WorldWideScience

Sample records for monitoring strategies prevention

  1. ProactiveVector control strategies and improved monitoring and evaluation practices for dengue prevention.

    Science.gov (United States)

    Eisen, Lars; Beaty, Barry J; Morrison, Amy C; Scott, Thomas W

    2009-11-01

    Despite tremendous efforts by public health organizations in dengue-endemic countries, it has proven difficult to achieve effective and sustainable control of the primary dengue virus vector Aedes aegypti (L.) and to effectively disrupt dengue outbreaks. This problem has multiple root causes, including uncontrolled urbanization, increased global spread of dengue viruses, and vector and dengue control programs not being provided adequate resources. In this forum article, we give an overview of the basic elements of a vector and dengue control program and describe a continuous improvement cyclical model to systematically and incrementally improve control program performance by regular efforts to identify ineffective methods and inferior technology, and then replacing them with better performing alternatives. The first step includes assessments of the overall resource allocation among vector/dengue control program activities, the efficacy of currently used vector control methods, and the appropriateness of technology used to support the program. We expect this will reveal that 1) some currently used vector control methods are not effective, 2) resource allocations often are skewed toward reactive vector control measures, and 3) proactive approaches commonly are underfunded and therefore poorly executed. Next steps are to conceptualize desired changes to vector control methods or technologies used and then to operationally determine in pilot studies whether these changes are likely to improve control program performance. This should be followed by a shift in resource allocation to replace ineffective methods and inferior technology with more effective and operationally tested alternatives. The cyclical and self-improving nature of the continuous improvement model will produce locally appropriate management strategies that continually are adapted to counter changes in vector population or dengue virus transmission dynamics. We discuss promising proactive vector control

  2. [Preventive strategies for dementia].

    Science.gov (United States)

    Müller, Patrick; Schmicker, Marlen; Müller, Notger G

    2017-05-01

    In the context of the demographically induced increase in the prevalence of dementia and the simultaneous lack of causal pharmacological therapies, preventive approaches are gaining in importance. By reducing risk factors and with measures which induce neuroplasticity successful aging can be supported. This article summarizes the current developments in preventing dementia by modification of life style factors. The main focus lies on the impact of cognitive and physical activity on neuroprotection. A promising approach combines both activities within a dance training program. Further studies that meet the demanding criteria of a randomized clinical trial are urgently needed.

  3. CO monitoring strategy. Letter report

    Energy Technology Data Exchange (ETDEWEB)

    Van der Swaluw, E.; Hoogerbrugge, R.; Van Pul, A.

    2012-02-15

    In the current Dutch monitoring network (LML) there are 21 locations where concentrations of carbon monoxide (CO) are being measured. However, according to European legislation, at the current measured concentrations of CO, measurements are no longer required. In order to keep track of trends in the levels of CO-concentration in the Netherlands, RIVM proposes to continue measurement of CO-monitoring at a limited number of stations. This work has been performed for the account of the Ministry of Infrastructure and the Environment in order to update the monitoring strategy of CO. It is recommended to continue measuring CO at the three different types of monitoring stations, i.e. rural background station, urban background station and traffic station. The urban background and traffic monitoring station should ideally be located in the same city such that the contribution of traffic to CO in a city can be accurately determined.

  4. Health promotion and prevention strategies.

    Science.gov (United States)

    Bradbury-Golas, Kathleen

    2013-09-01

    Opiate dependency is a medical disorder that requires treatment intervention. Primary health care not only entails treatment of illness but also involves disease prevention and health promotion. Based on Pender's revised Health Promotion Model, a descriptive study comparing the health promoting behaviors/practices in abusing and recovering opiate-dependent drug users is analyzed. Using the Health Promoting Lifestyle Profile II, a comparative descriptive, exploratory, nonexperimental design study was conducted to identify key health-promoting behaviors in recovering opiate-dependent drug users. Prevention strategy recommendations are discussed, along with future research recommendations.

  5. Strategies to Prevent Preterm Birth

    Directory of Open Access Journals (Sweden)

    John Phillips Newnham

    2014-11-01

    Full Text Available After several decades of research we now have evidence that at least six interventions are suitable for immediate use in contemporary clinical practice within high-resource settings and can be expected to safely reduce the rate of preterm birth. These interventions involve strategies to prevent non-medically indicated late preterm birth; use of maternal progesterone supplementation; surgical closure of the cervix with cerclage; prevention of exposure of pregnant women to cigarette smoke; judicious use of fertility treatments; and dedicated preterm birth prevention clinics. Quantification of the extent of success is difficult to predict and will be dependent on other clinical, cultural, societal and economic factors operating in each environment. Further success can be anticipated in the coming years as other research discoveries are translated into clinical practice, including new approaches to treating intra-uterine infection, improvements in maternal nutrition and lifestyle modifications to ameliorate maternal stress. The widespread use of human papillomavirus (HPV vaccination in girls and young women will decrease the need for surgical interventions on the cervix and can be expected to further reduce the risk of early birth.Together, this array of clinical interventions, each based on a substantial body of evidence, is likely to reduce rates of preterm birth and prevent death and disability in large numbers of children. The process begins with an acceptance that early birth is not an inevitable and natural feature of human reproduction. Preventative strategies are now available and need to be applied. The best outcomes may come from developing integrated strategies designed specifically for each health care environment.

  6. Strategies to Prevent Preterm Birth

    Science.gov (United States)

    Newnham, John P.; Dickinson, Jan E.; Hart, Roger J.; Pennell, Craig E.; Arrese, Catherine A.; Keelan, Jeffrey A.

    2014-01-01

    After several decades of research, we now have evidence that at least six interventions are suitable for immediate use in contemporary clinical practice within high-resource settings and can be expected to safely reduce the rate of preterm birth. These interventions involve strategies to prevent non-medically indicated late preterm birth; use of maternal progesterone supplementation; surgical closure of the cervix with cerclage; prevention of exposure of pregnant women to cigarette smoke; judicious use of fertility treatments; and dedicated preterm birth prevention clinics. Quantification of the extent of success is difficult to predict and will be dependent on other clinical, cultural, societal, and economic factors operating in each environment. Further success can be anticipated in the coming years as other research discoveries are translated into clinical practice, including new approaches to treating intra-uterine infection, improvements in maternal nutrition, and lifestyle modifications to ameliorate maternal stress. The widespread use of human papillomavirus vaccination in girls and young women will decrease the need for surgical interventions on the cervix and can be expected to further reduce the risk of early birth. Together, this array of clinical interventions, each based on a substantial body of evidence, is likely to reduce rates of preterm birth and prevent death and disability in large numbers of children. The process begins with an acceptance that early birth is not an inevitable and natural feature of human reproduction. Preventative strategies are now available and need to be applied. The best outcomes may come from developing integrated strategies designed specifically for each health-care environment. PMID:25477878

  7. Diagnosis and Prevention Strategies for Dental Caries

    Science.gov (United States)

    Lee, Yoon

    2013-01-01

    Dental caries is one of the oldest and most common diseases found in humans. With the recent shift from the surgical model, which emphasized restorative treatment, to a medical model of disease management, newer strategies emphasize disease prevention and conservation of tooth structure. For early detection and monitoring of caries, rather than waiting until a cavity is formed and restorative treatment is needed, devices such as DIAGNOdent, Digital Imaging Fiber-Optic Transillumination, quantitative light-induced fluorescence, and the Electronic Caries Monitor have been introduced. For caries prevention, oral hygiene measures, fluoride application, pit-and-fissure sealants, the use of xylitol, the development of a dental caries vaccine, and the role of the primary caregiver for infants are briefly discussed. PMID:26064846

  8. Monitoring of occupational exposure in medical staff and prevention strategies%医务人员职业暴露监测分析与防范对策

    Institute of Scientific and Technical Information of China (English)

    李润蓉; 沈振威

    2016-01-01

    目的:分析医务人员职业暴露的相关因素,针对性采取防范对策。方法:用自行设计的职业暴露登记表,对医务人员发生职业暴露的监测资料进行回顾性调查。结果:41名医务人员发生职业暴露,护士占70.73%,工龄5年以下占68.29%,职业暴露发生科室多见外科,占31.71%,发生地点病房居首,占46.34%。主要是锐器伤占90.24%,主要环节依次是拔针、术中切开或缝合、处置医疗废物,分别占39.02%、21.95%、14.63%,暴露源血源性传播疾病22人,占53.66%,乙型肝炎16人,占39.02%,职业暴露的系列处理到位,未发生职业暴露感染。2013、2014年职业暴露发生率分别为3.57%、2.29%;上报率分别为48.00%、68.75%。结论:建立职业安全防护制度,开展安全培训教育,定期体检及预防接种,督导医护人员的规范化操作,配备安全器具和防护用品等,能有效防范医务人员职业暴露发生。%Objective To analyze the factors associated with the occupational exposure in medical staff,and to probe possible prevention strategies. Method The retrospective review on the monitoring data of occupational exposure in medical staff was made by the self-designed occupation exposure registration form. Results There were 41 cases of occupational exposure during the re-view. The accidents occurred mainly in the nurses(70. 73%),most were less than five years of seniority(68. 29%),and the oc-cupational exposures were most common in the department of surgery( 31. 71%). Among the departments,the wards ranked the first place( 46. 34%),and the sharp injuries accounted for 90. 24%. The withdrawal of needles( 39. 02%),surgical sutures (21. 95%),disposal of medical waste(14. 63%),there were 22 patients(55. 36%)with blood-borne disease as the source of exposure,most of them were infected with hepatitis B(16 cases,39. 02%). The wound could be correctly handled after

  9. Workplace prevention and promotion strategies.

    Science.gov (United States)

    Vézina, Michel; Bourbonnais, Renée; Brisson, Chantal; Trudel, Louis

    2004-01-01

    Psychosocial factors refer to all organizational factors and interpersonal relationships in the workplace that may affect the health of the workers. Currently, two psychosocial risk models are universally recognized for producing solid scientific knowledge regarding the vital link between social or psychological phenomena at work and the development of several diseases, such as cardiovascular diseases or depression. The first is the "job demand-contro-support" model, which was defined by Karasek and to which the concept of social support has been added; the second is the "effort/reward imbalance" model defined by Siegrist. The public health perspective calls for theoretical models based on certain psychosocial attributes of the work environment for which there is empirical evidence of their pathogenic potential for exposed workers. Not only do these models reduce the complexity of the psychosocial reality of the work to components that are significant in terms of health risks, but they also facilitate the development and implementation of workplace interventions. Psychosocial risk intervention strategies currently implemented by companies are predominantly individual-oriented and aim chiefly at reducing the effects of stressful work situations by improving individual ability to adapt to the situation and manage stress. Like personal protection equipment for exposure to physical or chemical risks, these secondary prevention measures are commendable but insufficient, because they aim to reduce only the symptoms and not the cause of problems. Any intervention program for these risks should necessarily include a primary prevention component with a view to eliminating, or at least reducing, the psychosocial pathogenic agents in the workplace. Several authors have suggested that well-structured organizational approaches are most effective and should generate more important, longer-lasting effects than individual approaches. However, the evidence should be strengthened by

  10. A national strategy for a long-term monitoring of permafrost and periglacial processes and their relationship to natural hazard prevention in Austria

    Science.gov (United States)

    Kellerer-Pirklbauer, Andreas; Bartsch, Annett; Gitschthaler, Christoph; Reisenhofer, Stefan; Weyss, Gernot; Riedl, Claudia; Avian, Michael

    2016-04-01

    About 2.5% (~2000 km²) of the national territory of Austria is influenced by permafrost conditions. A slightly smaller area of Austria is additionally affected by deep seasonal frost which is, however, similarly exposed to intensive physical weathering and related geomorphic processes. Currently, 23 skiing resorts, 31 water reservoirs and 42 mountain huts are either directly or indirectly influenced by permafrost and associated processes in Austria as determined from regional permafrost models. Ground thermal changes most likely affect the ground stability and infrastructure in those areas. Therefore, changes in the distribution and characteristics of permafrost and seasonal frost are of high economic and ecological importance. A range of Austrian institutions are interested in systematic permafrost monitoring (several universities, geological surveys, the Austrian torrent and avalanche control agency or several different alpine clubs). However, to date no coordinated monitoring network has been established on a national scale and a strategy for long-term permafrost/periglacial observation did not exist so far. Such a national strategy has been developed in 2015 within the permAT project funded through the StartClim2014-program. During permAT an extensive literature review and data search as well as a workshop with 40 participants (scientists, stakeholder and policy maker) were accomplished. The workshop allowed the integration of national as well as international colleagues into the strategy development. Results of permAT clearly demonstrate that the number of present permafrost/periglacial monitoring sites is far too little in Austria. Only few alpine areas of Austria are well represented by the existing monitoring activities but large areas lack such instrumentations. Furthermore, permafrost boreholes exist at only three sites in central Austria (all contribution to the GTN-P network) and there is a lack of knowledge about thermal conditions and recent changes

  11. Preventive strategies for common mental disorders

    Directory of Open Access Journals (Sweden)

    Jasmin Garg

    2017-01-01

    Full Text Available Common Mental Disoders (CMDs include depressive and anxiety disorders; one in five individuals, worldwide, gets afflicted with CMDs over lifetime. A wide range of preventive strategies have shown promise when implemented across different stages of lifespan. There is a common thread of emerging preventive strategies for CMDs on the lines for those already established for non-communicable diseases. In India, although there is emerging research in this area, the much required prevention is still in its incipient stage. Some critical issues in planning research and implementing preventive strategies are also outlined to provide a more appropriate perspective.

  12. Moving toward Biobehavioral Prevention Strategie

    African Journals Online (AJOL)

    AJRH Managing Editor

    differences, as younger women are more likely to ... year old non-pregnant women in South Africa have an HIV ... context of relationships, women's unequal power – which in ... unique phase of life, characterized by rapid physical, emotional and developmental change19. ... people use a pill daily for prevention, as opposed.

  13. Optimal strategies for flood prevention

    NARCIS (Netherlands)

    Eijgenraam, Carel; Brekelmans, Ruud; den Hertog, Dick; Roos, C.

    2016-01-01

    Flood prevention policy is of major importance to the Netherlands since a large part of the country is below sea level and high water levels in rivers may also cause floods. In this paper we propose a dike height optimization model to determine economically efficient flood protection standards. We i

  14. Occupational injury insurance - A strategy for prevention?

    DEFF Research Database (Denmark)

    Jacobsen, Thomas

    1993-01-01

    Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French.......Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French....

  15. Occupational injury insurance - A strategy for prevention?

    DEFF Research Database (Denmark)

    Jacobsen, Thomas

    1993-01-01

    Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French.......Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French....

  16. Prevent: A Fragmented Counter-Terrorism Strategy

    Science.gov (United States)

    2015-05-21

    of the Prevent strategy. The British counter-insurgency experiences in Malaysia provide an invaluable insight into the historical lessons of...cultural diversity , and language are recognized, it becomes easier to appreciate why a separation from the rest of the United Kingdom’s society is...autonomy in Malaysia reflect a similar dichotomy that the OSCT and DCLG face today. The Prevent strategy of decentralized control and emphasis on local

  17. Efficient immunization strategies to prevent financial contagion

    Science.gov (United States)

    Kobayashi, Teruyoshi; Hasui, Kohei

    2014-01-01

    Many immunization strategies have been proposed to prevent infectious viruses from spreading through a network. In this work, we study efficient immunization strategies to prevent a default contagion that might occur in a financial network. An essential difference from the previous studies on immunization strategy is that we take into account the possibility of serious side effects. Uniform immunization refers to a situation in which banks are ``vaccinated'' with a common low-risk asset. The riskiness of immunized banks will decrease significantly, but the level of systemic risk may increase due to the de-diversification effect. To overcome this side effect, we propose another immunization strategy, called counteractive immunization, which prevents pairs of banks from failing simultaneously. We find that counteractive immunization can efficiently reduce systemic risk without altering the riskiness of individual banks.

  18. [Discussion of HIV control and prevention strategies].

    Science.gov (United States)

    Lyu, P

    2016-10-06

    Expansion of HIV testing and ART treatment are core strategies for achieving the ambitious global goal of ending the HIV epidemic by the end of 2030, and achieving the "90-90-90" target by 2020. In China, great progress in HIV control and prevention has been made; however, there is room to enhance the effectiveness of HIV-related strategies. In addition, some implemented strategies have not achieved their expected output. To confront the challenge of sexual transmission of HIV, which is the main route of transmission in China, more targeted HIV prevention strategies that lead to their expected outcomes are essential. It is important to strengthen existing strategies that have been proved effective. However, it is also critical to create innovative strategies, and there are five approaches to achieve this. First, a holistic perspective should be adopted, to better understand the current situation and problems. This means intervention strategies should give serious consideration of how to meet the sociocultural needs of target populations rather than merely carry out behavioral interventions. Second, community-based HIV prevention settings should have more important roles in providing HIV-related health care services. Moreover, to improve the effectiveness of these strategies, a problem-led working style should be integrated into HIV prevention measures overall. Third, thoroughly analyzing characteristics of the current HIV epidemic using more evidence-based considerations must be undertaken, to better control HIV sexual transmission. Fourth, continued improvement of AIDS prevention and control mechanisms is needed, to ensure their sustainable development. Last, it is necessary to involve more NGOs in HIV prevention work by strengthening their management and working capacities to provide HIV-related services. Also needed is further improvement in both technical and management capacities, so as to build a stable basis for effective response.

  19. Dietary strategies for cancer prevention.

    Science.gov (United States)

    Bal, D G; Foerster, S B

    1993-08-01

    Two-thirds of cancer cases are associated with two lifestyle practices: 35% with the typical American diet, and 30% with tobacco use. In contrast to the field of tobacco control, research and resources dedicated to the field of nutrition have been limited, in part because dietary change has been considered controversial and requires a more complex set of interventions. This series of papers reviews the science base underlying diet as a cancer control strategy, including research about diet-cancer relationships, current nutrition policy recommendations, American dietary trends, models of dietary behavior change, and diet in health care delivery. The history of technology transfer of new knowledge into widespread application will be compared and contrasted with other cancer control measures. There is scientific and policy agreement about three priority dietary goals for the year 2000: increase fruit and vegetable consumption to 5 or more servings every day, increase breads, cereals, and legumes to 6 or more servings daily, and decrease fat to no more than 30% of total calories. Current data do not indicate that these goals will be reached. As yet there is no organized effort, with clearly identified steps, to translate research into practice. The parallel with delays in implementing other cancer control measures, including Papanicolaou testing, mammography, and tobacco intervention, is striking. Without resources dedicated to dietary modification in the general population, it is not likely that the potential savings of more than 300,000 new cases, 160,000 deaths, and the $25 billion in associated costs will be realized in the foreseeable future.

  20. Preventing Mass Atrocities: Ideological Strategies and Interventions

    Directory of Open Access Journals (Sweden)

    Jonathan Leader Maynard

    2015-10-01

    Full Text Available Both scholars and international actors frequently stress the important role played by anti-civilian ideologies in escalating risks of mass atrocities against civilians. Yet strategies to combat and counter anti-civilian ideologies remain an uncertain and understudied component of atrocity prevention, and scepticism about their efficacy is to be expected. This paper provides a preliminary framework for thinking about strategies and interventions designed to counter the ideological causes of mass atrocities. First, I briefly clarify what existing research seems to suggest the role of ideology in mass atrocities is, and is not. I caution against cruder or overly strong theses about the role ideology plays, but clarify that whilst ideology’s actual causal impact is varying and complex, it is also significant. Second, I clarify what ideological interventions and strategies might be reasonably expected to do, and comparatively assess them against more dominant existing prevention tools to show that their preventive potential is sufficiently high to warrant usage. Finally, I provide guidelines on how the effort to formulate ideological strategies and interventions for preventing mass atrocities should best proceed.

  1. Danish preventive measures and deradicalization strategies

    DEFF Research Database (Denmark)

    Bertelsen, Preben

    2015-01-01

    The Danish anti- and de-radicalization strategy involves three interwoven elements: (a) an early prevention and exit programme, (b) prosecution of radicalized persons who have committed violent crimes (in Denmark or in a foreign country), including measures such as confiscation of passport, and (c...

  2. Preventing Mass Atrocities: Ideological Strategies and Interventions

    Directory of Open Access Journals (Sweden)

    Jonathan Leader Maynard

    2015-10-01

    Full Text Available Both scholars and international actors frequently stress the important role played by anti-civilian ideologies in escalating risks of mass atrocities against civilians. Yet strategies to combat and counter anti-civilian ideologies remain an uncertain and understudied component of atrocity prevention, and scepticism about their efficacy is to be expected. This paper provides a preliminary framework for thinking about strategies and interventions designed to counter the ideological causes of mass atrocities. First, I briefly clarify what existing research seems to suggest the role of ideology in mass atrocities is, and is not. I caution against cruder or overly strong theses about the role ideology plays, but clarify that whilst ideology’s actual causal impact is varying and complex, it is also significant. Second, I clarify what ideological interventions and strategies might be reasonably expected to do, and comparatively assess them against more dominant existing prevention tools to show that their preventive potential is sufficiently high to warrant usage. Finally, I provide guidelines on how the effort to formulate ideological strategies and interventions for preventing mass atrocities should best proceed.

  3. Educators' Perceptions on Bullying Prevention Strategies

    Science.gov (United States)

    de Wet, Corene

    2017-01-01

    I report on an investigation into a group of Free State educators' recognition of bullying, their reactions to incidences of bullying, and their perceptions of the effectiveness of a number of bullying prevention strategies. The research instrument was a synthesis of the Delaware Research Questionnaire and questions based on findings from previous…

  4. Prevention strategies for Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Gauthier Serge

    2012-06-01

    Full Text Available Abstract Symptomatic treatment during the dementia stage of Alzheimer’s disease(AD cannot delay or halt the progression of this disease. Therefore, prevention in the preclinical stage is likely the most effective way to decrease the incidence of this age-associated neurodegenerative condition, and its associated burden for individuals and society. Age, gender, family history, ApoE4, systolic blood pressure, body mass index, total cholesterol level and physical activity are all used as component of dementia risk score. There have been numerous challenges in conducting primary prevention trials in AD. Enrichment strategies for prevention studies include studying those subjects with more risk factors for AD, such as older age, those with a positive family history of late onset AD, and those who are ApoE4 positive. Each of these strategies is designed to increase the probability of developing AD thereby decreasing the sample size or the duration of follow up. Another strategy would be to target directly the pathophysiology of AD in its preclinical stages and use the biomarkers in prevention trial as surrogate markers. This will be done first in carriers of dominantly inherited early onset AD. As this research takes place networks of memory clinics must prepare to transfer new knowledge to persons interested in a preventive approach to AD.

  5. STD patients’ preferences for HIV prevention strategies

    Science.gov (United States)

    Castro, Jose G; Jones, Deborah L; Weiss, Stephen M

    2014-01-01

    The objective of this pilot study was to explore the knowledge of and preferences regarding effective biomedical interventions among high risk individuals attending a sexually transmitted diseases clinic, and to examine the effect of a brief information intervention on preference. Participants completed a baseline assessment, attended a presentation on human immunodeficiency virus (HIV) prevention methods, and completed a postintervention assessment. Outcome measures included: demographics and sexual risk factors, self-perceived HIV risk, and knowledge and attitudes regarding new biomedical methods of HIV prevention. After the baseline evaluation, participants were provided with information on new biomedical prevention strategies. Participants were given the option to review the information by reading a pamphlet or by viewing a brief video containing the same information. Participants (n=97) were female (n=51) and male (n=46). At baseline, only a small minority of participants were aware of the newer biomedical strategies to prevent HIV infection. Postintervention, 40% endorsed having heard about the use of HIV medications to prevent HIV infection; 72% had heard that male circumcision can decrease the risk of acquiring HIV infection in men; and 73% endorsed knowledge of the potential role of microbicides in decreasing the risk of acquiring HIV. Following the intervention, the most preferred prevention method was male condoms, followed by preexposure prophylaxis, and microbicides. The least preferred methods were male circumcision and female condoms. This study provides preliminary information on knowledge and attitudes regarding newer biomedical interventions to protect against HIV infection. PMID:25540597

  6. Preventive strategies in child and adolescent psychiatry

    Directory of Open Access Journals (Sweden)

    Rajesh Sagar

    2017-01-01

    Full Text Available Childhood and adolescence are periods of growth and development that are critical to the formation of adult personality and psychopathology. Moreover, childhood psychopathology may differ significantly in presentation and risk factors from those seen among adults and may require different preventive strategies. Service-related characteristics such as the shortage of trained child and adolescent mental health professionals also demand that the focus should shift from resource-intensive treatment interventions, toward preventive measures that can be delivered at lower cost in terms of workforce, money, and time; and can lead to improved outcomes for a wide variety of conditions. Preventive strategies that have been implemented in this population have mostly included both preventive measures (aiming at reducing the prevalence of risk factors and promotive components (aimed at increasing resilience and positive mental health characteristics, usually in combination. Interventions have been shown to be most effective when they are targeted at underlying latent structures that predict risk; they are also more effective when delivered over a prolonged period. Interventions must also be formulated such that they are developmentally appropriate, and with clearly stated outcome parameters for evaluation. A few example interventions that have made use of these strategies are discussed in the course of this article.

  7. Strategies for the prevention of oesophageal adenocarcinoma.

    Science.gov (United States)

    Almond, L Max; Old, Oliver; Barr, Hugh

    2014-01-01

    The incidence of oesophageal adenocarcinoma has increased by 500% over the past 30 years [1]. Improved understanding of the mechanisms of neoplastic progression provides an opportunity to reverse this trend. A thorough review of emerging strategies aiming to prevent the formation of oesophageal malignancy is presented. These include dietary modification, chemoprevention, early endoscopic identification and treatment of premalignant disease, and the potential for a non-endoscopic screening test. Oesophageal adenocarcinoma has become a major public health problem in the West and it is essential that clinicians are fully informed of risk reduction strategies so that they can be actively promoted in the community.

  8. Monitoring: A Strategy to Detect Imminent Mistakes

    NARCIS (Netherlands)

    Jossberger, Helen; Brand-Gruwel, Saskia; Boshuizen, Els; Van de Wiel, Margje

    2010-01-01

    Jossberger, H., Brand-Gruwel, S., Boshuizen, H. P. A., & Van de Wiel, M. (2010, August). Monitoring: A strategy to detect imminent mistakes. In D. Sembill (Chair), Human Fallibility: The Ambiguity of Errors for Work and Learning. Symposium conducted at the EARLI Learning and Professional Development

  9. Monitoring: A Strategy to Detect Imminent Mistakes

    NARCIS (Netherlands)

    Jossberger, Helen; Brand-Gruwel, Saskia; Boshuizen, Els; Van de Wiel, Margje

    2010-01-01

    Jossberger, H., Brand-Gruwel, S., Boshuizen, H. P. A., & Van de Wiel, M. (2010, August). Monitoring: A strategy to detect imminent mistakes. In D. Sembill (Chair), Human Fallibility: The Ambiguity of Errors for Work and Learning. Symposium conducted at the EARLI Learning and Professional Development

  10. Optimization of Sensor Monitoring Strategies for Emissions

    Science.gov (United States)

    Klise, K. A.; Laird, C. D.; Downey, N.; Baker Hebert, L.; Blewitt, D.; Smith, G. R.

