mm Hg) was associated with an increased risk of stroke (2.2; 1.4, 3.6), whereas below this level, the association was in the opposite direction (0.34; 0.13, 0.89), P=0.02 for interaction. The lowest risk of all events occurred at a nadir of ≈120 to 128 mm Hg systolic blood pressure and 65 to 70 mm Hg diastolic blood pressure. Future studies should evaluate the impact of excessive blood pressure reduction, especially in older populations with preexisting vascular disease. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059306. © 2015 American Heart Association, Inc.

Point-of-care cluster randomized trial in stroke secondary prevention using electronic health records.

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Dregan, Alex; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Ashworth, Mark; Charlton, Judith; Wolfe, Charles D A; Rudd, Anthony; Yardley, Lucy; Gulliford, Martin C; Trial Steering Committee

2014-07-01

The aim of this study was to evaluate whether the remote introduction of electronic decision support tools into family practices improves risk factor control after first stroke. This study also aimed to develop methods to implement cluster randomized trials in stroke using electronic health records. Family practices were recruited from the UK Clinical Practice Research Datalink and allocated to intervention and control trial arms by minimization. Remotely installed, electronic decision support tools promoted intensified secondary prevention for 12 months with last measure of systolic blood pressure as the primary outcome. Outcome data from electronic health records were analyzed using marginal models. There were 106 Clinical Practice Research Datalink family practices allocated (intervention, 53; control, 53), with 11 391 (control, 5516; intervention, 5875) participants with acute stroke ever diagnosed. Participants at trial practices had similar characteristics as 47,887 patients with stroke at nontrial practices. During the intervention period, blood pressure values were recorded in the electronic health records for 90% and cholesterol values for 84% of participants. After intervention, the latest mean systolic blood pressure was 131.7 (SD, 16.8) mm Hg in the control trial arm and 131.4 (16.7) mm Hg in the intervention trial arm, and adjusted mean difference was -0.56 mm Hg (95% confidence interval, -1.38 to 0.26; P=0.183). The financial cost of the trial was approximately US $22 per participant, or US $2400 per family practice allocated. Large pragmatic intervention studies may be implemented at low cost by using electronic health records. The intervention used in this trial was not found to be effective, and further research is needed to develop more effective intervention strategies. http://www.controlled-trials.com. Current Controlled Trials identifier: ISRCTN35701810. © 2014 American Heart Association, Inc.

Suicide Prevention Strategies for Improving Population Health.

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Wilcox, Holly C; Wyman, Peter A

2016-04-01

Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means. Copyright © 2016 Elsevier Inc. All rights reserved.

Pressure ulcer prevention and healing using alternating pressure mattress at home: the PARESTRY project.

Science.gov (United States)

Meaume, S; Marty, M

2015-08-01

Specialised pressure-relieving supports reduce or relieve the interface pressure between the skin and the support surface. The comparative effectiveness of dynamic support surfaces is debated. The aim of this study is to examine the impact of using an alternating pressure air mattress (APAM) on pressure ulcer (PU) incidence in patients receiving home-based care. A second aim was to determine the level of patient/family satisfaction with comfort and gain the views of the care team that used the APAM. The PARESTRY study was a prospective observational study conducted in patients with a high risk of PUs (Braden score prevention groups consisted of patients with no PU at baseline who were in bed for at least 20 hours a day. Patients at baseline with a category 3 or 4 PU or a category 1 or 2 PU in association with poor general health or end-of-life status were included in the secondary prevention group. All patients were laid on an APAM. The primary end point was the % of patients with a worsening skin condition in the pressure area (heel, sacrum, ischium) at day 90 or at the end of the study. The primary analysis was done on the full analysis set (patients included with at least a second assessment), using the last observation carried forward technique to handle missing data, at day 90. A 95% confidence interval was calculated. Analysis was performed on 92 patients (30 in primary prevention and 62 in secondary prevention). The average time spent in bed was 22.7 (SD 2.7) hours a day and 22.6 (SD 2.2) hours in the primary and secondary prevention groups, respectively. At baseline, in the secondary group, 77% of patients had a sacral PU, 63% a heel PU, 8% an ischial tuberosity PU and 45% a PU in another area, a number of patients having multiple PUs. In the primary prevention group, 63% (19/30) of patients dropped out of the study (5 were hospitalised, 9 died, 5 other causes). In the secondary prevention group, 61% (38/62) dropped out (7 were hospitalised, 23 died, 8

Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention.

Science.gov (United States)

Bachireddy, Chethan; Bazazi, Alexander R; Kavasery, Ravi; Govindasamy, Sumathi; Kamarulzaman, Adeeba; Altice, Frederick L

2011-07-01

Pre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts. In June 2007, 102 HIV-infected male prisoners within 6 months of community-release were anonymously surveyed in Kota Bharu, Malaysia. Nearly all subjects (95%) met criteria for opioid dependence. Overall, 66% of participants reported sharing needles, and 37% reported unprotected sex in the 30 days prior to incarceration. During this period, 77% reported injection drug use, with 71% injecting daily and 65% injecting more than one substance. Injection of buprenorphine (28%), benzodiazepines (28%) and methamphetamines (49%) was reported. Nearly all (97%) of those reporting unprotected sex did so with someone not known to be HIV-infected. While 51% believed that opioid substitution therapy (OST) would be helpful, only 33% believed they needed it to prevent relapse after prison release. Most participants (70%) expressed interest in learning more about OST. Those reporting the highest injection risks were more likely to believe OST would be helpful (pMalaysia is crucial to reduce community HIV transmission after release. Effectively reducing HIV risk associated with opioid injection will require OST expansion, including social marketing to improve its acceptability and careful monitoring. Access to sterile injection equipment, particularly for non-opioid injectors, and behavioral interventions that reduce sexual risk will also be required. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Trials in the prevention of type 1 diabetes: current and future.

Science.gov (United States)

Wherrett, Diane K

2014-08-01

A major thrust in type 1 diabetes research is stopping the destruction of beta cells that leads to type 1 diabetes. Research over the past 30 years has defined genetic factors and evidence of autoimmunity that have led to the development of robust prediction models in those at high risk for type 1 diabetes. The ability to identify those at risk and the development of new agents and of collaborative research networks has led to multiple trials aimed at preventing beta cell loss. Trials at all stages of beta cell loss have been conducted: primary prevention (prior to the development of autoimmunity); secondary prevention (after autoantibodies are found) and tertiary prevention (intervening after diagnosis to maintain remaining beta cells). Studies have shown mixed results; evidence of maintained insulin secretion after the time of diagnosis has been described in a number of studies, and primary and secondary prevention is proving to be elusive. Much has been learned from the increasing number of studies in the field in terms of network creation, study design and choice of intervention that will facilitate new avenues of investigation. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Stress-Prevention in Secondary Schools: Online- versus Face-to-Face-Training

Science.gov (United States)

Fridrici, Mirko; Lohaus, Arnold

2009-01-01

Purpose: The purpose of this paper is to focus on the evaluation of an internet-delivered stress-prevention program for adolescents as a possible alternative for school-based implementation of mental health promotion. Design/methodology/approach: A total of 904 adolescents in grades eight and nine were assigned to four treatment conditions…

Determinants of Dropout and Nonadherence in a Dementia Prevention Randomized Controlled Trial: The Prevention of Dementia by Intensive Vascular Care Trial

NARCIS (Netherlands)

Beishuizen, Cathrien R. L.; Coley, Nicola; Moll van Charante, Eric P.; van Gool, Willem A.; Richard, Edo; Andrieu, Sandrine

2017-01-01

To explore and compare sociodemographic, clinical, and neuropsychiatric determinants of dropout and nonadherence in older people participating in an open-label cluster-randomized controlled trial-the Prevention of Dementia by Intensive Vascular care (preDIVA) trial-over 6 years. Secondary analysis.

Pressure Ulcer Risk and Prevention Practices in Pediatric Patients: A Secondary Analysis of Data from the National Database of Nursing Quality Indicators®.

Science.gov (United States)

Razmus, Ivy; Bergquist-Beringer, Sandra

2017-01-01

Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status. Extracted data on pressure ulcer prevention included skin assessment, pressure-redistribution surface use, routine repositioning, nutritional support, and moisture management. These data were organized by unit type and merged with data on hospital characteristics for the analysis. The sample included 39 984 patients ages 1 day to 18 years on 678 pediatric acute care units (general pediatrics, pediatric critical care units, neonatal intensive care units, pediatric step-down units, and pediatric rehabilitation units). Descriptive statistics were used to analyze study data. Most of the pediatric patients (33 644; 89.2%) were assessed for pressure ulcer risk within 24 hours of admission. The Braden Q Scale was frequently used to assess risk on general pediatrics units (75.4%), pediatric step-down units (85.5%), pediatric critical care units (81.3%), and pediatric rehabilitation units (56.1%). In the neonatal intensive care units, another scale or method was used more often (55% to 60%) to assess pressure ulcer risk. Of the 11 203 pediatric patients (39%) determined to be at risk for pressure ulcers, the majority (10 741, 95.8%) received some kind of pressure ulcer prevention intervention during the 24 hours preceding the NDNQI pressure ulcer survey. The frequency

Systematic Review of the Effect of Diet and Exercise Lifestyle Interventions in the Secondary Prevention of Coronary Heart Disease

Directory of Open Access Journals (Sweden)

Judith A. Cole

2011-01-01

Full Text Available The effectiveness of lifestyle interventions within secondary prevention of coronary heart disease (CHD remains unclear. This systematic review aimed to determine their effectiveness and included randomized controlled trials of lifestyle interventions, in primary care or community settings, with a minimum follow-up of three months, published since 1990. 21 trials with 10,799 patients were included; the interventions were multifactorial (10, educational (4, psychological (3, dietary (1, organisational (2, and exercise (1. The overall results for modifiable risk factors suggested improvements in dietary and exercise outcomes but no overall effect on smoking outcomes. In trials that examined mortality and morbidity, significant benefits were reported for total mortality (in 4 of 6 trials; overall risk ratio (RR 0.75 (95% confidence intervals (CI 0.65, 0.87, cardiovascular mortality (3 of 8 trials; overall RR 0.63 (95% CI 0.47, 0.84, and nonfatal cardiac events (5 of 9 trials; overall RR 0.68 (95% CI 0.55, 0.84. The heterogeneity between trials and generally poor quality of trials make any concrete conclusions difficult. However, the beneficial effects observed in this review are encouraging and should stimulate further research.

Systematic Review of the Effect of Diet and Exercise Lifestyle Interventions in the Secondary Prevention of Coronary Heart Disease

Science.gov (United States)

Cole, Judith A.; Smith, Susan M.; Hart, Nigel; Cupples, Margaret E.

2011-01-01

The effectiveness of lifestyle interventions within secondary prevention of coronary heart disease (CHD) remains unclear. This systematic review aimed to determine their effectiveness and included randomized controlled trials of lifestyle interventions, in primary care or community settings, with a minimum follow-up of three months, published since 1990. 21 trials with 10,799 patients were included; the interventions were multifactorial (10), educational (4), psychological (3), dietary (1), organisational (2), and exercise (1). The overall results for modifiable risk factors suggested improvements in dietary and exercise outcomes but no overall effect on smoking outcomes. In trials that examined mortality and morbidity, significant benefits were reported for total mortality (in 4 of 6 trials; overall risk ratio (RR) 0.75 (95% confidence intervals (CI) 0.65, 0.87)), cardiovascular mortality (3 of 8 trials; overall RR 0.63 (95% CI 0.47, 0.84)), and nonfatal cardiac events (5 of 9 trials; overall RR 0.68 (95% CI 0.55, 0.84)). The heterogeneity between trials and generally poor quality of trials make any concrete conclusions difficult. However, the beneficial effects observed in this review are encouraging and should stimulate further research. PMID:21197445

STROKE PREVENTION IN INTERNIST PRACTICE

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D. A. Napalkov

2011-01-01

Full Text Available Stroke secondary prevention in internist practice is discussed in accordance with up to date guidelines. Modern pharmacotherapy includes antiaggregants or anticoagulants, statins, and antihypertensive drugs. The choice of drugs is mostly founded on the rules of evidence based medicine, which allow adjusting individual treatment depending on clinical conditions. The composition of perindopril and indapamide is a preferred nowadays combination of antihypertensive drugs.

The role of the accessory pathway radiofrequency catheter ablation in the secondary prevention of the malignant tachyarrhythmias in patients with Wolff-Parkinson-White syndrome

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Mujović Nebojša

2010-01-01

Full Text Available Background/Aim. The occurrence of atrial fibrillation (AF in the presence of an accessory pathway (AP that conducts rapidly is potentially lethal because the rapid ventricular response may lead to ventricular fibrillation (VF. The aim of the study was to determine long-term efficacy of AP catheter-ablation using radiofrequency (RF current in secondary prevention of VF in WPW patients. Methods. Study included a total of 192 symptomatic WPW patients who underwent RF catheter-ablation of AP in our institution from 1994 to 2007 and were available for clinical follow-up for more than 3 months after procedure. Results. Before ablation, VF was recorded in total of 27 patients (14.1%. In 14 of patients (51.9% VF was the first clinical manifestation of WPW syndrome. A total of 35 VF episodes were identified in 27 patients. The occurrence of VF was preceded by physical activity or emotional stress in 17.1% of cases, by alcohol abuse in 2.9% and by inappropriate intravenous drug administration in 28.6%. In addition, no clear precipitating factor was identified in 40% of VF cases, while informations about activities preceding 11.4% of VF episodes were not available. The follow-up of 5.7 ± 3.3 years was obtained in all of 27 VF patients. Of the 20 patients who underwent successful AP ablation, all were alive, without syncope or ventricular tachyarrhythmias during long-term follow-up. In 4 of 7 unsuccessfully treated patients, recurrence of supraventricular tachycardia and/or preexcited atrial fibrillation were recorded; one of these patients suddenly died of VF, 6 years after procedure. Conclusion. In significant proportion of WPW patients, VF was the first clinical manifestation of WPW syndrome, often precipitated by physical activity, emotional stress or inappropriate drug administration. Successful elimination of AP by percutaneous RF catheter-ablation is highly effective in secondary prevention of life-threatening tachyarrhythmias in patients with

Is Some Data Better than No Data at All? Evaluating the Utility of Secondary Needs Assessment Data

Science.gov (United States)

Shamblen, Stephen R.; Dwivedi, Pramod

2010-01-01

Needs assessments in substance abuse prevention often rely on secondary data measures of consumption and consequences to determine what population subgroup and geographic areas should receive a portion of limited resources. Although these secondary data measures have some benefits (e.g. large sample sizes, lack of survey response biases and cost),…

Seasonal nutrient dynamics and biomass quality of giant reed (Arundo donax L. and miscanthus (Miscanthus x giganteus Greef et Deuter as energy crops

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Nicoletta Nassi o Di Nasso

2011-08-01

Full Text Available The importance of energy crops in displacing fossil fuels within the energy sector in Europe is growing. Among energy crops, the use of perennial rhizomatous grasses (PRGs seems promising owing to their high productivity and their nutrient recycling that occurs during senescence. In particular, nutrient requirements and biomass quality have a fundamental relevance to biomass systems efficiency. The objective of our study was to compare giant reed (Arundo donax L. and miscanthus (Miscanthus × giganteus Greef et Deuter in terms of nutrient requirements and cellulose, hemicelluloses and lignin content. This aim was to identify, in the Mediterranean environment, the optimal harvest time that may combine, beside a high biomass yield, high nutrient use efficiency and a good biomass quality for second generation biofuel production. The research was carried out in 2009, in San Piero a Grado, Pisa (Central Italy; latitude 43°41’ N, longitude 10°21’ E, on seven-year-old crops in a loam soil characterised by good water availability. Maximum above-ground nutrient contents were generally found in summer. Subsequently, a decrease was recorded; this suggested a nutrient remobilisation from above-ground biomass to rhizomes. In addition, miscanthus showed the highest N, P, and K use efficiency, probably related to its higher yield and its C4 pathway. Regarding biomass quality, stable values of cellulose (38%, hemicelluloses (25% and lignin (8% were reported from July onwards in both crops. Hence, these components appear not to be discriminative parameters in the choice of the harvest time in the Mediterranean environment. In conclusion, our results highlighted that, in our environment, a broad harvest period (from late autumn to winter seems suitable for these PRGs. However, further research is required to evaluate the role of rhizomes in nutrient storage and supply during the growing season, as well as ecological and productive performances in marginal

Cost-effectiveness of increasing statin adherence for primary and secondary prevention in community pharmacies

NARCIS (Netherlands)

Vegter, S.; Oosterhof, P.; Van Boven, J.F.; Stuurman-Bieze, A.G.G.; Hiddink, E.G.; Postma, M.J.