    2016-12-01

    Continuous or regularly scheduled monitoring has the potential to quickly identify changes in air quality. However, even with low-cost sensors, only a limited number of sensors can be placed to monitor airborne pollutants. The physical placement of these sensors and the sensor technology used can have a large impact on the performance of a monitoring strategy. Furthermore, sensors can be placed for different objectives, including maximum coverage, minimum time to detection or exposure, or to quantify emissions. Different objectives may require different monitoring strategies, which need to be evaluated by stakeholders before sensors are placed in the field. In this presentation, we outline methods to enhance ambient detection programs through optimal design of the monitoring strategy. These methods integrate atmospheric transport models with sensor characteristics, including fixed and mobile sensors, sensor cost and failure rate. The methods use site specific pre-computed scenarios which capture differences in meteorology, terrain, concentration averaging times, gas concentration, and emission characteristics. The pre-computed scenarios become input to a mixed-integer, stochastic programming problem that solves for sensor locations and types that maximize the effectiveness of the detection program. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

  11. STD patients’ preferences for HIV prevention strategies

    Directory of Open Access Journals (Sweden)

    Castro JG

    2014-12-01

    Full Text Available Jose G Castro,1 Deborah L Jones,2 Stephen M Weiss2 1Infectious Diseases, Department of Medicine, 2Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA Abstract: The objective of this pilot study was to explore the knowledge of and preferences regarding effective biomedical interventions among high risk individuals attending a sexually transmitted diseases clinic, and to examine the effect of a brief information intervention on preference. Participants completed a baseline assessment, attended a presentation on human immunodeficiency virus (HIV prevention methods, and completed a postintervention assessment. Outcome measures included: demographics and sexual risk factors, self-perceived HIV risk, and knowledge and attitudes regarding new biomedical methods of HIV prevention. After the baseline evaluation, participants were provided with information on new biomedical prevention strategies. Participants were given the option to review the information by reading a pamphlet or by viewing a brief video containing the same information. Participants (n=97 were female (n=51 and male (n=46. At baseline, only a small minority of participants were aware of the newer biomedical strategies to prevent HIV infection. Postintervention, 40% endorsed having heard about the use of HIV medications to prevent HIV infection; 72% had heard that male circumcision can decrease the risk of acquiring HIV infection in men; and 73% endorsed knowledge of the potential role of microbicides in decreasing the risk of acquiring HIV. Following the intervention, the most preferred prevention method was male condoms, followed by preexposure prophylaxis, and microbicides. The least preferred methods were male circumcision and female condoms. This study provides preliminary information on knowledge and attitudes regarding newer biomedical interventions to protect against HIV infection. Keywords: STD clinic, biomedical HIV prevention, PrEP, male

  12. [Nutritional dynamic monitoring during pregnancy: a personalized intervention of prevention].

    Science.gov (United States)

    De Cristofaro, Paolo; Pompilii, Sonia; Di Bonifacio, M Teresa; Malatesta, Guido; Pantoni, Natascia; Xhebraj, Elona; Dragani, Beatrice

    2008-06-01

    Obesity is an increasing condition spreading out in all of the world, independently by race, sex and age. Obesity in pregnancy represent a risk condition for both mother and her offspring. All of the studies are observational and show intervention strategies on weight gain improvement during gestational period, a current topic, but still controversial. Our study is based on nutritional dynamic monitoring during pregnancy in order to improve health and wellbeing status of both mother and her offspring, through an early and efficacy prevention.

  13. Vaccines and immunization strategies for dengue prevention.

    Science.gov (United States)

    Liu, Yang; Liu, Jianying; Cheng, Gong

    2016-07-20

    Dengue is currently the most significant arboviral disease afflicting tropical and sub-tropical countries worldwide. Dengue vaccines, such as the multivalent attenuated, chimeric, DNA and inactivated vaccines, have been developed to prevent dengue infection in humans, and they function predominantly by stimulating immune responses against the dengue virus (DENV) envelope (E) and nonstructural-1 proteins (NS1). Of these vaccines, a live attenuated chimeric tetravalent DENV vaccine developed by Sanofi Pasteur has been licensed in several countries. However, this vaccine renders only partial protection against the DENV2 infection and is associated with an unexplained increased incidence of hospitalization for severe dengue disease among children younger than nine years old. In addition to the virus-based vaccines, several mosquito-based dengue immunization strategies have been developed to interrupt the vector competence and effectively reduce the number of infected mosquito vectors, thus controlling the transmission of DENV in nature. Here we summarize the recent progress in the development of dengue vaccines and novel immunization strategies and propose some prospective vaccine strategies for disease prevention in the future.

  14. Photocarcinogenesis and Skin Cancer Prevention Strategies.

    Science.gov (United States)

    Seebode, Christina; Lehmann, Janin; Emmert, Steffen

    2016-03-01

    In this review the basic principles of UV-induced carcinogenesis are summarized and the state of the art diagnosis and therapeutic strategies are discussed. The prevalent keratinocyte-derived neoplasms of the skin are basal cell and squamous cell carcinomas. Cutaneous melanoma is less frequent but associated with high mortality. Common risk factors for all three tumor entities include sun exposure and DNA-repair deficiencies. Photocarcinogenesis follows a multistep model of cancer development in which ultraviolet-induced DNA damage leads to mutations resulting in activation of oncogenes or silencing of tumor-suppressor genes. This ends in a cellular mutator phenotype even more prone to mutation acquisition. DNA repair, especially the nucleotide excision repair (NER) pathway, counteracts mutation formation and skin cancer development. This is vividly demonstrated by the NER-defective disorder xeroderma pigmentosum. Primary skin cancer preventative strategies, therefore, include reduction of DNA photodamage by protection from the sun. Secondary preventative strategies include skin cancer screening. This implies standard examination techniques with the naked eye, an epiluminescence microscope, or digital epiluminescence microscopy. More advanced techniques include confocal laser scan microscopy.

  15. Mechanism Design of Fashion Virtual Enterprise under Monitoring Strategy

    Directory of Open Access Journals (Sweden)

    Min Huang

    2014-01-01

    Full Text Available Designing a revenue sharing contract to prevent the moral hazard is one of the most important issues in virtual enterprise (VE. As the partners’ productive effort level cannot be observed by the owner and other partners, there is usually moral hazard problem in VE. To mitigate the moral hazard, the owner sets the monitoring effort with monitoring cost. Considering a risk-neutral owner and multiple downside risk-averse partners, the owner’s problem of determining the monitoring effort and incentive intensity to maximize his profit while the partners determine their productive effort to maximize their profit is addressed. The principal agent based model of this problem is proposed. By solving the model, the optimal strategy of owner and partner is derived. By comparing with the no monitoring scenario, we find that implementing suitable monitoring strategy can reduce the moral hazard effectively. Finally, by analyzing the partners’ risk attitude, the result reveals that the lower the risk level of the partner is, the more the owner wants. These results suggest that VE should not only focus on the risk attitude but also on monitoring.

  16. Uncovering effective strategies for hearing loss prevention.

    Science.gov (United States)

    Morata, Thais C; Meinke, Deanna

    2016-04-01

    Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations.

  17. Improving influenza vaccination coverage among high-risk patients : a role for computer-supported prevention strategy?

    NARCIS (Netherlands)

    Hak, E; van Essen, G A; Stalman, W A; de Melker, R A

    1998-01-01

    BACKGROUND: Worldwide, population-based influenza vaccination strategies are being developed to trace, immunize and monitor high-risk persons efficiently. Computerized prevention modules may facilitate such a strategy in general practice. OBJECTIVES: We established the applicability of a computerize

  18. Osteosarcopenic obesity and fall prevention strategies.

    Science.gov (United States)

    Hita-Contreras, Fidel; Martínez-Amat, Antonio; Cruz-Díaz, David; Pérez-López, Faustino R

    2015-02-01

    Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal women's balance, leading to a decreased risk of falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Monitoring strategy to match the advanced fabs

    Science.gov (United States)

    Ackmann, Paul W.

    2004-06-01

    The reduction in feature size below the exposure wavelength, the requirement for high yields, the expectation for consistent cycletime and shipment to mix, all mean that the reticle industry must be like advanced wafer fabrication centers. Due to the lower output of write tools versus steppers, and the fact that a reticle is a lot of one instead of 25 or 50 wafers as well as the need to match ship data to Fab ramp, the reticle line monitoring strategy must be optimized for small sample size. The use of tool time and alternative inspection strategies can lead to the early detection of problems. Because every reticle is a customer specific design, the monitoring strategy takes on a new look compared to the Fab. We have organized the AMTC to resemble a wafer fab. We have a dedicated Integration group that works with the customers and technologists, to monitor the needs of the customers and then drive the development programs that improve reticle capability. We have dedicated yield team to identify and classify the yield loss mechanisms and define probable causes. The teams then work with the Process owners to fix the source of yield loss and track the corrective actions. All sources of variations must be modeled and then sources of errors reduced to levels below the tool specification. The manufacturing organization has all the process and tool experts to focus on Pilot Line and Development tasks to meet the advance needs of our customers. With the organization in place we can then develop the methods based on Reticle and Fab manufacturing to best control the line and provide development with manufacturing cycle times.

  20. Hepatocellular carcinoma in Asia: Prevention strategy andplanning

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    , diabetes andNAFLD is of a great medical importance.CONCLUSION: The main challenge which still presentin Asia, is the high prevalence of chronic hepatitis.So, prevention of HBV and HCV is the key strategy toreduce the incidence of HCC in Asia.

  1. OBESITY: health prevention strategies in school environments

    Directory of Open Access Journals (Sweden)

    Pâmela Ferreira Todendi

    2013-04-01

    Full Text Available At present, obesity configures a public health problem which calls for attention from different sectors, given the proportion it assumes all over the world. Several studies relate this problem to metabolic health problems, including endocrinal, cardiovascular, lung, gastrointestinal, psychiatric, hematological disturbances, among others. Obesity is not only associated with genetic and environmental factors, but also with unhealthy lifestyles. In view of its social importance, it is ascertained, through analyses of studies, that there are not many health prevention strategies focused on this situation. As a result of this ascertainment, the proposal is for updating prevention actions in the realm of obese schoolchildren, resulting from a work conducted during the Master’s Degree lessons in Health Promotion at the University of Santa Cruz do Sul (UNISC. The point in question is the fact that many schools pose no restrictions to products sold in their canteens. Food stuffs sold in schools should have adequate nutritional quality, and snacks prepared at school are extremely important in meeting all nutritional requirements. However, many children do not consume these school lunches, but they bring them from home or purchase them at the canteen, spending public resources, along with not taking in healthy foods and, as a consequence, leading to health problems over the years. For all this, it is of fundamental importance to carry out investigating processes with regard to how public actions and policies are being implemented towards this end, in view of the fact that obesity in schoolchildren is on a rising trend.

  2. Monitoring nearest neighbor queries with cache strategies

    Institute of Scientific and Technical Information of China (English)

    PAN Peng; LU Yan-sheng

    2007-01-01

    The problem of continuously monitoring multiple K-nearest neighbor (K-NN) queries with dynamic object and query dataset is valuable for many location-based applications. A practical method is to partition the data space into grid cells, with both object and query table being indexed by this grid structure, while solving the problem by periodically joining cells of objects with queries having their influence regions intersecting the cells. In the worst case, all cells of objects will be accessed once. Object and query cache strategies are proposed to further reduce the I/O cost. With object cache strategy, queries remaining static in current processing cycle seldom need I/O cost, they can be returned quickly. The main I/O cost comes from moving queries, the query cache strategy is used to restrict their search-regions, which uses current results of queries in the main memory buffer. The queries can share not only the accessing of object pages, but also their influence regions. Theoretical analysis of the expected I/O cost is presented, with the I/O cost being about 40% that of the SEA-CNN method in the experiment results.

  3. Evidence-based prevention, management, and monitoring of dental caries.

    Science.gov (United States)

    Barber, Lois Rigmont; Wilkins, Esther M

    2002-01-01

    Dental caries, not unlike periodontal diseases, is now recognized as an infectious, transmissible, multifactorial disease of bacterial origin. Current evidence-based emphasis is on the need to recognize a carious lesion in its earliest stage before demineralization has produced a cavitated lesion that requires restoration by a dentist. As a result of current understanding of caries control, the dental hygienist's role as a prevention specialist is to determine the dental caries risk factors for patients of all ages and to introduce remineralization strategies into the patient's dental hygiene care plan. Conservative strategies of a concentrated program include initial infection control with a chlorhexidine rinse; extra daily fluoride exposures; placement of pit and fissure sealants where indicated; control of sucrose exposures; use of sugar substitutes, particularly xylitol-containing sugar-free chewing gum; and an emphasis on a daily bacterial plaque removal routine. Evidence supports the management and monitoring of dental caries. Caries risk level must be reevaluated at each maintenance appointment. Appropriate in-office strategies to preserve tooth structure should be carried out and followed by applicable home regimens that are based on need, not age.

  4. Clostridium difficile outbreaks: prevention and treatment strategies

    Directory of Open Access Journals (Sweden)

    Martinez FJ

    2012-07-01

    Full Text Available Fernando J Martinez,1 Daniel A Leffler,2 Ciaran P Kelly21Division of Gastroenterology, Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA; 2Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USAAbstract: The incidence and severity of Clostridium difficile infection (CDI have increased dramatically over the past decade. Its treatment, however, has largely remained the same with the exception of oral vancomycin use as a first-line agent in severe disease. From 1999 to 2004, 20,642 deaths were attributed to CDI in the United States, almost 7 times the rate of all other intestinal infections combined. Worldwide, several major CDI outbreaks have occurred, and many of these were associated with the NAP1 strain. This ‘epidemic’ strain has contributed to the rising incidence and mortality of CDI. The purpose of this article is to review the current management, treatment, infection control, and prevention strategies that are needed to combat this increasingly morbid disease.Keywords: antibiotic, antimicrobial, infectious colitis, pseudomembranous colitis, nosocomial, iatrogenic, toxin, Clostridium difficile

  5. Crucial elements in suicide prevention strategies

    DEFF Research Database (Denmark)

    Nordentoft, Merete

    2011-01-01

    Ways of conceptualizing suicide prevention are reviewed briefly, and the preventive model: Universal, Selected, and Indicated prevention (USI) is chosen as the structure for the literature review, and the discussion. Universal preventive interventions are directed toward entire population......; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. On the universal prevention level, an overview of the literature is presented with focus...... on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate...

  6. High School Teachers' Perceptions of Cyberbullying Prevention and Intervention Strategies

    Science.gov (United States)

    Stauffer, Sterling; Heath, Melissa Allen; Coyne, Sarah Marie; Ferrin, Scott

    2012-01-01

    Recent meta-analyses indicate that bully prevention programs produce minimal change in student behavior. This study examined 66 high school teachers' perceptions regarding the effect of cyberbullying on students, which intervening strategies teachers would use when dealing with cyberbullying, and which prevention strategies would assist in…

  7. High School Teachers' Perceptions of Cyberbullying Prevention and Intervention Strategies

    Science.gov (United States)

    Stauffer, Sterling; Heath, Melissa Allen; Coyne, Sarah Marie; Ferrin, Scott

    2012-01-01

    Recent meta-analyses indicate that bully prevention programs produce minimal change in student behavior. This study examined 66 high school teachers' perceptions regarding the effect of cyberbullying on students, which intervening strategies teachers would use when dealing with cyberbullying, and which prevention strategies would assist in…

  8. Internationally coordinated glacier monitoring: strategy and datasets

    Science.gov (United States)

    Hoelzle, Martin; Armstrong, Richard; Fetterer, Florence; Gärtner-Roer, Isabelle; Haeberli, Wilfried; Kääb, Andreas; Kargel, Jeff; Nussbaumer, Samuel; Paul, Frank; Raup, Bruce; Zemp, Michael

    2014-05-01

    Internationally coordinated monitoring of long-term glacier changes provide key indicator data about global climate change and began in the year 1894 as an internationally coordinated effort to establish standardized observations. Today, world-wide monitoring of glaciers and ice caps is embedded within the Global Climate Observing System (GCOS) in support of the United Nations Framework Convention on Climate Change (UNFCCC) as an important Essential Climate Variable (ECV). The Global Terrestrial Network for Glaciers (GTN-G) was established in 1999 with the task of coordinating measurements and to ensure the continuous development and adaptation of the international strategies to the long-term needs of users in science and policy. The basic monitoring principles must be relevant, feasible, comprehensive and understandable to a wider scientific community as well as to policy makers and the general public. Data access has to be free and unrestricted, the quality of the standardized and calibrated data must be high and a combination of detailed process studies at selected field sites with global coverage by satellite remote sensing is envisaged. Recently a GTN-G Steering Committee was established to guide and advise the operational bodies responsible for the international glacier monitoring, which are the World Glacier Monitoring Service (WGMS), the US National Snow and Ice Data Center (NSIDC), and the Global Land Ice Measurements from Space (GLIMS) initiative. Several online databases containing a wealth of diverse data types having different levels of detail and global coverage provide fast access to continuously updated information on glacier fluctuation and inventory data. For world-wide inventories, data are now available through (a) the World Glacier Inventory containing tabular information of about 130,000 glaciers covering an area of around 240,000 km2, (b) the GLIMS-database containing digital outlines of around 118,000 glaciers with different time stamps and

  9. On preventive blood pressure self-monitoring at home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Grönvall, Erik

    2015-01-01

    -called Quantified Self). In this article, we explore socio-technical complexities that may occur when introducing preventive health-measurement technologies into older adults’ daily routines and everyday lives. In particular, the original study investigated blood pressure (BP) measurement in non-clinical settings......, to understand existing challenges, and uncover opportunities for self-monitoring technologies to support preventive healthcare activities among older adults. From our study, several important aspects emerged to consider when designing preventive self-monitoring technology, such as the complexity of guidelines...... to develop better tools to support people’s preventive self-monitoring needs, compared to existing solutions. Supporting the active and informed individual can help improve people’s self-care, awareness, and implementation of preventive care. Based on our study, we also reflect on the findings to illustrate...

  10. Vaccines and immunization strategies for dengue prevention

    National Research Council Canada - National Science Library

    Liu, Yang; Liu, Jianying; Cheng, Gong

    2016-01-01

    .... Dengue vaccines, such as the multivalent attenuated, chimeric, DNA and inactivated vaccines, have been developed to prevent dengue infection in humans, and they function predominantly by stimulating...

  11. Mental Retardation: Prevention Strategies That Work.

    Science.gov (United States)

    President's Committee on Mental Retardation, Washington, DC.

    The report by the President's Committee on Mental Retardation reviews the current state of knowledge in the area of biological and environmental prevention of mental retardation and describes programs on the frontiers of research or service delivery. Section I examines programs that are effectively preventing mental retardation through biomedical…

  12. [The sociological monitoring as a tool to evaluate preventive activities].

    Science.gov (United States)

    Mazus, A I; Leven, I I; Vinogradova, O V; Zelenev, V V; Makarenko, O V

    2009-01-01

    The monitoring of conditions of HIV-infection spreading includes qualitative research methods to reveal specified information from people relating immediately to the problem of HIV-infection prevalence. The acquired information can be used both for monitoring of the conditions of HIV-infection spreading (morbidity, prevalence, mortality) and adjustment of preventive activities at the level of specific administrative territory.

  13. Watershed Monitoring Strategy, Fort Benning, Georgia

    Science.gov (United States)

    2011-05-11

    sustainability 6 New Challenge UNCLASSIFIED Compliance • NPDES Permitting (construction sites) • TMDLs (6 streams for sediment, 1 for coliform ...Solution (Part 1) - Conventional Monitoring UNCLASSIFIED Locations: 6 segments (sediment); monitoring in MS4 areas 1 segment ( coliform ); up/inter...weather) TMDL ( coliform ) Coliform Bacteria Quarterly (shared with Columbus Water Works) 10 Solution (Part 2) - TMDL Monitoring UNCLASSIFIED

  14. Strategies for the prevention of unsafe abortion.

    Science.gov (United States)

    Faúndes, Anibal

    2012-10-01

    Unsafe abortion is one of the main causes of maternal mortality and severe morbidity in countries with restrictive abortion laws. In 2007, the International Federation of Gynecology and Obstetrics (FIGO) created a Working Group on the Prevention of Unsafe Abortion and its Consequences (WGPUA). This led to a FIGO initiative with that aim which has the active participation of 43 FIGO member societies. The WGPUA has recommended that the plans of action of the countries participating in the initiative consider several levels of prevention shown to have the potential to successfully reduce unsafe abortions: (1) primary prevention of unintended pregnancy and induced abortion; (2) secondary prevention to ensure the safety of an abortion procedure that could not be avoided; (3) tertiary prevention of further complications of an unsafe abortion procedure that has taken place already, through high-quality postabortion care; and (4) quaternary prevention of repeated abortion procedures through postabortion family planning counseling and contraceptive services. This paper reviews these levels of prevention and the evidence that they can be effective.

  15. Suicide Prevention Strategies for Improving Population Health.

    Science.gov (United States)

    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.

  16. Strategy for AIDS Prevention and Treatment

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    HIV/AIDS has been circulating in China for over 25 year. While making progress and achievements on HIV/AIDS prevention, there still are great challenge and difficulties such as HIV epidemic controlling and vaccine research.

  17. Crucial elements in suicide prevention strategies

    DEFF Research Database (Denmark)

    Nordentoft, Merete

    2011-01-01

    on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate...... with regard to prevention at the universal, the selected and the indicated level and clinical and research implications are outlined....

  18. Hip Fracture Prevention: Cost-Effective Strategies

    OpenAIRE

    Peter Vestergaard; Lars Rejnmark; Leif Mosekilde

    2001-01-01

    The available literature on cost benefit, cost effectiveness and cost utility of different drug and non-drug regimens in preventing hip fractures was reviewed. The cost of a hip fracture and of the different treatment regimens varied considerably from one country to another. In primary prevention, potential savings only exceeded costs in women over the age of 70 years treated with hormonal replacement therapy (HRT). In the case of HRT, treating those with low bone mineral density levels (seco...

  19. 1. HUMAN POPULATION MONITORING FOR CANCER PREVENTION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Most of the chemicals classified by the International Agency for Research on Cancer (IARC) as human carcinogens are mutagenic across test systems, cf. [www.epa.gov/gapdb ] and induce tumors at multiple sites in rodent species. They are therefore readity detected in short term tests for gene-tic and related effects (GRE), in animal carcinogenesis bioassays and in human monitoring studies. Carcinogens that are not genotoxic may be studied using new toxicogenomic approaches as will be discussed. A Chemical Effects in Biological Systems (CEBS) database is planned by the National Center for Toxicogenomics to contain information on such compounds. The 1992 Preamble to the IARC Monographs

  20. Prevention strategies for cardioembolic stroke: present and future perspectives.

    Science.gov (United States)

    Giacalone, Giacomo; Abbas, Mohammed Abballa; Corea, Francesco

    2010-06-15

    Atrial fibrillation (AF) is the most common cause of cardioembolism. An update on secondary prevention strategies, used to protect patients from the risk of stroke in many common cardiac conditions, is presented in the paper. The main line of actions of stroke prevention in cardioembolism is mostly connected with antithrombotic drugs, but also other, more invasive, techniques are quickly emerging. Also the classic pharmacological prevention with coumarins may soon be overcome by new generation anticoagulants. Is an aggressive treatment of Patent Foramen Ovale (PFO) always recommended? One of the main challenges of the future years will be to understand competitiveness between old and new preventive strategies.

  1. The Epidemic of Youth Violence in America: Using Public Health Prevention Strategies to Prevent Violence.

    Science.gov (United States)

    Prothrow-Stith, Deborah B.

    1995-01-01

    Argues that there is no single strategy, institution, or discipline that can create the changes needed to reduce violence in America. Preventing violence requires long-term commitments, a comprehensive set of strategies, and new partnerships combined and focused on prevention of, not responses to, youth violence. (GR)

  2. Developing a Strategy Menu for Community-Level Obesity Prevention.

    Science.gov (United States)

    Spahr, Christopher; Wells, Alexandra; Christens, Brian D; Pollard, Ethen; LaGro, James; Morales, Alfonso; Dennis, Samuel; Hilgendorf, Amy; Meinen, Amy; Korth, Amy; Gaddis, Jennifer; Schoeller, Dale; Tomayko, Emily J; Carrel, Aaron; Adams, Alexandra

    2016-11-01

    Childhood obesity is a complex problem influenced by policies, systems, and environments across multiple settings. The prevention of childhood obesity requires changes across a range of community settings. To describe the development of an obesity prevention strategy menu that incorporates effective policy, systems, and environmental changes for reducing and preventing childhood obesity, and which offers the flexibility to consider local community needs and capacity. We describe the development of a strategy menu and some of the challenges of this process. We then elaborate on how communities will interact with the strategy menu and the development of a website to facilitate this interaction. No single discipline has all of the expertise needed to identify strategies for childhood obesity prevention. Therefore, a multidisciplinary team of researchers and practitioners reviewed evidence and organized a menu that assists communities in choosing complementary strategies tailored for efficacy in specific community settings. The strategies will eventually be part of a web-based point of access that complements the foundational relationships built between communities, researchers, and practitioners. The strategy menu is comprised of a set of effective approaches that communities can use to develop tailored, context-specific health interventions. By developing a framework to engage communities in the selection and implementation of multi-setting obesity prevention strategies, we aim to create and sustain momentum toward a long-term reduction in obesity in Wisconsin children.

  3. Strategies for the prevention of knee osteoarthritis

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Arden, Nigel K

    2016-01-01

    Osteoarthritis (OA) has been thought of as a disease of cartilage that can be effectively treated surgically at severe stages with joint arthroplasty. Today, OA is considered a whole-organ disease that is amenable to prevention and treatment at early stages. OA develops slowly over 10-15 years...

  4. Danish preventive measures and deradicalization strategies

    DEFF Research Database (Denmark)

    Bertelsen, Preben

    2015-01-01

    ) prevention and countering of threats to national security, by the Danish Security and Intelligence Service (PET). The last two elements are in line with measures adopted by the international community. The element (a) is well known in some countries; however, the Danish programme and in particular the so...

  5. Sustainable prevention of obesity through integrated strategies

    DEFF Research Database (Denmark)

    Lakerveld, Brug J, Bot S, Teixeira P, Rutter H, Woodward E, Samdal O, Stockley L, De Bourdeaudhuij I, van Assema P, Robertson A, Lobstein T, Oppert JM, Adány R, Nijpels G., Jeroen; Robertson, Aileen

    2012-01-01

    and instead embrace system-based multi-level intervention approaches that address both the individual and environment. The EU-funded project “sustainable prevention of obesity through integrated strategies” (SPOTLIGHT) aims to increase and combine knowledge on the wide range of determinants of obesity...