2013-01-01

Objectives: Therapy persistence is important to achieve optimal clinical benefits of statin therapy. The aim of this study was to determine the cost-effectiveness of pharmaceutical care in community pharmacies, aimed to increase persistence with statin therapy for both primary and secondary

Association between plasma fatty acids and inflammatory markers in patients with and without insulin resistance and in secondary prevention of cardiovascular disease, a cross-sectional study.

Science.gov (United States)

Bersch-Ferreira, Ângela Cristine; Sampaio, Geni Rodrigues; Gehringer, Marcella Omena; Torres, Elizabeth Aparecida Ferraz da Silva; Ross-Fernandes, Maria Beatriz; da Silva, Jacqueline Tereza; Torreglosa, Camila Ragne; Kovacs, Cristiane; Alves, Renata; Magnoni, Carlos Daniel; Weber, Bernardete; Rogero, Marcelo Macedo

2018-02-21

Proinflammatory biomarkers levels are increased among patients with cardiovascular disease, and it is known that both the presence of insulin resistance and diet may influence those levels. However, these associations are not well studied among patients with established cardiovascular disease. Our objective is to compare inflammatory biomarker levels among cardiovascular disease secondary prevention patients with and without insulin resistance, and to evaluate if there is any association between plasma fatty acid levels and inflammatory biomarker levels among them. In this cross-sectional sub-study from the BALANCE Program Trial, we collected data from 359 patients with established cardiovascular disease. Plasma fatty acids and inflammatory biomarkers (interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12, high sensitive C-reactive protein (hs-CRP), adiponectin, and tumor necrosis factor (TNF)-alpha) were measured. Biomarkers and plasma fatty acid levels of subjects across insulin resistant and not insulin resistant groups were compared, and general linear models were used to examine the association between plasma fatty acids and inflammatory biomarkers. Subjects with insulin resistance had a higher concentration of hs-CRP (p = 0.002) and IL-6 (p = 0.002) than subjects without insulin resistance. Among subjects without insulin resistance there was a positive association between stearic fatty acid and IL-6 (p = 0.032), and a negative association between alpha-linolenic fatty acid and pro-inflammatory biomarkers (p fatty acids and arachidonic fatty acid and adiponectin (p fatty acids and pro-inflammatory biomarkers (p fatty acids and adiponectin (p fatty acids. Subjects in secondary prevention for cardiovascular disease with insulin resistance have a higher concentration of hs-CRP and IL-6 than individuals without insulin resistance, and these inflammatory biomarkers are positively associated with saturated fatty acids and negatively associated with

Secondary arterial hypertension: when, who, and how to screen?

Science.gov (United States)

Rimoldi, Stefano F; Scherrer, Urs; Messerli, Franz H

2014-05-14

Secondary hypertension refers to arterial hypertension due to an identifiable cause and affects ∼5-10% of the general hypertensive population. Because secondary forms are rare and work up is time-consuming and expensive, only patients with clinical suspicion should be screened. In recent years, some new aspects gained importance regarding this screening. In particular, increasing evidence suggests that 24 h ambulatory blood pressure (BP) monitoring plays a central role in the work up of patients with suspected secondary hypertension. Moreover, obstructive sleep apnoea has been identified as one of the most frequent causes. Finally, the introduction of catheter-based renal denervation for the treatment of patients with resistant hypertension has dramatically increased the interest and the number of patients evaluated for renal artery stenosis. We review the clinical clues of the most common causes of secondary hypertension. Specific recommendations are given as to evaluation and treatment of various forms of secondary hypertension. Despite appropriate therapy or even removal of the secondary cause, BP rarely ever returns to normal with long-term follow-up. Such residue hypertension indicates either that some patients with secondary hypertension also have concomitant essential hypertension or that irreversible vascular remodelling has taken place. Thus, in patients with potentially reversible causes of hypertension, early detection and treatment are important to minimize/prevent irreversible changes in the vasculature and target organs. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.

Secondary Hypertension

Science.gov (United States)

Secondary hypertension Overview Secondary hypertension (secondary high blood pressure) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, ...

Secondary Channel Bifurcation Geometry: A Multi-dimensional Problem

Science.gov (United States)

Gaeuman, D.; Stewart, R. L.

2017-12-01

The construction of secondary channels (or side channels) is a popular strategy for increasing aquatic habitat complexity in managed rivers. Such channels, however, frequently experience aggradation that prevents surface water from entering the side channels near their bifurcation points during periods of relatively low discharge. This failure to maintain an uninterrupted surface water connection with the main channel can reduce the habitat value of side channels for fish species that prefer lotic conditions. Various factors have been proposed as potential controls on the fate of side channels, including water surface slope differences between the main and secondary channels, the presence of main channel secondary circulation, transverse bed slopes, and bifurcation angle. A quantitative assessment of more than 50 natural and constructed secondary channels in the Trinity River of northern California indicates that bifurcations can assume a variety of configurations that are formed by different processes and whose longevity is governed by different sets of factors. Moreover, factors such as bifurcation angle and water surface slope vary with discharge level and are continuously distributed in space, such that they must be viewed as a multi-dimensional field rather than a single-valued attribute that can be assigned to a particular bifurcation.

Early secondary alveoloplasty in cleft lip and palate.

Science.gov (United States)

Arangio, Paolo; Marianetti, Tito M; Tedaldi, Massimiliano; Ramieri, Valerio; Cascone, Piero

2008-09-01

The aims of this study were to present a personal surgical technique throughout the review of international literature concerning surgical techniques, objectives, and outcomes in early secondary alveoloplasty and to describe our personal surgical techniques in alveolar bone defect repair in cleft lip and palate.Throughout a literature analysis, it is now settled that early secondary alveoloplasty could reestablish the continuity of alveolar bone and prevent upper dental arch collapse after presurgical orthopedic upper maxilla expansion; it also might give a good bone support for teeth facing the cleft and allow the eruption of permanent elements with the bone graft and rebalance the symmetry of dental arch, improve facial aesthetic, guarantee an adequate amount of bone tissue for a further prosthetic reconstruction with implant, and finally close the eventual oronasal fistula.The surgical technique we are presenting permitted a total number of 35 early secondary alveoloplasty on which a long-term follow-up is still taking place.We can assess that early secondary alveoloplasty must be performed before permanent canine eruption. Iliac crest is the suggested donor site for bone grafting; orthopedic and orthodontic treatments must be performed in association with surgery, and if there is the dental element agenesia, an implantation treatment must be considered.

Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions

OpenAIRE

Kotseva, Kornelia; De Bacquer, Dirk; De Backer, Guy; Ryden, Lars; Jennings, Catriona; Gyberg, Viveca; Abreu, Ana; Aguiar, Carlos; Conde, Almudena C.; Davletov, Kairat; Dilic, Mirza; Dolzhenko, Maryna; Gaita, Dan; Georgiev, Borislav; Gotcheva, Nina

2016-01-01

BACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practi...

Shoot growth, radiation interception and dry matter production and partitioning during the establishment phase of Miscanthus sinensis 'Giganteus' grown at two densities in the UK

International Nuclear Information System (INIS)

Bullard, M.J.; Heath, M.C.; Nixon, P.M.I.

1995-01-01

Photosynthetic area index (PAI), radiation interception (I) and dry matter partitioning between shoots and roots were measured for Miscanthus sinensis‘Giganteus' grown from micro-propagated transplants on a fertile peaty loam soil in eastern England. In the establishment year, Miscanthus plants produced 35 and 70 shoots plant -1 at densities of 4.0 and 1.8 plants m -2 respectively. At the higher density, there were 140 shoots m -2 with the largest reaching a height of 1.8 m; these canopies attained a maximum PAI of 5.45, intercepting 94% of incident radiation. Leaf lamina contributed c. 90% of total photosynthetic area with stems contributing the remainder. At the lower density, maximum PAI and I values were 2.88 and 86% respectively. PAI was related to I by calculating attenuation coefficients (k); these indicated that Miscanthus canopies were more effective at intercepting radiation per unit PAI at the lower density (k= -0.31) compared with the higher density (k= -0.20). Radiation interception was related to dry matter accumulated by calculating conversion efficiencies (e). At 4 plants m -2 , × for shoot dry matter production was 1.17g MJ -1 . Miscanthus partitioned a relatively large amount of total dry matter into below-ground biomass. By plant senescence, c. 30% of total dry matter had been partitioned into root and rhizome; rhizome biomass contributed 80% of below-ground dry matter, × increased to 1.62 g MJ -1 when calculated on a total dry matter basis (shoot + root + rhizome). Total dry matter production was increased 68% by a 2.2-fold increase in plant density. (author)

Preventing Child Behavior Problems in the Erlangen-Nuremberg Development and Prevention Study: Results from Preschool to Secondary School Age

Directory of Open Access Journals (Sweden)

Friedrich Lösel

2012-12-01

Full Text Available A brief overview of the prevention part of the long-term Erlangen-Nuremberg Development and Prevention Study, which combines a prospective longitudinal and experimental design. Findings up to five years after intervention are reported. From a sample of 609 families with kindergarten children, subgroups participated in the universal prevention program EFFEKT (child social skills training, a parent training and a combination of both or were assigned to equivalent control groups. The short-term evaluation showed significant effects in mediating constructs (social problem solving and parenting behavior and in educators’ratings of children’s social behavior. In a follow-up after two to three years, school report cards showed fewer children with multiple behavior problems. In a further follow up after four to five years program children reported fewer externalizing and internalizing problems than the control group. There were no significant effects in the mothers’ reports on their children’s behavior. Most significant effect sizes ranged between d = 0.20 and d = 0.40. The findings suggest various positive long-term effects of the intervention. However, one need to be cautious with regard to over-generalizing the positive findings, because effectsizes vary over time and the positive findings could not be replicated in all investigated variables.

Oil in the FFTF secondary loop cover gas piping. Final unusual occurrence report

International Nuclear Information System (INIS)

Kuechle, J.D.

1981-01-01

The final unusual occurrence report describes the discovery of oil in the FFTF secondary sodium system cover gas piping. A thorough evaluation has been performed and corrective actions have been implemented to prevent a recurrence of this event

Vaccination in secondary school students expedites rubella control and prevents congenital rubella syndrome.

Science.gov (United States)

He, Hanqing; Yan, Rui; Tang, Xuewen; Zhou, Yang; Deng, Xuan; Xie, Shuyun

2016-11-30

In order to control the spread of rubella and reduce the risk for congenital rubella syndrome, an additional rubella vaccination program was set up for all secondary school students since 2008 in Zhejiang, China. We conducted a descriptive analysis of rubella incidence among different age groups from 2005 to 2015 and a serosurvey of female subjects aged 15-39 years to understand the possible effects of this immunization program. The average annual rubella incidence rate had decreased from 15.86 per 100,000 population (2005-2007) to 0.75 per 100,000 population (2013-2015) in Zhejiang. The decrease in the rate of rubella incidence in girls aged 15-19 years was more accelerated (from 138.30 to 0.34 per 100,000) than in the total population during 2008-2015 (from 32.20 to 0.46 per 100,000). Of 1225 female subjects in the serosurvey, 256 (20.9%) were not immune to rubella. The proportion of subjects immune to rubella was significantly different among different age groups (Wald χ2 = 22.19, p = 0.000), and subjects aged 15-19 years old had the highest immunity (88.0%). Rubella antibody levels were significantly lower in women aged 25-30 years with 26.7% of them not immune, followed by the group aged 20-24 years (25.0%) and 30-35 years (24.5%). Rubella vaccine included in the Expanded Program on Immunization together with vaccination activities for secondary school students can help in rubella control, particularly in targeted age groups in the program. Seroprevalence of antibodies to the rubella virus amongst the female population within childbearing age in Zhejiang, China, is still too low to provide immunity. In addition to vaccination programs in the secondary schools, rubella vaccination should also be encouraged in women of childbearing age, which can be done effectively combined with pre-marital examination in China.

Secondary traumatic stress among emergency nurses: a cross-sectional study.

Science.gov (United States)

Duffy, Emer; Avalos, Gloria; Dowling, Maura

2015-04-01

Emergency department nurses are required to deal with emotional trauma issues on a daily basis, which may result in them experiencing symptoms of secondary traumatic stress, a consequence of stress experienced when helping or wanting to help a person traumatised or suffering. This study measured emergency department nurses' self-reported levels of secondary traumatic stress. Registered nurses (n = 117) working at three emergency departments in the Western geographical region of Ireland were invited to complete the secondary traumatic stress scale (STSS). A response rate of 90% (n = 105) was achieved. Most participants (n = 67/64%) met the criteria for secondary traumatic stress. A statistically significant finding was that the highest proportion (82%) of secondary traumatic stress existed in the staff nurse group (p = 0.042). Moreover, for those nurses reporting secondary traumatic stress, statistical significance was found for the variables 'change of career considered' (p = 0.017) and 'finds alcohol helpful in alleviating work-related stress' (p = 0.004), when compared with nurses not reporting secondary traumatic stress. The findings suggest the need to examine current crisis management interventions and to introduce new systems to support nurses in Irish emergency departments. Moreover, because different types of traumatic events in the ED require different types of interventions, the prevention and management of STS among emergency department nurses must be tackled using a variety of approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

Collaborative Knowledge-Making in the Everyday Practice of Youth Suicide Prevention Education

Science.gov (United States)

White, Jennifer; Morris, Jonathan; Hinbest, Jerry

2012-01-01

The development and implementation of a new school-based suicide prevention education programme in one secondary school in Vancouver, British Columbia, recently provided us with an opportunity to conduct an in-depth, qualitative case study. The purpose of our study was to deepen our understanding of how school-based suicide prevention education…

Systematic review: primary and secondary prevention of gastrointestinal cancers with antioxidant supplements

DEFF Research Database (Denmark)

Bjelakovic, G.; Nikolova, D.; Simonetti, R.G.

2008-01-01

BACKGROUND: The evidence on whether antioxidant supplements prevent gastrointestinal cancers is contradictory. AIM: To assess the beneficial and harmful effects of antioxidant supplements in preventing gastrointestinal cancers. METHODS: Using the Cochrane Collaboration methodology, we reviewed...... the randomized trials comparing antioxidant supplements with placebo or no intervention on the occurrence of gastrointestinal cancers. We searched electronic databases and reference lists until October, 2007. Our outcome measures were gastrointestinal cancers, overall mortality and adverse events. Outcomes were....... The antioxidant supplements were without a significant effect on the occurrence of gastrointestinal cancers (RR 0.94, 95% CI 0.83-1.06, I(2) = 54.0%). The heterogeneity seemed to be explained by bias risk (low-bias risk trials RR 1.04, 95% CI 0.96-1.13 compared to high-bias risk trials RR 0.59, 95% CI 0...

Development and feasibility of falls prevention advice.

Science.gov (United States)

van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth

2011-10-01

This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

ANTITHROMBOCYTIC THERAPY IN THE SECONDARY PREVENTION OF ISCHEMIC STROKE

Directory of Open Access Journals (Sweden)

Andrey Viktorovich Fonyakin

2009-01-01

Full Text Available Approaches to preventing recurrent stroke by antithrombocytic therapy are shown to be as diverse as its causes. The diagnosis of cardioembolic stroke in patients with atrial fibrillation should not limit the choice of an antithrombocytic agent to only oral (indirect anticoagulants (OAC. If OAC cannot be used, antithrombocytic therapy, including combined (clopidogrel + ASA one, may be considered as a reasonable alternative. Approaches to choosing the optimal antithrombocytic drug in noncardioembolic strokes are intricate since atherosclerosis is a systemic vascular disease and the poststroke period is characterized by a higher risk for not only recurrent stroke, but also for coronary catastrophes. It is concluded that an antithrombocytic agent should be chosen, by taking into account the multifocality of atherosclerosis, associated clinical conditions, diabetes mellitus, intravascular interventions and the individual risk of all cardiovascular events.

Evidence-based integrated environmental solutions for secondary lead smelters: Pollution prevention and waste minimization technologies and practices

Energy Technology Data Exchange (ETDEWEB)

Genaidy, A.M., E-mail: world_tek_inc@yahoo.com [University of Cincinnati, Cincinnati, Ohio (United States); Sequeira, R. [University of Cincinnati, Cincinnati, Ohio (United States); Tolaymat, T. [U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, Ohio (United States); Kohler, J. [US Environmental Protection Agency, Office of Solid Waste and Emergency Response, Washington DC (United States); Rinder, M. [WorldTek Inc, Cincinnati (United States)

2009-05-01

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO2 and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

Evidence-based integrated environmental solutions for secondary lead smelters: pollution prevention and waste minimization technologies and practices.

Science.gov (United States)

Genaidy, A M; Sequeira, R; Tolaymat, T; Kohler, J; Rinder, M

2009-05-01

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO(2) and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

Preventing childhood obesity: the sentinel site for obesity prevention in Victoria, Australia.

Science.gov (United States)

Bell, A Colin; Simmons, Anne; Sanigorski, Andrea M; Kremer, Peter J; Swinburn, Boyd A

2008-12-01

In spite of greater awareness of the need for action to reduce obesity, the evidence on sustainable community approaches to prevent childhood and adolescent obesity is surprisingly sparse. This paper describes the design and methodological components of the Sentinel Site for Obesity Prevention, a demonstration site in the Barwon-South West region of Victoria, Australia, that aims to build the programs, skills and evidence necessary to attenuate and eventually reverse the obesity epidemic in children and adolescents. The Sentinel Site for Obesity Prevention is based on a partnership between the region's university (Deakin University) and its health, education and local government agencies. The three basic foundations of the Sentinel Site are: multi-strategy, multi-setting interventions; building community capacity; and undertaking program evaluations and population monitoring. Three intervention projects have been supported that cover different age groups (preschool: 2-5 years, primary school: 5-12 years, secondary school: 13-17 years), but that have many characteristics in common including: community participation and ownership of the project; an intervention duration of at least 3 years; and full evaluations with impact (behaviours) and outcome measures (anthropometry) compared with regionally representative comparison populations. We recommend the Sentinel Site approach to others for successfully building evidence for childhood obesity prevention and stimulating action on reducing the epidemic.

Efficiency or equity? Simulating the impact of high-risk and population intervention strategies for the prevention of disease

Directory of Open Access Journals (Sweden)

Jonathan M. Platt

2017-12-01

Full Text Available Maximizing both efficiency and equity are core considerations for population health. These considerations can result in tension in population health science as we seek to improve overall population health while achieving equitable health distributions within populations. Limited work has explored empirically the consequences of different population health intervention strategies on the burden of disease and on within- and between-group differences in disease. To address this gap, we compared the impact of four simulated interventions using data from the National Health and Nutrition Examination Survey. In particular, we focus on assessing how population and high-risk primary prevention and population and high-risk secondary interventions efforts to reduce smoking behavior influence systolic blood pressure (SBP and hypertension, and how such strategies influence inequalities in SBP by income. The greatest reductions in SBP mean and standard deviation resulted from the population secondary prevention. High-risk primary and secondary prevention and population secondary prevention programs all yielded substantial reductions in hypertension prevalence. The effect of population primary prevention did little to decrease population SBP mean and standard deviation, as well as hypertension prevalence. Both high-risk strategies had a larger impact in the low-income population, leading to the greatest narrowing the income-related gap in disease. The population prevention strategies had a larger impact in the high-income population. Population health approaches must consider the potential impact on both the whole population and also on those with different levels of risk for disease within a population, including those in under-represented or under-served groups.

[Consequence of secondary complications during the rehabilitation of patients with severe brain injury].

Science.gov (United States)

Dénes, Zoltán

2009-01-25

Recovery from brain injury is not only determined by the primary injury, but a very important element is the development of secondary complications which have a major role in determining the possibility of the achievement of available maximal functional abilities and the quality of life of the patients and their family after rehabilitation. This is why during medical treatment the prevention of secondary complications is at least as important as the prevention of primary injury. Determination of the most important secondary complications after severe brain injury, and observation of these effects on the rehabilitation process. Retrospective study in the Brain Injury Rehabilitation unit of the National Institute for Medical Rehabilitation in Hungary. 166 patients were treated with brain injury; the mean age of the patients was 33 (8-83) years in 2004. The majority of patients suffered traumatic brain injury in traffic accidents (125/166), while the rest of them through falls or acts of violence. Sixty-four patients were admitted directly from an intensive care unit, 18 from a second hospital ward (traumatology, neurosurgery or neurology) and the rest of the patients were treated in several different units before they were admitted for rehabilitation. The time that has elapsed between injury and rehabilitation admission was 50 days (21-177). At the time of admission 27 patients were in a vegetative state, 38 patients in a minimal conscious state, and 101 patients had already regained consciousness. 83 patients were hemiparetic, 54 presented tetraparesis, and 1 paraparesis, but 28 patients were not paretic. The most frequent complications in patients with severe brain injury at admission in our rehabilitation unit were: contractures (47%), pressure sores (35%), respiratory (14%) and urinary (11%) tract infections, malnutrition (20%). The functional outcome was worse in the cases arriving with secondary complications during the same rehabilitation period. The length of

Inspection of secondary cooling system piping of JMTR

International Nuclear Information System (INIS)

Hanawa, Yoshio; Izumo, Hironobu; Fukasaku, Akitomi; Nagao, Yoshiharu; Kawamura, Hiroshi

2008-06-01

Piping condition was inspected form the view point of long term utilization before the renewal work of the secondary cooling system in the JMTR on FY 2008. As the result, it was confirmed that cracks, swellings and exfoliations in inner lining of the piping could be observed, and corrosion, which was reached by piping ingot, or decrease of piping thickness could hardly be observed. It was therefore confirmed that the strength or the functionality of the piping had been maintained by usual operation and maintenance. Repair of inner lining of the piping during the refurbishment of the JMTR is necessary to long term utilization of the secondary cooling system after restart of the JMTR from the view point of preventive maintenance. In addition, a periodic inspection of inner lining condition is necessary after repair of the piping. (author)

Pleiotropic effects of statins in stroke prevention

Directory of Open Access Journals (Sweden)

Yenny Yenny

2016-02-01

Full Text Available Cardiovascular disease is the leading cause of death and disability, and  contributes substantially to healthcare budgets. The lipid-lowering drugs, 3-hydroxy-3-methylgulutaryl-coenzyme A (HMG-CoA reductase inhibitor or statins, reducing mortality and cardiovascular morbidity in patients with established cardiovascular disease. Statins therefore have a place in the secondary prevention of cardiovascular disease. Recent experimental and clinical studies suggest that statins may exert vascular protective effect beyond cholesterol reduction. The cholesterol-independet or “pleiotropic” effects of statin include the upregulation and activation of endothelial nitric acid synthase (eNOS that can increase nitric oxide (NO production. Augmentation of NO production increases cerebral blood flow, which can lead to neuroprotection during brain ischaemia. By inhibiting mevalonate synthesis, statins prevent the formation of several isoprenoids (including farnesylpyrophosphate and geranylgeranylpyrophosphate. Inhibiting geranylgeranylation of RhoA small G proteins increases the stability of eNOS mRNA through the remodeling of endothelial actin microfilamens. Moreover, statins directly increase eNOS activity within minutes by activating the pathway involving phosphoinositide 3-kinase and protein kinase B. In the secondary prevention of stroke, the use of statins reduces the incidence of either recurrent stroke or other major vascular events and treatment should be initiated soon after the event. The use of statins does not increase hemorrhagic stroke or cancer and may also favor atherosclerotic plaque regression.

Pleiotropic effects of statins in stroke prevention

Directory of Open Access Journals (Sweden)

Yenny

2009-08-01

Full Text Available Cardiovascular disease is the leading cause of death and disability, and contributes substantially to healthcare budgets. The lipid-lowering drugs, 3-hydroxy-3-methylgulutaryl-coenzyme A (HMG-CoA reductase inhibitor or statins, reducing mortality and cardiovascular morbidity in patients with established cardiovascular disease. Statins therefore have a place in the secondary prevention of cardiovascular disease. Recent experimental and clinical studies suggest that statins may exert vascular protective effect beyond cholesterol reduction. The cholesterol-independet or “pleiotropic” effects of statin include the upregulation and activation of endothelial nitric acid synthase (eNOS that can increase nitric oxide (NO production. Augmentation of NO production increases cerebral blood flow, which can lead to neuroprotection during brain ischaemia. By inhibiting mevalonate synthesis, statins prevent the formation of several isoprenoids (including farnesylpyrophosphate and geranylgeranylpyrophosphate. Inhibiting geranylgeranylation of RhoA small G proteins increases the stability of eNOS mRNA through the remodeling of endothelial actin microfilamens. Moreover, statins directly increase eNOS activity within minutes by activating the pathway involving phosphoinositide 3-kinase and protein kinase B. In the secondary prevention of stroke, the use of statins reduces the incidence of either recurrent stroke or other major vascular events and treatment should be initiated soon after the event. The use of statins does not increase hemorrhagic stroke or cancer and may also favor atherosclerotic plaque regression.

Low temperature leaf photosynthesis of a Miscanthus germplasm collection correlates positively to shoot growth rate and specific leaf area

DEFF Research Database (Denmark)

Jiao, Xiurong; Sørensen, Kirsten Kørup; Andersen, Mathias Neumann

2016-01-01

and CO2 response curves were obtained from 11 of the genotypes, and shoot growth rate was measured under field conditions. Key Results A positive linear relationship was found between SLA and light-saturated photosynthesis (Asat) across genotypes, and also between shoot growth rate under cool field...... conditions and A1000 at 14 °C in a climate chamber. When lowering the temperature from 24 to 14 °C, one M. sacchariflorus exhibited significantly higher Asat and maximum photosynthetic rate in the CO2 response curve (Vmax) than other genotypes at 14 °C, except M. × giganteus ‘Hornum’. Several genotypes...... returned to their pre-chilling A1000 values when the temperature was increased to 24 °C after 24 d growth at 14 °C. Conclusions One M. sacchariflorus genotype had similar or higher photosynthetic capacity than M. × giganteus, and may be used for cultivation together with M. × giganteus or for breeding new...

Influenza vaccines for preventing cardiovascular disease

OpenAIRE

Clar,Christine; Oseni,Zainab; Flowers,Nadine; Keshtkar-Jahromi,Maryam; Rees,Karen

2015-01-01

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 Coch...

[Review of the approach to exercise behavior modification from the viewpoint of preventive medicine].

Science.gov (United States)

Nomura, Takuo; Kouta, Munetsugu; Shigemori, Kenta; Yoshimoto, Yoshinobu; Sato, Atsushi

2008-05-01

The purpose of this study was to summarize the approaches to behavior modification for exercise from the viewpoint of preventive medicine. Articles were searched according to the particular field of preventive medicine, i.e., primary prevention, secondary prevention, tertiary prevention, and other fields of prevention. In the field of primary prevention for elderly people living at home, many fall prevention programs were found to have been carried out. In these studies, various programs were found to be effective if the exercise proved to be sufficient. Although some approaches were observed to be based on the productive aging theory and social capital, the number of such studies was small. In the field of secondary prevention, illness and functional disorders are prevented from becoming worse. It is therefore important for each individual to exercise by himself/herself and also acquire sufficient self-monitoring skills. Social capital is useful for learning good exercise habits. In the field of tertiary prevention, although exercise therapy is effective for improving physical functions and preventing disease recurrence in patients with chronic disease, some patients nevertheless find it difficult to continue such an exercise therapy. The approaches to behavior modification were extremely effective for patients with chronic disease. In other fields of preventive medicine, daily exercises such stair climbing are effective methods for reducing the risk of chronic disease and such a behavior modification may lead to a considerable public health gain. In the future, further studies with a many lines of evidence should be performed, and approaches based on behavioral science should be established.

Can we prevent OA? Epidemiology and public health insights and implications.

Science.gov (United States)

Runhaar, Jos; Zhang, Yuqing

2018-05-01

This narrative review discusses the potential of prevention of OA in different stages of the disease. The theoretical background for primary prevention (i.e. prevention of occurrence of definite structural or clinical OA in subjects free of the disease) and secondary prevention (i.e. prevention of progression of the disease in subjects with pre-clinical pathological changes to the joint) is provided and evidence for effective strategies is discussed. Since direct evidence for the prevention of OA development and progression is scarce, indirect evidence enhancing our current knowledge on the potential of OA prevention is additionally discussed. Also, implications of preventive strategies for study design and public health are considered. Prevention of OA has great potential, but as deliberated in the current review, there are still large gaps in our current knowledge and the implications of preventive strategies for the development and progression of OA require consideration.

Secondary Conditions Among Males With Duchenne or Becker Muscular Dystrophy.