  6. Underutilization of preventive strategies in patients receiving NSAIDs.

    NARCIS (Netherlands)

    M.C.J.M. Sturkenboom (Miriam); T.A. Burke; J.P. Dieleman (Jeanne); M.J. Tangelder; F. Lee; J.L. Goldstein

    2003-01-01

    textabstractBACKGROUND: Multiple treatment guidelines for non-steroidal anti-inflammatory drugs (NSAIDs) suggest that patients with one or more risk factors for NSAID-associated upper gastrointestinal (UGI) ulcer complications should be prescribed preventive strategies such as

  7. Underutilization of preventive strategies in patients receiving NSAIDs.

    NARCIS (Netherlands)

    M.C.J.M. Sturkenboom (Miriam); T.A. Burke; J.P. Dieleman (Jeanne); M.J. Tangelder; F. Lee; J.L. Goldstein

    2003-01-01

    textabstractBACKGROUND: Multiple treatment guidelines for non-steroidal anti-inflammatory drugs (NSAIDs) suggest that patients with one or more risk factors for NSAID-associated upper gastrointestinal (UGI) ulcer complications should be prescribed preventive strategies such as

  8. [Suicide prevention strategies around the world and in Japan].

    Science.gov (United States)

    Takahashi, Yoshitomo

    2011-01-01

    "Prevention of suicide: Guidelines for the formulation and implementation of national strategies" was published by the United Nations and the World Health Organization in 1996. It emphasizes the importance of each country developing suicide prevention strategies in accordance with its own socio-cultural characteristics. Finland is known as one of the countries that successfully reduced its suicide rate. The medical model, which detects mental disorders at an early stage and starts appropriate psychiatric treatments, should be closely integrated with the community model, which educates the general public with accurate information on mental disorders and suicide prevention. Suicide prevention strategies should be conducted on a long-term basis. The author describes some considerations on current suicide prevention activities in Japan, and compares them against UN/WHO guidelines and national activities in Finland.

  9. Neurocysticercosis: risk and primary prevention strategies update.

    Science.gov (United States)

    Enander, Richard T; Ramirez Amaya, Antonio; Enander, Richard A; Gute, David M

    2010-10-01

    Neurocysticercosis results from the infestation of the central nervous system with invading tapeworm larvae. Though uncommon in the US prior to 1965, new cases are currently being diagnosed at an unprecedented rate. Drawing on environmental health, intervention and risk data retrieved from standard/alternative databases and in-country sources, we present an update and summary of modifiable risk factors and field-tested primary prevention measures. While points of intervention, subpopulations at risk and overall magnitude of the problem are addressed, particular attention is paid to defining risk reduction measures that can be adopted by individuals and high risk groups in the near-term to interrupt or eliminate pathways of exposure leading to disease transmission. Though global eradication is not attainable in the near future, effective preventative measures exist and should be taken now by international travellers and workers, US/foreign government agencies, and individuals living in endemic regions to reduce human suffering.

  10. Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

    Science.gov (United States)

    Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

    2012-01-01

    The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

  11. SOLUTIONS OF HOMESTIC VIOLENCE AGAINST WOMEN: PREVENTION STRATEGIES FROM ABROAD

    Directory of Open Access Journals (Sweden)

    Líšková Barbora

    2014-05-01

    Full Text Available Violence against women is now one of the most common human rights violations. Although in the past, this issue was hidden, currently it is recognized as widely acclaimed action and action against humanity. The purpose of the study is to focus on violence against women and to offer intervention and prevention strategies. In this article, we focus on the various options for addressing this serious problem. We describe the strategy used in the United States and other countries. We also describe the role of women's movements in highlighting the seriousness of domestic violence and to define the importance of gender equality. It is a theoretical study focusing on causes, forms and prevention strategies of violence against women. The aim of our study is to bring an effective prevention strategy, which can be used internationally. Offered prevention strategy has a big potential in elimination this problem. Study finds that there is a big need in intervention and prevention of violence against women by using existed strategies.

  12. Strategies to prevent HIV transmission to serodiscordant couples.

    Science.gov (United States)

    Hallal, Ronaldo Campos; Raxach, Juan Carlos; Barcellos, Nêmora Tregnago; Maksud, Ivia

    2015-09-01

    The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples. This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil. A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde. The articles recovered exhibit four main strategies: (1) condom; (2) reduction of risks in sexual practices; (3) use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP) and pre-exposure prophylaxis (PrEP); (4) risk reduction in reproduction. TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies. When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

  13. Simulation of monitoring strategies for atrial arrhythmia detection

    Directory of Open Access Journals (Sweden)

    Federica Censi

    2013-06-01

    Full Text Available INTRODUCTION: The current external monitoring strategies used to detect atrial fibrillation (AF and atrial tachycardia (AT episodes are based either on transient periods of short-term ECG recordings or on infrequent period of long-term continuous monitoring. The aim of this study was to investigate the ability of short-term daily ECG monitoring strategies for the detection of AF events. METHODS AND MATERIALS: The investigation was based on simulations performed on data extracted from Burden II study (patients implanted with pacemaker for brady-tachy syndrome, reporting date, time and duration of each episodes. RESULTS AND CONCLUSIONS: We found that a short-term daily temporally-optimized ECG monitoring allows to detect a higher percentage of episodes than 1-day Holter monitoring and to be at least as effective as a 7-days monitoring.

  14. 40 CFR 52.1680 - Control strategy: Monitoring and reporting.

    Science.gov (United States)

    2010-07-01

    ... Control strategy: Monitoring and reporting. (a) Section 227.6 (a) and (f) are disapproved because they are not consistent with the continuous monitoring and reporting requirements of 40 CFR 51.214. ... reporting. 52.1680 Section 52.1680 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...

  15. 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...... 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....

  16. [Allergic risk of transgenic food: prevention strategies].

    Science.gov (United States)

    Moneret-Vautrin, Denise-Anne

    2002-01-01

    Numerous allergens proceed from foods. The allergic risk of transgenic foods needs to be evaluated according recommendations from the Joint Expert Committee FAO/WHO. Potential issues are the risk of cross reactivity with existing allergens, the modification of allergenicity of the transgenic protein induced by a modified metabolism in the host, the modified allergenicity of the proteins of the transgenic plant, a potential neo-allergenicity of the transgenic protein, and the risk of dissemination through pollens, inducing a respiratory sensitization then a cross food allergy. The algorithm includes three steps for evaluation: first the search for significant homology of the protein with allergens listed in allergen databanks, or the identity of a sequence of six aminoacids with known allergens, then a cross reactivity explored through the binding to IgEs from patients allergic to the source of the gene, or allergic to organisms of the same group or botanical family, and finally the extent of the pepsine resistance. The risk of immunogenicity has to be studied with appropriate animal models. A post-marketing surveillance is recommended for monitoring of adverse effects. The structure of an Allergo-Vigilance Network, the tools for efficiency and the groups at higher risk will be discussed.

  17. Business case Roteb: recovery strategies for monitors

    NARCIS (Netherlands)

    Krikke, H.R.; Harten, van A.; Schuur, P.C.

    1999-01-01

    Due to the introduction of extended producer responsibility, European Original Equipment Manufacturers (OEMs) are forced to set up a reverse logistic system for their discarded products. As part of this set-up, OEMs or their service providers have to determine strategies for the recovery of these pr

  18. Spasticity - Pathogenesis, prevention and treatment strategies

    Directory of Open Access Journals (Sweden)

    Anju Ghai

    2013-01-01

    Full Text Available This review of the long-term management of spasticity addresses some of the clinical dilemmas in the management of patients with chronic disability. It is important for clinicians to have clear objectives in patient treatment and the available treatment strategies. The review reiterates the role of physical treatment in the management, and thereafter the maintenance of patients with spasticity. Spasticity is a physiological consequence of an injury to the nervous system. It is a complex problem which can cause profound disability, alone or in combination with the other features of an upper motor neuron syndrome, and can give rise to significant difficulties in the process of rehabilitation. This can be associated with profound restriction to activity and participation due to pain, weakness, and contractures. Optimum management is dependent on an understanding of its underlying physiology, an awareness of its natural history, an appreciation of the impact on the patient, and a comprehensive approach to minimizing that impact. The aim of this article is to highlight the importance, basic approach, and management options available to the general practitioner in such a complex condition.

  19. Parental Strategies for Knowledge of Adolescents' Friends: Distinct from Monitoring?

    Science.gov (United States)

    Bourdeau, Beth; Miller, Brenda A.; Duke, Michael R.; Ames, Genevieve M.

    2011-01-01

    Parental monitoring is defined as a set of behaviors used to gain knowledge about an adolescent's whereabouts, friends and associates, and activities. However, can knowledge of adolescents' whereabouts/activities, and friends all be attained through the same strategies? Or do they require their own strategies? This study used qualitative…

  20. Strategies to prevent injury in adolescent sport: a systematic review

    OpenAIRE

    Abernethy, Liz; Bleakley, Chris

    2007-01-01

    This systematic review set out to identify randomised controlled trials and controlled intervention studies that evaluated the effectiveness of preventive strategies in adolescent sport and to draw conclusions on the strength of the evidence. A literature search in seven databases (Medline, SportDiscus, EMBASE, CINAHL, PEDro, Cochrane Review and DARE) was carried out using four keywords: adolescent, sport, injury and prevention (expanded to capture any relevant literature). Assessment of 154 ...

  1. Strategies for preventing occupational exposure to potent compounds.

    Science.gov (United States)

    Calhoun, Dean M; Coler, Angela B; Nieusma, Joe L

    2011-02-01

    Occupational exposure to active pharmaceutical ingredients in a manufacturing or laboratory environmental can cause unintended health effects in workers handling these compounds. Occupational health professionals in the pharmaceutical industry have responded to this hazard recognition by employing strategies for the risk evaluation and management of potent APIs, otherwise known by the term 'potent compounds'. The purpose of this paper is to provide an overview of the necessary strategy components for preventing occupational exposure to potent compounds.

  2. A strategy for rock/coal outburst prevention

    Institute of Scientific and Technical Information of China (English)

    D.H. Steve Zou; CHENG Jiu-long

    2007-01-01

    The current practice of rock/coal outburst monitoring, prevention and control was reviewed. The uncertainty of major factors contributing to the occurrence of such hazards and the complexicity of mining conditions surrounding the occurrence were analyzed. A strategic concept for rock/coal outburst prevention was introduced. The objective is to identify the bursting potential in an area, rather than predicting the bursting, by introducing a multi- dimension index model: potential-of-bursting (POB), taking into consideration major contributing factors. In application, once the index has passed certain critical level indicating high risk, actions must be taken to reduce the bursting potential and to effectively prevent the hazard from occurring. A conceptual 2D model involving stress and methane pressure was described to demonstrate the methodology for determining the POB. However in practice, a POB model has to be established through experiments, field monitoring and calibration against case studies. To achieve this objective, coordinated research and international collaboration will be needed.

  3. Prevention strategies for herpes zoster and post-herpetic neuralgia

    Science.gov (United States)

    Levin, Myron J.; Gershon, Anne A.; Dworkin, Robert H.; Brisson, Marc; Stanberry, Lawrence

    2017-01-01

    SUMMARY Impairment of varicella zoster virus (VZV)-specific cell-mediated immunity, including impairment due to immunosenescence, is associated with an increased risk of developing herpes zoster (HZ), whereas levels of anti-VZV antibodies do not correlate with HZ risk. This crucial role of VZV-specific cell-mediated immunity suggests that boosting these responses by vaccination will be an effective strategy for reducing the burden of HZ. Other strategies focus on preventing the major complication of HZ – post-herpetic neuralgia. These strategies include pre-emptive treatment with drugs such as tricyclic antidepressants, anticonvulsants and analgesics. PMID:20510262

  4. Design and Evaluation of a Pressure and Temperature Monitoring System for Pressure Ulcer Prevention

    Directory of Open Access Journals (Sweden)

    Farve Daneshvar Fard

    2014-08-01

    Full Text Available Introduction Pressure ulcers are tissue damages resulting from blood flow restriction, which occurs when the tissue is exposed to high pressure for a long period of time. These painful sores are common in patients and elderly, who spend extended periods of time in bed or wheelchair. In this study, a continuous pressure and temperature monitoring system was developed for pressure ulcer prevention. Materials and Methods The monitoring system consists of 64 pressure and 64 temperature sensors on a 40×50 cm2 sheet. Pressure and temperature data and the corresponding maps were displayed on a computer in real-time. Risk assessment could be performed by monitoring and recording absolute pressure and temperature values, as well as deviations over time. Furthermore, a posture detection procedure was proposed for sitting posture identification. Information about the patient’s movement history may help caregivers make informed decisions about the patient’s repositioning and ulcer prevention strategies. Results Steady temporal behaviour of the designed system and repeatability of the measurements were evaluated using several particular tests. The results illustrated that the system could be utilized for continuous monitoring of interface pressure and temperature for pressure ulcer prevention. Furthermore, the proposed method for detecting sitting posture was verified using a statistical analysis. Conclusion A continuous time pressure and temperature monitoring system was presented in this study. This system may be suited for pressure ulcer prevention given its feasibility for simultaneous monitoring of pressure and temperature and alarming options. Furthermore, a method for detecting different sitting postures was proposed and verified. Pressure ulcers in wheelchair-bound patients may be prevented using this sitting posture detection method.

  5. Comparison of Two Educational Strategies in Teaching Preventive Cardiology.

    Science.gov (United States)

    Stroup-Benham, Christine A.; And Others

    This study assessed the impact of two educational strategies: text only versus text plus small group discussion, among two groups of third-year internal medicine clerkship students in a preventive cardiology course. The course was a required, 12-week Internal Medical clerkship at the University of Texas Medical Branch. The first group reviewed…

  6. Why the prevention strategies are in low priority?

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    It is a puzzle to many researchers that with so extensive resources, so advanced technology, and so urgent need the world over, so little has been done to alleviate the suffering of the people. Why is it so difficult to develop the prevention and health promotion strategies? This paper tries to discuss the issue.

  7. A microwave tomography strategy for structural monitoring

    Science.gov (United States)

    Catapano, I.; Crocco, L.; Isernia, T.

    2009-04-01

    The capability of the electromagnetic waves to penetrate optical dense regions can be conveniently exploited to provide high informative images of the internal status of manmade structures in a non destructive and minimally invasive way. In this framework, as an alternative to the wide adopted radar techniques, Microwave Tomography approaches are worth to be considered. As a matter of fact, they may accurately reconstruct the permittivity and conductivity distributions of a given region from the knowledge of a set of incident fields and measures of the corresponding scattered fields. As far as cultural heritage conservation is concerned, this allow not only to detect the anomalies, which can possibly damage the integrity and the stability of the structure, but also characterize their morphology and electric features, which are useful information to properly address the repair actions. However, since a non linear and ill-posed inverse scattering problem has to be solved, proper regularization strategies and sophisticated data processing tools have to be adopt to assure the reliability of the results. To pursue this aim, in the last years huge attention has been focused on the advantages introduced by diversity in data acquisition (multi-frequency/static/view data) [1,2] as well as on the analysis of the factors affecting the solution of an inverse scattering problem [3]. Moreover, how the degree of non linearity of the relationship between the scattered field and the electromagnetic parameters of the targets can be changed by properly choosing the mathematical model adopt to formulate the scattering problem has been shown in [4]. Exploiting the above results, in this work we propose an imaging procedure in which the inverse scattering problem is formulated as an optimization problem where the mathematical relationship between data and unknowns is expressed by means of a convenient integral equations model and the sought solution is defined as the global minimum of a

  8. Lifestyle strategies for the prevention of vision loss.

    Science.gov (United States)

    Sharts-Hopko, Nancy C

    2010-01-01

    As the baby boom generation ages, it is anticipated that half a million cases per year will be added to the 19 to 21 million Americans not living in institutions or serving in the military who have low vision or blindness. The 4 major causes of vision loss and blindness in the United States are cataract, diabetic retinopathy, glaucoma, and age-related macular degeneration. All 4 diseases involve change in the microcirculation in eye structures. Holistic approaches to health incorporate attention to individuals' lifestyle choices. Relevant research literature was reviewed to identify strategies for lifestyle modification that nurses can use to prevent or slow progression of these diseases. Prevention strategies in general are those that promote avoidance of cardiovascular disease and diabetes. Because vision loss has been shown to be associated with diminished quality of life and increased mortality, lifestyle changes that prevent or moderate the impact of these diseases are an important focus of nursing care.

  9. Chronotherapeutic strategy: Rhythm monitoring, manipulation and disruption.

    Science.gov (United States)

    Ohdo, Shigehiro

    2010-07-31

    Mammalians circadian pacemaker resides in the paired suprachiasmatic nuclei (SCN) and influences a multitude of biological processes, including the sleep-wake rhythm. Clock genes are the genes that control the circadian rhythms in physiology and behavior. 24h rhythm is demonstrated for the function of physiology and the pathophysiology of diseases. The effectiveness and toxicity of many drugs vary depending on dosing time. Such chronopharmacological phenomena are influenced by not only the pharmacodynamics but also pharmacokinetics of medications. The underlying mechanisms are associated with 24h rhythms of biochemical, physiological and behavioral processes under the control of circadian clock. Thus, the knowledge of 24h rhythm in the risk of disease plus evidence of 24h rhythm dependencies of drug pharmacokinetics, effects, and safety constitutes the rationale for pharmacotherapy. Chronotherapy is especially relevant, when the risk and/or intensity of the symptoms of disease vary predictably over time as exemplified by allergic rhinitis, arthritis, asthma, myocardial infarction, congestive heart failure, stroke, and peptic ulcer disease. Morning once-daily administration of corticosteroid tablet medications results in little adrenocortical suppression, while the same daily dose split into four equal administrations to coincide with daily meals and bedtime results in significant hypothalamus-pituitary-adrenal (HPA) axis suppression. However, the drugs for several diseases are still given without regard to the time of day. Identification of a rhythmic marker for selecting dosing time will lead to improved progress and diffusion of chronopharmacotherapy. To monitor the rhythmic marker such as clock genes it may be useful to choose the most appropriate time of day for administration of drugs that may increase their therapeutic effects and/or reduce their side effects. Furthermore, to produce new rhythmicity by manipulating the conditions of living organs by using

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

    Science.gov (United States)

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

    2016-01-01

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

  11. The costs of HIV prevention strategies in developing countries.

    Science.gov (United States)

    Söderlund, N; Lavis, J; Broomberg, J; Mills, A

    1993-01-01

    Since many evaluations of HIV (human immunodeficiency virus) prevention programmes do not include data on costs, a preliminary analysis of the costs and outputs of a sample of HIV prevention projects was attempted. Case studies, representing six broad HIV prevention strategies in developing countries with differing levels of per capita gross domestic product, were sought on the basis of availability of data and potential generalizability. The six prevention strategies studied were mass media campaigns, peer education programmes, sexually transmitted disease treatment, condom social marketing, safe blood provision, and needle exchange/bleach provision programmes. Financial cost data were abstracted from published studies or were obtained directly from project coordinators. Although estimates of cost-effectiveness were not made, calculations of the relative cost per common process measure of output were compared. Condom distribution costs ranged from US$ 0.02 to 0.70 per condom distributed, and costs of strategies involving personal educational input ranged from US$ 0.15 to 12.59 per contact.

  12. Exercise Strategies to Optimize Glycemic Control in Type 2 Diabetes: A Continuing Glucose Monitoring Perspective

    OpenAIRE

    van Dijk, Jan-Willem; van Loon, Luc J. C.

    2015-01-01

    IN BRIEF The introduction of continuous glucose monitoring (CGM) several years ago enabled researchers to investigate the impact of exercise strategies on 24-hour glycemic control. Such unique information on the glucoregulatory properties of exercise will ultimately lead to more effective exercise programs to prevent and treat type 2 diabetes. This article reviews the role of exercise and physical activity in the treatment of type 2 diabetes, complemented by recent data obtained by CGM.

  13. Strategies to prevent HIV transmission to serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Ronaldo Campos Hallal

    2015-09-01

    Full Text Available ABSTRACTIntroduction:The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples.Objective:This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil.Methods:A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde.Results:The articles recovered exhibit four main strategies: (1 condom; (2 reduction of risks in sexual practices; (3 use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP and pre-exposure prophylaxis (PrEP; (4 risk reduction in reproduction.Discussion:TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies.Conclusions:When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

  14. [Integrated prevention and control strategy for dengue in Mesoamerica].

    Science.gov (United States)

    Gómez-Dantés, Héctor; San Martín, José Luis; Danis-Lozano, Rogelio; Manrique-Saide, Pablo

    2011-01-01

    Dengue in the Americas is a public health problem in ascent. The control strategies have not been effective when sustained in the intensive use of insecticides and poor community participation. The Mesoamerican Initiative for the Prevention and the Integrated Control of Dengue synthesizes the works generated by the Integrated Strategy of the Pan-American Health Organization (PAHO) and the risks stratification strategy designed by the countries of the Mesoamerican region. The objective is to progressively reduce the incidence of dengue cases until a 50% reduction is reached over a five years period. This document describes the elements for the risk stratification, the activities for prevention and control organized by levels of intensity and frequency and the indicators used to pursuit the objectives. To face the dispersion of the problem a concentration of efforts for control in the areas of greater risk is presented; the opportunity in the detection of cases is highlighted to tackle the fast dissemination of the infection; focus on the most productive breeding sites is proposed to battle against the vast dissemination of the breeding sites; and the severity of the infection must be addressed by capable clinical human resources. This strategy was designed along with the national representatives of the control programs to create master plans that provided the basis for the integrated prevention and control of dengue in the Mesoamerican region.

  15. A strategy for monitoring and evaluating massive open online courses.

    Science.gov (United States)

    Chapman, S A; Goodman, S; Jawitz, J; Deacon, A

    2016-08-01

    We argue that the complex, innovative and adaptive nature of Massive Open Online Course (MOOC) initiatives poses particular challenges to monitoring and evaluation, in that any evaluation strategy will need to follow a systems approach. This article aims to guide organizations implementing MOOCs through a series of steps to assist them in developing a strategy to monitor, improve, and judge the merit of their initiatives. We describe how we operationalise our strategy by first defining the different layers of interacting agents in a given MOOC system. We then tailor our approach to these different layers. Specifically, a two-pronged approach was developed, where we suggest that individual projects be assessed through performance monitoring; assessment criteria for which would be defined at the outset to include coverage, participation, quality and student achievement. In contrast, the success of an overall initiative should be considered within a more adaptive, emergent evaluation inquiry framework. We present the inquiry framework we developed for MOOC initiatives, and show how this framework might be used to develop evaluation questions and an assessment methodology. We also define the more fixed indicators and measures for project performance monitoring. Our strategy is described as it was developed to inform the evaluation of a MOOC initiative at the University of Cape Town (UCT), South Africa.

  16. Process Monitoring of an HIV Treatment as Prevention Program in British Columbia, Canada

    Science.gov (United States)

    Lourenço, Lillian; Lima, Viviane D.; Heath, Kate; Nosyk, Bohdan; Gilbert, Mark; Colley, Guillaume; Consolacion, Theodora; Barrios, Rolando; Robert, Hogg; Krajden, Mel; Konrad, Stephanie; Murti, Michelle; Nelson, Joanne; May-Hadford, Jennifer; Haggerstone, James; Pick, Neora; Gustafson, Reka; Rusch, Melanie; Day, Irene; Montaner, Julio Sg

    2014-01-01

    Background In light of accumulated scientific evidence of the secondary preventive benefits of antiretroviral therapy, a growing number of jurisdictions worldwide have formally started to implement HIV Treatment as Prevention (TasP) programs. To date, no gold standard for TasP program monitoring has been described. Here, we describe the design and methods applied to TasP program process monitoring in British Columbia (BC), Canada. Methods Monitoring indicators were selected through a collaborative and iterative process by an interdisciplinary team including representatives from all five regional health authorities, the BC Centre for Disease Control (BCCDC), and the BC Centre for Excellence in HIV/AIDS (BC-CfE). An initial set of 36 proposed indicators were considered for inclusion. These were ranked on the basis of eight criteria: data quality, validity, scientific evidence, informative power of the indicator, feasibility, confidentiality, accuracy, and administrative requirement. The consolidated list of indicators was included in the final monitoring report, which was executed using linked population-level data. Results A total of 13 monitoring indicators were included in the BC TasP Monitoring Report. Where appropriate, indicators were stratified by subgroups of interest, including HIV risk group and demographic characteristics. Six Monitoring Reports are generated quarterly: one for each of the regional health authorities and a consolidated provincial report. Conclusions We have developed a comprehensive TasP process monitoring strategy using evidence-based HIV indicators derived from linked population-level data. Standardized longitudinal monitoring of TasP program initiatives is essential to optimize individual and public health outcomes and to enhance program efficiencies. PMID:25072608

  17. An update on necrotizing enterocolitis: pathogenesis and preventive strategies

    Directory of Open Access Journals (Sweden)

    Jang Hoon Lee

    2011-09-01

    Full Text Available Necrotizing enterocolitis (NEC is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

  18. An update on necrotizing enterocolitis: pathogenesis and preventive strategies.

    Science.gov (United States)

    Lee, Jang Hoon

    2011-09-01

    Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birth-weight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

  19. Sentinel areas: a monitoring strategy in public health

    Directory of Open Access Journals (Sweden)

    Teixeira Maria da Glória

    2002-01-01

    Full Text Available Available techniques for monitoring the health situation have proven insufficient, thus leading to a discussion of the need for their improvement based on new data collection strategies allowing for data use by local health systems. This article presents the methodological basis for a strategy to monitor health problems utilizing demarcated intra-urban spaces called "sentinel areas" to collect fundamental social, economic, behavioral, and biological data for public health that allow for a closer approach to the reality of complex social spaces. The authors present an experience that is being developed in Salvador, Bahia, Brazil, to evaluate the epidemiological impact of an environmental sanitation program. They discuss selection criteria for the areas and the potential uses of this strategy allowing for the rapid utilization of epidemiological resources by health services and the timely application of the results to reorient and enhance health intervention practices.

  20. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  1. Health promotion and disease prevention strategies for today's physicians.

    Science.gov (United States)

    Rubens, Muni; Ramamoorthy, Venkataraghavan; Attonito, Jennifer; Saxena, Anshul; Nair, Rakesh Ravikumaran; Shehadeh, Nancy

    2015-01-01

    The majority of preventable diseases in both developed and developing countries could be strategically controlled by effectively implementing existing health promotion and disease prevention (HPDP) interventions. An important juncture for the implementation of risk-reduction strategies is the point of interaction between health care providers and patients during their scheduled visits. This article targets strategies for physicians to effectively implement HPDP interventions in a clinical setting. The factors that improve delivery of HPDP interventions are discussed briefly. We subsequently introduce and discuss the conceptual framework for enhanced patient education, which is based on the information-motivation-behavioral skills model and the health belief model. The article also describes an adapted patient-practitioner collaborative model for HPDP. This adapted model may serve as a blueprint for physicians to effectively execute HPDP interventions during clinical encounters. The recommended models and our conceptual frameworks could have limitations which need to be field tested.

  2. Prevention of OHSS: Current strategies and new insights

    Directory of Open Access Journals (Sweden)

    Cristiano E. Busso

    2010-10-01

    Full Text Available Ovarian hyperstimulation syndrome (OHSS is an iatrogenic and potentially life threatening condition that affects young healthy patients. Many strategies have been proposed to prevent this syndrome. However, to avoid OHSS without compromising on IVF outcome is still a challenge. The most important action is to identify patients at risk even before ovarian stimulation is initiated and to give them special attention. Coasting is the most popular method to avoid/minimize OHSS. Cycle cancellation, cryopreservation, GnRH antagonists, GnRH agonists, i.v. albumin are other strategies that can provide some kind of benefit but do not completely avoid both early and late forms of OHSS and/or cannot be applied to every patient. Recent studies demonstrate that dopamine agonists can prevent or minimize OHSS without affecting IVF outcome but clinical protocols are not well established yet.

  3. Modern monitoring with preventive role for a production capacity

    Science.gov (United States)

    Tomescu, Cristian; Lupu, Constantin; Szollosi-Mota, Andrei; Rădoi, Florin; Chiuzan, Emeric

    2016-10-01

    In the process of exploitation of coal, the appearance of the phenomenon of spontaneous combustion represents a risk factor identified by the subjective and objective the causes, which requires the development of appropriate prevention methods. In order to control the risk, shall be drawn up incipient intervention solutions with preventive function, which consist in the direct and indirect measurement of the working environment, of the temperature of the coal massif and of the concentrations of gases, O2, CO2, CO. Monitoring instruments which fall within the modern concept for proactively anticipation is represented by thermography applied in the exploitation of coal and by the gas chromatograph for the analysis of the air collected. The drawing up of thermal maps on the basis of the thermograms and analysis of the chromatograms resulted represents the binome for assessing and treatments of the spontaneous combustion risk, which will be discussed in this work.

  4. Strategies for the prevention of volleyball related injuries.

    Science.gov (United States)

    Reeser, J C; Verhagen, E; Briner, W W; Askeland, T I; Bahr, R

    2006-07-01

    Although the overall injury rate in volleyball and beach volleyball is relatively low compared with other team sports, injuries do occur in a discipline specific pattern. Epidemiological research has revealed that volleyball athletes are, in general, at greatest risk of acute ankle injuries and overuse conditions of the knee and shoulder. This structured review discusses both the known and suspected risk factors and potential strategies for preventing the most common volleyball related injuries: ankle sprains, patellar tendinopathy, and shoulder overuse.

  5. Strategies for the prevention of volleyball related injuries

    Science.gov (United States)

    Reeser, J C; Verhagen, E; Briner, W W; Askeland, T I; Bahr, R

    2006-01-01

    Although the overall injury rate in volleyball and beach volleyball is relatively low compared with other team sports, injuries do occur in a discipline specific pattern. Epidemiological research has revealed that volleyball athletes are, in general, at greatest risk of acute ankle injuries and overuse conditions of the knee and shoulder. This structured review discusses both the known and suspected risk factors and potential strategies for preventing the most common volleyball related injuries: ankle sprains, patellar tendinopathy, and shoulder overuse. PMID:16799111

  6. Current strategies for the prevention of breast cancer

    OpenAIRE

    Advani P; Moreno-Aspitia A

    2014-01-01

    Pooja Advani, Alvaro Moreno-AspitiaDepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USAAbstract: Due to the high incidence of breast cancer in the United States, optimal strategies for its prevention are imperative. This entails identification of women who are at an increased risk for breast cancer and an integrative approach that includes effective screening methods as well as nutritional, pharmacologic, and surgical management. Several breast cancer risk-assessment tool...

  7. Cancer risk and preventive behavior: persuasion as an intervention strategy.

    Science.gov (United States)

    Tonani, Marcela; Carvalho, Emilia Campos de

    2008-01-01

    The effectiveness of interventions for health promotion, protection, and early diagnosis may include the process of persuasion employed. This study aims to evaluate the risk level of developing cancer, considering the pertinent risk factors, and the presence of persuasion and characteristics in communication regarding cancer prevention and early detection. It is an observational study, conducted among 110 inhabitants of a neighborhood in Ribeirao Preto, Sao Paulo, Brazil. It was confirmed that there are high risks for colon/rectum, cervical, and endometrial cancer; and moderate risks for the above as well as lung and breast cancer. In terms of persuasion, it was observed that cancer information was spread but not sustained for long periods. Moreover, there was no reinforcement. In view of cancer risk and the identified preventive behaviors, persuasion is considered a useful strategy to reduce these risks, as well as to encourage and sustain preventive behaviors, since it indicates routes to be followed.

  8. Bifurcation analysis of vertical transmission model with preventive strategy

    Directory of Open Access Journals (Sweden)

    Gosalamang Ricardo Kelatlhegile

    2016-07-01

    Full Text Available We formulate and analyze a deterministic mathematical model for the prevention of a disease transmitted horizontally and vertically in a population of varying size. The model incorporates prevention of disease on individuals at birth and adulthood and allows for natural recovery from infection. The main aim of the study is to investigate the impact of a preventive strategy applied at birth and at adulthood in reducing the disease burden. Bifurcation analysis is explored to determine existence conditions for establishment of the epidemic states. The results of the study showed that in addition to the disease-free equilibrium there exist multiple endemic equilibria for the model reproduction number below unity. These results may have serious implications on the design of intervention programs and public health policies. Numerical simulations were carried out to illustrate analytical results.

  9. Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes

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    Faiman B

    2016-05-01

    Full Text Available Beth Faiman, Jason Valent Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA Abstract: Improved understanding as to the biology of multiple myeloma (MM and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus requiring clinicians to become more astute in assessment, monitoring, and intervention of side effects as well as monitoring response to therapy. Appropriate diagnosis and monitoring strategies are essential to ensure that patients receive the appropriate chemotherapy and supportive therapy at relapse, and that side effects are appropriately managed to allow for continued therapy and adherence to the regimen. Multiple drugs with complex regimens are currently available with varying side effect profiles. Knowledge of the drugs used to treat MM and the common adverse events will allow for preventative strategies to mitigate adverse events and prompt intervention. The purpose of this paper is to review updates in the diagnosis and management of MM, and to provide strategies for assessment and monitoring of patients receiving chemotherapy for MM. Keywords: multiple myeloma, treatment, symptoms, assessment, monitoring, symptom management, targeted therapies

  10. Radiation health consequences for astronauts: mechanisms, monitoring and prevention

    Science.gov (United States)

    Neyfakh, E.

    During space flights crews are exposed chronically to uneven irradiation of enhanced bioefficiency following with significant elevation for chromosomal aberrations as minimum. To protect in space rationally monitoring and preventing of health radiogenic individual primary consequences for astronauts are of high importance. Majority of Chernobyl-touched population has some common etiologic radiogenic mechanisms and radioloads with astronauts ones during long-term missions and former is able to be used well as the close ground-level model. Primary radiogenic deviations. Two radiogenic pathologies as lipoperoxic ( LP ) stress with coupled deficits for essential bioantioxidants ( BAO ) were typical for chronic low-dose Chernobyl-touched contingents. When BAO expenditure had led to their subnormal levels, radiogenic free radical chain -b ranched LP processes occurred in vivo hyperbolically. Catabolites and their free radicals of the abnormal LP cascade are known to be toxic, mutagenic / carcinogenic and teratogenic factors as such, as they are for retinol and tocopherol deficiencies. Both coupled pathogenic factors interrelated synergistically. Simultaneous dysbalances for LP and / or BAO systems were evaluated as the cause and markers for metabolic disregulations. Human LP stress was proved to be the most radiosensible known marker to mo nitor least invasively of blood microsamples in a ground lab via the developed PC Program. But for capsule conditions the best approach is assumed to be LP monitoring via skin ultraweak green-blue chemiluminescence ( CL ) caused by recombination of peroxyl radicals. CL from surfaces of organs was embedded first ( E. Neyfakh, 1964 - 71 ) to reflect their internal LP velocities in vivo and it is the non-invasive on-line simple method of the highest sensitivity, supplying with data transmissible to the ground directly. Related deviations. a) Radiogenic hypermutagenesis: LP catabolites and their free radicals are responsible for direct DNA

  11. Strategies for the prevention of sudden cardiac death during sports.

    Science.gov (United States)

    Corrado, Domenico; Drezner, Jonathan; Basso, Cristina; Pelliccia, Antonio; Thiene, Gaetano

    2011-04-01

    Sudden cardiac death of a young athlete is the most tragic event in sports and devastates the family, the sports medicine team, and the local community. Such a fatality represents the first manifestation of cardiac disease in up to 80% of young athletes who remain asymptomatic before sudden cardiac arrest occurs; this explains the limited power of screening modalities based solely on history and physical examination. The long-running Italian experience showed that electrocardiogram (ECG) screening definitively improves the sensitivity of pre-participation evaluation for heart diseases and substantially reduces the risk of death in the athletic field (primary prevention). However, some cardiac conditions, such as coronary artery diseases, present no abnormalities on 12-lead ECG. Moreover, cardiac arrest due to non-penetrating chest injury (commotio cordis) cannot be prevented by screening. This justifies the efforts for implementing programmes of early external defibrillation of unpredictable arrhythmic cardiac arrest. This article reviews the epidemiology of sudden cardiac arrest in the athlete in terms of incidence, sport-related risk, underlying causes, and the currently available prevention programmes such as pre-participation screening and early external defibrillation by using automated external defibrillators. The best strategy is to combine synergistically primary prevention of sudden cardiac death by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with back-up defibrillation of unpredictable sudden cardiac arrest on the athletic field.

  12. Gestational diabetes mellitus: does an effective prevention strategy exist?

    Science.gov (United States)

    Agha-Jaffar, Rochan; Oliver, Nick; Johnston, Desmond; Robinson, Stephen

    2016-09-01

    The overall incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Preventing pathological hyperglycaemia during pregnancy could have several benefits: a reduction in the immediate adverse outcomes during pregnancy, a reduced risk of long-term sequelae and a decrease in the economic burden to healthcare systems. In this Review we examine the evidence supporting lifestyle modification strategies in women with and without risk factors for GDM, and the efficacy of dietary supplementation and pharmacological approaches to prevent this disease. A high degree of heterogeneity exists between trials so a generalised recommendation is problematic. In population studies of dietary or combined lifestyle measures, risk of developing GDM is not improved and those involving a physical activity intervention have yielded conflicting results. In pregnant women with obesity, dietary modification might reduce fetal macrosomia but in these patients, low compliance and no significant reduction in the incidence of GDM has been observed in trials investigating physical activity. Supplementation with probiotics or myoinositol have reduced the incidence of GDM but confirmatory studies are still needed. In randomized controlled trials, metformin does not prevent GDM in certain at-risk groups. Given the considerable potential for reducing disease burden, further research is needed to identify strategies that can be easily and effectively implemented on a population level.

  13. Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

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    Pattharawin Pattharanitima

    2014-01-01

    Full Text Available Contrast-induced acute kidney injury (CI-AKI is the most common iatrogenic cause of acute kidney injury after intravenous contrast media administration. In general, the incidence of CI-AKI is low in patients with normal renal function. However, the rate is remarkably elevated in patients with preexisting chronic kidney disease, diabetes mellitus, old age, high volume of contrast agent, congestive heart failure, hypotension, anemia, use of nephrotoxic drug, and volume depletion. Consequently, CI-AKI particularly in high risk patients contributes to extended hospitalizations and increases long-term morbidity and mortality. The pathogenesis of CI-AKI involves at least three mechanisms; contrast agents induce renal vasoconstriction, increase of oxygen free radicals through oxidative stress, and direct tubular toxicity. Several strategies to prevent CI-AKI have been evaluated in experimental studies and clinical trials. At present, intravascular volume expansion with either isotonic saline or sodium bicarbonate solutions has provided more consistent positive results and was recommended in the prevention of CI-AKI. However, the proportion of patients with risk still develops CI-AKI. This review critically evaluated the current evidence for pharmacological strategies to prevent CI-AKI in patients with a risk of developing CI-AKI.

  14. Coccidiosis in poultry: anticoccidial products, vaccines and other prevention strategies.

    Science.gov (United States)

    Peek, H W; Landman, W J M

    2011-09-01

    Coccidiosis in chickens is a parasitic disease with great economic significance, which has been controlled successfully for decades using mainly anticoccidial products. However, large-scale and long-term use of anticoccidial drugs has led to the worldwide development of resistance against all these drugs. In order to minimize the occurrence of resistance, the rotation of various anticoccidial drugs in single and/or shuttle programmes is used. Unfortunately, this has not solved the anticoccidial resistance problem. Recently, live anticoccidial vaccines have been incorporated into rotation programmes, resulting in an increasing incidence of anticoccidial drug-sensitive Eimeria spp. field isolates, which may ameliorate the efficacy of anticoccidial drugs. Nevertheless, possible upcoming bans restricting the use of anticoccidials as feed additives, consumer concerns on residues and increasing regulations have prompted the quest for alternative coccidiosis control strategies. Although management and biosecurity measures could halt the introduction of Eimeria spp. to a farm, in practice they do not suffice to prevent coccidiosis outbreaks. Phytotherapy, aromatherapy and pre- and probiotics either show conflicting, non-consistent or non-convincing results, and have therefore not been applied at a large scale in the field. So far, live attenuated and non-attenuated anticoccidial vaccines have proved to be the most solid and successful coccidiosis prevention and control strategy. Despite the drawbacks associated with their production and use, their popularity is increasing. If with time, the immunogenicity of subunit vaccines can be improved, they could represent the next generation of highly efficient and low-cost anticoccidial strategies.

  15. Hydrogeological modeling for improving groundwater monitoring network and strategies

    Science.gov (United States)

    Thakur, Jay Krishna

    2016-09-01

    The research aimed to investigate a new approach for spatiotemporal groundwater monitoring network optimization using hydrogeological modeling to improve monitoring strategies. Unmonitored concentrations were incorporated at different potential monitoring locations into the groundwater monitoring optimization method. The proposed method was applied in the contaminated megasite, Bitterfeld/Wolfen, Germany. Based on an existing 3-D geological model, 3-D groundwater flow was obtained from flow velocity simulation using initial and boundary conditions. The 3-D groundwater transport model was used to simulate transport of α-HCH with an initial ideal concentration of 100 mg/L injected at various hydrogeological layers in the model. Particle tracking for contaminant and groundwater flow velocity realizations were made. The spatial optimization result suggested that 30 out of 462 wells in the Quaternary aquifer (6.49 %) and 14 out of 357 wells in the Tertiary aquifer (3.92 %) were redundant. With a gradual increase in the width of the particle track path line, from 0 to 100 m, the number of redundant wells remarkably increased, in both aquifers. The results of temporal optimization showed different sampling frequencies for monitoring wells. The groundwater and contaminant flow direction resulting from particle tracks obtained from hydrogeological modeling was verified by the variogram modeling through α-HCH data from 2003 to 2009. Groundwater monitoring strategies can be substantially improved by removing the existing spatio-temporal redundancy as well as incorporating unmonitored network along with sampling at recommended interval of time. However, the use of this model-based method is only recommended in the areas along with site-specific experts' knowledge.

  16. An Injury Prevention Strategy for Teen Restaurant Workers

    Science.gov (United States)

    Ward, Julie A.; de Castro, A. B.; Tsai, Jenny Hsin-Chun; Linker, Darren; Hildahl, Lyle; Miller, Mary E.

    2011-01-01

    High levels of youth employment, workplace hazards, and characteristics unique to adolescents contribute to a relatively high incidence of injuries among teens in the restaurant industry. This article discusses the ProSafety model of injury prevention among teen restaurant workers. Through integration with an existing career and technical education program, the ProSafety project seeks to prevent occupational injuries among the teen worker population through classroom safety education and internship skills reinforcement. ProSafety is the product of an innovative collaboration with occupational health nurses, business professionals, educators, and government. Its approach is derived from Social Cognitive Theory, is consistent with key values and strategies of occupational health nurses, and provides lessons for practitioners seeking to reduce occupational injuries in food service or among other populations of adolescent workers. PMID:20180503

  17. Strategies of functional food for cancer prevention in human beings.

    Science.gov (United States)

    Zeng, Ya-Wen; Yang, Jia-Zheng; Pu, Xiao-Ying; Du, Juan; Yang, Tao; Yang, Shu-Ming; Zhu, Wei-Hua

    2013-01-01

    Functional food for prevention of chronic diseases is one of this century's key global challenges. Cancer is not only the first or second leading cause of death in China and other countries across the world, but also has diet as one of the most important modifiable risk factors. Major dietary factors now known to promote cancer development are polished grain foods and low intake of fresh vegetables, with general importance for an unhealthy lifestyle and obesity. The strategies of cancer prevention in human being are increased consumption of functional foods like whole grains (brown rice, barley, and buckwheat) and by-products, as well some vegetables (bitter melon, garlic, onions, broccoli, and cabbage) and mushrooms (boletes and Tricholoma matsutake). In addition some beverages (green tea and coffee) may be protective. Southwest China (especially Yunnan Province) is a geographical area where functional crop production is closely related to the origins of human evolution with implications for anticancer influence.

  18. EDUCATIONAL ACTIONS TO PREVENT DENGUE: EXPERIENCES AND STRATEGIES WITH ELDERLY

    Directory of Open Access Journals (Sweden)

    Rosamaria Rodrigues Garcia

    2015-04-01

    Full Text Available Objective: Describe the activities performed on apublic specialized ambulatory care for dengue prevention among elderly. Case report: the epidemiological outlook of dengue is scaring being characterized as a public health problem. The elderly are most at risk for hospitalization and severe forms of the disease, thus health education activities are essential to improve awareness of the need to fight and prevent the disease. A Health Education project was created, evolving communication strategies to raise awareness on the issue. They were performed by a post graduate Gerontology group in activities such as interactive puppet show, myths and truths dynamic, informative folder, parody, posters, training seniors, caregivers and family members, internal and external health professionals, staff and residents of nearby long term care facilities. The materials were available in print and digital version. 2,500 elderly and 350 professionals were trained and encouraged to multiply the information and inspire adoption of preventive measures. The actions provided intergenerational interaction and empowerment of the elderly, whom trained, had the opportunity to exercise social participation and disseminate recommendations for other users. Conclusion: the project enabled the construction of knowledge through interactive educational activities that contributed to strengthen the individual and collective awareness, awareopinion leaderstothe importance of communication/education in the fight against dengue, which emphasized social responsibility in rescuing citizenship in a perspective thateach citizen is responsible for himself and for community. DESCRIPTORS: Dengue. Aged. Disease prevention. Health education.

  19. Evaluation of malaria prevention strategies during pregnancy in Ndola, Zambia

    Science.gov (United States)

    Mulamba, Mwamba

    2010-01-01

    ABSTRACT Background Malaria in pregnancy is associated with many negative outcomes for the woman, foetus and neonate. Intermittent preventive treatment during pregnancy (IPTp) using three doses of sulfadoxine/pyrimethamine (SP), insecticide-treated mosquito nets (ITNs) and indoor residual spray (IRS), constitute the main strategies used to prevent malaria. The aim of this study is to evaluate the effectiveness of these strategies for the reduction of malaria prevalence in pregnant women. Methods A questionnaire on socio-demographic information, history of malaria during current pregnancy and prevention strategies used was administered to 450 consecutive patients admitted into labour wards at three local clinics. From the antenatal cards, information was collected on the last menstrual period, date of each dose of SP taken, gravidity, and HIV status. A blood slide to detect Plasmodium was then collected from each woman after consent. Results Of the participants in the study, 2.4% had a positive blood slide at term and 15.8% reported malaria during pregnancy. All the participants took at least one dose of SP with 87.6% completing the stipulated three doses. The mean gestational ages for each dose were 22.1 (SD 4.6), 29.1 (SD 4.4) and 34.4 (SD 3.9) weeks for the first, second and third dose respectively. With regard to ITNs, 79.5% had one, but only 74.1% used it regularly. IRS was completed in all three of the clinics’ catchment areas. Only 23.4% used commercial insecticide. Conclusion The measured prevalence of malaria at term in Ndola was remarkably low, although the self-reported rate during pregnancy was still high. The national targets for accessing IPTp were exceeded, although the timing of each dose needs to be improved. Access to ITNs was high, but usage needs to increase.

  20. Evaluation of malaria prevention strategies during pregnancy in Ndola, Zambia

    Directory of Open Access Journals (Sweden)

    Mwamba Mulamba

    2010-03-01

    Full Text Available Background: Malaria in pregnancy is associated with many negative outcomes for the woman,foetus and neonate. Intermittent preventive treatment during pregnancy (IPTp using three doses of sulfadoxine/pyrimethamine (SP, insecticide-treated mosquito nets (ITNs and indoor residual spray (IRS, constitute the main strategies used to prevent malaria. The aim of this study is to evaluate the effectiveness of these strategies for the reduction of malaria prevalence in pregnant women.Methods: A questionnaire on socio-demographic information, history of malaria during current pregnancy and prevention strategies used was administered to 450 consecutive patients admitted into labour wards at three local clinics. From the antenatal cards, information was collected on the last menstrual period, date of each dose of SP taken, gravidity, and HIV status. A blood slide to detect Plasmodium was then collected from each woman after consent.Results: Of the participants in the study, 2.4% had a positive blood slide at term and 15.8% reported malaria during pregnancy. All the participants took at least one dose of SP with 87.6% completing the stipulated three doses. The mean gestational ages for each dose were 22.1 (SD 4.6, 29.1 (SD 4.4and 34.4 (SD 3.9 weeks for the first, second and third dose respectively. With regard to ITNs, 79.5% had one, but only 74.1% used it regularly. IRS was completed in all three of the clinics’ catchment areas. Only 23.4% used commercial insecticide.Conclusion: The measured prevalence of malaria at term in Ndola was remarkably low, although the self-reported rate during pregnancy was still high. The national targets for accessing IPTp were exceeded, although the timing of each dose needs to be improved. Access to ITNs was high, but usage needs to increase.

  1. Community participation in the prevention and control of dengue: the patio limpio strategy in Mexico.

    Science.gov (United States)

    Tapia-Conyer, Roberto; Méndez-Galván, Jorge; Burciaga-Zúñiga, Pierre

    2012-05-01

    Community participation is vital to prevent and control the spread of dengue in Latin America. Initiatives such as the integrated management strategy for dengue prevention and control (IMS-Dengue) and integrated vector management (IVM) incorporate social mobilisation and behavioural change at the community level as part of a wider strategy to control dengue. These strategies aim to improve the efficacy, cost-effectiveness, environmental impact and sustainability of vector control strategies. Community empowerment is a key aspect of the strategy as it allows the local population to drive eradication of the disease in their environment. Through the patio limpio campaign, the concept of community participation has been employed in Mexico to raise awareness of the consequences of dengue. patio limpio consists of training local people to identify, eliminate, monitor and evaluate vector breeding sites systematically in households under their supervision. A community participation programme in Guerrero State found that approximately 54% were clean and free of breeding sites. Households that were not visited and assessed had a 2·4-times higher risk of developing dengue than those that were. However, after a year, only 30% of trained households had a clean backyard. This emphasises the need for a sustainable process to encourage individuals to maintain efforts in keeping their environment free of dengue.

  2. Bone Fragility in Turner Syndrome: Mechanisms and Prevention Strategies.

    Science.gov (United States)

    Faienza, Maria Felicia; Ventura, Annamaria; Colucci, Silvia; Cavallo, Luciano; Grano, Maria; Brunetti, Giacomina

    2016-01-01

    Bone fragility is recognized as one of the major comorbidities in Turner syndrome (TS). The mechanisms underlying bone impairment in affected patients are not clearly elucidated, but estrogen deficiency and X-chromosomal abnormalities represent important factors. Moreover, although many girls with TS undergo recombinant growth hormone therapy to treat short stature, the efficacy of this treatment on bone mineral density is controversial. The present review will focus on bone fragility in subjects with TS, providing an overview on the pathogenic mechanisms and some prevention strategies.

  3. BONE FRAGILITY IN TURNER SYNDROME: MECHANISMS AND PREVENTION STRATEGIES

    Directory of Open Access Journals (Sweden)

    Maria Felicia Faienza

    2016-04-01

    Full Text Available Bone fragility is recognized as one of major comorbidities in Turner Syndrome (TS. The mechanisms underlying bone impairment in affected patients are not clearly elucidated, but estrogen deficiency and X-chromosomal abnormalities represent important factors. Moreover, although many girls with TS undergo recombinant growth hormone (rGH therapy to treat short stature, the efficacy of this treatment on BMD is controversial. The present review will focus on bone fragility in subjects with TS, providing an overview on the pathogenic mechanisms and some prevention strategies.

  4. Pivot and cluster strategy: a preventive measure against diagnostic errors

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2012-11-01

    Full Text Available Taro Shimizu,1 Yasuharu Tokuda21Rollins School of Public Health, Emory University, Atlanta, GA, USA; 2Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, JapanAbstract: Diagnostic errors constitute a substantial portion of preventable medical errors. The accumulation of evidence shows that most errors result from one or more cognitive biases and a variety of debiasing strategies have been introduced. In this article, we introduce a new diagnostic strategy, the pivot and cluster strategy (PCS, encompassing both of the two mental processes in making diagnosis referred to as the intuitive process (System 1 and analytical process (System 2 in one strategy. With PCS, physicians can recall a set of most likely differential diagnoses (System 2 of an initial diagnosis made by the physicians’ intuitive process (System 1, thereby enabling physicians to double check their diagnosis with two consecutive diagnostic processes. PCS is expected to reduce cognitive errors and enhance their diagnostic accuracy and validity, thereby realizing better patient outcomes and cost- and time-effective health care management.Keywords: diagnosis, diagnostic errors, debiasing

  5. Integrated System for Monitoring and Prevention in Obstetrics-Gynaecology.

    Science.gov (United States)

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

    2016-01-01

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

  6. Microbial environmental monitoring in museums: preventive conservation of graphic collections

    Directory of Open Access Journals (Sweden)

    Giovanna Pasquariello

    2014-12-01

    Full Text Available In museums, the biological component of indoor air, called bioaerosol or biological aerosol, is a potential biodeteriogen for graphic collections. The biological particles settling on the surface of artworks find favorable nutritional and environmental conditions for their growth, and promote biodeterioration. As is well known, biological attacks depend on microclimatic conditions; for this reason their control is essential to assess contamination and estimate biological risks. This article presents the partial application of a methodological model, in the National Institute of Graphic Arts (Istituto Nazionale per la Grafica-ING, a museum of international importance in Rome, on a collection of ancient drawings in the Fondo Corsini, preserved in repository no.1. This model is based on an integrated system of biological environmental monitoring (air and surfaces in association with microclimatic monitoring (repository no.1, cabinet no.6, volumes, drawings and outdoor carried out in an interdisciplinary research project.The values of thermohygrometric parameters were stable enough during the monitored month and had no daily fluctuations. The qualitative and quantitative analysis of air contamination and that on the surfaces of drawings did not show a critical situation.This article describes a pilot study which has focused attention on the biological contamination of the graphic collections and is a contribution to standardizing a system of diagnosis-intervention for preventive conservation of organic cultural heritage preserved in museums and in other indoor environments and the protection of the health of operators and visitors.

  7. Underage Drinking: A Review of Trends and Prevention Strategies.

    Science.gov (United States)

    Harding, Frances M; Hingson, Ralph W; Klitzner, Michael; Mosher, James F; Brown, Jorielle; Vincent, Robert M; Dahl, Elizabeth; Cannon, Carol L

    2016-10-01

    Underage drinking and its associated problems have profound negative consequences for underage drinkers themselves, their families, their communities, and society as a whole, and contribute to a wide range of costly health and social problems. There is increased risk of negative consequences with heavy episodic or binge drinking. Alcohol is a factor related to approximately 4,300 deaths among underage youths in the U.S. every year. Since the mid-1980s, the nation has launched aggressive underage drinking prevention efforts at the federal, state, and local levels, and national epidemiologic data suggest that these efforts are having positive effects. For example, since 1982, alcohol-related traffic deaths among youth aged 16-20 years have declined by 79%. Evidence-based or promising strategies for reducing underage drinking include those that limit the physical, social, and economic availability of alcohol to youth, make it illegal for drivers aged drinking, and provide mechanisms for early identification of problem drinkers. Strategies may be implemented through a comprehensive prevention approach including policies and their enforcement, public awareness and education, action by community coalitions, and early brief alcohol intervention and referral programs. This paper focuses on underage drinking laws and their enforcement because these constitute perhaps the most fundamental component of efforts to limit youth access to and use of alcohol.