Science.gov (United States)

Latimer, Rebecca; Street, Natalie; Conway, Kristin Caspers; James, Kathy; Cunniff, Christopher; Oleszek, Joyce; Fox, Deborah; Ciafaloni, Emma; Westfield, Christina; Paramsothy, Pangaja

2017-06-01

Duchenne and Becker muscular dystrophy are X-linked neuromuscular disorders characterized by progressive muscle degeneration. Despite the involvement of multiple systems, secondary conditions among affected males have not been comprehensively described. Two hundred nine caregivers of affected males (aged 3-31 years) identified by the Muscular Dystrophy Surveillance, Tracking, and Research Network completed a mailed survey that included questions about secondary conditions impacting multiple body functions. The 5 most commonly reported conditions in males with Duchenne were cognitive deficits (38.4%), constipation (31.7%), anxiety (29.3%), depression (27.4%), and obesity (19.5%). Higher frequencies of anxiety, depression, and kidney stones were found among nonambulatory males compared to ambulatory males. Attention-deficit hyperactivity disorder (ADHD) was more common in ambulatory than nonambulatory males. These data support clinical care recommendations for monitoring of patients with Duchenne or Becker muscular dystrophy by a multidisciplinary team to prevent and treat conditions that may be secondary to the diagnosis.

Obesity among secondary school students in Bahrain.

Science.gov (United States)

Musaiger, A O; Matter, A M; Alekri, S A; Mahdi, A R

1993-01-01

The aim of this study is to estimate the prevalence of obesity and factors associated with it in Bahraini secondary school students. A cross-sectional study involving a sample of 825 students (417 boys and 408 girls) aged 15 to 21 years was obtained from secondary schools. Obesity was determined using body mass index (BMI = Wt/Ht2). The findings revealed that 15.6% of boys and 17.4% of girls were either overweight or obese (BMI > or = 25). Family size, parents education, and family history of obesity were significantly associated with obesity among boys, while family history was the only socio-economic factors statistically associated with obesity among girls. Meal patterns such as eating between meals, number of meals per day, and method of eating were not associated with obesity in students. Boys who ate alone were 3 times more likely to be obese than those who ate with family members (odd ratio = 3.4). Measures to prevent and control obesity among children are suggested.

Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

Directory of Open Access Journals (Sweden)

Joshua Byrnes

Full Text Available The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]. This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most.

[Secondary hypertension].

Science.gov (United States)

Yoshida, Yuichi; Shibata, Hirotaka

2015-11-01

Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice.

Neurological presentations of a secondary antiphospholipid syndrome

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Yesaulenko I.E.

2017-03-01

Full Text Available The aim of the study is to turn the attention of specialists to antiphospholipid syndrome (APS, which is of interest to physicians of many specialties. The observation of the patient W., 32 years, with secondary APS was analyzed. Poor prognostic factors in CFA are the high frequency of thrombotic complications and thrombocytopenia, and laboratory markers — the presence of lupus anticoagulant. All patients with APS should be under medical supervision, whose main task is to assess the risk of recurrence of venous or arterial thrombosis and its prevention.

Diuretics, calciuria and secondary hyperparathyroidism in the Chronic Renal Insufficiency Cohort

Science.gov (United States)

Isakova, Tamara; Anderson, Cheryl A. M.; Leonard, Mary B.; Xie, Dawei; Gutiérrez, Orlando M.; Rosen, Leigh K.; Theurer, Jacquie; Bellovich, Keith; Steigerwalt, Susan P.; Tang, Ignatius; Anderson, Amanda Hyre; Townsend, Raymond R.; He, Jiang; Feldman, Harold I.; Wolf, Myles

2011-01-01

Background. Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD) that is associated with bone disease, cardiovascular disease and death. Pathophysiological factors that maintain secondary hyperparathyroidism in advanced CKD are well-known, but early mechanisms of the disease that can be targeted for its primary prevention are poorly understood. Diuretics are widely used to control volume status and blood pressure in CKD patients but are also known to have important effects on renal calcium handling, which we hypothesized could alter the risk of secondary hyperparathyroidism. Methods. We examined the relationship of diuretic treatment with urinary calcium excretion, parathyroid hormone (PTH) levels and prevalence of secondary hyperparathyroidism (PTH ≥ 65 pg/mL) in a cross-sectional study of 3616 CKD patients in the Chronic Renal Insufficiency Cohort. Results. Compared with no diuretics, treatment with loop diuretics was independently associated with higher adjusted urinary calcium (55.0 versus 39.6 mg/day; P secondary hyperparathyroidism (odds ratio 2.1; 95% CI 1.7–2.6). Thiazide monotherapy was associated with lower calciuria (25.5 versus 39.6 mg/day; P hyperparathyroidism (odds ratio 1.3 versus 2.1; P for interaction = 0.05) compared with loop diuretics alone. Conclusions. Loop diuretic use was associated with greater calciuria, PTH levels and odds of secondary hyperparathyroidism compared to no treatment. These associations were attenuated in patients who were coadministered thiazides. Diuretic choice is a potentially modifiable determinant of secondary hyperparathyroidism in CKD. PMID:21382989

Using Information and Communication Technologies to Prevent Suicide Among Secondary School Students in Two Regions of Chile: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Franco Mascayano

2018-06-01

Full Text Available Background: There is an increasing concern for addressing suicide among adolescents in Latin America. Recent mental health policies encourage the development and implementation of preventive interventions for suicide. Such initiatives, however, have been scarcely developed, even in countries with solid mental health services such as Chile. The use of information and communications technology (ICT might contribute to create accessible, engaging, and innovative platforms to promote well-being and support for adolescents with mental health needs and suicide risk.Objective: To evaluate a program based on ICT to prevent suicide and enhance mental health among adolescents in Chile. Method: A cluster randomized controlled trial (RCT will be conducted including 428 high-school students aged 18–14 years in two regions of Chile. Study procedures will take place as follows: (1 design of the intervention model and creation of prototype; (2 selection and randomization of the participating public schools; (3 implementation of the 3-month intervention and evaluation at baseline, post-intervention period, and a 2-month follow-up. Suicidal ideation at the 2-month follow up is the primary outcome in this study. Secondary outcomes include negative psychological outcomes (e.g., stigma, depression, anxiety as well as a number of protective psychological and social factors. Indicators regarding the study implementation will be also gathered. Discussion: Here we describe a novel program based on technological devices and aimed to target youth suicide in Chile. This is the first clinical trial of such a program in Latin America, and to our knowledge, the first of its kind in any middle income country.Trial Registration: gov Identifier: NCT03514004

[Primary and secondary prevention of urinary tract infections].

Science.gov (United States)

Wagenlehner, F M E; Vahlensieck, W; Bauer, H W; Weidner, W; Naber, K G; Piechota, H J

2011-10-01

Urinary tract infections (UTI) are among the most frequent bacterial infections in the community and health care setting. Mostly young and, to some extent, postmenopausal women are affected by recurrent UTI (rUTI) defined as ≥3 UTI/year. On the other hand rUTI are frequently found in patients with complicating urological factors, e.g. urinary catheters. Modifiable predisposing factors in uncomplicated rUTI in women are rare. Continuous antibiotic prophylaxis or postcoital prophylaxis, if there is close correlation with sexual intercourse, are most effective to prevent rUTI. Nitrofurantoin, trimethoprim (or cotrimoxazole), and fosfomycin trometamol are available as first-line drugs. Oral cephalosporins and quinolones should be restricted to specific indications. Antibiotic prophylaxis reduces the number of uropathogens in the gut and/or vaginal flora and reduces bacterial"fitness". Given the correct indication, the recurrence rate of rUTI can be reduced by about 90%. In postmenopausal patients vaginal substitution of oestriol should be started first. Oral or parenteral immunoprophylaxis is another option in patients with rUTI. Other possibilities with varying scientific evidence are prophylaxis with cranberries or probiotics. The prophylaxis of catheter-associated UTI or asymptomatic bacteriuria should employ strategies which result in a reduction of frequency and duration of catheter drainage of the urinary tract. The currently available catheter materials have only little influence on reducing catheter-associated rUTI.

Diuretics, calciuria and secondary hyperparathyroidism in the Chronic Renal Insufficiency Cohort.

Science.gov (United States)

Isakova, Tamara; Anderson, Cheryl A M; Leonard, Mary B; Xie, Dawei; Gutiérrez, Orlando M; Rosen, Leigh K; Theurer, Jacquie; Bellovich, Keith; Steigerwalt, Susan P; Tang, Ignatius; Anderson, Amanda Hyre; Townsend, Raymond R; He, Jiang; Feldman, Harold I; Wolf, Myles

2011-04-01

Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD) that is associated with bone disease, cardiovascular disease and death. Pathophysiological factors that maintain secondary hyperparathyroidism in advanced CKD are well-known, but early mechanisms of the disease that can be targeted for its primary prevention are poorly understood. Diuretics are widely used to control volume status and blood pressure in CKD patients but are also known to have important effects on renal calcium handling, which we hypothesized could alter the risk of secondary hyperparathyroidism. We examined the relationship of diuretic treatment with urinary calcium excretion, parathyroid hormone (PTH) levels and prevalence of secondary hyperparathyroidism (PTH ≥ 65 pg/mL) in a cross-sectional study of 3616 CKD patients in the Chronic Renal Insufficiency Cohort. Compared with no diuretics, treatment with loop diuretics was independently associated with higher adjusted urinary calcium (55.0 versus 39.6 mg/day; P diuretics. However, coadministration of thiazide and loop diuretics was associated with blunted urinary calcium (30.3 versus 55.0 mg/day; P diuretics alone. Loop diuretic use was associated with greater calciuria, PTH levels and odds of secondary hyperparathyroidism compared to no treatment. These associations were attenuated in patients who were coadministered thiazides. Diuretic choice is a potentially modifiable determinant of secondary hyperparathyroidism in CKD.

The effects of preventive mental health programmes in secondary schools.

Science.gov (United States)

Andersen, Bror Just

2013-01-01

The author wanted to test the effects of preventive mental health programmes in schools and established a longitudinal study with a test group and a control group, using Solomon's method. Data was collected through questionnaires prior to intervention and at 1, 6, 12, and 24 months after the intervention. The size of the effect on the various indices were estimated in terms of (a) differences in improvement of total percentage scores and (b) Cohen's d. From to to t1, t2 and t3 the intervention group showed significantly greater progress in six out of seven knowledge indexes, and 12 months later we found significant effects on the level of mental health problems.

Recognition and pseudonymisation of medical records for secondary use.

Science.gov (United States)

Heurix, Johannes; Fenz, Stefan; Rella, Antonio; Neubauer, Thomas

2016-03-01

Health records rank among the most sensitive personal information existing today. An unwanted disclosure to unauthorised parties usually results in significant negative consequences for an individual. Therefore, health records must be adequately protected in order to ensure the individual's privacy. However, health records are also valuable resources for clinical studies and research activities. In order to make the records available for privacy-preserving secondary use, thorough de-personalisation is a crucial prerequisite to prevent re-identification. This paper introduces MEDSEC, a system which automatically converts paper-based health records into de-personalised and pseudonymised documents which can be accessed by secondary users without compromising the patients' privacy. The system converts the paper-based records into a standardised structure that facilitates automated processing and the search for useful information.

New opportunities for the regulation of secondary metabolism in plants: focus on microRNAs.

Science.gov (United States)

Bulgakov, Victor P; Avramenko, Tatiana V

2015-09-01

Plant cell cultures are of particular interest in industrial applications as a source of biologically active substances. It is difficult, however, to achieve stable production of secondary metabolites for many plant cell cultures using classical techniques. Novel approaches should be developed for removal of the inhibitor blocks that prevent pathway activation and shift the regulatory balance to the activation of entire biosynthetic pathways. MicroRNAs (miRNAs) are small RNAs that play important regulatory roles in various biological processes. Only recently miRNAs have been demonstrated as active in secondary metabolism regulation. In this work, we summarize recent data on the emerging approaches based on regulation of secondary metabolism by miRNAs.

Condutas na prevenção secundária do câncer de mama e fatores associados Breast cancer's secondary prevention and associated factors

Directory of Open Access Journals (Sweden)

Marcelo Leal Sclowitz

2005-06-01

Full Text Available OBJETIVO: Avaliar a prevalência de condutas na prevenção secundária do câncer de mama e fatores associados. MÉTODOS: Foi realizado estudo transversal de base populacional na cidade de Pelotas, RS, em 2002, com amostra de 879 mulheres de 40 a 69 anos. Foram coletadas informações sobre variáveis demográficas, socioeconômicas, comportamentais, biológicas e referentes ao manejo médico. A análise estatística das variáveis foi realizada utilizando o método de regressão de Poisson. RESULTADOS: A prevalência do "hábito de realizar o auto-exame" encontrada foi de 83,5% (IC 95%: 80,9-85,9, sendo que, dessas mulheres, 80,4% (IC 95%: 77,3-83,2 o realizavam ao menos uma vez ao mês. A prevalência de "exame clínico de mamas" foi de 83,3% (IC 95%: 80,6-85,7. "Mamografia alguma vez na vida" mostrou prevalência de 70% (IC 95%: 66,8-73,0, sendo que 83,7% (IC 95%: 80,5-86,6 realizaram a última mamografia há dois anos ou menos. Das entrevistadas, 62% (IC 95%: 58,7-65,2 consultaram ginecologista ao menos uma vez no último ano. Os fatores associados a maiores prevalências das condutas na prevenção secundária do câncer de mama foram: pertencer às classes sociais mais altas; ter a maior combinação de fatores de risco para neoplasia mamária; ter história familiar de câncer de mama; fazer uso de terapia de reposição hormonal e ter sido submetida à biópsia por patologia mamária. CONCLUSÕES: As medidas preventivas para o câncer de mama vêm sendo bastante utilizadas quantitativamente; entretanto, os dados apontam para limitações em relação à sua adequação. O nível socioeconômico parece ser o principal determinante do acesso à consulta ginecológica e, conseqüentemente, às demais condutas na prevenção secundária do câncer de mama.OBJECTIVE: To evaluate the prevalence of secondary prevention of breast cancer and associated factors. METHODS: A population-based cross-sectional study was conducted in the city of

Preventive maintenance and reliability-centered maintenance

International Nuclear Information System (INIS)

Anderson, J.G.

1989-01-01

In the recent past, the primary function of the preventive maintenance program at a nuclear power plant was to maintain the operability and reliability of the plant. Reducing overall maintenance costs by performing effective preventive maintenance, instead of more costly and disruptive corrective maintenance, instead of more costly and disruptive corrective maintenance, was a secondary consideration. In today's operating environment, the preventive maintenance program must meet the test of cost-effectiveness as well as many new standards for performance that are being required by rate regulators. The preventive maintenance program must be able to withstand the challenge of independent audit to a new standard of technical adequacy and compliance with recommendations from component vendors. In this new environment, the standard that is being applied at the San Onofre nuclear generating station (SONGS) is that the preventive maintenance program must meet the test of cost-effectiveness, improve equipment performance, support increased plant availability, and (a) literally implement the recommendations of the vendor, (b) provide other compensation for the vendor recommendation, or (c) provide technical justification for the deviation. The subject of this paper is the way that reliability-centered maintenance (RCM) is helping SONGS meet these challenges

The Prevalence and Predictors of Cigarette Smoking among Secondary School Students in Nigeria.