  8. Strategy for preventing the waste of human resources

    Science.gov (United States)

    Jones, William E.

    1992-05-01

    Rapid technological advances and the declining educational preparedness of industrial workers has established a need for new training strategies and initiatives regarding human resource development. The productivity, competitiveness, motivation, and creativity of our people determines whether our business enterprises succeed or fail during the next decade. Due to a change process that many organizations have undertaken to become more competitive toward the year 2000, many of the previous styles of engineering leadership that involves the management of projects and human resources require new approaches. It is also important to recognize that technology has its limits and a broader focus to include the human aspects of accomplishing jobs over the long term is more critical than ever before. More autonomy and the responsibility for broader practices by the professional staff requires that the professional worker operate differently. Business planning and development of the organization's future strategic intent requires a high priority on the human resource linkage to the business plans and strategies. A review of past practices to motivate the worker toward higher productivity clearly shows that past techniques are not as effective in today's work environment. Many practices of organizational and individual leadership don't fit today's approach of worker involvement because they were designed for administrative supervisory control processes. Therefore, if we are going to organize a business strategy that prevents the `waste of human resources,' we need to develop a strategy that is appropriate for the times which considers the attitude of the employees and their work environment. Having worked with scientists and engineers for the majority of my twenty-five year career, I know they see and appreciate the logic of a formula. A formula fits when developing a future strategy because a formula can become a model to enhance balanced planning. In this paper, I want to

  9. Retaining clients in an outcome monitoring evaluation study: HIV prevention efforts in community settings.

    Science.gov (United States)

    Smith, Bryce D; Kalayil, Elizabeth J; Patel-Larson, Alpa; Chen, Brenda; Vaughan, Marla

    2012-02-01

    The Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) conducted outcome monitoring studies on evidence-based interventions (EBIs) provided by CDC-funded community-based organizations (CBOs). Critical to the success of outcome monitoring was the ability of CBOs to recruit and retain clients in evaluation studies. Two EBIs, Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) and Healthy Relationships, were evaluated using repeated measure studies, which require robust follow-up retention rates to increase the validity and usefulness of the findings. The retention rates were high for both VOICES/VOCES CBOs (95.8% at 30 days and 91.1% at 120 days), and Healthy Relationships CBOs (89.5% at 90 days and 83.5% at 180 days). This paper presents an overview of the retention of clients, challenges to follow-up, and strategies developed by CBOs to achieve high retention rates. These strategies and rates are discussed within the context of the CBOs' target populations and communities. Published by Elsevier Ltd.

  10. Delivering insecticide-treated nets for malaria prevention: innovative strategies

    Directory of Open Access Journals (Sweden)

    Krezanoski PJ

    2016-09-01

    Full Text Available Paul J Krezanoski1–3 1Department of Medicine, 2Department of Pediatrics, Massachusetts General Hospital, 3Medicine and Pedatrics, Harvard Medical School, Boston, MA, USA Abstract: The wide-scale adoption of insecticide-treated nets (ITNs has led to significant reductions in malaria morbidity and mortality worldwide. Delivery of ITNs to the 3.2 billion people at risk of malaria requires multiple steps in diverse settings. The effectiveness of the delivery of ITNs in order to prevent malaria relies on activities that include ITN manufacturing and design, integration into national and international malaria prevention policies, supplying and distributing ITNs to households and individuals, and, finally, programs focused on spurring demand for and use of ITNs by individuals at risk. This paper reviews some recent innovative strategies for ITN delivery across these four domains, places these innovations within the context of the history of ITN deployment, and identifies opportunities to further improve the effectiveness of this ubiquitous public health tool. Keywords: malaria, insecticide-treated bed nets, prevention, access, ownership, use, policies

  11. Strategies for Reducing or Preventing the Generation of Oxidative Stress

    Directory of Open Access Journals (Sweden)

    B. Poljsak

    2011-01-01

    Full Text Available The reduction of oxidative stress could be achieved in three levels: by lowering exposure to environmental pollutants with oxidizing properties, by increasing levels of endogenous and exogenous antioxidants, or by lowering the generation of oxidative stress by stabilizing mitochondrial energy production and efficiency. Endogenous oxidative stress could be influenced in two ways: by prevention of ROS formation or by quenching of ROS with antioxidants. However, the results of epidemiological studies where people were treated with synthetic antioxidants are inconclusive and contradictory. Recent evidence suggests that antioxidant supplements (although highly recommended by the pharmaceutical industry and taken by many individuals do not offer sufficient protection against oxidative stress, oxidative damage or increase the lifespan. The key to the future success of decreasing oxidative-stress-induced damage should thus be the suppression of oxidative damage without disrupting the wellintegrated antioxidant defense network. Approach to neutralize free radicals with antioxidants should be changed into prevention of free radical formation. Thus, this paper addresses oxidative stress and strategies to reduce it with the focus on nutritional and psychosocial interventions of oxidative stress prevention, that is, methods to stabilize mitochondria structure and energy efficiency, or approaches which would increase endogenous antioxidative protection and repair systems.

  12. Editorial: Prevention Strategies Targeting Different Preclinical Stages of Alzheimer's Disease.

    Science.gov (United States)

    Zhou, Bin

    2015-01-01

    The incidence of dementia is rapidly increasing not only in developed countries but also in developing countries with rising aging populations. This trend is expected to worsen, with the number of cases possibly tripling in the coming decades. Over the last few decades, epidemiological studies have revealed that vascular-or lifestyle-related factors are associated with an increased risk of Alzheimer's disease (AD) and dementia. Researches into the pathophysiological processes of AD have revealed that the pathological brain lesions of AD begin decades before the onset of symptoms. Many prevention studies have indicated that physical activity and/or mental training can improve cognition and daily life in subjects with AD or mild cognitive impairment (MCI). However, issues with early detection and preclinical staging and effective preventive approaches that are based on these stages remain unresolved. Therefore, we propose different strategies for AD prevention based on its preclinical stages: one involves physical and mental training that targets the risk factors in subjects without pathophysiological changes, and the second approach combines nonpharmacological and pharmacological methods and aims to treat MCI in individuals with amyloid deposits and/or neurodegeneration with drugs that target the amyloid cascade. The results of several ongoing and promising trials are expected in the next few years.

  13. Reprogramming: A Preventive Strategy in Hypertension Focusing on the Kidney

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    You-Lin Tain

    2015-12-01

    Full Text Available Adulthood hypertension can be programmed in response to a suboptimal environment in early life. However, developmental plasticity also implies that one can prevent hypertension in adult life by administrating appropriate compounds during early development. We have termed this reprogramming. While the risk of hypertension has been assessed in many mother-child cohorts of human developmental programming, interventions necessary to prove causation and provide a reprogramming strategy are lacking. Since the developing kidney is particularly vulnerable to environmental insults and blood pressure is determined by kidney function, renal programming is considered key in developmental programming of hypertension. Common pathways, whereby both genetic and acquired developmental programming converge into the same phenotype, have been recognized. For instance, the same reprogramming interventions aimed at shifting nitric oxide (NO-reactive oxygen species (ROS balance, such as perinatal citrulline or melatonin supplements, can be protective in both genetic and developmentally programmed hypertension. Furthermore, a significantly increased expression of gene Ephx2 (soluble epoxide hydrolase was noted in both genetic and acquired animal models of hypertension. Since a suboptimal environment is often multifactorial, such common reprogramming pathways are a practical finding for translation to the clinic. This review provides an overview of potential clinical applications of reprogramming strategies to prevent programmed hypertension. We emphasize the kidney in the following areas: mechanistic insights from human studies and animal models to interpret programmed hypertension; identified risk factors of human programmed hypertension from mother-child cohorts; and the impact of reprogramming strategies on programmed hypertension from animal models. It is critical that the observed effects on developmental reprogramming in animal models are replicated in human

  14. Reprogramming: A Preventive Strategy in Hypertension Focusing on the Kidney.

    Science.gov (United States)

    Tain, You-Lin; Joles, Jaap A

    2015-12-25

    Adulthood hypertension can be programmed in response to a suboptimal environment in early life. However, developmental plasticity also implies that one can prevent hypertension in adult life by administrating appropriate compounds during early development. We have termed this reprogramming. While the risk of hypertension has been assessed in many mother-child cohorts of human developmental programming, interventions necessary to prove causation and provide a reprogramming strategy are lacking. Since the developing kidney is particularly vulnerable to environmental insults and blood pressure is determined by kidney function, renal programming is considered key in developmental programming of hypertension. Common pathways, whereby both genetic and acquired developmental programming converge into the same phenotype, have been recognized. For instance, the same reprogramming interventions aimed at shifting nitric oxide (NO)-reactive oxygen species (ROS) balance, such as perinatal citrulline or melatonin supplements, can be protective in both genetic and developmentally programmed hypertension. Furthermore, a significantly increased expression of gene Ephx2 (soluble epoxide hydrolase) was noted in both genetic and acquired animal models of hypertension. Since a suboptimal environment is often multifactorial, such common reprogramming pathways are a practical finding for translation to the clinic. This review provides an overview of potential clinical applications of reprogramming strategies to prevent programmed hypertension. We emphasize the kidney in the following areas: mechanistic insights from human studies and animal models to interpret programmed hypertension; identified risk factors of human programmed hypertension from mother-child cohorts; and the impact of reprogramming strategies on programmed hypertension from animal models. It is critical that the observed effects on developmental reprogramming in animal models are replicated in human studies.

  15. Strategies for monitoring of priority pollutant emission barriers

    DEFF Research Database (Denmark)

    Pettersson, Maria; De Keyser, Webbey; Birch, Heidi;

    2010-01-01

    The objective of Task 7.5 was to develop tools for model-based planning of sampling campaigns in the design of monitoring strategies for priority pollutant emission barriers. Using integrated urban wastewater system (IUWS) models, measurement campaigns can be designed to improve the calibration...... of the model‟s parameters (Optimal Experiment Design for Parameter Estimation (OED/PE)). Furthermore, the knowledge contained in the IUWS models can be used to optimize the planning of sampling campaigns aiming at assessing the efficiency of emission control strategies. To do this, the emission barriers need...... to be implemented in the IUWS model, as well as the sampling and measuring devices that will be used. The simulation results are presented as a Substance Flow Analysis (SFA). These SFAs can be compared with empirical SFAs and can also be used to set up measurement campaigns aiming at gathering information...

  16. Therapeutic strategies to prevent motor complications in Parkinson's disease.

    Science.gov (United States)

    Kieburtz, Karl

    2008-08-01

    Dopaminergic treatment of Parkinson's disease (PD) leads to significant improvement in Parkinsonian features; however, the treatment response is hampered by the appearance of motor complications, including dyskinesias and motor fluctuations. These motor complications have a significant negative impact on quality-of-life. Therapeutic strategies using different types and timing of dopaminergic therapy may influence the emergence of motor complications. While sustained release preparations of levodopa have not shown benefit over immediate release preparations, the early combination of a dopamine agonist with levodopa appears to reduce the onset of motor fluctuations. An even larger body of evidence has found that initiating treatment with a dopamine receptor agonist (as compared to immediate release levodopa) is associated with a reduction in motor fluctuations, particularly dyskinesias. These data have led to evidence-based medicine evaluations indicating that the use of dopamine agonists is efficacious and clinically useful for the prevention of motor complications.

  17. Nonpharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Paweena Susantitaphong

    2014-01-01

    Full Text Available Contrast-induced AKI (CI-AKI has been one of the leading causes for hospital-acquired AKI and is associated with independent risk for adverse clinical outcomes including morbidity and mortality. The aim of this review is to provide a brief summary of the studies that focus on nonpharmacological strategies to prevent CI-AKI, including routine identification of at-risk patients, use of appropriate hydration regimens, withdrawal of nephrotoxic drugs, selection of low-osmolar contrast media or isoosmolar contrast media, and using the minimum volume of contrast media as possible. There is no need to schedule dialysis in relation to injection of contrast media or injection of contrast agent in relation to dialysis program. Hemodialysis cannot protect the poorly functioning kidney against CI-AKI.

  18. Volcano monitoring using the Global Positioning System: Filtering strategies

    Science.gov (United States)

    Larson, K.M.; Cervelli, Peter; Lisowski, M.; Miklius, Asta; Segall, P.; Owen, S.

    2001-01-01

    Permanent Global Positioning System (GPS) networks are routinely used for producing improved orbits and monitoring secular tectonic deformation. For these applications, data are transferred to an analysis center each day and routinely processed in 24-hour segments. To use GPS for monitoring volcanic events, which may last only a few hours, real-time or near real-time data processing and subdaily position estimates are valuable. Strategies have been researched for obtaining station coordinates every 15 min using a Kalman filter; these strategies have been tested on data collected by a GPS network on Kilauea Volcano. Data from this network are tracked continuously, recorded every 30 s, and telemetered hourly to the Hawaiian Volcano Observatory. A white noise model is heavily impacted by data outages and poor satellite geometry, but a properly constrained random walk model fits the data well. Using a borehole tiltmeter at Kilauea's summit as ground-truth, solutions using different random walk constraints were compared. This study indicates that signals on the order of 5 mm/h are resolvable using a random walk standard deviation of 0.45 cm/???h. Values lower than this suppress small signals, and values greater than this have significantly higher noise at periods of 1-6 hours. Copyright 2001 by the American Geophysical Union.

  19. Volcano monitoring using the Global Positioning System: Filtering strategies

    Science.gov (United States)

    Larson, Kristine M.; Cervelli, Peter; Lisowski, Michael; Miklius, Asta; Segall, Paul; Owen, Susan

    2001-09-01

    Permanent Global Positioning System (GPS) networks are routinely used for producing improved orbits and monitoring secular tectonic deformation. For these applications, data are transferred to an analysis center each day and routinely processed in 24-hour segments. To use GPS for monitoring volcanic events, which may last only a few hours, real-time or near real-time data processing and subdaily position estimates are valuable. Strategies have been researched for obtaining station coordinates every 15 min using a Kalman filter; these strategies have been tested on data collected by a GPS network on Kilauea Volcano. Data from this network are tracked continuously, recorded every 30 s, and telemetered hourly to the Hawaiian Volcano Observatory. A white noise model is heavily impacted by data outages and poor satellite geometry, but a properly constrained random walk model fits the data well. Using a borehole tiltmeter at Kilauea's summit as ground-truth, solutions using different random walk constraints were compared. This study indicates that signals on the order of 5 mm/h are resolvable using a random walk standard deviation of 0.45 cm/√h. Values lower than this suppress small signals, and values greater than this have significantly higher noise at periods of 1-6 hours.

  20. Dental caries: Strategies to control this preventable disease

    Directory of Open Access Journals (Sweden)

    Andrew Rugg-Gunn

    2013-11-01

    Full Text Available Objective. To provide a brief commentary review of strategies to control dental caries. Dental decay is one of man’s most prevalent diseases. In many counties, severity increased in parallel with importation of sugar, reaching its zenith about 1950s and 1960s. Since then, severity has declined in many countries, due to the wide use of fluoride especially in toothpaste, but dental caries remains a disease of medical, social and economic importance. Within the EU in 2011, the cost of dental treatment was estimated to be €79 billion. The pathogenesis is well understood: bacteria in dental plaque (biofilm metabolise dietary sugars to acids which then dissolve dental enamel and dentine. Possible approaches to control caries development, therefore, involve: removal of plaque, reducing the acidogenic potential of plaque, reduction in sugar consumption, increasing the tooth’s resistance to acid attack, and coating the tooth surface to form a barrier between plaque and enamel. At the present time, only three approaches are of practical importance: sugar control, fluoride, and fissure sealing. The evidence that dietary sugars are the main cause of dental caries is extensive, and comes from six types of study. Without sugar, caries would be negligible. Fluoride acts in several ways to aid caries prevention. Ways of delivering fluoride can be classed as: ‘automatic’, ‘home care’ and ‘professional care’: the most important of these are discussed in detail in four articles in this issue of the Acta Medica Academica. Conclusion. Dental caries is preventable – individuals, communities and countries need strategies to achieve this.

  1. Dental caries: strategies to control this preventable disease.

    Science.gov (United States)

    Rugg-Gunn, Andrew

    2013-11-01

    To provide a brief commentary review of strategies to control dental caries. Dental decay is one of man's most prevalent diseases. In many counties, severity increased in parallel with importation of sugar, reaching its zenith about 1950s and 1960s. Since then, severity has declined in many countries, due to the wide use of fluoride especially in toothpaste, but dental caries remains a disease of medical, social and economic importance. Within the EU in 2011, the cost of dental treatment was estimated to be €79 billion. The pathogenesis is well understood: bacteria in dental plaque (biofilm) metabolise dietary sugars to acids which then dissolve dental enamel and dentine. Possible approaches to control caries development, therefore, involve: removal of plaque, reducing the acidogenic potential of plaque, reduction in sugar consumption, increasing the tooth's resistance to acid attack, and coating the tooth surface to form a barrier between plaque and enamel. At the present time, only three approaches are of practical importance: sugar control, fluoride, and fissure sealing. The evidence that dietary sugars are the main cause of dental caries is extensive, and comes from six types of study. Without sugar, caries would be negligible. Fluoride acts in several ways to aid caries prevention. Ways of delivering fluoride can be classed as: 'automatic', 'home care' and 'professional care': the most important of these are discussed in detail in four articles in this issue of the Acta Medica Academica. Dental caries is preventable - individuals, communities and countries need strategies to achieve this. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  2. Epidemiological characteristics and preventive strategies for fall injury

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To elucidate the epidemiological characteristics and to define some preventive strategies for fall injury (FI). Methods: The medical records of patients admitted following a fall from a certain height between August 1996and July 1997 were analyzed retrospectively. Results: A total of 138 patients were assessed, with a mortality of 31.2%. The male-to-female ratio was 3.5: 1.The persons between 20 and 59 years old were the main victims (81.8%), of which 52.2% were related with their work altitude. The remaining adults fall because of,accidents in daily life, suicide attempts, drug abuse,alcohol, or criminal behavior. There were significant differences between the death group and the survival group in the Revised Trauma Score (RTS) and the Injury Severity Score (ISS) value (P <0.05 and P <0.01, respectively).Six children fall from balconies, open windows or roofs.There were significant differences for the height of fall and RTS value in aged group than those in children,adolescents, and adults (P <0.001, 0.005, 0.05; and P <0.05, 0.01, 0.05, respectively). The mortality of FI was significantiy correlated to the height of fall (r = 0.897, P <0.005). Conclusions: Male adults are the main victims,especially the workers at high altitudes. The mortality of FI is significantly correlated to the height of fall. The preventive strategies developed through analyzing the risk factors of fall in different age groups might reduce the injuries and deaths following fall.

  3. Developing Primary Intervention Strategies to Prevent Allergic Disease.

    Science.gov (United States)

    Rueter, Kristina; Haynes, Aveni; Prescott, Susan L

    2015-07-01

    Allergic diseases are a major cause of morbidity in the developed world, now affecting up to 40 % of the population with no evidence that this is abating. If anything, the prevalence of early onset allergic diseases such as eczema and food allergy appears to be still increasing. This is almost certainly due to the changing modern environment and lifestyle factors, acting to promote immune dysfunction through early perturbations in immune maturation, immune tolerance and regulation. This early propensity to inflammation may also have implications for the rising risk of other inflammatory non-communicable diseases (NCDs) later in life. Identifying risk factors and pathways for preventing early onset immune disease like allergy is likely to have benefits for many aspects of human health, particularly as many NCDs share similar risk factors. This review focuses on recent advances in primary intervention strategies for promoting early immune health and preventing allergic disease, highlighting the current evidence-based guidelines where applicable and areas requiring further investigation.

  4. Novel pharmacological strategies to prevent aortic complications in Marfan syndrome

    Institute of Scientific and Technical Information of China (English)

    Peter Matt; Friedrich Eckstein

    2011-01-01

    The Marfan syndrome (MFS) is a systemic connective tissue disorder caused by mutations in the FBN1 gene.Recent molecular studies,most performed in mouse models,revealed that the MFS is more a developmental abnormality with broad and complex effects on the morphogenesis and function of multiple organ systems.FBN1 haploinsufficiency and dysregulated transforming growth factor-beta (TGF-β)signaling seem to be critical for clinical manifestations in MFS including aortic root dilatation.Aortic root aneurysm and aortic dissection represent the main causes of morbidity and mortality in MFS.Most importantly,TGF-β antagonism through angiotensin Ⅱ type 1 receptor blockers (ARBs),for example losartan,has been shown to prevent and possibly reverse aortic root dilatation in a mouse model of MFS.A first human study on a small pediatric cohort confirmed those promising results in reducing the aortic root growth over a follow-up period of 12 to 47 months.So,a large multicenter trial has been set up and results should be available soon.Other therapeutic strategies which might be combined with losartan include traditional β-blockade,doxycyclin and statins.Such management could offer the first potential for primary prevention of clinical manifestations in MFS.

  5. Incorporating IPMVP and Six Sigma Strategies into Monitoring and Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Kathleen [Verified, Inc. (United States); Mowris, Robert; Jones, Ean [Robert Mowris and Associates (United States)

    2007-07-01

    Increased emphasis on energy efficiency to reduce energy use and mitigate global warming requires rigorous evaluations based on the International Performance Measurement and Verification Protocol (IPMVP). The California Public Utilities Commission, New York State Energy Research and Development Authority (NYSERDA), the World Bank, and many state and federal agencies require adherence to IPMVP. The World Resources Inst. recommends evaluation standards such as IPMVP for the Kyoto Protocol. Increased emphasis on customer satisfaction and resource efficiency to improve profitability has motivated businesses worldwide to adopt Six Sigma strategies. Motorola, General Electric, Sony, Honda, Toyota, and many other companies have adopted Six Sigma to decrease costs and increase profitability and market share. The objectives of IPMVP and Six Sigma are similar to IEA Annex 40 which provides tools, guidelines, and recommendations for commissioning HVAC systems to optimize building energy efficiency. IPMVP provides a framework to measure, verify, and commission energy efficiency and renewable energy savings. Six Sigma provides a framework to measure and verify energy efficiency performance metrics at critical steps in the market chain (i.e., design, manufacturing, installation). Incorporating IPMVP and Six Sigma into monitoring and evaluation will help program implementers, utilities, consumers, corporations, and government agencies better understand the value of energy efficiency.This paper provides an example of how to incorporate IPMVP and Six Sigma strategies into monitoring and evaluation studies of four residential air conditioner incentive programs implemented by public utilities in California. The net realization rates for the four residential air conditioner programs are 0.53 {+-} 0.1 for kWh and 0.58 {+-} 0.04 for kW. The net realization rates are lower than anticipated due to lower baseline usage, lower ex post savings, and lower net-to-gross ratios. Findings for the

  6. Primary prevention of diabetes mellitus: current strategies and future trends

    Directory of Open Access Journals (Sweden)

    Prasanta K. Bhattacharya

    2016-04-01

    Full Text Available Aim of this paper is to find evidence for primary prevention of type-2 diabetes mellitus (T2DM from epidemiological studies and clinical trials, and the feasibility of applying these interventions in resource limited countries. T2DM, which accounts for more than nine-tenths of all diabetics, results from inadequate insulin secretion or underlying insulin resistance. The prevalence of diabetes, mainly T2DM, has increased rapidly during the last few decades worldwide. Since the genetic background is unlikely to change during this short time period, the growing epidemic of T2DM is more likely due to changes in environmental or lifestyle risk factors including obesity, physical inactivity, smoking, alcohol and stress. The scope and feasibility for primary prevention of T2DM is based on elimination of these risk factors. This evidence that T2DM is preventable comes from epidemiologic studies and clinical trials of effect of lifestyle changes and drugs in development of T2DM. The positive effects are more profound and safer with lifestyle modifications (LSM compared to medications. This is shown to be effective globally, across various ethnicities and races and sustainable on long-term follow-up. However, there is a major challenge in translating this evidence into economically viable and sustained community programs, as these LSM interventions are expensive, even from western standards point of view. Future plan should focus on health education of the public, improving the national capacity to detect and manage the environmental risks including strategies to reduce stress, and development of innovative, cost effective, and scalable methodologies.

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

    Directory of Open Access Journals (Sweden)

    Yadneshwar Khobragade

    2016-01-01

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

  8. Strategies for treatment to prevent fragility fractures in postmenopausal women.

    Science.gov (United States)

    Geusens, Piet

    2009-12-01

    The objective of treatment of osteoporosis is to decrease the risk of fractures in patients at high risk for a first or subsequent fracture. The efficacy of treatment will depend on the efficiency and level of implementation of clinical case finding to select patients at risk, the results of additional investigations, the efficacy, tolerance and safety of medical intervention and the adherence to treatment during follow-up. Each of these steps is critical in treatment in daily practice. Failure to consider one or another step can result in suboptimal fracture prevention or overtreatment. The aim of case finding is to identify patients for treatment, who have disease characteristics of patients in whom fracture prevention has been demonstrated in randomised controlled trials (RCTs). These include patients with a low-trauma hip or vertebral fracture, with a low bone mineral density (BMD) or with a high risk of fracture based on the presence of clinical risk factors (CRFs) for osteoporosis and fractures such as included in the FRAX case-finding algorithm, with or without BMD. Case finding starts clinically, with systematic or opportunistic doctor- and/or patient-driven evaluation for the presence of CRFs, but its implementation is low. Further investigations aim to assess the risk of fracture(s) and to have baseline measurements for the subsequent monitoring of treatment, to exclude diseases that mimic osteoporosis, to identify the cause of osteoporosis and contributory factors and to select the most appropriate treatment. Medical intervention consists of providing information about osteoporosis to the patient, lifestyle advice, optimalisation of calcium intake and vitamin D status, fall prevention to reduce fall risk, correction of reversible contributors to secondary osteoporosis and a wide array of drugs for prevention of a first or subsequent vertebral, hip and non-vertebral, non-hip fracture. Drug treatment is based on manipulation of bone remodelling by

  9. Beyond UHC: monitoring health and social protection coverage in the context of tuberculosis care and prevention.

    Science.gov (United States)

    Lönnroth, Knut; Glaziou, Philippe; Weil, Diana; Floyd, Katherine; Uplekar, Mukund; Raviglione, Mario

    2014-09-01

    Tuberculosis (TB) remains a major global public health problem. In all societies, the disease affects the poorest individuals the worst. A new post-2015 global TB strategy has been developed by WHO, which explicitly highlights the key role of universal health coverage (UHC) and social protection. One of the proposed targets is that "No TB affected families experience catastrophic costs due to TB." High direct and indirect costs of care hamper access, increase the risk of poor TB treatment outcomes, exacerbate poverty, and contribute to sustaining TB transmission. UHC, conventionally defined as access to health care without risk of financial hardship due to out-of-pocket health care expenditures, is essential but not sufficient for effective and equitable TB care and prevention. Social protection interventions that prevent or mitigate other financial risks associated with TB, including income losses and non-medical expenditures such as on transport and food, are also important. We propose a framework for monitoring both health and social protection coverage, and their impact on TB epidemiology. We describe key indicators and review methodological considerations. We show that while monitoring of general health care access will be important to track the health system environment within which TB services are delivered, specific indicators on TB access, quality, and financial risk protection can also serve as equity-sensitive tracers for progress towards and achievement of overall access and social protection.

  10. Beyond UHC: monitoring health and social protection coverage in the context of tuberculosis care and prevention.

    Directory of Open Access Journals (Sweden)

    Knut Lönnroth

    2014-09-01

    Full Text Available Tuberculosis (TB remains a major global public health problem. In all societies, the disease affects the poorest individuals the worst. A new post-2015 global TB strategy has been developed by WHO, which explicitly highlights the key role of universal health coverage (UHC and social protection. One of the proposed targets is that "No TB affected families experience catastrophic costs due to TB." High direct and indirect costs of care hamper access, increase the risk of poor TB treatment outcomes, exacerbate poverty, and contribute to sustaining TB transmission. UHC, conventionally defined as access to health care without risk of financial hardship due to out-of-pocket health care expenditures, is essential but not sufficient for effective and equitable TB care and prevention. Social protection interventions that prevent or mitigate other financial risks associated with TB, including income losses and non-medical expenditures such as on transport and food, are also important. We propose a framework for monitoring both health and social protection coverage, and their impact on TB epidemiology. We describe key indicators and review methodological considerations. We show that while monitoring of general health care access will be important to track the health system environment within which TB services are delivered, specific indicators on TB access, quality, and financial risk protection can also serve as equity-sensitive tracers for progress towards and achievement of overall access and social protection.

  11. Interim data monitoring to enroll higher-risk participants in HIV prevention trials

    Directory of Open Access Journals (Sweden)

    Umo-Otong John

    2009-06-01

    Full Text Available Abstract Background Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. Methods We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. Results A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. Conclusion Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. Trial Registration The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770

  12. Current strategies for the prevention of breast cancer

    Directory of Open Access Journals (Sweden)

    Advani P

    2014-05-01

    Full Text Available Pooja Advani, Alvaro Moreno-AspitiaDepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USAAbstract: Due to the high incidence of breast cancer in the United States, optimal strategies for its prevention are imperative. This entails identification of women who are at an increased risk for breast cancer and an integrative approach that includes effective screening methods as well as nutritional, pharmacologic, and surgical management. Several breast cancer risk-assessment tools, such as the Gail and Claus models, can help clinicians determine the quantitative risk of breast cancer. The role of selective estrogen receptor modulators, such as tamoxifen and raloxifene, for the prevention of breast cancer has been well established. Several other agents, such as aromatase inhibitors, are currently being investigated. The potential adverse effects of these chemopreventive agents, which include an impact on the quality of life, must be discussed with the patient before deciding on this approach. Additionally, breast cancer risk factors have been identified over the years; some of them are modifiable, but others are not. Although there is no conclusive evidence to suggest the protective role of specific dietary components, alcohol consumption and obesity are associated with an increased breast cancer risk; thus lifestyle changes can lead to a lower risk of developing breast cancer. Surgical approaches, including bilateral risk-reduction mastectomy and salpingo-oophorectomy, are usually limited to women with a hereditary predisposition to development of breast cancer. The objective of this review is to summarize the various approaches directed at reducing the incidence of breast cancer.Keywords: chemoprevention, tamoxifen, raloxifene, prophylactic surgery

  13. The Roles of Mothers' Neighborhood Perceptions and Specific Monitoring Strategies in Youths' Problem Behavior

    Science.gov (United States)

    Byrnes, Hilary F.; Miller, Brenda A.; Chen, Meng-Jinn; Grube, Joel W.

    2011-01-01

    The neighborhood context can interfere with parents' abilities to effectively monitor their children, but may be related to specific monitoring strategies in different ways. The present study examines the importance of mothers' perceptions of neighborhood disorganization for the specific monitoring strategies they use and how each of these…

  14. Control Strategies for Prevention of Undesirable Traits in Cattle - Review

    Directory of Open Access Journals (Sweden)

    Daniela Elena Ilie

    2011-05-01

    Full Text Available Cattle genome sequencing has a major impact on livestock breeding and provides useful information in the field biotechnology that can ultimately lead to the development of several techniques for early molecular diagnosis. These developments within molecular genetics have made possible the rapid and effective detection of lethal or mutant alleles associated with a disease-specific phenotype by DNA isolation followed by in vitro amplification techniques and enzymatic restriction. DNA tests are currently in use for the detection of heterozygotes and diagnosis of genetic diseases such as bovine leukocyte adhesion deficiency (BLAD, deficiency of uridine monophosphate synthase (DUMPS and bovine citrullinemia. These genetic defects are autosomal recessive disorders which were widespread trough advanced reproductive technologies, including artificial insemination and multiple ovulation embryo transfer, as result of selection focused on desirable traits carried by elite bulls with high genetic merit. In order to prevent the risk of dissemination of inherited defects in dairy herds and to decrease the economic losses all bulls have to be tested, although the prevalence of the above mentioned recessive alleles is low. Therefore, it is advisable to use molecular markers to assess bovine health and to implement such programs for the purpose of monitoring hereditary diseases in cattle.

  15. Prevention and Control Strategies to Counter ZIKA Epidemic

    Science.gov (United States)

    Rather, Irfan A.; Kumar, Sanjay; Bajpai, Vivek K.; Lim, Jeongheui; Park, Yong-Ha

    2017-01-01

    ZIKA virus (ZIKA) has now become a global phenomenon. Since 2007, evidence of ZIKA transmission has been reported over 72 countries and territories. The transmission of ZIKA has made World Health Organization to categorize the situation under the ambit of a health emergency. This situation is serious because there appears to be a highly tangible link between infection during pregnancy and the occurrence of microcephaly and Guillain–Barré syndrome. In the context of this emergency situation, this review article intends to discuss the prevention and control strategies such as avoiding travel to infected area, being careful from mosquito bites, take precautions to reduce the risk of sexual transmission, and seek medical care for any acute illness with rash or fever. This review is an attempt to analyze the results of those campaigns, keeping in view the variables and constants that affect any such measures. Furthermore, this article will suggest proactive measures that can be employed to effectively combat the epidemic transmission of the ZIKA. PMID:28293228

  16. Localization Strategies in WSNs as applied to Landslide Monitoring (Invited)

    Science.gov (United States)

    Massa, A.; Robol, F.; Polo, A.; Giarola, E.; Viani, F.

    2013-12-01

    represent a fine tuning of large scale satellite acquisitions, usually adopted for remote sensing of landslides. The integration of dense and frequent WSN data within satellite image analysis will enhance the sensing capabilities leading to a multi-resolution and an highly space-time calibrated system. The WSN-based system has been preliminary tested in controlled environments in the ELEDIA laboratories and is now installed in a real test site where an active landslide is evolving. Preliminary data are here presented to assess the feasibility of the investigated solution in landslide monitoring and event forecasting. REFERENCES [1] M. Benedetti, L. Ioriatti, M. Martinelli, and F. Viani, 'Wireless sensor network: a pervasive technology for earth observation,' in IEEE Journal of Selected Topics in App. Earth Obs. And Remote Sens., vol. 3, no. 4, pp. 488-497, 2010. [2] F. Viani, M. Donelli, P. Rocca, G. Oliveri, D. Trinchero, and A. Massa, 'Localization, tracking and imaging of targets in wireless sensor networks,' Radio Science, vol. 46, no. 5, 2011. [3] F. Viani, F. Robol, M. Salucci, E. Giarola, S. De Vigili, M. Rocca, F. Boldrini, G. Benedetti, and A. Massa, 'WSN-based early alert system for preventing wildlife-vehicle collisions in Alps regions - From the laboratory test to the real-world implementation,' 7th European Conference on Antennas and Propagation 2013 (EUCAP2013), Gothenburg, Sweden, April 8-12, 2013.

  17. Necessity of Rethinking about the Preventive Strategies of Addiction

    Directory of Open Access Journals (Sweden)

    Ali Riasaty

    2017-07-01

    Full Text Available According to the last official statistics of national organization, there are nearly 220 million addicted people in the world until 2008. Therefore, it seems that addiction has become a scourge of the world which cannot be dealt with by countries alone. Generally, social damages prevention has priority over other methods, especially in addiction. We can see two approaches in this field: community based and risk-awareness preventive strategies.1‎ Obviously, prevention approaches are developed on theoretical basis. Some of the theories on which the first strategy is based are as follows: Talkot Parsons had the opinion that if social institutions like family, school and media don’t have proper functioning, the society will be suffering from the ravages and it will be deviant. Travis Hirsch’s social control theory is generally based on the Durkheim’s social cohesion. Social control theory, instead of focusing on the main causes of social deviations, focuses on the explanation of the need to avoid criminal activities: interest, obligation, partnership, and belief. Sutherland believes that more criminal behaviors prevail among the first groups, such as peer groups. Delinquency primarily takes place through social interaction with intimate groups. One of the important theories was suggested by Lyder. He combined theories of sociology and social psychology. He processed the difficulty of distinguishing individual and social fields; the concept of a bio-psycho refers to the “personality as a unique individual identity who immersed in social processes”. Various elements such as mental bio-psycho, social reality of social domain theory and bio-psychological domain will be used in developing a prevention program which is based on social harms of this theory.2,3 On the other hand,‎ awareness-raising approaches are developed on the basis of theories such as “Rational Choice Theory”, “Value-Rational Action”, “Health Belief Model”, and

  18. Strategy implementation for the CTA Atmospheric monitoring program

    Directory of Open Access Journals (Sweden)

    Doro Michele

    2015-01-01

    Full Text Available The Cherenkov Telescope Array (CTA is the next generation facility of Imaging Atmospheric Cherenkov Telescopes. It reaches unprecedented sensitivity and energy resolution in very-high-energy gamma-ray astronomy. CTA detects Cherenkov light emitted within an atmospheric shower of particles initiated by cosmic-gamma rays or cosmic rays entering the Earth's atmosphere. From the combination of images the Cherenkov light produces in the telescopes, one is able to infer the primary particle energy and direction. A correct energy estimation can be thus performed only if the local atmosphere is well characterized. The atmosphere not only affects the shower development itself, but also the Cherenkov photon transmission from the emission point in the particle shower, at about 10–20 km above the ground, to the detector. Cherenkov light on the ground is peaked in the UV-blue region, and therefore molecular and aerosol extinction phenomena are important. The goal of CTA is to control systematics in energy reconstruction to better than 10%. For this reason, a careful and continuous monitoring and characterization of the atmosphere is required. In addition, CTA will be operated as an observatory, with data made public along with appropriate analysis tools. High-level data quality can only be ensured if the atmospheric properties are consistently and continuously taken into account. In this contribution, we concentrate on discussing the implementation strategy for the various atmospheric monitoring instruments currently under discussion in CTA. These includes Raman lidars and ceilometers, stellar photometers and others available both from commercial providers and public research centers.

  19. Strategies for designing and monitoring malaria vaccines targeting diverse antigens

    Directory of Open Access Journals (Sweden)

    Alyssa E Barry

    2014-07-01

    Full Text Available After more than 50 years of intensive research and development, only one malaria vaccine candidate, RTS,S, has progressed to Phase 3 clinical trials. Despite only partial efficacy, this candidate is now forecast to become the first licensed malaria vaccine. Hence, more efficacious second-generation malaria vaccines that can significantly reduce transmission are urgently needed. This review will focus on a major obstacle hindering development of effective malaria vaccines: parasite antigenic diversity. Despite extensive genetic diversity in leading candidate antigens, vaccines have been and continue to be formulated using recombinant antigens representing only one or two strains. These vaccine strains represent only a small fraction of the diversity circulating in natural parasite populations, leading to escape of non-vaccine strains and challenging investigators’ abilities to measure strain-specific efficacy in vaccine trials. Novel strategies are needed to overcome antigenic diversity in order for vaccine development to succeed. Many studies have now catalogued the global diversity of leading Plasmodium falciparum and Plasmodium vivax vaccine antigens. In this review, we describe how population genetic approaches can be applied to this rich data source to predict the alleles that best represent antigenic diversity, polymorphisms that contribute to it, and to identify key polymorphisms associated with antigenic escape. We also suggest an approach to summarise the known global diversity of a given antigen to predict antigenic diversity, how to select variants that best represent the strains circulating in natural parasite populations and how to investigate the strain-specific efficacy of vaccine trials. Use of these strategies in the design and monitoring of vaccine trials will not only shed light on the contribution of genetic diversity to the antigenic diversity of malaria, but will also maximise the potential of future malaria vaccine

  20. Report seeks new prevention strategies for young people.

    Science.gov (United States)

    1997-05-16

    The AIDS Research Institute and Center for AIDS Prevention at the University of California, San Francisco collaborated with the Harvard AIDS Institute on a report that considers HIV/AIDS among young people in the United States. The report indicates that AIDS is becoming a disease of the young, and prevention policies are not addressing the realities of youth beliefs or behaviors. The report calls for expanding age-appropriate sex education and condoms in schools, increasing government prevention funding, urging prevention educators to use private-sector marketing tools, and encouraging the private sector to market HIV prevention.

  1. Strategy Developed for Selecting Optimal Sensors for Monitoring Engine Health

    Science.gov (United States)

    2004-01-01

    Sensor indications during rocket engine operation are the primary means of assessing engine performance and health. Effective selection and location of sensors in the operating engine environment enables accurate real-time condition monitoring and rapid engine controller response to mitigate critical fault conditions. These capabilities are crucial to ensure crew safety and mission success. Effective sensor selection also facilitates postflight condition assessment, which contributes to efficient engine maintenance and reduced operating costs. Under the Next Generation Launch Technology program, the NASA Glenn Research Center, in partnership with Rocketdyne Propulsion and Power, has developed a model-based procedure for systematically selecting an optimal sensor suite for assessing rocket engine system health. This optimization process is termed the systematic sensor selection strategy. Engine health management (EHM) systems generally employ multiple diagnostic procedures including data validation, anomaly detection, fault-isolation, and information fusion. The effectiveness of each diagnostic component is affected by the quality, availability, and compatibility of sensor data. Therefore systematic sensor selection is an enabling technology for EHM. Information in three categories is required by the systematic sensor selection strategy. The first category consists of targeted engine fault information; including the description and estimated risk-reduction factor for each identified fault. Risk-reduction factors are used to define and rank the potential merit of timely fault diagnoses. The second category is composed of candidate sensor information; including type, location, and estimated variance in normal operation. The final category includes the definition of fault scenarios characteristic of each targeted engine fault. These scenarios are defined in terms of engine model hardware parameters. Values of these parameters define engine simulations that generate

  2. POLLUTION PREVENTION STRATEGIES FOR THE MINIMIZING OF INDUSTRIAL WASTES IN THE VCM-PVC INDUSTRY

    Science.gov (United States)

    In many U.S. companies, pollution prevention strategies coincide with economic interests. Typically a company strives to be the lowest-cost producer, to be competitive, and to reduce wastes. In this paper, the author reviews pollution prevention strategies in the vinyl chloride m...

  3. Reducing medication errors: Teaching strategies that increase nursing students' awareness of medication errors and their prevention.

    Science.gov (United States)

    Latimer, Sharon; Hewitt, Jayne; Stanbrough, Rebecca; McAndrew, Ron

    2017-02-14

    Medication errors are a patient safety and quality of care issue. There is evidence to suggest many undergraduate nursing curricula do not adequately educate students about the factors that contribute to medication errors and possible strategies to prevent them. We designed and developed a suite of teaching strategies that raise students' awareness of medication error producing situations and their prevention.

  4. Alcohol Prevention Strategies on College Campuses and Student Alcohol Abuse and Related Problems

    Science.gov (United States)

    Ringwalt, Christopher L.; Paschall, Mallie J.; Gitelman, Amy M.

    2011-01-01

    This study examined the relationship between colleges' alcohol abuse prevention strategies and students' alcohol abuse and related problems. Alcohol prevention coordinators and first year students in 22 colleges reported whether their schools were implementing 48 strategies in six domains, and students (N = 2041) completed another survey…

  5. Research on Integrated Monitoring and Prevention System for Stray Current in Metro

    Institute of Scientific and Technical Information of China (English)

    李威; 严旭

    2001-01-01

    On the basis of analyzing the influencing factors and harmfulness of stray current, and discussing the existing problems of monitoring and prevention system for stray current, the integrated monitoring and prevention system for stray current in metro was developed. A net system of distributed computers for monitoring was set up. It can monitor the distribution of stray current in metro and the corrosion of the metal structure in the whole line. According to the situation of monitoring it can also control the drainage of its tank to reach the best effect and eliminate the negative effect of polarity drainage. By using the new type unilateral electric device, the problem of burning the rail by electric arc can be avoided. The unilateral electric device can be connected with the monitoring net system directly to realize the monitor in line and improve the reliability of the device.

  6. Clinical review: non-antibiotic strategies for preventing ventilator-associated pneumonia.

    Science.gov (United States)

    Ferrer, Ricard; Artigas, Antonio

    2002-02-01

    Prevention of nosocomial pneumonia (NP) is the most important step towards reducing hospitalisation costs. The non-antibiotic prevention strategies include measures related to the correct care of the artificial airway, strategies related directly to the maintenance of the mechanical ventilator and the equipment, strategies focused in the gastrointestinal tract, and strategies related to the position of the intubated patients. While simple methods should be part of routine practice, the use of more invasive and expensive preventive measures should be used only in patients who are at high risk of NP. The appropriate use of these techniques can reduce the incidence of NP in intensive care unit patients.

  7. The Contribution of Earth Observation Technologies to Monitoring Strategies of Cultural Landscapes and Sites

    Science.gov (United States)

    Cuca, B.

    2017-08-01

    Coupling of Climate change effects with management and protection of cultural and natural heritage has been brought to the attention of policy makers since several years. On the worldwide level, UNESCO has identified several phenomena as the major geo-hazards possibly induced by climate change and their possible hazardous impact to natural and cultural heritage: Hurricane, storms; Sea-level rise; Erosion; Flooding; Rainfall increase; Drought; Desertification and Rise in temperature. The same document further referrers to satellite Remote Sensing (EO) as one of the valuable tools, useful for development of "professional monitoring strategies". More recently, other studies have highlighted on the impact of climate change effects on tourism, an economic sector related to build environment and traditionally linked to heritage. The results suggest that, in case of emergency the concrete threat could be given by the hazardous event itself; in case of ordinary administration, however, the threat seems to be a "hazardous attitude" towards cultural assets that could lead to inadequate maintenance and thus to a risk of an improper management of cultural heritage sites. This paper aims to illustrate potential benefits that advancements of Earth Observation technologies can bring to the domain of monitoring landscape heritage and to the management strategies, including practices of preventive maintenance. The attempt here is to raise awareness on the importance of integrating satellite remote sensing imagery and the deriving products with other geospatial information (even geo-referenced historic maps) for a more complete insight on the environmental dynamics of landscapes.

  8. Pig herd monitoring and undesirable tripping and stepping prevention

    DEFF Research Database (Denmark)

    Gronskyte, Ruta; Clemmensen, Line Katrine Harder; Hviid, Marchen Sonja

    2015-01-01

    at the slaughterhouse and identify undesirable events such as pigs tripping or stepping on each other. In this paper, we monitor pig behavior in color videos recorded during unloading from transportation trucks. We monitor the movement of a pig herd where the pigs enter and leave a surveyed area. The method is based...... performed the unloading of the pigs from the trucks in the available datasets, indicates that the drivers perform significantly differently. Driver 1 has 2.95 times higher odds to have pigs tripping and stepping on each other than the two others, and Driver 2 has 1.11 times higher odds than Driver 3. (C...

  9. Preventing Challenging Behaviors in Preschool: Effective Strategies for Classroom Teachers

    Science.gov (United States)

    Coleman, Janelle C.; Crosby, Megan G.; Irwin, Heather K.; Dennis, Lindsay R.; Simpson, Cynthia G.; Rose, Chad A.

    2013-01-01

    This article provides practical strategies and techniques that early childhood educators can implement in their classrooms to effectively manage challenging behaviors. The specific strategies addressed fall under the following categories: (a) classroom management, (b) reinforcement, and (c) communication. Suggestions are made for how parents can…

  10. Enamel Demineralization Prevention during Fixed Orthodontic Treatment and Remineralization Strategies

    Institute of Scientific and Technical Information of China (English)

    SUN Xin-hua; Wayne J Sampson

    2007-01-01

    Preventing enamel demineralization and remineralization of orthodontic patients is important and it differs from other dental patients.Oral hygiene education and oral examination is essential to prevent enamel demineralization,and dietary education or control of sugar intake should not be ignored during fixed orthodontic treatment.Laser irradiation is a noteworthy method to prevent enamel mineralization.Products containing fluoride and fluoride released not only can be used to prevent demineralization but also have the ability of remineralization during orthodontic treatment.Oral hygiene products containing casein-phosphopeptide amorphous calcium phosphate (CPP-ACP) have been demonstrated to have the ability of remineralization such as sugar-free chewing gum added CPP-ACP,lozenges containing CPP-AGP and milk protein casein tabilized by phosphopeptides.

  11. Tibetan Traditional Strategies on Thunder and Lighting Prevention

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The Frequent occurrence of thunder and lighting in Ti-bet inconveniences Tibetan people,even endangering their lives.However,Tibetans have accumulated rich experience to pre-vent injury from thunder and lighting.

  12. Suicide prevention: a proposed national strategy for South Africa

    African Journals Online (AJOL)

    Dysfunctional problem-solving skills. Suicidal ... verbal or non-verbal behavioural cues that indicate the suicidal .... Promoting skills development on how to support and assist suicidal ... can play an essential role in the prevention of suicidal.

  13. Avaliação da exposição ocupacional ao chumbo: proposta de uma estratégia de monitoramento para prevenção dos efeitos clínicos e subclínicos Occupational lead exposure assessment: a proposal for a strategy to monitor prevention of clinical and subclinical effects

    Directory of Open Access Journals (Sweden)

    Ulisses C. Araujo

    1999-01-01

    , with a possible 46% of workers presenting a Pb-B range of 25-60 µg/dl in risk areas. Recent data suggest that Pb-B levels above 25 µg/dl are related to subclinical alterations in human body that should be investigated during clinical examination. Finally, we propose a strategy based on environmental and biological monitoring to prevent both clinical and subclinical effects.

  14. EDUCATIONAL ACTIONS TO PREVENT DENGUE: EXPERIENCES AND STRATEGIES WITH ELDERLY

    OpenAIRE

    Rosamaria Rodrigues Garcia; Vanessa Lopes Munhoz Afonso; Carolina Menezes Sinato; Filomena Neves Pereira Vieira Adduci; Regina Garcia do Nascimento; Francisco Souza do Carmo; Paulo Sérgio Pelegrino

    2015-01-01

    Objective: Describe the activities performed on apublic specialized ambulatory care for dengue prevention among elderly. Case report: the epidemiological outlook of dengue is scaring being characterized as a public health problem. The elderly are most at risk for hospitalization and severe forms of the disease, thus health education activities are essential to improve awareness of the need to fight and prevent the disease. A Health Education project was created, evolving communication strateg...

  15. Educational Strategies for Preventing Pressure Ulcer in Japan

    OpenAIRE

    2012-01-01

    The purpose of this study was to identify and understand the educational measures that Japanese nurses use to support prevention of pressure ulcers (PrU), by conducting an integrative review of the Japanese nursing literature from 2000 to 2011. We found seven theses by searching with the keywords "pressure ulcer", "prevention", and "education" in nursing research articles cataloged in the "Ichushi" database of the Japan Medical Abstracts Society. Using this approach, we searched for the follo...

  16. Fire Risks and Prevention Strategies for Architecture at Historic Sites

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This paper mainly discusses the features of China's architecture at historic sites with regard to fire protection, the causes of fire since 1949, reviewing their weaknesses in fire protection, and exploring modern technologies for fire prevention that are applicable to ancient buildings. We put forward suggestions to improve fire prevention and management: eliminating potential problems of fire, improving fire protection and establishing a better fire security system, which is especially important to protect ancient buildings.

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

    Science.gov (United States)

    Jialal, I; Devaraj, S

    2015-08-01

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

  18. RT-ABCDE Strategy for Management and Prevention of Human Diseases

    Institute of Scientific and Technical Information of China (English)

    HU Chun-song

    2008-01-01

    In this article,the authors summarized the RT-ABCDE strategy for the management and prevention of human diseases,which includes ReTrO-ABCDE(Examination regularity,Disease and risk factor control,Changing lifestyrle and reducing pathways of infection and spread,Biochemical and Antagonistic index control and therapeutic treatment as well as RT-Routine and Right Treatment).The RT-ABCDE strategy,a novel concept and an essential method,should be a routine strategy for disease control and prevention.It should be proposed and applied in both clinical and preventive medicine.

  19. Monitoring antifolate resistance in intermittent preventive therapy for malaria

    DEFF Research Database (Denmark)

    Venkatesan, Meera; Alifrangis, Michael; Roper, Cally;

    2013-01-01

    Mutations in the Plasmodium falciparum genes Pfdhfr and Pfdhps have rendered sulfadoxine-pyrimethamine (SP) ineffective for malaria treatment in most regions of the world. Yet, SP is efficacious as intermittent preventive therapy in pregnant women (IPTp) and infants (IPTi) and as seasonal malaria...... control in children (SMC). SP-IPTp is being widely implemented in sub-Saharan Africa. SP-IPTi is recommended where the prevalence of SP-resistant malaria parasites is low, whereas SMC is recommended for areas of intense seasonal malaria transmission. The continuing success of these interventions depends...

  20. Air pollution prevention manual on emission monitoring. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-08-15

    The Manual on Emission Monitoring covers the need for information about the national practice in the field of emission control at plants, requiring official approval. The legal bases for discontinuous and continuous measurements for emission control at plants, requiring official approval, are treated. Thereby also the European environmental legislation is considered. The publication procedure for testing institutes, which execute such measurements, is described. The execution of discontinuous emission measurements (course of the measurement and measurement requests) and for continuous emission measurement (suitability test, installation, maintenance, functional test and calibration of the automated measuring system) including the evaluation and documentation of the measured values is described. The procedure of remote emission monitoring is explained. The most important measuring procedures (continuous and discontinuous) are reported. The guide also includes an up-to-date list of tested and appropriate measurement devices. Such tested measuring devices are described by their manufacturers. Indications are given as to how the devices function together with their technical data (e. g. parameters from the suitability test). (orig.)