Science.gov (United States)

Odeyemi, K A; Osibogun, A; Akinsete, A O; Sadiq, L

2009-03-01

This study was carried out to determine the prevalence of smoking among secondary school students and identify factors that influence smoking amongst them. This descriptive and explorative study was conducted among 1,183 secondary school students, selected by multistage sampling from each of the 6 geopolitical zones in Nigeria. Data was collected by using interviewer administered structured questionnaires. This study recorded a lifetime smoking prevalence of 26.4% and current smoking prevalence of 17.1% among secondary school students in Nigeria. Most (82%) of the students had seen warnings against smoking and most of them were aware that it is possible for cigarette smoking to damage body organs. Unfortunately, however, seeing such warnings had no significant effect on their decision to smoke or not. The students who smoke were introduced to smoking mainly by their friends (67.4 %), and the television (13.4%). Smoking habits of the respondents were influenced by parents' educational status (psmoke (psmoked. Peer pressure was the main reason cited by respondents for initiating smoking. It is suggested that our smoking prevention programmes be reviewed and appropriate health education and smoking cessation programmes be developed and implemented in order to prevent and control smoking among Nigerian students.

Secondary Containment Design for the LLNL B801 Diala Oil Tank

Energy Technology Data Exchange (ETDEWEB)

Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2016-12-14

Design is to add an extension to the secondary containment of tank T1-A3 at building 801. Piping from the inner tank penetrates the secondary containment tank below the liquid level of the primary tank. To meet Oil Pollution Prevention Regulation 40 CFR 120.7 the single wall piping needs to be provided with secondary containment. Steel Tank Institute (STI) conference publication states: §112.3(d)(1)(iii) –SPCC Plan requirements- Systems shall be designed in accordance with good engineering practice, including consideration of applicable industry standards and that procedures for required inspections and testing have been established. Section 112.7(a)(2) allows for deviations from specific rule requirements, provided the Owner/operator responsible to select, document and implement alternate measure and a PE certifies the SPCC Plan in accordance with good engineering practices, including consideration of industry standards

Characteristics and generation of secondary jets and secondary gigantic jets

Science.gov (United States)

Lee, Li-Jou; Huang, Sung-Ming; Chou, Jung-Kung; Kuo, Cheng-Ling; Chen, Alfred B.; Su, Han-Tzong; Hsu, Rue-Rou; Frey, Harald U.; Takahashi, Yukihiro; Lee, Lou-Chuang

2012-06-01

Secondary transient luminous events (TLEs) recorded by the ISUAL-FORMOSAT2 mission can either be secondary jets or secondary gigantic jets (GJs), depending on their terminal altitudes. The secondary jets emerge from the cloud top beneath the preceding sprites and extend upward to the base of the sprites at ˜50 km. The secondary jets likely are negative electric discharges with vertically straight luminous columns, morphologically resembling the trailing jet of the type-I GJs. The number of luminous columns in a secondary jet seems to be affected by the size of the effective capacitor plate formed near the base of the preceding sprites and the charge distribution left behind by the sprite-inducing positive cloud-to-ground discharges. The secondary GJs originate from the cloud top under the shielding area of the preceding sprites, and develop upward to reach the lower ionosphere at ˜90 km. The observed morphology of the secondary GJs can either be the curvy shifted secondary GJs extending outside the region occupied by the preceding sprites or the straight pop-through secondary GJs developing through the center of the preceding circular sprites. A key factor in determining the terminal height of the secondary TLEs appears to be the local ionosphere boundary height that established by the preceding sprites. The abundance and the distribution of the negative charge in the thundercloud following the sprite-inducing positive cloud-to-ground discharges may play important role in the generation of the secondary TLEs.

Mass media and disclosures of child abuse in the perspective of secondary prevention: putting ideas into practice.

NARCIS (Netherlands)

Hoefnagels, C.J.; Mudde, A.

2000-01-01

Objective: From a theoretical and practical point of view, it is worthwhile to utilize the full potential of prevention of child abuse. However, prevention strategies in the field of child abuse were generally limited to prevention by means of interpersonal communications. This paper seeks to

Effective components of nurse-coordinated care to prevent recurrent coronary events: a systematic review and meta-analysis

NARCIS (Netherlands)

Snaterse, Marjolein; Dobber, Jos; Jepma, Patricia; Peters, Ron J. G.; ter Riet, Gerben; Boekholdt, S. Matthijs; Buurman, Bianca M.; Scholte op Reimer, Wilma J. M.

2016-01-01

Current guidelines on secondary prevention of cardiovascular disease recommend nurse-coordinated care (NCC) as an effective intervention. However, NCC programmes differ widely and the efficacy of NCC components has not been studied. To investigate the efficacy of NCC and its components in secondary

Secondary prevention- an essential component of the comprehensive rehabilitation of patients with heart failure

Directory of Open Access Journals (Sweden)

Pop Dana

2017-12-01

Full Text Available Heart failure is currently a real public health problem due to the extremely high morbidity and mortality of this disease. In this context, cardiovascular prevention measures should be implemented as early as possible. In addition to classic prevention measures, a number of extremely important specific recommendations should be considered: informing patients about their underlying disease, identifying the cardiovascular and non-cardiovascular factors that have led to cardiac decompensation, reducing daily salt consumption, monitoring body weight, forbidding smoking and recreational substances, conducting a regular exercise program under supervision, and increasing adherence to treatment.

Preventive care delivered within Public Dental Service after caries risk assessment of young adults

DEFF Research Database (Denmark)

Hänsel Petersson, G; Ericson, E; Twetman, S

2016-01-01

OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

[Violence prevention in childhood and adolescence--a brief overview].

Science.gov (United States)

Pawils, Silke; Metzner, Franka

2016-01-01

Aggressive and violent behaviour in children and adolescents can be associated with physical and psychological health effects continuing into adulthood. Early programs for violence prevention in childhood and adolescence are intended to prevent or reduce aggressive behaviour in order to decrease the risk for short- and long-term developmental impairments. In a literature review, research findings on prevalence, typical courses of development, and predictors of violent behavior in childhood are first summarized and compared with findings on the frequency, developmental course, and consequences of youth violence. International and German programs for violence prevention in children and adolescents are presented in the context of various settings (family, school, community), target groups (primary vs. secondary prevention) as well as target variables (universal vs. specific). Empirical findings on efficacy testing of violence prevention programs are described and discussed. The presented findings stress the relevance and potential of services for violence prevention for children and adolescents, but also demonstrate the challenges and gaps.

Risk factors for nutritional status determination and indications for preventive nutrition therapy in hospitalized gastroenterological patients

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Roganović Branka

2007-01-01

Full Text Available Background/Aim. Risk factors for the intrahospital nutritional status worsening (NSW have not been precisely defined in the literature. The objective was defining thoese factors among gastroenterological patients and defining the risk patients requiring a preventive nutritional therapy. Methods. In 650 gastroenterological patients, NSW was evaluated on the basis of reducing of the six parameters: body weight, body mass index (BMI, triceps skinfold thickness (TSF, midupper arm muscle circumference (MAMC, serum albumin level (ALB, and lymphocyte count (LYM. The influence on NSW was tested for 13 factors concerning characteristics of the patient, disease, and diagnostic procedures. Among the factors influencing significantly the NSW, primary and secondary risk factors were selected. After scoring of risk factors had been performed, the risk-score for NSW (RSNSW was defined. The critical value of RSNSW which required preventive nutritional therapy was also calculated. Results. The incidence of NSW was in the range 29.2%−57.9%. The presence of general complications and severe disease activity were considered as primary risk factors, whereas malignant disease, age above 71, hepato-billiary tract involvement, hospitalization longer than 14 days, and mobility worsening were considered as secondary risk factors. The best predictive value for the NSW was proved for the RSNSW ≥ 6. Because of that, preventive nutritional therapy should be indicated in patients presenting with both primary risk factors or in patients presenting with one primary factor combined with three secondary risk factors at least. Conclusion. There are 7 risk factors for NSW in gastroenterological patients, but they are not of the same importance - two primary and five secondary risk factors can be differentiated. Preventive nutritional therapy is indicated only in patients having both primary risk factors or in those presenting with one primary risk factor combined with three

Differences in school environment, school policy and actions regarding overweight prevention between Dutch schools. A nationwide survey

Directory of Open Access Journals (Sweden)

Buijs Goof

2010-01-01

Full Text Available Abstract Background Schools are regarded as an important setting for the prevention of overweight. This study presents a nationally representative picture of the obesogenity of the school environment, the awareness of schools regarding overweight, and actions taken by the schools aiming at overweight prevention. In addition, differences between school levels were studied. Methods In 2006-2007, questionnaires were sent to all Dutch secondary schools (age group 12-18 years. Prevalences of the outcome variables were calculated for the schools in total and by school level. The association between school level and outcome variables were analysed by a log linear regression. Results Unhealthy foods and drinks are widely available at secondary schools. One third of the schools indicated that overweight has increased among students and half of the schools agreed that schools were (coresponsible for the prevention of overweight. Only 3% of the schools have a policy on overweight prevention. Small differences were observed between vocational education schools and higher education schools. The presence of vending machines did not differ by school level, but at vocational education schools, the content of the vending machines was less healthy. Conclusion This study describes the current situation at schools which is essential for the development and evaluation of future overweight prevention policies and interventions. In general, secondary schools are not actively involved in overweight prevention and the nutritional environment at most schools could be improved. The small differences between school levels do not give reason for a differential approach for a certain school level for overweight prevention.

Reconsideration of Secondary Risk Management Strategies in Patients with Ischemic Heart Disease.

Science.gov (United States)

Kashiyama, Kuninobu; Sonoda, Shinjo; Otsuji, Yutaka

2017-01-01

The main risk factors in ischemic heart diseases, including myocardial infarction, are hypertension, dyslipidemia, diabetes, obesity and smoking. The incidence of ischemic heart disease in Japan has been lower than that in Western countries because of differences in lifestyle and the anatomy of the coronary arteries, but the situation has been changing recently because of the westernization of lifestyle. Cardiovascular diseases have become the second most common cause of death in Japan, and 40% of those deaths are attributed to ischemic heart disease. Patients with a history of myocardial infarction, especially, have an increased risk of re-infarction, so strict management of coronary risk factors is important for the prevention of secondary ischemic heart disease. Although there are many guidelines about how to manage the risk factors, there are still many problems. Although lipid management has been demonstrated to have a protective effect against coronary artery disease and arteriosclerotic guidelines have been developed, it is reported that only about one third of patients achieved the low-density lipoprotein (LDL) target value under secondary prevention. Moreover, it is unclear whether the lower target value is required for high-risk patients. Recent research on diabetes has reported increased mortality in patients with intensive glycemic control. We should discuss when to start treatment, which medicine to use, and to what extent we should manage glycemic control. Strict management based on current therapeutic guidelines is effective for secondary prevention of ischemic heart disease, with target values of less than 135/85 mmHg for home blood pressure, less than 100 mg/dl for LDL-C, more than 40 mg/dl for HDL-C, less than 150 mg/dl for TG, and, for diabetic patients, less than 7.0% for HbA1c (NGSP).

An analysis of family-school collaboration in preventing adolescent ...

African Journals Online (AJOL)

The purpose of this article is to describe how school staff members, learners and parents collaborate to prevent adolescent learner violence in two different urban secondary schools. The increase in acts of interpersonal learner violence has a destructive effect on the safe and positive development of young people.

Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

Science.gov (United States)

Slone, Michelle; Shoshani, Anat

2010-01-01

The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

Safety and efficacy of device closure for patent foramen ovale for secondary prevention of neurological events: Comprehensive systematic review and meta-analysis of randomized controlled trials

International Nuclear Information System (INIS)

Hakeem, Abdul; Marmagkiolis, Konstantinos; Hacioglu, Yalcin; Uretsky, Barry F.; Gundogdu, Betul; Leesar, Massoud; Bailey, Steven R.; Cilingiroglu, Mehmet

2013-01-01

Background: Controversy persists regarding the management of patients with cryptogenic stroke and patent foramen ovale (PFO). We performed a meta-analysis of randomized controlled trials comparing PFO closure with medical therapy. Methods and Results: A prospective protocol was developed and registered using the following data sources: PubMed, Cochrane Register of Controlled Trials, conference proceedings, and Internet-based resources of clinical trials. Primary analyses were performed using the intention-to-treat method. Three randomized trials comparing percutaneous PFO closure vs. medical therapy for secondary prevention of embolic neurological events formed the data set. Baseline characteristics were similar. During long-term follow-up, the pooled incidence of the primary endpoint (composite of stroke, death, or fatal stroke) was 3.4% in the PFO closure arm and 4.8% in the medical therapy group [risk-reduction (RR) 0.7 (0.48–1.06); p = 0.09]. The incidence of recurrent neurological events (secondary endpoint) was 1.7% for PFO closure and 2.7% for medical therapy [RR 0.66 (0.35–1.24), p = 0.19]. There was no difference in terms of death or adverse events between the two groups. Conclusions: While this meta-analysis of randomized clinical trials demonstrated no statistical significance in comparison to medical therapy, there was a trend towards overall improvement in outcomes in the PFO closure group

Safety and efficacy of device closure for patent foramen ovale for secondary prevention of neurological events: Comprehensive systematic review and meta-analysis of randomized controlled trials

Energy Technology Data Exchange (ETDEWEB)

Hakeem, Abdul [University of Arkansas for Medical Sciences, Little Rock, AR (United States); Marmagkiolis, Konstantinos [Citizens Memorial Hospital Heart and Vascular Institute, Bolivar, MO (United States); Hacioglu, Yalcin; Uretsky, Barry F.; Gundogdu, Betul [University of Arkansas for Medical Sciences, Little Rock, AR (United States); Leesar, Massoud [University of Alabama at Birmingham, Birmingham, AL (United States); Bailey, Steven R. [University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States); Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com [Arkansas Heart Hospital, Little Rock, AR (United States)

2013-11-15

Background: Controversy persists regarding the management of patients with cryptogenic stroke and patent foramen ovale (PFO). We performed a meta-analysis of randomized controlled trials comparing PFO closure with medical therapy. Methods and Results: A prospective protocol was developed and registered using the following data sources: PubMed, Cochrane Register of Controlled Trials, conference proceedings, and Internet-based resources of clinical trials. Primary analyses were performed using the intention-to-treat method. Three randomized trials comparing percutaneous PFO closure vs. medical therapy for secondary prevention of embolic neurological events formed the data set. Baseline characteristics were similar. During long-term follow-up, the pooled incidence of the primary endpoint (composite of stroke, death, or fatal stroke) was 3.4% in the PFO closure arm and 4.8% in the medical therapy group [risk-reduction (RR) 0.7 (0.48–1.06); p = 0.09]. The incidence of recurrent neurological events (secondary endpoint) was 1.7% for PFO closure and 2.7% for medical therapy [RR 0.66 (0.35–1.24), p = 0.19]. There was no difference in terms of death or adverse events between the two groups. Conclusions: While this meta-analysis of randomized clinical trials demonstrated no statistical significance in comparison to medical therapy, there was a trend towards overall improvement in outcomes in the PFO closure group.

Wall thinning trend analyses for secondary side piping of Korean NPPs

International Nuclear Information System (INIS)

Hwang, K.M.; Jin, T.E.; Lee, S.H.; Jeon, S.C.