  1. Salamander chytrid fungus (Batrachochytrium salamandrivorans) in the United States—Developing research, monitoring, and management strategies

    Science.gov (United States)

    Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L.D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieka; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

    2016-01-20

    The recently (2013) identified pathogenic chytrid fungus, Batrachochytrium salamandrivorans (Bsal), poses a severe threat to the distribution and abundance of salamanders within the United States and Europe. Development of a response strategy for the potential, and likely, invasion of Bsal into the United States is crucial to protect global salamander biodiversity. A formal working group, led by Amphibian Research and Monitoring Initiative (ARMI) scientists from the U.S. Geological Survey (USGS) Patuxent Wildlife Research Center, Fort Collins Science Center, and Forest and Rangeland Ecosystem Science Center, was held at the USGS Powell Center for Analysis and Synthesis in Fort Collins, Colorado, United States from June 23 to June 25, 2015, to identify crucial Bsal research and monitoring needs that could inform conservation and management strategies for salamanders in the United States. Key findings of the workshop included the following: (1) the introduction of Bsal into the United States is highly probable, if not inevitable, thus requiring development of immediate short-term and long-term intervention strategies to prevent Bsal establishment and biodiversity decline; (2) management actions targeted towards pathogen containment may be ineffective in reducing the long-term spread of Bsal throughout the United States; and (3) early detection of Bsal through surveillance at key amphibian import locations, among high-risk wild populations, and through analysis of archived samples is necessary for developing management responses. Top research priorities during the preinvasion stage included the following: (1) deployment of qualified diagnostic methods for Bsal and establishment of standardized laboratory practices, (2) assessment of susceptibility for amphibian hosts (including anurans), and (3) development and evaluation of short- and long-term pathogen intervention and management strategies. Several outcomes were achieved during the workshop, including development

  2. A comprehensive fracture prevention strategy in older adults

    DEFF Research Database (Denmark)

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

    2016-01-01

    ), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) - European society for clinical and economic aspects...... 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....

  3. Cost-benefit analysis of a delirium prevention strategy in the intensive care unit.

    Science.gov (United States)

    Lee, Eunhee; Kim, Jinhyun

    2014-10-29

    The aim of this study was to evaluate the effect of a delirium prevention strategy. A high prevalence has been reported for delirium after liver transplantation surgery in the intensive care unit (ICU). Delirium increases treatment costs because of treatment delays, prolonged hospital stays and other associated complications. Despite all those problems associated with delirium, a systemic prevention strategy does not exist yet. This study used an economic evaluation design by reviewing relevant medical records. Study objects were 130 patients who were admitted to the ICU after liver transplantation surgery. After looking at the medical records of these patients, we divided them into two groups according to the application of the prevention strategy. This study analysed the costs and benefits of the prevention strategy between the groups. The prevalence rate of delirium was 35·3% in the prevention-care group and 51·6% in the usual-care group. A sum of $38·4 was invested for the prevention strategy in opposite to the expected total costs of $5578 for a probable treatment. Thus, the net benefit was $5539·6 with a benefit ratio of 145·3 CONCLUSIONS: A strategy is necessary for the delirium prevention of patients in the ICU to decrease the economic burden. This study demonstrated that a prevention strategy was cost-effective because of its low input costs. With low additional investment, it is expected that this prevention strategy will be more available to other patients in the future. © 2014 British Association of Critical Care Nurses.

  4. Renal Dysfunction after Off-Pump Coronary Artery Bypass Surgery- Risk Factors and Preventive Strategies

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2009-01-01

    preoperative risk factors and therefore the high risk groups by developing clinical scoring systems. Preoperative treatment of congestive cardiac failure and volume depletion is mandatory. Avoidance of nephrotoxic drugs and prevention of significant hemodynamic events that may insult the kidney are essential. Perioperative hydration, aggressive control of serum glucose, haemodynamic monitoring and optimization of ventricular function are important strategies. Several drugs have been evaluated with inconsistent results. Dopamine and diuretics once thought to be renoprotective has not been shown to prevent renal failure. Mannitol is probably effective if given before the insult takes place. Some of the newer drugs like fenoldopam, atrial natriuretic peptide, N-acetylcysteine, clonidine and diltiazem have shown some promise in preventing renal dysfunction but more studies are needed to establish their role of renoprotection in cardiac surgery.

  5. Remote monitoring within the framework of rock burst prevention. Fernueberwachung in der Gebirgsschlagverhuetung

    Energy Technology Data Exchange (ETDEWEB)

    Hahnekamp, H.G.; Koenig, W.; Kuzia, M.

    1991-12-12

    The DMT Institute for Rock Control and Backfilling of Cavities has developed a technically simple remote monitoring system for use within the framwork of rock burst prevention. With this system coal faces can be continuously monitored even under difficult underground conditions without serious operating problems. For the monitoring the variables measured underground, viz. rock pressure, rock movement and deformation of test boreholes, are transmitted via the telecommunication network of the colliery to a computer on the surface, where they are evaluated online with regard to recognition of a rock burst hazard. Display of the actual monitoring situation on the computer screen permits immediate initiation of safety measures in the event of danger. (orig.).

  6. Risk Factors and Prevention Strategies for Suicide among the Elderly

    Science.gov (United States)

    Franks, Rebecca; Burnett, Donna O.; Evans, Retta R.

    2012-01-01

    Suicide is a preventable public health concern affecting the nation as the 10th leading cause of death. The prevalence of suicide among the elderly is higher than any other group. Risk factors attributed to this phenomenon are depression, social isolation, substance abuse, poor physical health or function, financial stress, and access to lethal…

  7. Development of prevention and treatment strategies for parasites in poultry

    OpenAIRE

    2007-01-01

    Parasitic infections are likely to be more important in organic and other free-range hens than in birds kept indoors. Several workpackages of QLIF aim at improving prevention and therapy of helminth (Ascaridia galli and Heterakis gallinarum) and arthropod (Dermanyssus gallinae) parasites of laying hens. This paper is a summary of the work undertaken in the first 3 years of QLIF.

  8. Improving Strategies to Prevent and Prepare for Radiological Attack

    Science.gov (United States)

    2010-03-01

    and grains in order to study the effects on germination rates, induce or prevent germination , and conduct...11.26% Cancer Treatment 11.03% Dangerous/Harmful 10.89% Sickness/Illness (General) 9.17% Heat 7.03% Microwaves 6.45% Table 1. Top ten

  9. Strategy and Management Guideline on Preventive School Maintenance in Eritrea

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    An action-oriented and practical guideline for the planning, organisation and management of preventive school maintenance in Eritrea. The manual is the result of a participatory planning process which has involved actors at the school and community level, district levels and the national policy l...

  10. Teen Depression and Suicide: Effective Prevention and Intervention Strategies

    Science.gov (United States)

    King, Keith A.; Vidourek, Rebecca A.

    2012-01-01

    Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

  11. Teen Depression and Suicide: Effective Prevention and Intervention Strategies

    Science.gov (United States)

    King, Keith A.; Vidourek, Rebecca A.

    2012-01-01

    Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

  12. Violence Prevention Strategies of Inner-City Student Experts.

    Science.gov (United States)

    Skovholt, Thomas; Cognetta, Phillip; Ye, Gretchen; King, Lolita

    1997-01-01

    Reports on violence prevention in an inner-city middle school. Interviews of students, deemed by peers and teachers as good at managing conflict, revealed eight themes. For example, student experts inoculated themselves in attitude to avoid violence; de-escalated situations when provoked; and believed the cost of fighting exceeds the reward. (RJM)

  13. Violence Prevention Strategies of Inner-City Student Experts.

    Science.gov (United States)

    Skovholt, Thomas; Cognetta, Phillip; Ye, Gretchen; King, Lolita

    1997-01-01

    Reports on violence prevention in an inner-city middle school. Interviews of students, deemed by peers and teachers as good at managing conflict, revealed eight themes. For example, student experts inoculated themselves in attitude to avoid violence; de-escalated situations when provoked; and believed the cost of fighting exceeds the reward. (RJM)

  14. Reprogramming : A Preventive Strategy in Hypertension Focusing on the Kidney

    NARCIS (Netherlands)

    Tain, You-Lin; Joles, JA

    2015-01-01

    Adulthood hypertension can be programmed in response to a suboptimal environment in early life. However, developmental plasticity also implies that one can prevent hypertension in adult life by administrating appropriate compounds during early development. We have termed this reprogramming. While th

  15. A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes.

    Science.gov (United States)

    Trogrlić, Zoran; van der Jagt, Mathieu; Bakker, Jan; Balas, Michele C; Ely, E Wesley; van der Voort, Peter H J; Ista, Erwin

    2015-04-09

    Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strategies have been tested to improve ICU clinicians' ability to effectively assess, prevent and treat delirium and to evaluate the effect of these strategies on clinical outcomes. We searched PubMed, Embase, PsychINFO, Cochrane and CINAHL (January 2000 and April 2014) for studies on implementation strategies that included delirium-oriented interventions in adult ICU patients. Studies were suitable for inclusion if implementation strategies' efficacy, in terms of a clinical outcome, or process outcome was described. We included 21 studies, all including process measures, while 9 reported both process measures and clinical outcomes. Some individual strategies such as "audit and feedback" and "tailored interventions" may be important to establish clinical outcome improvements, but otherwise robust data on effectiveness of specific implementation strategies were scarce. Successful implementation interventions were frequently reported to change process measures, such as improvements in adherence to delirium screening with up to 92%, but relating process measures to outcome changes was generally not possible. In meta-analyses, reduced mortality and ICU length of stay reduction were statistically more likely with implementation programs that employed more (six or more) rather than less implementation strategies and when a framework was used that either integrated current evidence on pain, agitation and delirium management (PAD) or when a strategy of early awakening, breathing, delirium screening and early exercise (ABCDE bundle) was employed. Using implementation strategies aimed at organizational change, next to behavioral change, was also associated with reduced mortality

  16. Tools and strategies to monitor the ATLAS online computing farm

    CERN Document Server

    Ballestrero, S; The ATLAS collaboration; Darlea, G L; Dumitru, I; Scannicchio, DA; Twomey, M S; Valsan, M L; Zaytsev, A

    2012-01-01

    In the ATLAS experiment the collection, processing, selection and conveyance of event data from the detector front-end electronics to mass storage is performed by the ATLAS online farm consisting of nearly 3000 PCs with various characteristics. To assure the correct and optimal working conditions the whole online system must be constantly monitored. The monitoring system should be able to check up to 100000 health parameters and provide alerts on a selected subset. In this paper we present the assessment of a new monitoring and alerting system based on Icinga. This is an open source monitoring system derived from Nagios, granting backward compatibility with already known configurations, plugins and add-ons, while providing new features. We also report on the evaluation of different data gathering systems and visualization interfaces.

  17. Workplace violence: theories of causation and prevention strategies.

    Science.gov (United States)

    Olson, N K

    1994-10-01

    1. Occupational violence is a multi-causal phenomenon that continues to escalate and significantly impact worker health and safety as well as productivity and morale. 2. The available data sources provide only a "tip of the iceberg" glimpse of the problem. The occupational health nurse can contribute to a greater understanding of workplace violence by collecting and disseminating statistics on non-fatal injuries accompanied by accurate occupational titles. 3. The occupational health nurse is the critical link between management and workers. Using the public health model of primary, secondary, and tertiary prevention, the occupational health nurse can create and implement a company wide policy aimed at preventing occupational violence from all causes.

  18. Gamification strategy on prevention of STDs for youth.

    Science.gov (United States)

    Gabarron, Elia; Schopf, Thomas; Serrano, J Artur; Fernandez-Luque, Luis; Dorronzoro, Enrique

    2013-01-01

    Sexually transmitted diseases (STDs) and especially chlamydia is a worrying problem among North-Norwegian youngsters. Gamified web applications should be valued for sexual health education, and thus STDs prevention, for their potential to get users engaged and involved with their healthcare. Aiming to achieve that youngsters become more aware of STDs we have developed "sjekkdeg.no", a gamified web application focused on sexual health targeting North-Norwegian youngsters. Gamification techniques like avatars, achievement-based gifts and social network sharing buttons have been implemented in the site that includes educational content on sexual health and a STDs symptom checker. Preliminary results show that the game-style web app could be useful to encourage users to learn more on sexual health and STDs and thus changing their risky behaviors and preventing sexually transmitted diseases.

  19. Strategies for application of scientific findings in prevention

    OpenAIRE

    Wei, SHY

    1995-01-01

    Dental research in the last 50 years has accomplished numerous significant advances in preventive dentistry, particularly in the area of research in fluorides, periodontal diseases, restorative dentistry, and dental materials, as well as craniofacial development and molecular biology. The transfer of scientific knowledge to clinical practitioners requires additional effort. It is the responsibility of the scientific communities to transfer the fruits of their findings to society through publi...

  20. A Strategy for Conflict Prevention and Management in the Mediterranean

    Directory of Open Access Journals (Sweden)

    Abdelwahad Biad

    1997-09-01

    Full Text Available The author states that the conflicts in the Mediterranean are put down to interrelated factors –frontier disputes, ethnic-cultural rivalries, low-intensity violence– that make them appear to be “intractable conflicts”, specific to the area, and to which it cannot be automatically applied the model of conflict prevention and management that marked East-West relations during the Cold War. But the author’s analysis goes farther: Biad argues that the initiatives of conflict prevention and management have not done well because of the inadequate definition of objectives (Euro-Arab Dialogue, CSCM,Mediterranean Forum, as well as for the discrimination against some of the southern members and the lack of clearly identified principles and rules for a security dialogue (WEU, NATO, and the OSCE. The Barcelona Process appears to offer a much broader framework as it does underline the need for common action in the prevention of conflicts based on the principles of transparency and sufficiency. Nevertheless, after an analysis of both which focuses on the military dimension of security, the author reminds us that the Barcelona Declaration does not include institutional mechanisms for the application of these principles.

  1. A comprehensive fracture prevention strategy in older adults : The European union geriatric medicine society (EUGMS) statement

    NARCIS (Netherlands)

    Blain, H.; Masud, T.; Dargent-Molina, P.; Martin, F. C.; Rosendahl, E.; van der Velde, N.; Bousquet, J.; Benetos, A.; Cooper, C.; Kanis, J. A.; Reginster, J. Y.; Rizzoli, R.; Cortet, B.; Barbagallo, M.; Dreinhöfer, K.; Vellas, B.; Maggi, S.; Strandberg, T.; Alvarez, M. N.; Annweiler, C.; Bernard, P. L.; Beswetherick, N.; Bischoff-Ferrari, H. A.; Bloch, F.; Boddaert, J.; Bonnefoy, M.; Bousson, V.; Bourdel-Marchasson, I.; Capisizu, A.; Che, H.; Clara, J. G.; Combe, B.; Delignieres, D.; Eklund, P.; Emmelot-Vonk, M.; Freiberger, E.; Gauvain, J. B.; Goswami, N.; Guldemond, N.; Herrero, C.; Joël, M. E.; Jónsdóttir, A. B.; Kemoun, G.; Kiss, I.; Kolk, H.; Kowalski, M. L.; Kutsal, Y. G.; Lauretani, F.; Macijauskienė, J.; Mellingsæter, M.; Morel, J.; Mourey, F.; Nourashemi, F.; Nyakas, C.; Puisieux, F.; Rambourg, P.; Ramírez, A. G.; Rapp, K.; Rolland, Y.; Ryg, J.; Sahota, O.; Snoeijs, S.; Stephan, Y.; Thomas, E.; Todd, C.; Treml, J.; Adachi, R.; Agnusdei, D.; Body, J. J.; Breuil, V.; Bruyère, O.; Burckardt, P.; Cannata-Andia, J. B.; Carey, J.; Chan, D. C.; Chapuis, L.; Chevalley, T.; Cohen-Solal, M.; Dawson-Hughes, B.; Dennison, E. M.; Devogelaer, J. P.; Fardellone, P.; Féron, J. M.; Perez, A. D.; Felsenberg, D.; Glueer, C.; Harvey, N.; Hiligsman, M.; Javaid, M. K.; Jörgensen, N. R.; Kendler, D.; Kraenzlin, M.; Laroche, M.; Legrand, E.; Leslie, W. D.; Lespessailles, E.; Lewiecki, E. M.; Nakamura, T.; Papaioannou, A.; Roux, C.; Silverman, S.; Henriquez, M. S.; Thomas, T.; Vasikaran, S.; Watts, N. B.; Weryha, G.; Adachi, R.

    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), in

  2. Youth Audience Segmentation Strategies for Smoking-Prevention Mass Media Campaigns Based on Message Appeal

    Science.gov (United States)

    Flynn, Brian S.; Worden, John K.; Bunn, Janice Yanushka; Dorwaldt, Anne L.; Connolly, Scott W.; Ashikaga, Takamaru

    2007-01-01

    Mass media interventions are among the strategies recommended for youth cigarette smoking prevention, but little is known about optimal methods for reaching diverse youth audiences. Grades 4 through 12 samples of youth from four states (n = 1,230) rated smoking-prevention messages in classroom settings. Similar proportions of African American,…

  3. Economic evaluation of pressure ulcer care : A Cost Minimization Analysis of Preventive Strategies

    NARCIS (Netherlands)

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; van Engelshoven, I.; van Ramshorst, B.; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was c

  4. Economic evaluation of pressure ulcer care: a cost minimization analysis of preventive strategies.

    NARCIS (Netherlands)

    Schuurman, J.P.; Schoonhoven, L.J.; Defloor, T.; Engelshoven, I. van; Ramshorst, B. van; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was c

  5. Is monitoring implementation the key to preventing repeated workplace corruption?

    Directory of Open Access Journals (Sweden)

    Ray Plibersek

    2010-12-01

    Full Text Available Survey results published in 2009 by the Independent Commission Against Corruption (ICAC of New South Wales reported that most public sector organisations in its jurisdiction have established integrity policies and procedures – or ‘organisational integrity systems’ (ICAC 2009. Despite this, many of the public inquiries conducted by the ICAC that find corrupt conduct often also find a failure to implement or enforce existing anti-corruption mechanisms in agencies. More recently an ICAC inquiry reported that similar patterns of repeated corrupt conduct had been pervasive in one government agency since the early 1990s despite being prohibited by organisational policy (ICAC 2008. These findings are also consistent with the anecdotal experience of integrity practitioners that public sector agencies are experiencing repeated workplace corruption despite the presence of apparently adequate organisational integrity systems. When workplace corruption is exposed, it may be professionally investigated and reforms to address the problems proposed and attempted, yet the same or similar workplace corruption reoccurs. As Barber suggests, ensuring successful delivery requires a “long grind” of “steady, persistent implementation” and “gentle pressure, relentlessly applied” (Barber 2008:112 and 119. This paper examines cases of low-level non-compliance in a municipal waste collection services and a state owned railway to identify some of the factors that could be contributing to reoccurring workplace corruption. The analysis suggests that a major factor in repeated workplace corruption is the failure to monitor and implement reforms recommended by investigations and existing organisational integrity systems.

  6. Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

    Science.gov (United States)

    Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

    2016-05-01

    Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

  7. Tissue electrical properties monitoring for the prevention of pressure sore.

    Science.gov (United States)

    Ching, Congo Tak-Shing; Chou, Mei-Yun; Jiang, Siou-Jhen; Huang, Su-Hua; Sun, Tai-Ping; Liu, Wei-Hao; Liu, Chia-Ming

    2011-12-01

    Pressure sores are a significant problem in the healthcare sector. Although they may cause considerable morbidity, they are preventable. The objectives of this study are to (1) investigate the electrical properties of a tissue close to and away from the pressure sore site, and (2) establish a new approach for objective, reliable, low-cost and noninvasive screening or detection of pressure sore in its early stage. Randomised controlled trial. Fifteen patients participated in this study. They all had stage I or stage II sacral pressure sores. Tiny surface electrodes in four-electrode configuration were used for all tissue electrical properties measurements recorded over the frequency range of 30-10 MHz. Intraclass correlation coefficient (ICC) showed that all measurements (ICC > 0.90 for all measurements) had good reliability and validity. The real part of impedance (R) and the imaginary part of impedance (X) of a tissue measured close to the pressure sore site was found to be significantly smaller (p pressure sore site at a specific frequency range (R: 30.00-38.55 Hz; X: 43.95-606.40 Hz). It was also found that the extracellular resistance (R(e)) and the ratio of extracellular resistance to intracellular resistance (R(e)/R(i)) of a tissue measured close to the pressure sore site were significantly smaller (p pressure sore site. Since the electrical properties (R, X, R(e), R(e)/R(i) ) of a tissue close to, and away from, the pressure sore site can be significantly distinguished, a potentially promising method for the screening of pressure sores at an early stage has been proposed.

  8. Novel Therapeutic Strategy for the Prevention of Bone Fractures

    Science.gov (United States)

    2015-02-01

    myostatin’s role in age- related bone loss, so that targeted therapies to prevent bone fractures by enhancing muscle and bone strength can be developed. We...loss of muscle mass in the form of sarcopenia, and loss of bone density and strength in the form of osteoporosis . Mus cle weakness and frailty contribute...Bollag, W.B., Curl, W.W., Yu, J., Isales, C.M., 2006. Age- related loss of muscle mass and bone strength in mice is associated with a decline in physical

  9. Arsenical keratoses in Bangladesh--update and prevention strategies.

    Science.gov (United States)

    Ruiz de Luzuriaga, Arlene M; Ahsan, Habibul; Shea, Christopher R

    2011-01-01

    Arsenic is considered a Class I human carcinogen by the International Agency for Research on Cancer because of its increased risk for skin cancer, as well as internal cancers, such as lung and bladder cancer. Arsenic contamination of drinking water in Bangladesh has been called the "largest mass poisoning of a population in history." This inorganic arsenic contamination is of natural origin, with arsenic thought to be released to the groundwater from the surrounding sediment. Arsenicosis and its risk factors and prevention and management are discussed in this article.

  10. Strategies for experiment-specific monitoring in the Grid

    CERN Document Server

    Mendez Lorenzo, Patricia; Campana, Simone; Santinelli, Roberto; Lanciotti, Elisa; Miccio, Enzo; Magini, Nicolo; Di Girolamo, Alessandro

    2008-01-01

    This contribution describes how the LHC experiments implement their own Grid resource monitoring, either by internally developed tools, or by reusing tools used for Grid operations, like the Service Availability Monitor (SAM) used for the EGEE operations. The LHC experiments perform most, if not all, of their computing activities on Grid resources. This requires an accurate and updated picture of the status of the Grid services used by them, and of the services which are specific to the experiment. To achieve this, a common method is to periodically execute tests on the services, where the functionalities tested may be different from a VO to another. The SAM framework, developed for the EGEE operations, can be easily used to run and publish the results of arbitrary tests, from basic functionality tests, to high-level operations from real production activities. This contribution describes in detail how the monitoring system of each LHC experiment has taken advantage of SAM. The work covered by this contributio...

  11. The cooperative monitoring of military forces: An exercise in strategy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    This exercise examines a hypothetical security problem associated with conventional military forces and border security: a surprise attack. The goal of the exercise is to provide an opportunity to think about how cooperative monitoring can be part of regional security. Two hypothetical countries, VOLCANOES and MOUNTAINS, have been created for this exercise based on the US states of Arizona and New Mexico. They were selected for their size and variety of terrain. Hypothetical background information and characteristics of the two countries are provided. An outline of activities is given, including prioritization of security concerns and monitoring of objectives for security concerns. 6 tabs.

  12. Design and Evaluation of a Pressure and Temperature Monitoring System for Pressure Ulcer Prevention

    OpenAIRE

    Farve Daneshvar Fard; Sahar Moghimi; Reza Lotfi

    2014-01-01

    Introduction Pressure ulcers are tissue damages resulting from blood flow restriction, which occurs when the tissue is exposed to high pressure for a long period of time. These painful sores are common in patients and elderly, who spend extended periods of time in bed or wheelchair. In this study, a continuous pressure and temperature monitoring system was developed for pressure ulcer prevention. Materials and Methods The monitoring system consists of 64 pressure and 64 temperature sensors on...

  13. Suicide prevention strategies in Japan: a 15-year review (1998-2013).

    Science.gov (United States)

    Takeshima, Tadashi; Yamauchi, Takashi; Inagaki, Masatoshi; Kodaka, Manami; Matsumoto, Toshihiko; Kawano, Kenji; Katsumata, Yotaro; Fujimori, Maiko; Hisanaga, Ayaka; Takahashi, Yoshitomo

    2015-02-01

    Suicide is a global public health problem and solutions to it can be found only through a global dialog. The suicide rate in Japan has been alarming, but Japan has made substantial efforts to reduce this rate, making prevention a high priority. This report reviews the developmental stages of a comprehensive policy of suicide prevention in Japan from 1998 to 2013. Our review suggests that suicide prevention activities were facilitated by the 2006 Basic Act for Suicide Prevention and the 2007 General Principles of Suicide Prevention Policy. Along with the establishment of a Special Fund program for local governments, the Basic Act and General Principles led to the development of a comprehensive and multi-sector approach to suicide prevention. Suicide rates in Japan, especially among middle-aged men, decreased consistently after 2009, suggesting that the initiatives were effective. Continuous monitoring is needed to evaluate Japan's suicide prevention policy.

  14. Mounting dengue awareness: A cost effective Strategy for prevention

    Directory of Open Access Journals (Sweden)

    Kajal Srivastava

    2015-12-01

    Full Text Available Background: Dengue is a serious illness which takes toll on human health every year. The best way to prevent it is by increasing awareness among common people. This study was conducted to assess the level of knowledge, attitudes and practices regarding dengue fever in people urban heath training centre in Pune, Maharashtra. Methods: A cross-sectional study was conducted among patients attending OPD of Urban heath training centre of department of community medicine, Pune situated in Ajmera, Pimpri, Pune. Through convenience sampling, a questionnaire was administered to patients after taking their informed consent. Results: A total of 100 patients were interviewed. Among knowledge 83% had heard about dengue and the most common source of information was TV & radio (72.3% Most of them were aware regarding mosquito bite being the mode of dengue transmission (80.7%. 22% were unaware regarding biting time of mosquito while 22% said night is the biting time of dengue mosquito. 62.7% were using coils for mosquito bite prevention followed by mosquito net (43.4% and spray (31.3%.. Conclusion: This study revealed that most of the study population is aware of dengue illness and increasing education level is having positive attitude on dengue illness.

  15. Preventing and treating osteoporosis: strategies at the millennium.

    Science.gov (United States)

    Sherman, S

    2001-12-01

    Osteoporosis has been defined as "a progressive systemic disease characterized by low bone density and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture." Osteoporosis and the consequences of compromised bone strength--particularly vertebral and hip fractures--are a significant cause of frailty, and increased morbidity and even mortality and hence are a serious and costly public health problem in the elderly population. However, due to remarkable advances in basic and clinical research and in drug design, development, and testing, a number of efficacious, evidence-based options are available for the prevention and treatment of osteoporosis. These options extend far beyond estrogen/progestin therapy and include lifestyle and dietary changes such as increasing weight-bearing activity, enhancing calcium and vitamin D intake, as well as incorporating pharmacologic agents such as the bisphosphonates and selective estrogen receptor modulators (SERMs) such as raloxifene. In addition to its efficacy in increasing bone mineral density and reducing vertebral fractures by almost 40% in women with osteoporosis, the SERM raloxifene appears to promote a cardioprotective profile and to offer some protection against breast cancer. The potential of raloxifene to prevent or delay the development of a number of chronic diseases of aging such as osteoporosis, cardiovascular disease, and perhaps even Alzheimer's disease has stimulated the development and refinement of subsequent generations of SERMs aimed at maximizing beneficial effects in a wide variety of tissues while eliminating deleterious outcomes and side effects.