2003-01-01

Since the mid-1990s, nuclear power plants in Korea have experienced wall thinning, leaks, and ruptures of secondary side piping caused by flow-accelerated corrosion (FAC). The pipe failures have increased as operating time progresses. In order to prevent the FAC-induced pipe failures and to develop an effective FAC management strategy, KEPRI and KOPEC have conducted a study for developing systematic FAC management technology for secondary side piping of all Korean nuclear power plants. As a part of the study, FAC analyses were performed using the CHECWORKS code. The analysis results were used to select components for inspection and to determine inspection intervals on each nuclear power plant. This paper describes the introduction of the FAC analysis method and the wall thinning trend analysis results by reactor type, system, and water treatment amine. This paper also represents the site application feasibility for secondary side piping management. The site application feasibility of the analysis results was proven by comparisons of predicted and measured wear rates. (author)

Preventive psychiatry: Current status in contemporary psychiatry

Directory of Open Access Journals (Sweden)

Rakesh Kumar Chadda

2017-01-01

Full Text Available Preventive psychiatry is one of the most ignored subdiscipline of psychiatry, which has got important role to play in the contemporary psychiatry. Mental disorders are very common with lifetime prevalence of about 25%, and tend to be chronic. Due to the stigma associated with mental disorders, lack of awareness, and also lack of adequate mental health resources, nearly 60%–80% of the persons suffering from mental disorders do not access mental health care services. Mental and substance use disorders have been identified as one of the major contributors to the disease-related burden and disability-adjusted life years. In this background, preventive psychiatry has an important role to play in public health sector. Since etiology of most of the mental disorders is not known, it is not possible to follow here the standard model of primary, secondary, and tertiary prevention of public health. A concept of universal, selective, and indicated prevention has been proposed in primary prevention. Preventive approaches in psychiatry focus on evidence-based risk and protective factors, promoting quality of life, reducing stressors, and improving resilience. Such interventions, when planned targeting at specific mental disorders, have a potential to prevent mental disorders. Thus, preventive psychiatry has a crucial role to play in mental health, considering the high prevalence of mental disorders, the associated disability and burden, and a great drain on human resources.

How Setswana Cultural Beliefs and Practices on Sexuality Affect Teachers' and Adolescents' Sexual Decisions, Practices, and Experiences as well as HIV/AIDS and STI Prevention in Select Botswanan Secondary Schools.

Science.gov (United States)

Nleya, Paul T; Segale, Emelda

2015-01-01

The article reports on the aspects of a Botswana Ministry of Education and Skills Development (MoE & SD) HIV/AIDS Instructional Television (ITV) project modeled on a similar HIV/AIDS program implemented in Brazil. This Teacher Capacity Building Project (TCBP) in Botswana is in its initial years of implementation. Its overall goal is to contribute to the prevention and mitigation of the impact of HIV and AIDS by strengthening the capacity of the education and communication sectors to deliver interactive, distance HIV/AIDS education primarily to teachers so that they act as agents of behavior change among the in-school youth. One of the components of the TCBP program is a live teacher education television HIV/AIDS program called Talk Back program. Talk Back is a collaborative effort of the MoE & SD and the Botswana national television station. The Talk Back program involves development and implementation of weekly 1 hour live HIV/AIDS education interactive TV broadcasts for teachers. The development of the live programs is guided by a curriculum that provides a wide range of themes related to HIV/AIDS and education. This article reports the results of a survey of a sample of teachers and students at junior secondary schools and senior secondary schools, first, on their views and opinions regarding the Talk Back program as a TCBP. Second, how Setswana cultural beliefs, myths, and practices on sexuality affect teachers' and adolescents' sexual decisions, practices, and experiences as well as HIV/AIDS and sexually transmitted infection prevention. A questionnaire survey and focus group interviews were used as data collection instruments in selected secondary schools. The findings of the study suggest that the Talk Back program has not met much success as a TCBP. The findings further suggest that several myths, beliefs, misconceptions, and attitudes about HIV/AIDS exist among Botswana teachers and students and thus make it difficult for the Talk Back program to impart

Sepsis is a preventable public health problem.

Science.gov (United States)

Kempker, Jordan A; Wang, Henry E; Martin, Greg S

2018-05-06

There is a paradigm shift happening for sepsis. Sepsis is no longer solely conceptualized as problem of individual patients treated in emergency departments and intensive care units but also as one that is addressed as public health issue with population- and systems-based solutions. We offer a conceptual framework for sepsis as a public health problem by adapting the traditional model of primary, secondary, and tertiary prevention.

Mass media and disclosures of child abuse in the perspective of secondary prevention: putting ideas into practice.

Science.gov (United States)

Hoefnagels, C; Mudde, A

2000-08-01

From a theoretical and practical point of view, it is worthwhile to utilize the full potential of prevention of child abuse. However, prevention strategies in the field of child abuse were generally limited to prevention by means of interpersonal communications. This paper seeks to address this lacuna. A case-study is presented by describing and analyzing the organization and program development of a Dutch mass-media intervention aimed at the enhancement of disclosure of abuse of 8- to 15-year-old children, including physical, sexual, and emotional abuse. In the developmental process, several shortcomings are noticed, with respect to problem analysis, goal setting, and the assessment of unplanned effects. Critical comments are made on the intervention density, and the input and output of financial and human resources. Contrary to most preventive interventions, the described intervention could interrupt between the dependency of the abused child on the perpetrator and communicate with children directly. In a field which is in need of more effective prevention strategies, the program described may serve as an example of an ecological approach, which goes beyond the micro system, extending our potential in preventing ongoing abuse.

Sexual risk during pregnancy and postpartum periods among HIV-infected and -uninfected South African women: Implications for primary and secondary HIV prevention interventions.

Science.gov (United States)

Joseph Davey, Dvora; Farley, Elise; Gomba, Yolanda; Coates, Thomas; Myer, Landon

2018-01-01

HIV acquisition in pregnancy and breastfeeding contributes significantly toward pediatric HIV infection. However, little is known about how sexual behavior changes during pregnancy and postpartum periods which will help develop targeted HIV prevention and transmission interventions, including pre-exposure prophylaxis (PrEP). Cross-sectional study in HIV-infected and uninfected pregnant and postpartum women in Cape Town, South Africa. Interviewers collected survey data on demographic, sexual behaviors, and alcohol use among pregnant and post-partum women. We report descriptive results of sexual behavior by trimester and postpartum period, and results of multivariable logistic regression stratified by pregnancy status. We enrolled 377 pregnant and postpartum women (56% pregnant, 40% HIV-infected). During pregnancy, 98% of women reported vaginal sex (8% anal sex, 44% oral sex) vs. 35% and 88% during the periods 0-6 and 7-12 months postpartum, respectively (p1 partner in the past 12-months compared to postpartum women (18% vs. 13%, respectively, p6-months postpartum (13 mean sex acts in first trimester; 17 mean sex acts >6-months postpartum). Pregnant women had increased odds of reporting condomless sex at last sex (aOR = 2.96;95%CI = 1.84-4.78) and ever having condomless sex in past 3-months (aOR = 2.65;95%CI = 1.30-5.44) adjusting for age, HIV status, and sex frequency compared to postpartum women. We identified that sexual behaviors and risk behaviors were high and changing during pregnancy and postpartum periods, presenting challenges to primary and secondary HIV prevention efforts, including PrEP delivery to pregnant and breastfeeding women.

Effect of health education on knowledge and prevention on Hepatitis ...

African Journals Online (AJOL)

Effect of health education on knowledge and prevention on Hepatitis infection among secondary school students in Ibadan North Local Government Area of Oyo state. ... Based on these findings, the study recommended that health education/ health campaign should be directed to school students and Specific risk practices ...

Preventing HIV/AIDS through education: the role of primary and ...

African Journals Online (AJOL)

Objective: This study was aimed at assessing the knowledge, opinion and practices of Nigerian primary and secondary school teachers on HIV/AIDS education. Method: A self-administered questionnaire was used to collect data on demography, knowledge of HIV transmission and prevention, training on HIV transmission ...

Influence of Health Education on Prevention of Drug Abuse ...

African Journals Online (AJOL)

This study was undertaken to investigate the influence of health education on prevention of drug abuse. 192 adolescents comprising of male and females, randomly selected from two secondary schools and a university were used as sample with ages ranging from 12-22years with a mean of 17years. The questionnaire ...

Primary and secondary cases in Escherichia coli O157 outbreaks: a statistical analysis.

LENUS (Irish Health Repository)

Snedeker, Kate G

2009-01-01

category. CONCLUSION: Our analyses indicated that ~20% of E. coli O157 outbreak cases were the result of secondary spread, and that this spread is significantly influenced by age and modes of primary and secondary transmission, but not country. In particular, the results provide further data emphasising the importance of simple but effective preventive strategies, such as handwashing, that can reduce the risk of secondary spread, particularly amongst young children in nurseries.

Lumbar Supports for Prevention and Treatment of Low Back Pain: A Systematic Review Within the Framework of the Cochrane Back Review Group

DEFF Research Database (Denmark)

Jellema, Petra; van Tulder, Maurits W; van Poppel, Mireille N M

2001-01-01

Study Design : A systematic review of randomized and nonrandomized controlled trials. Summary of Background Data : Lumbar supports are used in the treatment of low back pain, but also to prevent the onset (primary prevention) or recurrences of a low back pain episode (secondary prevention......). Objectives: To assess the effects of lumbar sup-ports for prevention and treatment of nonspecific low back pain. Methods: The Medline, Cinahl, and Current Contents databases; the Cochrane Controlled Trials Register up to September 1999; and the Embase database up to September 1998 were all searched...... are not effective for primary prevention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, whereas it is still unclear whether lumbar...

Strategies for Prevention and Intervention of Drug Abuse among Students in Secondary Schools in Kenya

Science.gov (United States)

Marais, Petro; Maithya, Redempta

2015-01-01

Drug abuse is becoming an increasing problem among students in Kenya. The major cause for concern is that a high proportion of the Kenyan youth in secondary schools are involved in drugs (NACADA 2012). As a result, these young people eventually become addicted, posing a threat to their own health and safety. This study sought to establish the…

Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

Science.gov (United States)

Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

2015-01-01

After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

Rationale and protocol of a trial for prevention of diabetic atherosclerosis by using antiplatelet drugs: study of Diabetic Atherosclerosis Prevention by Cilostazol (DAPC study

Directory of Open Access Journals (Sweden)

Kawamori Ryuzo

2006-08-01

Full Text Available Abstract Background Secondary treatment of arteriosclerosis may be applicable for the primary prevention of atherosclerosis in diabetic patients. This prospective, 2-year follow-up study was designed to determine the efficacy and safety of antiplatelet therapy in the prevention of atherosclerosis of diabetic subjects. Methods Patients with type 2 diabetes and arteriosclerosis obliterans from the Eastern Asian countries were registered online and randomly assigned either to the aspirin group (81–100 mg/day or the cilostazol group (100–200 mg/day in this international, 2-year, prospective follow-up interventional study. Results The primary study endpoint was changes in right and left maximum intima-media thickness of the common carotid artery. Secondary endpoints include changes in right and left maximum intima-media thickness of the internal carotid artery; semiquantitative evaluation of cerebral infarction by magnetic resonance imaging; cardiovascular events including sudden death, stroke, transient cerebral ischemic attacks, acute myocardial infarction, angina, and progression of arteriosclerosis obliterans; overall death; withdrawal; and change in ankle-brachial pressure index. Conclusion This is the first study to use an online system that was developed in Asian countries for pooling data from an international clinical trial. These findings are expected to help in the prevention of diabetic atherosclerosis and subsequent cardiovascular and cerebrovascular disease.

Pressure Relief Behaviors and Weight-Shifting Activities to Prevent Pressure Ulcers in Persons with SCI

Science.gov (United States)

2014-10-01

SUPPLEMENTARY NOTES 14. ABSTRACT Pressure ulcers (PU) are the most costly secondary complication following an SCI. In addition to the medical costs ...Introduction Pressure ulcers (PU) are the most costly secondary complication following an SCI. In addition to the medical costs , the development of a...Prevent Pressure Ulcers in Persons with SCI PRINCIPAL INVESTIGATOR: Stephen Sprigle, PhD CONTRACTING ORGANIZATION: Georgia Tech Research

Self-Regulation, Cooperative Learning, and Academic Self-Efficacy: Interactions to Prevent School Failure

OpenAIRE

Fernández Río, Francisco Javier; Cecchini Estrada, José Antonio; Méndez Giménez, Antonio; Prieto Saborit, José Antonio

2017-01-01

Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.20...

Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review.

Science.gov (United States)

de Graaff, Lisanne F; Honig, Adriaan; van Pampus, Mariëlle G; Stramrood, Claire A I

2018-06-01

Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder. Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms. After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section. No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

[Perception of Primary Care physicians on the integration with cardiology through continuity of healthcare programs in secondary prevention].

Science.gov (United States)

Cosin-Sales, J; Orozco Beltrán, D; Ledesma Rodríguez, R; Barbon Ortiz Casado, A; Fernández, G

2018-02-17

To determine the perception of Primary Care (PC) physicians on the integration with cardiology (CA) through continuity of healthcare programs. A cross-sectional and multicentre study was conducted, in which a total of 200 PC physicians from all over Spain completed a qualitative survey that evaluated the level of integration with CA in secondary prevention. Physicians were grouped according to the level of PC-CA integration. The integration between CA and PC was good, but it was better in those centres with a higher integration (74.0% vs. 60.0%; p=.02) and in general, physicians considered that integration had improved (92.0% vs. 73.0%; pintegration. In 55.8%, 63.6%, and 51.3% of hospital discharge reports, indications were given on when to perform the follow-up blood analysis, as well as information about returning to working life and sexual activity, respectively. The most common communication method was the paper-based report (75 vs. 84%; p=NS). The communication between healthcare levels was greater in those Primary Care centres with a higher level of integration, as well as periodicity of the communication and the satisfaction of physicians (80.0% vs. 63.0%; p=.005). The level of integration between PC and CA is, in general, satisfactory, but those centres with a higher level of integration benefit more from a greater communication and satisfaction. Copyright © 2018 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

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

Science.gov (United States)

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

2014-12-01

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

Percutaneous patent foramen ovale closure: the Paradoxical Cerebral Embolism Prevention Registry.

Science.gov (United States)

Paiva, Luís; Dinis, Paulo; Providência, Rui; Costa, Marco; Margalho, Susana; Goncalves, Lino

2015-03-01

The natural history and therapeutic interventions for secondary prevention after a cerebrovascular event in patients with patent foramen ovale (PFO) are not yet established. This study aims to assess the safety and efficacy of percutaneous PFO closure in a population of patients with ischemic cerebrovascular disease of unknown etiology. This prospective observational study included patients with a history of cryptogenic transient ischemic attack (TIA) or stroke who underwent percutaneous PFO closure. The effectiveness of the device for the secondary prevention of TIA or stroke was assessed by comparing observed events in the sample with expected events for this clinical setting. The sample included 193 cases of percutaneous PFO closure (age 46.4 ± 13.1 years, 62.2% female) with a mean follow-up of 4.3 ± 2.2 years, corresponding to a total exposure to ischemic events of 542 patient-years. The high-risk characteristics of the PFO were assessed prior to device implantation. There were seven primary endpoint events during follow-up (1.3 per 100 patient-years), corresponding to a relative risk reduction of 68.2% in recurrent TIA or stroke compared to medical therapy alone. The procedure was associated with a low rate of device- or intervention-related complications (1.5%). In this long-term registry, percutaneous PFO closure was shown to be a safe and effective therapy for the secondary prevention of cryptogenic stroke or TIA. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Primary prevention of chronic obstructive pulmonary disease in primary care.

Science.gov (United States)

van der Molen, Thys; Schokker, Siebrig

2009-12-01

Chronic obstructive pulmonary disease (COPD) is a prevalent disease, with cigarette smoking being the main risk factor. Prevention is crucial in the fight against COPD. Whereas primary prevention is targeted on whole populations, patient populations are the focus of primary care; therefore, prevention in this setting is mainly aimed at preventing further deterioration of the disease in patients who present with the first signs of disease (secondary prevention). Prevention of COPD in primary care requires detection of COPD at an early stage. An accurate definition of COPD is crucial in this identification process. The benefits of detecting new patients with COPD should be determined before recommending screening and case-finding programs in primary care. No evidence is available that screening by spirometry results in significant health gains. Effective treatment options in patients with mild disease are lacking. Smoking cessation is the cornerstone of COPD prevention. Because cigarette smoking is not only a major cause of COPD but is also a major cause of many other diseases, a decline in tobacco smoking would result in substantial health benefits.

Low-waste technology of prevention, decontamination and localization of radioactive contamination

International Nuclear Information System (INIS)

Kizhnerov, L. V.; Konstantinov, Ye. A.; Prokopenko, V. A.; Sorokin, N. M.

1997-01-01

The report presents the results of research in developing a low-waste technology of prevention, decontamination and localization of radioactive contamination founded on the of easily removed protective polymeric coating based on water and alcohol latexes and dispersion of polymers with special activating additives. The developed technology provides for the reduction of weakly fixed radioactive contamination of non-painted and painted surfaces to admissible levels (as a rule), it securely prevents and localizes contamination and does not generate secondary liquid radioactive wastes

New Technology for Corrosion Mitigation of Steam Generator Tubesheet in Secondary Side Environments

International Nuclear Information System (INIS)

Hur, Do Haeng; Choi, Myung Sik; Lee, Deok Hyun; Han, Jung Ho

2013-01-01

Denting has been mitigated by a modification of the design and material of the tube support structures, it has been an inevitable problem in the crevice region of the top of the tubesheet(TTS). Denting at the TTS has been a significant concern regardless of the tube materials. This is because it is a mechanical process resulted from a volume expansion of corrosion products of the tubesheet materials. It should be noted that the corrosion rate of low alloy tubesheet materials is accelerated due to the presence of corrosion products accumulated at the top of the tubesheet. Therefore a reduction of the corrosion rate of the tubesheet material should be a key strategy to prevent tube denting at the TTS as well as an improvement of the secondary water chemistry. This paper provides a new technology to prevent denting by cladding the secondary side surface of the tubesheet with a corrosion resistant material. In this study, Alloy 690 material on the surface of the SA508 tubesheet was cladded to a thickness of about 9mm. The corrosion rates of the SA508 original tubesheet and Alloy 690 clad material were measured in acidic and caustic simulated environments. Denting has been a precursor of stress corrosion cracking in nuclear steam generator tubing, although it may be mitigated by a design and material modification of the tube support structures and secondary water chemistry control. Corrosion resistant Alloy 690 tubing is not an exception because denting at the TTS is due to corrosion of the tubesheet material. In this paper, a new technology was suggested to prevent denting at the TTS by cladding the secondary side surface of the tubesheet with a corrosion resistant material. It was verified that the corrosion rates of a tubesheet with an Alloy 690 clad layer drastically decreased in both acidic and alkaline environments, even inside the magnetite sludge pile. Because the cladding processes of Alloy 690 have already been applied to the primary side surface of a

Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction.

Science.gov (United States)

Arundale, Amelia J H; Cummer, Kathleen; Capin, Jacob J; Zarzycki, Ryan; Snyder-Mackler, Lynn

2017-10-01

Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation. The purpose of this study was to determine whether there were differences at 1 and 2 years after ACL reconstruction between the male SAP (strengthening, agility, and secondary prevention) and SAP+PERT (SAP protocol with the addition of perturbation training) groups with respect to (1) quadriceps strength and single-legged hop limb symmetry; (2) patient-reported knee outcome scores; (3) the proportion who achieve self-reported normal knee function; and (4) the time from surgery to passing return to sport criteria. Forty men who had completed ACL reconstruction rehabilitation and met enrollment criteria (3-9 months after ACL reconstruction, > 80% quadriceps strength limb symmetry, no pain, full ROM, minimal effusion) were randomized into the SAP or SAP+PERT groups of the Anterior Cruciate Ligament-Specialised Post-Operative Return to Sports trial (ACL-SPORTS), a single-blind randomized clinical study of secondary prevention and return to sport. Quadriceps strength, single-legged hopping, the International Knee Documentation Committee (IKDC) 2000 subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS)-sports and recreation, and KOOS-quality-of-life subscales were collected 1 and 2 years after surgery by investigators blind to group. Athletes were categorized as having normal or abnormal knee function at each time point based on IKDC score, and the time until athletes passed strict return

[Statins in the secondary prevention of stroke: New evidence from the SPARCL Study].

Science.gov (United States)

Castilla-Guerra, Luis; Fernández-Moreno, María Del Carmen; López-Chozas, José Manuel

2016-01-01

Until recently there was little evidence that statin therapy reduced the risk of stroke recurrence. The SPARCL trial, published in 2006, was the first trial to show the benefits of statin therapy in preventing recurrent stroke. The SPARCL trial showed that treatment with atorvastatin 80mg/day reduced recurrent stroke in patients with a recent stroke or transient ischemic attack (TIA). Several post hoc analyses of different subgroups followed the SPARCL trial. They have not revealed any significant differences when patients were grouped by age, sex or type of stroke. The SPARCL trial has also helped to identify patients who may have a greater benefit from statins: Patients with carotid stenosis, with more intense lipid lowering, and those who achieve optimal levels of LDL-C, HDL-C, triglycerides, and blood pressure. The trial has also helped to identify individuals at high risk of new vascular events. Clearly there is a before and after in stroke prevention since the SPARCL trial was published. Copyright © 2015 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

Occupational risks prevention in colombian companies

Directory of Open Access Journals (Sweden)

Leonardo Briceño

2003-06-01

Full Text Available We assessed the preventive activitiesperformed in 120 Colombian workplacesin Bogotá and El Valle delCauca, Colombia.The results were analyzed by level of interventionconsidering the primary, secondary andtertiary levels, and by size of the workplace.It was established that those enterprisesaffiliated to the Professional Risk insurancesystem –part of the Social security system– withhigher levels of premiums paid to the insurancecompanies, had more prevention activities thanthose with lower payments–75% vs. 16%.The Professional risks administrators –Insurancecompanies– gave more services to thoseworkplaces with high premiums than thoseprovided to enterprises with low premiums.75% of the big factories had a commitmentsigned by the insurance company related toprevention services, while only 19% of the littleenterprises had one. The enterprises with less than20 employees had less prevention activities thanthose with more than 100 employees.None of the evaluated workplaces with lessthan 100 workers had a licensed occupationalhealth counselor.Primary prevention activities like IndustrialHygiene studies in specific risks factors are scarce–24% of the workplaces had any evaluation aboutnoise levels, illumination, temperatures or anyother occupational risks factor 22.5% of theworkplaces show any activity of risk control.It was concluded that the preferential servicesprovided to the biggest enterprises carry a lossof cross subsidies in the social security systembetween big and little factories. Finally, the governmentmust create an information systemregarding the preventive services surveillance inthe highest risks factories.

[Pain in herpes zoster: Prevention and treatment].

Science.gov (United States)

Calvo-Mosquera, G; González-Cal, A; Calvo-Rodríguez, D; Primucci, C Y; Plamenov-Dipchikov, P

Shingles is a painful rash that results from reactivation of latent varicella-zoster virus in the dorsal root ganglia or cranial nerves. In this article an update is presented on the prevention and pharmacological treatment of the secondary pain from the virus infection. The most effective way to prevent post-herpetic neuralgia and its consequences is the prevention of herpes itself. A live attenuated vaccine (the Oka strain varicella zoster virus) has been available for several years, and is approved in adults aged 50 years old. Although this vaccine has shown to be effective against herpes zoster and post-herpetic neuralgia, its effectiveness decreases with age and is contraindicated in patients with some form of immunosuppression. Today the recombinant vaccines provide an alternative, and may be administered to immunocompromised persons. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

A Survey of Sun Protection Policy and Education in Secondary Schools

Science.gov (United States)

Buller, David B.; Buller, Mary Klein; Reynolds, Kim D.

2006-01-01

Background The Centers for Disease Control and Prevention (CDC) issued recommendations for school programs to reduce skin cancer. Objective Personnel at U.S. secondary schools were surveyed to describe sun protection policy and education prior to these recommendations. Methods School principals or other personnel at 484 secondary schools in 27 cities responded to a telephone survey in January and February 2002 (response rate = 31%). Results A sun protection policy was reported at 10% of the schools but sun protection education occurred at nearly all schools (96%). Policies were more prevalent in regions with high ultraviolet radiation (pprotection was a low policy priority for U.S. schools. Sun safety education was prevalent but written materials were used infrequently. A substantial proportion of school personnel were receptive to the CDC’s advice. PMID:16488293

Knowledge of cervical cancer and acceptance of HPV vaccination among secondary school students in Sarawak, Malaysia.

Science.gov (United States)

Rashwan, Hesham; Lubis, Syarif Husin; Ni, Kiat Aun

2011-01-01

Cervical cancer is the third most common cancer in women in peninsular Malaysia and very prevalent worldwide. HPV vaccination and routine Pap smear testing are the best preventive measures. The objective of this study was to determine the knowledge level of secondary school students from Sarawak, East Malaysia regarding cervical cancer and its prevention. Multistage random sampling with various methods in each step was employed to select the sample of 76 students. Results showed that 61.8% had poor knowledge level of cervical cancer and its prevention. There were 60.5% of students who were aware of cervical cancer with Chinese and form four students showing significantly the highest awareness (pSarawak. This in turn will enhance the practice of prevention against cervical cancer among students.

Ischaemic stroke in children secondary to post varicella angiopathy.

LENUS (Irish Health Repository)

Hayes, B

2007-01-01

Varicella in childhood is a self-limiting disease, which usually follows a benign course. However, complications, although rare, may have serious consequences. Ischaemic stroke secondary to post varicella angiopathy is a well-described complication and is estimated to account for up to a third of all strokes in infants. We present three previously healthy children who presented to our centre with ischaemic cerebrovascular infarction due to varicella angiopathy. All three children first presented within six weeks after onset of varicella infection and had MRI changes characteristic of ischaemic stroke secondary to post varicella angiopathy. While one child made an excellent recovery being left with only a minor deficit, the remaining two children were left with considerable morbidity severely affecting quality of life. The varicella vaccine has been proven to be well tolerated, safe and effective. We conclude that varicella vaccination should be considered for inclusion in the vaccination schedule to prevent serious complications which while rare may have devastating consequences.

Knowledge, Attitude and Perception of Ebola Virus Disease among Secondary School Students in Ondo State, Nigeria, October, 2014

OpenAIRE

Ilesanmi, Olayinka; Alele, Faith Osaretin

2016-01-01

Introduction: The first case of Ebola Virus Disease (EVD) in Nigeria was imported on 20th July 2014, by an air traveller. On 8th August, 2014, WHO declared the Ebola outbreak in West Africa a Public Health Emergency of International Concern (PHEIC). This study aimed at assessing the knowledge, perception and attitude of secondary school students towards EVD and adopting disease preventive behaviour. Methods: A descriptive cross sectional study of 440 students from a mixed secondary school in ...

Individualized cardiovascular disease prevention in clinical practice : Estimation of benefit and cost

NARCIS (Netherlands)

Slob, MC

2017-01-01

For treatment decisions in clinical practice, group-level treatment effects need to be translated into benefit for an individual patient. In both the primary and secondary cardiovascular prevention setting (Chapter 2), patients differ widely in the risk for cardiovascular events, and the benefit

Building Safer Secondary Schools in Uganda through Collective Commitment to Health and Safety Compliance

Science.gov (United States)

Sekiwu, Denis; Kabanda, Milly

2014-01-01

The area of safety and accident prevention is of great concern to managers, because of the increasing number of deaths and accidents at work places. Using a case of Wakiso district, the study sought to investigate the relationship between collective commitment and management of health and safety in Ugandan secondary schools. The study employed a…

Antifungal Prevention of Systemic Candidiasis in Immunocompetent ICU Adults: Systematic Review and Meta-Analysis of Clinical Trials.

Science.gov (United States)

Dupont, Hervé; Mahjoub, Yazine; Chouaki, Taieb; Lorne, Emmanuel; Zogheib, Elie

2017-11-01

The aim of this study was to identify the impact of antifungal prevention in critically ill immunocompetent adult patients on mortality and subsequent infection. A systematic review and meta-analysis of randomized controlled trials comparing any antifungal use versus placebo to prevent candidiasis in ICU patients were performed. Searches were performed on PubMed, Embase, Scopus, main conference proceedings, and ClinicalTrials.gov, as well as reference lists. The primary outcomes were mortality and invasive candidiasis. The secondary outcome was the rate of Candida albicans and nonalbicans strains after treatment. A random effect model was used, and sensitivity analysis was performed for both outcomes. Results are expressed as risk ratios and their 95% CIs. Nineteen trials (10 with fluconazole, four with ketoconazole, one with itraconazole, three with micafungin, and one with caspofungin) including 2,792 patients were identified. No individual trial showed a decreased mortality rate. Combined analysis showed that preventive antifungal did not decrease mortality (risk ratio, 0.88; 95% CI, 0.74-1.04; p = 0.14) but significantly decreased secondary fungal infections by 50% (risk ratio, 0.49; 95% CI, 0.35-0.68; p = 0.0001). No shift across nonalbicans strains was observed during treatment (risk ratio, 0.62; 95% CI, 0.19-1.97; p = 0.42). However, publication biases preclude any definite conclusions for prevention of infection. Antifungal prevention of systemic candidiasis in immunocompetent critically ill adults did not reduce mortality and may have decreased secondary fungal infection rates. However, significant publication bias was present.

The Management of Secondary Glaucoma in Nanophthalmic Patients

Institute of Scientific and Technical Information of China (English)

Shengsong Huang; Minbin Yu; Changyu Qiu; Tiancai Ye

2002-01-01

Purpose: To investigate the clinical characteristcs, management of secondary glaucoma in nanophthalmos, and the prevention of its complications.Methods: Retrospectively, 9 cases (17 eyes) with nanophthalmic glaucoma were studied.Results: The axial length of the eyes ranged (14.36 ～ 19.33) mm; All of the cases combined with hyperopia ranged (+7.00～+16.00)D. All 17 eyes had the manifestation like angle-closure glaucoma.The glaucoma was controlled in 9 of 17 eyes at the early stage, which underwent laser iridotomy (4 of 9 eyes also underwent laser iridoplasty). 1 eye underwent ciliary photocoagulation because its visual acuity was lost and the patient complained of pain. The other 7 eyes underwent filtration surgery and 3 of them had permanent loss of vision caused by disastrous complications after the surgery.Conclusions: Management of secondary glaucoma in nanophthalmos is complicated. The laser iris surgery is safe and effective in glaucoma at the early stage. Vortex vein decompression, sclerotectomy or anterior sclerotomy may be performed to reduce disastrous complications.

Can the exceptional chilling tolerance of C4 photosynthesis found in Miscanthus × giganteus be exceeded? Screening of a novel Miscanthus Japanese germplasm collection.

Science.gov (United States)

Głowacka, Katarzyna; Jørgensen, Uffe; Kjeldsen, Jens B; Kørup, Kirsten; Spitz, Idan; Sacks, Erik J; Long, Stephen P

2015-05-01

A clone of the hybrid perennial C4 grass Miscanthus × giganteus (Mxg) is known for achieving exceptionally high rates of leaf CO2 uptake during chilling. This is a requisite of success in the early spring, as is the ability of the leaves to survive occasional frosts. The aim of this study was to search for genotypes with greater potential than Mxg for photosynthesis and frost survival under these conditions. A total of 864 accessions representing 164 local populations of M. sacchariflorus (Msa), M. sinensis (Msi) and M. tinctorius (Mti) collected across Japan were studied. Accessions whose leaves survived a natural late frost in the field were screened for high maximum photosystem II efficiency (Fv/Fm) following chilling weather, as an indicator of their capacity for light-limited photosynthesis. Those showing the highest Fv/Fm were transferred to a high-light-controlled environment and maintained at chilling temperatures, where they were further screened for their capacities for high-light-limited and light-saturated leaf uptake of CO2 (ΦCO2,max and Asat, respectively). For the first time, relatives of Mxg with significantly superior capacities for photosynthesis at chilling temperatures were identified. Msa accession '73/2' developed leaves in the spring that survived night-time frost, and during growth under chilling maintained a statistically significant 79 % higher ΦCO2,max, as a measure of light-limited photosynthesis, and a 70 % higher Asat, as a measure of light-saturated photosynthesis. A second Msa accession, '73/3' also showed significantly higher rates of leaf uptake of CO2. As remarkable as Mxg has proved in its chilling tolerance of C4 photosynthesis, this study shows that there is still value and potential in searching for yet more superior tolerance. Msa accession '73/2' shows rates of light-limited and light-saturated photosynthesis at chilling temperatures that are comparable with those of the most cold-tolerant C3 species. This adds

The preventing recurrent vascular events and neurological worsening through intensive organized case-management (PREVENTION trial protocol [clinicaltrials.gov identifier: NCT00931788

Directory of Open Access Journals (Sweden)

Tsuyuki Ross

2010-04-01

Full Text Available Abstract Background Survivors of transient ischemic attack (TIA or stroke are at high risk for recurrent vascular events and aggressive treatment of vascular risk factors can reduce this risk. However, vascular risk factors, especially hypertension and high cholesterol, are not managed optimally even in those patients seen in specialized clinics. This gap between the evidence for secondary prevention of stroke and the clinical reality leads to suboptimal patient outcomes. In this study, we will be testing a pharmacist case manager for delivery of stroke prevention services. We hypothesize this new structure will improve processes of care which in turn should lead to improved outcomes. Methods We will conduct a prospective, randomized, controlled open-label with blinded ascertainment of outcomes (PROBE trial. Treatment allocation will be concealed from the study personnel, and all outcomes will be collected in an independent and blinded manner by observers who have not been involved in the patient's clinical care or trial participation and who are masked to baseline measurements. Patients will be randomized to control or a pharmacist case manager treating vascular risk factors to guideline-recommended target levels. Eligible patients will include all adult patients seen at stroke prevention clinics in Edmonton, Alberta after an ischemic stroke or TIA who have uncontrolled hypertension (defined as systolic blood pressure (BP > 140 mm Hg or dyslipidemia (fasting LDL-cholesterol > 2.00 mmol/L and who are not cognitively impaired or institutionalized. The primary outcome will be the proportion of subjects who attain 'optimal BP and lipid control'(defined as systolic BP Conclusions Nearly one-quarter of those who survive a TIA or minor stroke suffer another vascular event within a year. If our intervention improves the provision of secondary prevention therapies in these patients, the clinical (and financial implications will be enormous.

The effect of antibiotic- and hydrocortisone-containing ointments in preventing secondary infections in guinea worm disease

DEFF Research Database (Denmark)

Magnussen, P.; Yakubu, A.; Bloch, P.

1994-01-01

A randomized, single-blind, controlled study comparing the efficacy of an ointment containing two antibiotics, one containing one antibiotic plus hydrocortisone, and no treatment in reducing secondary infections in patients with patent Guinea worm was undertaken in the northern region of Ghana. S...... for application at the early stage of patent Guinea worm infection....

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

Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

Directory of Open Access Journals (Sweden)

Hextan Y. S. Ngan

2011-01-01

The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed.

Traditional herbal remedies and dietary spices from Cameroon as novel sources of larvicides against filariasis mosquitoes?

Science.gov (United States)

Pavela, Roman; Maggi, Filippo; Mbuntcha, Hélène; Woguem, Verlaine; Fogang, Hervet Paulin Dongmo; Womeni, Hilaire Macaire; Tapondjou, Léon Azefack; Barboni, Luciano; Nicoletti, Marcello; Canale, Angelo; Benelli, Giovanni

2016-12-01

In Cameroon, many dietary spices are used by traditional healers to cure several diseases such as cancer and microbial infections. Aframomum daniellii, Dichrostachys cinerea and Echinops giganteus are Cameroonian spices widely used as flavourings and as food additives. Moreover, they are traditionally herbal remedies employed to treat several diseases, as well as to control populations of insect pests. In this research, we analysed the chemical composition of A. daniellii, D. cinerea and E. giganteus essential oils and we evaluated their larvicidal potential against larvae of the filariasis and West Nile virus vector Culex quinquefasciatus. The essential oils were obtained from different plant parts by hydrodistillation and their composition was analysed by GC-MS. The three spices exhibited different volatile chemical profiles, being characterized by 1,8-cineole, sabinene and β-pinene (A. daniellii), geraniol and terpinen-4-ol (D. cinerea), and silphiperfol-6-ene and presilphiperfolan-8-ol (E. giganteus). Results showed that the highest larvicidal toxicity on Cx. quinquefasciatus was exerted by D. cinerea essential oil (LC 50  = 39.1 μL L -1 ), followed by A. daniellii (pericarp essential oil: LC 50  = 65.5 μL L -1 ; leaves: LC 50  = 65.5μL L -1 ; seeds: LC 50  = 106.5μL L -1 ) and E. giganteus (LC 50  = 227.4 μL L -1 ). Overall, the chance to use the D. cinerea essential oil against Cx. quinquefasciatus young instars seems promising, since it is effective at moderate doses and could be an advantageous alternative to build newer mosquito control tools.

Functional food supplements to ameliorate the secondary complications in high fructose fed diabetic rats.

Science.gov (United States)

Gite, S S; Yadav, S A; Nilegaonkar, S S; Agte, V V

2017-05-24

Functional foods are the most natural and safest source of health ingredients, providing health benefits beyond basic nutrition, and hence can be used as supplements for the prevention of secondary complications in diabetes. Persistent diabetes may cause glycation of various tissue proteins such as of those in lens, kidney, blood, and brain, which may further lead to the development of pathological conditions such as cataract and cardiovascular diseases. This study on adult rats was designed to assess if the functional food supplements A and B (proprietary blends of antioxidant rich plant materials) can reduce secondary complications such as cataract, dyslipidemia, and oxidative stress under severe diabetic conditions. After nine weeks of intervention of the supplements, it was found that the % HbA1c levels in the formulation group B significantly (p functional foods in the effective management of secondary complications associated with severe diabetic conditions.

Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial.

Science.gov (United States)

Hagen, Suzanne; Glazener, Cathryn; McClurg, Doreen; Macarthur, Christine; Elders, Andrew; Herbison, Peter; Wilson, Don; Toozs-Hobson, Philip; Hemming, Christine; Hay-Smith, Jean; Collins, Marissa; Dickson, Sylvia; Logan, Janet

2017-01-28

Pelvic floor muscle training can reduce prolapse severity and symptoms in women seeking treatment. We aimed to assess whether this intervention could also be effective in secondary prevention of prolapse and the need for future treatment. We did this multicentre, parallel-group, randomised controlled trial at three centres in New Zealand and the UK. Women from a longitudinal study of pelvic floor function after childbirth were potentially eligible for inclusion. Women of any age who had stage 1-3 prolapse, but had not sought treatment, were randomly assigned (1:1), via remote computer allocation, to receive either one-to-one pelvic floor muscle training (five physiotherapy appointments over 16 weeks, and annual review) plus Pilates-based pelvic floor muscle training classes and a DVD for home use (intervention group), or a prolapse lifestyle advice leaflet (control group). Randomisation was minimised by centre, parity (three or less vs more than three deliveries), prolapse stage (above the hymen vs at or beyond the hymen), and delivery method (any vaginal vs all caesarean sections). Women and intervention physiotherapists could not be masked to group allocation, but allocation was masked from data entry researchers and from the trial statistician until after database lock. The primary outcome was self-reported prolapse symptoms (Pelvic Organ Prolapse Symptom Score [POP-SS]) at 2 years. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01171846. Between Dec 21, 2008, and Feb 24, 2010, in New Zealand, and Oct 27, 2010, and Sept 5, 2011, in the UK, we randomly assigned 414 women to the intervention group (n=207) or the control group (n=207). One participant in each group was excluded after randomisation, leaving 412 women for analysis. At baseline, 399 (97%) women had prolapse above or at the level of the hymen. The mean POP-SS score at 2 years was 3·2 (SD 3·4) in the intervention group versus 4·2 (SD 4·4) in the

A Simple Technique for Accurate Transfer of Secondary Copings in a Tooth-Supported Telescopic Prosthesis.

Science.gov (United States)

Shankargouda, Swapnil B; Sidhu, Preena; Kardalkar, Swetha; Desai, Pooja M

2017-02-01

Residual ridge resorption is a rapid, progressive, irreversible, and inevitable process of bone resorption. Long-standing teeth and implants have been shown to have maintained the bone around them without resorption. Thus, overdenture therapy has been proven to be beneficial in situations where few remaining teeth are present. In addition to the various advantages seen with tooth-supported telescopic overdentures, a few shortcomings can also be expected, including unseating of the overdenture, increased bulk of the prosthesis, secondary caries, etc. The precise transfer of the secondary telescopic copings to maintain the spatial relationship, without any micromovement, remains the most critical step in ensuring the success of the tooth-supported telescopic prosthesis. Thus, a simple and innovative technique of splinting the secondary copings was devised to prevent distortion and micromovement and maintain its spatial relationship. © 2015 by the American College of Prosthodontists.

A Skin Cancer Prevention Facial-Aging Mobile App for Secondary Schools in Brazil: Appearance-Focused Interventional Study

Science.gov (United States)

Heckl, Marlene; Gatzka, Martina; Heppt, Markus V; Resende Rodrigues, Henrique; Schneider, Sven; Sondermann, Wiebke; de Almeida e Silva, Carolina; Kirchberger, Michael C; Klode, Joachim; Enk, Alexander H; Knispel, Sarah; von Kalle, Christof; Stoffels, Ingo; Schadendorf, Dirk; Nakamura, Yasuhiro; Esser, Stefan; Assis, Aisllan; Bernardes-Souza, Breno

2018-01-01

Background The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. Southeast Brazil has especially high incidences of melanoma, and early detection is low. Exposure to ultraviolet (UV) radiation is a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation among adolescents for tanning. A medical student-delivered intervention that takes advantage of the broad availability of mobile phones and adolescents’ interest in their appearance indicated effectiveness in a recent study from Germany. However, the effect in a high-UV index country with a high melanoma prevalence and the capability of medical students to implement such an intervention remain unknown. Objective In this pilot study, our objective was to investigate the preliminary success and implementability of a photoaging intervention to prevent skin cancer in Brazilian adolescents. Methods We implemented a free photoaging mobile phone app (Sunface) in 15 secondary school classes in southeast Brazil. Medical students “mirrored” the pupils’ altered 3-dimensional (3D) selfies reacting to touch on tablets via a projector in front of their whole grade accompanied by a brief discussion of means of UV protection. An anonymous questionnaire capturing sociodemographic data and risk factors for melanoma measured the perceptions of the intervention on 5-point Likert scales among 356 pupils of both sexes (13-19 years old; median age 16 years) in grades 8 to 12 of 2 secondary schools in Brazil. Results We measured more than 90% agreement in both items that measured motivation to reduce UV exposure and only 5.6% disagreement: 322 (90.5%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 321 (90.2%) that it motivated them to improve their sun protection; 20 pupils (5.6%) disagreed with both items. The perceived effect on motivation was higher in female pupils in both tanning bed

[Statins and ASS for primary prevention of cardiovascular and cerebrovascular disease].

Science.gov (United States)

Goltz, L; Bodechtel, U; Siepmann, T

2014-02-01

Whereas statins and acetylsalicylic acid (ASA) are considered gold standard for secondary prevention following myocardial infarction or atherotrombotic stroke, there are inconsistent data on the use of these drugs for primary prevention in patients with increased cardiovascular risk. Some meta-analyses indicated that the use of statins and ASA for primary prevention of cardiovascular disease can reduce the risk of cardiovascular events such as ischemic stroke or myocardial infarction. However, the effects of primary prevention with statins and ASA on mortality varied in the data included in these meta-analyses. Therefore the guidelines of the German College of General Practitioners and Family Physicians recommend primary prevention with statins and ASA only in those patients who have a 10-year risk of cardiovascular events which exceeds 20 %. Divergently, primary prevention with ASA is not recommended by the European Society of Cardiology. Observational studies suggested that treatment success of primary prevention with statins and ASA depends on various factors such as adherence to medication and prescription behavior of physicians. This review summarizes the current literature on primary prevention of cardiovascular events with ASA and statins. © Georg Thieme Verlag KG Stuttgart · New York.

[Technology and prevention in the era of mobile health: applications for cancer screening programs].

Science.gov (United States)

Bert, Fabrizio; Gualano, Maria Rosaria; Clemente, Salvatore; Villa, Giulia; Siliquini, Roberta

2017-01-01

The Italian national health system provides screening to detect breast, colorecatal and cervical cancers, however, population adherence is not as high as expected. Smartphones and their applications (apps) could be used as a tool to communicate with the population and to help improve adherence. The aim of this study was to analyze the features and functions of smartphone applications aimed at secondary prevention of oncological diseases. In February 2016, we reviewed online app stores, using specific key-words, to search for available apps for cancer screening. We identified 32 apps meeting our inclusion criteria. The most frequent types of app are breast cancer (13/32) and cervical cancer (4/32) screening apps. We also found apps addressing secondary prevention of cancers for which screening is not provided to the Italian population (melanoma, prostate cancer and hepatocellular carcinoma). The most common features are: information providers (22/32), risk calculators (10/32), reminders for appointments and tests (7/32). Only one app has been validated for diagnostic accuracy or utility using established international certification (CE Marking). The results show a large potential for development and utilization of applications in secondary prevention. Despite their potential usefulness, there are also disadvantages such as language barriers (only 2 of 32 apps are in Italian), and the digital divide. Future efforts should focus on improving education regarding approaches to technologies, strengthen national and international regulations and monitoring inequalities in access to services.