  16. Challenging nanoparticles: a target of personalized adhesion prevention strategy

    Directory of Open Access Journals (Sweden)

    Mynbaev OA

    2014-07-01

    Full Text Available Ospan A Mynbaev,1–4 Marina Yu Eliseeva,2 Antonio Malvasi,5 Andrea Tinelli6 1International Translational Medicine and Biomodeling Research Team, MIPT Center for Human Physiology, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University, Dolgoprudny, Moscow Region, Russia; 2Department of Obstetrics, Gynecology and Reproductive Medicine, Peoples’ Friendship University of Russia, Moscow, Russia; 3Laboratory of Pilot Projects, Moscow State University of Medicine and Dentistry, Moscow, Russia; 4The New European Surgical Academy, Berlin, Germany; 5Department of Obstetrics and Gynecology, Santa Maria Hospital, Bari, Italy; 6Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Vito Fazzi Hospital, Lecce, ItalyWith great interest we have read an article by Wu et al1 recently published in the International Journal of Nanomedicine aimed to estimate cytotoxicity, toxicity, and histopathological changes, as well as the postsurgical antiadhesion potential of biodegradable and thermosensitive micelles by combining in vitro and in vivo models.Our congratulations to Wu et al1 for their new, precisely designed, and promising study of nanoparticles used in the prevention of postsurgical adhesions. Even more so when we know that in most clinical studies the adhesion prevention adjuvants have failed. Taking into account medical and financial problems associated with postsurgical adhesions worldwide in the health care system, new developments in this area are welcomed and call for further investigation.View orginal paper by Wu et al

  17. Cross-site scripting attacks procedure and Prevention Strategies

    Directory of Open Access Journals (Sweden)

    Wang Xijun

    2016-01-01

    Full Text Available Cross-site scripting attacks and defense has been the site of attack and defense is an important issue, this paper, the definition of cross-site scripting attacks, according to the current understanding of the chaos on the cross-site scripting, analyzes the causes and harm cross-site scripting attacks formation of attacks XXS complete process XSS attacks made a comprehensive analysis, and then for the web program includes Mobility there are cross-site scripting filter laxity given from ordinary users browse the web and web application developers two the defense cross-site scripting attacks effective strategy.

  18. Wide-field monitoring strategy for the study of fast optical transients

    Science.gov (United States)

    Beskin, Grigory; Bondar, Sergey; Karpov, Sergey; Guarnieri, Adriano; Bartolini, Corrado; Greco, Giuseppe; Piccioni, Adalberto

    2010-10-01

    We discuss the strategy of search for fast optical transients accompanying gamma-ray bursts by means of continuous monitoring of wide sky fields with high temporal resolution. We describe the design, performance and results of our cameras, FAVOR and TORTORA. Also we discuss the perspectives of this strategy and possible design of next-generation equipment for wide-field monitoring which will be able to detect optical transients and to study their color and polarization properties with high time resolution.

  19. [Prescribing monitoring in clinical practice: from enlightened empiricism to rational strategies].

    Science.gov (United States)

    Buclin, Thierry; Herzig, Lilli

    2013-05-15

    Monitoring of a medical condition is the periodic measurement of one or several physiological or biological variables to detect a signal regarding its clinical progression or its response to treatment. We distinguish different medical situations between diagnostic, clinical and therapeutic process to apply monitoring. Many clinical, variables can be used for monitoring, once their intrinsic properties (normal range, critical difference, kinetics, reactivity) and external validity (pathophysiological importance, predictive power for clinical outcomes) are established. A formal conceptualization of monitoring is being developed and should support the rational development of monitoring strategies and their validation through appropriate clinical trials.

  20. Obesity prevention strategies: could food or soda taxes improve health?

    Science.gov (United States)

    Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S

    2016-03-01

    Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?

  1. Using Strategy Instruction and Confidence Judgments to Improve Metacognitive Monitoring

    Science.gov (United States)

    Huff, Jessica D.; Nietfeld, John L.

    2009-01-01

    Current models of self-regulated learning emphasize the pervasive need for metacognitive monitoring skills at all phases of the learning process (Winne and Hadwin in "Studying as self-regulated learning." In D. J. Hacker, J. Dunlosky, & A. C. Graesser (Eds.), "Metacognition in educational theory and practice" (pp. 227-304). Mahwah, NJ: Erlbaum,…

  2. Monitoring contaminant strategies: tools, techniques, methodologies and model approaches

    Science.gov (United States)

    A century-long history of experiments on solute transport in soils has resulted in a wide range of experimental setups and procedures, as well as methods for interpreting observations which has led to considerable ambiguity regarding monitoring approaches. This presentation will focus on results an...

  3. Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2013-01-01

    Full Text Available Diabetes mellitus has emerged as one of the fastest growing non communicable diseases worldwide. Management of diabetic patients during surgical and critically illness is of paramount challenge to anesthesiologist and intensivist. Among its major acute complications, hypoglycemia has been given lesser attention as compared to other major acute complications; diabetic ketoacidosis and hyperosmolar non ketotic coma. However, newer studies and literary evidence have established the serious concerns of morbidity and mortality, both long- and short-term, related to hypoglycemia. basis. Invariably, diabetic patients are encountered in our daily routine practice of anesthesia. During fasting status as well as the perioperative period, it is hypoglycemia that is of high concern to anesthesiologist. Management has to be based on clinical, pharmacological, social, and psychological basis, so as to completely prevent the complications arising from an acute episode of hypoglycemia. This review aims to highlight various aspects of hypoglycemia and its management both from endocrine and anesthesia perspective.

  4. Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies.

    Science.gov (United States)

    Kalra, Sanjay; Bajwa, Sukhminder Jit Singh; Baruah, Manash; Sehgal, Vishal

    2013-10-01

    Diabetes mellitus has emerged as one of the fastest growing non communicable diseases worldwide. Management of diabetic patients during surgical and critically illness is of paramount challenge to anesthesiologist and intensivist. Among its major acute complications, hypoglycemia has been given lesser attention as compared to other major acute complications; diabetic ketoacidosis and hyperosmolar non ketotic coma. However, newer studies and literary evidence have established the serious concerns of morbidity and mortality, both long- and short-term, related to hypoglycemia. basis. Invariably, diabetic patients are encountered in our daily routine practice of anesthesia. During fasting status as well as the perioperative period, it is hypoglycemia that is of high concern to anesthesiologist. Management has to be based on clinical, pharmacological, social, and psychological basis, so as to completely prevent the complications arising from an acute episode of hypoglycemia. This review aims to highlight various aspects of hypoglycemia and its management both from endocrine and anesthesia perspective.

  5. Transcutaneous carbon dioxide monitoring for the prevention of neonatal morbidity and mortality.

    Science.gov (United States)

    Bruschettini, Matteo; Romantsik, Olga; Zappettini, Simona; Ramenghi, Luca Antonio; Calevo, Maria Grazia

    2016-02-13

    Carbon dioxide (CO2) measurement is a fundamental evaluation in a neonatal intensive care unit (NICU), as both low and high values of CO2 might have detrimental effects on neonatal morbidity and mortality. Though measurement of CO2 in the arterial blood gas is the most accurate way to assess the amount of CO2, it requires blood sampling and it does not provide a continuous monitoring of CO2. To assess whether the use of continuous transcutaneous CO2 (tcCO2) monitoring in newborn infants reduces mortality and improves short and long term respiratory and neurodevelopmental outcomes. We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 11), MEDLINE via PubMed (1966 to November 1, 2015), EMBASE (1980 to November 1, 2015), and CINAHL (1982 to November 1, 2015). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials. Randomized, quasi-randomized and cluster randomized controlled trials comparing different strategies regarding tcCO2 monitoring in newborns. Three comparisons were considered, that is, continuous tcCO2 monitoring versus 1) any intermittent modalities to measure CO2; 2) other continuous CO2 monitoring; and 3) with or without intermittent CO2 monitoring. We used the standard methods of the Cochrane Neonatal Review Group. Two review authors independently assessed studies identified by the search strategy for inclusion. Our search strategy yielded 106 references. Two review authors independently assessed all references for inclusion. We did not find any completed studies for inclusion, nor ongoing trials. There was no evidence to recommend or refute the use of transcutaneous CO2 monitoring in neonates. Well-designed, adequately powered randomized controlled studies are necessary to address efficacy and safety of transcutaneous CO2 monitoring

  6. Nursing strategies to prevent ventilator-associated pneumonia.

    Science.gov (United States)

    Hixson, S; Sole, M L; King, T

    1998-02-01

    Critically ill patients who require mechanical ventilation are at high risk for development of pneumonia during the course of treatment. Ventilator-associated pneumonia leads to higher rates of mortality and morbidity, increased length of hospital stay, and higher hospital costs. The intubation that is necessary for mechanical ventilation impairs the patient's normal defense mechanisms for fighting infection. Impaired defenses, along with such risk factors as age of the patient, equipment used, and failure of the staff to wash hands increase the likelihood of colonization of the lower airways. Colonization and subsequent pneumonia commonly occurs from microaspiration of secretions from the oropharynx and gastrointestinal tract. In this article, the mechanism of microaspiration, diagnosis of ventilator-associated pneumonia, and nursing strategies to reduce the incidence of pneumonia are described.

  7. The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for adults.

    Science.gov (United States)

    Evans, R W; Pakdaman, A; Dennison, P J; Howe, E L C

    2008-03-01

    In the absence of effective caries preventive methods, operative care became established as the means for caries control in general practice. Water fluoridation resulted in a declining caries incidence which decreased further following the advent of fluoridated toothpaste. The challenge today is to develop a non-invasive model of practice that will sustain a low level of primary caries experience in the younger generation and reduce risk of caries experience in the older generations. The Caries Management System is a ten step non-invasive strategy to arrest and remineralize early lesions. The governing principle of this system is that caries management must include consideration of the patient at risk, the status of each lesion, patient management, clinical management and monitoring. Both dental caries risk and treatment are managed according to a set of protocols that are applied at various steps throughout patient consultation and treatment. The anticipated outcome of implementing the Caries Management System in general dental practice is reduction in caries incidence and increased patient satisfaction. Since the attainment and maintenance of oral health is determined mainly by controlling both caries and periodontal disease, the implementation of the Caries Management System in general practice will promote both outcomes.

  8. Whole of Systems Trial of Prevention Strategies for Childhood Obesity: WHO STOPS Childhood Obesity

    Directory of Open Access Journals (Sweden)

    Steven Allender

    2016-11-01

    Full Text Available Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1 strengthen community action for childhood obesity prevention, and (2 measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1 to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7–8 y, grade four (9–10 y and grade six (11–12 y students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools. An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.

  9. Vector dynamics and transmission of dengue virus: implications for dengue surveillance and prevention strategies: vector dynamics and dengue prevention.

    Science.gov (United States)

    Scott, Thomas W; Morrison, Amy C

    2010-01-01

    Accounting for variation in mosquito vector populations will improve dengue surveillance and prevention. Because Aedes aegypti, the principle dengue virus (DENV) vector, transmit the virus with remarkable efficiency, entomological thresholds are especially low. Assessing risk of human infection based on immature mosquito indices has proven difficult. Greater emphasis should be placed on relative abundance of adult vectors in relation to human serotype-specific herd immunity, introduction of unique viruses, mosquito-human contact and weather. The most appropriate spatial scale for assessing entomological risk is the individual household. The scale for measuring DENV transmission risk has yet to be determined but is clearly larger than the household and likely to exceed several city blocks. Because households are expected to be a primary site for human DENV infection, intradomicile vector control strategies should be a priority, especially when the force of transmission is high. The most effective intervention strategy will combine vector control with vaccine delivery for rapid and sustained disease prevention.

  10. Mitigating Concerns and Maximizing Returns: Social Media Strategies for Injury Prevention Non-profits

    Directory of Open Access Journals (Sweden)

    Tressie McMillan-Cottom

    2014-08-01

    Full Text Available Injury prevention programs can use social media to disseminate information and recruit participants. Non-profit organizations have also used social media for fundraising and donor relationship management. Non-profit organizations (NPOs with injury prevention missions often serve vulnerable populations. Social media platforms have varied levels of access and control of shared content. This variability can present privacy and outreach challenges that are of particular concern for injury prevention NPOs. This case report of social media workshops for injury prevention NPOs presents concerns and strategies for successfully implementing social media campaigns.

  11. Mitigating concerns and maximizing returns: social media strategies for injury prevention non-profits.

    Science.gov (United States)

    McMillan-Cottom, Tressie

    2014-08-01

    Injury prevention programs can use social media to disseminate information and recruit participants. Non-profit organizations have also used social media for fundraising and donor relationship management. Non-profit organizations (NPOs) with injury prevention missions often serve vulnerable populations. Social media platforms have varied levels of access and control of shared content. This variability can present privacy and outreach challenges that are of particular concern for injury prevention NPOs. This case report of social media workshops for injury prevention NPOs presents concerns and strategies for successfully implementing social media campaigns.

  12. Developing detection and monitoring strategies for Planococcus minor (Hemiptera: Pseudococcidae).

    Science.gov (United States)

    Roda, Amy; Millar, Jocelyn G; Rascoe, John; Weihman, Scott; Stocks, Ian

    2012-12-01

    A pheromone-based system to locate and monitor Planococcus minor (Maskell), a pest of over 250 plants including citrus, grape, and cacao, was tested. The difficulty in distinguishing P. minor from the citrus mealybug, P. citri, makes finding and evaluating the impact of the pest challenging. Studies conducted in Puerto Rico determined that synthetic P. minor pheromone lures preaged 120 d in the field caught similar number of males as lures not aged (fresh). Molecular analysis of trapped mealybug males using mitochondrial cytochrome oxidase-1, the internal transcriber space two locus, and 28S-D2 gene showed the pheromone traps to be species specific. Traps baited with P. minor pheromone were used to monitor the pest in south Florida and to locate potential infestations. P. minor males were found at all locations studied in South Florida and were present in low numbers (1.03 +/- 0.69 mean +/- SE/trap/14 d). Over 14,000 terminals, fruit, and flowers were visually inspected over a 6 mo period of peak trap catches before the first adult P. minor female was found. The synthetic pheromone lures proved to be an effective tool to locate and monitor this pest new to the continental United States.

  13. What drives successful implementation of pollution prevention and cleaner technology strategy? The role of innovative capability.

    Science.gov (United States)

    Bhupendra, Kumar Verma; Sangle, Shirish

    2015-05-15

    Firms that are dynamic and prepared to implement environmental strategies have a potential competitive advantage over their industry counterparts. Therefore, it is important to understand, what capabilities are required to implement proactive environmental strategies. The paper discusses the attributes of innovative capability required by firms in order to adopt pollution prevention and cleaner technology strategies. Empirical results show that process and behavioral innovativeness are required by firms to implement a pollution prevention strategy. In addition to process and behavioral innovativeness, firms need a top management with high risk-taking ability as well as market, product, and strategic innovativeness to implement a cleaner technology strategy. The paper proposes some important managerial implications on the basis of the above research findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Strategies for prevention of ultrasound-guided prostate biopsy infections

    Directory of Open Access Journals (Sweden)

    Lu DD

    2016-07-01

    Full Text Available Diane D Lu, Jay D Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA Abstract: Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. Keywords: prostate cancer, prostate biopsy, urinary tract infection, sepsis, complications

  15. Antibody-Based Strategies to Prevent and Treat Influenza

    Directory of Open Access Journals (Sweden)

    Ram eSasisekharan

    2015-07-01

    Full Text Available Passive immunization using antibodies has been suggested to offer several benefits in comparison to other antiviral treatment options. The potential for seasonal protection arising from a single injection of antibodies is appealing and has been pursued for a number of infectious agents. However, until recently, antibody-based strategies to combat infectious agents has been hampered due to the fact that typical antibodies have been found to be strain-specific, with the virus evolving resistance in many cases. The discovery of broadly neutralizing antibodies (bNAbs in, for example, influenza, dengue virus, and HIV, which bind to multiple, structurally-diverse strains has provided renewed interest in this area. This review will focus on new technologies that enable the discovery of bNAbs, the challenges and opportunities of immunotherapies as an important addition to existing antiviral therapy, and the role of antibody discovery in informing rational vaccine discovery – with agents targeting influenza specifically addressed. Multiple agents have entered the clinic and raise the possibility that a single antibody or small combination of antibodies can effectively neutralize a wide variety of strains. However, challenges remain - including combating escape variants, pharmacodynamics of antibody distribution, and development of efficacy biomarkers beyond virologic endpoints.

  16. The PreventCD Study design : towards new strategies for the prevention of coeliac disease

    NARCIS (Netherlands)

    Esch, Caroline Elisabeth Hogen; Rosen, Anna; Auricchio, Renata; Romanos, Jihane; Chmielewska, Anna; Putter, Hein; Ivarsson, Anneli; Szajewska, Hania; Koning, Frits; Wijmenga, Cisca; Troncone, Riccardo; Mearin, Maria Luisa

    2010-01-01

    Background PreventCD (www.preventcd.com) is a European multicentre study, which studies the influence of infant nutrition, and that of genetic, immunologic and environmental factors, on the risk of developing coeliac disease (CD). The hypothesis is that it is possible to induce tolerance to gluten b

  17. Development and monitoring of a novel monoclonal antibody purification strategy

    OpenAIRE

    Capito, Florian

    2014-01-01

    The studies presented in the cumulative part of this thesis illustrate the different steps to develop a polymer-driven antibody purification process. These peer-reviewed reports show in detail fundamental research, additional method development useful in the development of such a purification process as well as implementation of the final process. A strategy for analyzing copolymers, synthesized by a lab in house, was implemented with particular emphasis on copolymer composition analysis. Thi...

  18. Assessment of Food Waste Prevention and Recycling Strategies Using a Multilayer Systems Approach.

    Science.gov (United States)

    Hamilton, Helen A; Peverill, M Samantha; Müller, Daniel B; Brattebø, Helge

    2015-12-15

    Food waste (FW) generates large upstream and downstream emissions to the environment and unnecessarily consumes natural resources, potentially affecting future food security. The ecological impacts of FW can be addressed by the upstream strategies of FW prevention or by downstream strategies of FW recycling, including energy and nutrient recovery. While FW recycling is often prioritized in practice, the ecological implications of the two strategies remain poorly understood from a quantitative systems perspective. Here, we develop a multilayer systems framework and scenarios to quantify the implications of food waste strategies on national biomass, energy, and phosphorus (P) cycles, using Norway as a case study. We found that (i) avoidable food waste in Norway accounts for 17% of sold food; (ii) 10% of the avoidable food waste occurs at the consumption stage, while industry and retailers account for only 7%; (iii) the theoretical potential for systems-wide net process energy savings is 16% for FW prevention and 8% for FW recycling; (iv) the theoretical potential for systems-wide P savings is 21% for FW prevention and 9% for FW recycling; (v) while FW recycling results in exclusively domestic nutrient and energy savings, FW prevention leads to domestic and international savings due to large food imports; (vi) most effective is a combination of prevention and recycling, however, FW prevention reduces the potential for FW recycling and therefore needs to be prioritized to avoid potential overcapacities for FW recycling.

  19. Strategies to prevent intraoperative lung injury during cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Siminelakis Stavros N

    2010-01-01

    Full Text Available Abstract During open heart surgery the influence of a series of factors such as cardiopulmonary bypass (CPB, hypothermia, operation and anaesthesia, as well as medication and transfusion can cause a diffuse trauma in the lungs. This injury leads mostly to a postoperative interstitial pulmonary oedema and abnormal gas exchange. Substantial improvements in all of the above mentioned factors may lead to a better lung function postoperatively. By avoiding CPB, reducing its time, or by minimizing the extracorporeal surface area with the use of miniaturized circuits of CPB, beneficial effects on lung function are reported. In addition, replacement of circuit surface with biocompatible surfaces like heparin-coated, and material-independent sources of blood activation, a better postoperative lung function is observed. Meticulous myocardial protection by using hypothermia and cardioplegia methods during ischemia and reperfusion remain one of the cornerstones of postoperative lung function. The partial restoration of pulmonary artery perfusion during CPB possibly contributes to prevent pulmonary ischemia and lung dysfunction. Using medication such as corticosteroids and aprotinin, which protect the lungs during CPB, and leukocyte depletion filters for operations expected to exceed 90 minutes in CPB-time appear to be protective against the toxic impact of CPB in the lungs. The newer methods of ultrafiltration used to scavenge pro-inflammatory factors seem to be protective for the lung function. In a similar way, reducing the use of cardiotomy suction device, as well as the contact-time between free blood and pericardium, it is expected that the postoperative lung function will be improved.

  20. QRAC-the-Code: a comprehension monitoring strategy for middle school social studies textbooks.

    Science.gov (United States)

    Berkeley, Sheri; Riccomini, Paul J

    2013-01-01

    Requirements for reading and ascertaining information from text increase as students advance through the educational system, especially in content-rich classes; hence, monitoring comprehension is especially important. However, this is a particularly challenging skill for many students who struggle with reading comprehension, including students with learning disabilities. A randomized pre-post experimental design was employed to investigate the effectiveness of a comprehension monitoring strategy (QRAC-the-Code) for improving the reading comprehension of 323 students in grades 6 and 7 in inclusive social studies classes. Findings indicated that both general education students and students with learning disabilities who were taught a simple comprehension monitoring strategy improved their comprehension of textbook content compared to students who read independently and noted important points. In addition, students in the comprehension monitoring condition reported using more reading strategies after the intervention. Implications for research and practice are discussed.

  1. Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries.

    Science.gov (United States)

    Ocampo, Wrechelle; Cheung, Amanda; Baylis, Barry; Clayden, Nancy; Conly, John M; Ghali, William A; Ho, Chester H; Kaufman, Jaime; Stelfox, Henry T; Hogan, David B

    2017-07-01

    To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review

  2. Prevention and control strategies for ticks and pathogen transmission.

    Science.gov (United States)

    de La Fuente, J; Kocan, K M; Contreras, M

    2015-04-01

    Ticks and tick-borne pathogens have evolved together, resulting in a complex relationship in which the pathogen's life cycle is perfectly coordinated with the tick's feeding cycle, and the tick can harbour high pathogen levels without affecting its biology. Tick-borne diseases (TBDs) continue to emerge and/or spread, and pose an increasing threatto human and animal health. The disruptive impacts of global change have resulted in ecosystem instability and the future outcomes of management and control programmes for ticks and TBDs are difficult to predict. In particular, the selection of acaricide-resistant ticks has reduced the value of acaricides as a sole means of tick control. Vaccines provide an alternative control method, but the use of tick vaccines has not advanced since the first vaccines were registered in the early 1990s. An understanding of the complex molecular relationship between hosts, ticks and pathogens and the use of systems biology and vaccinomics approaches are needed to discover proteins with the relevant biological function in tick feeding, reproduction, development, immune response, the subversion of host immunity and pathogen transmission, all of which mediate tick and pathogen success. The same approaches will also be required to characterise candidate protective antigens and to validate vaccine formulations. Tick vaccines with a dual effect on tick infestations and pathogen transmission could reduce both tick infestations and their vector capacity for humans, animals and reservoir hosts. The development of integrated tick control strategies, including vaccines and synthetic and botanical acaricides, in combination with managing drug resistance and educating producers, should lead to the sustainable control of ticks and TBDs.

  3. Optimization of remediation strategies using vadose zone monitoring systems

    Science.gov (United States)

    Dahan, Ofer

    2016-04-01

    In-situ bio-remediation of the vadose zone depends mainly on the ability to change the subsurface hydrological, physical and chemical conditions in order to enable development of specific, indigenous, pollutants degrading bacteria. As such the remediation efficiency is much dependent on the ability to implement optimal hydraulic and chemical conditions in deep sections of the vadose zone. These conditions are usually determined in laboratory experiments where parameters such as the chemical composition of the soil water solution, redox potential and water content of the sediment are fully controlled. Usually, implementation of desired optimal degradation conditions in deep vadose zone at full scale field setups is achieved through infiltration of water enriched with chemical additives on the land surface. It is assumed that deep percolation into the vadose zone would create chemical conditions that promote biodegradation of specific compounds. However, application of water with specific chemical conditions near land surface dose not necessarily results in promoting of desired chemical and hydraulic conditions in deep sections of the vadose zone. A vadose-zone monitoring system (VMS) that was recently developed allows continuous monitoring of the hydrological and chemical properties of deep sections of the unsaturated zone. The VMS includes flexible time-domain reflectometry (FTDR) probes which allow continuous monitoring of the temporal variation of the vadose zone water content, and vadose-zone sampling ports (VSPs) which are designed to allow frequent sampling of the sediment pore-water and gas at multiple depths. Implementation of the vadose zone monitoring system in sites that undergoes active remediation provides real time information on the actual chemical and hydrological conditions in the vadose zone as the remediation process progresses. Up-to-date the system has been successfully implemented in several studies on water flow and contaminant transport in

  4. Critical aspects of integrated monitoring systems for landslides risk management: strategies for a reliable approach

    Science.gov (United States)

    Castagnetti, C.; Bertacchini, E.; Capra, A.; Corsini, A.

    2012-04-01

    The use of advanced technologies for remotely monitor surface processes is a successful way for improving the knowledge of phenomena evolution. In addition, the integration of various techniques is becoming more and more common in order to implement early warning systems that can monitor the evolution of landslides in time and prevent emergencies. The reliability of those systems plays a key role when Public Administrations have to plan actions in case of disasters or for preventing an incoming emergency. To have confidence in the information given by the system is an essential condition for a successful policy aiming to protect the population. The research deals with the major critical aspects to be taken into account when implementing a reliable monitoring system for unstable slopes. The importance of those aspects is often neglected, unlike the effects of a not careful implementation and management of the system can lead to erroneous interpretations of the phenomenon itself. The case study which ruled the research and highlighted the actual need of guidelines for setting up a reliable monitoring system is the Valoria landslide, located in the Northern Italy. The system is based on the integration of an automatic Total Station (TS) measuring 45 reflectors and a master GPS, acting as the reference station for three rovers placed within the landslide. In order to monitor local disturbing effects, a bi-dimensional clinometer has been applied on the TS pillar. Topographic measurements have been also integrated with geotechnical sensors (inclinometers and piezometers) in a GIS for landslide risk management. At the very beginning, periodic measurements were carried out, while the system is now performing continuously since 2008. The system permitted to evaluate movements from few millimeter till some meters per day in most dangerous areas. A more spatially continuous description has been also provided by LiDAR and terrestrial SAR interferometry. Some of the most

  5. A Novel Strategy for landslide displacement and its direction monitoring

    Science.gov (United States)

    Zhu, Z.-W.; Yuan, Q.-Y.; Liu, D.-Y.; Liu, B.; Liu, J.-C.; Luo, H.

    2013-12-01

    Landslide monitoring is important in predicting the behavior of landslides, thereby ensuring environmental, life, and property safety. On the basis of our previous studies, we conducted the double shear test by using a third-generation optical fiber transducer that uses expandable polystyrene (EPS) as base material. However, the third-generation transducer has poor performance when cohesive force is present between the grout and capillary stainless steel pipe of the transducer. Thus, the fourth-generation optical fiber transducer was invented. Similar to the third-generation transducer, the fourth-generation transducer also used EPS as its base material. Single shear test was conducted on the fourth-generation transducer after being grouted with cement mortar (1:1 mix ratio). The micro-bend loss mechanism of the optical fiber was considered, and the optical time domain reflectometry instrument was used. The fact that the loss sequence of optical fibers subjected to loading is different at various locations is found. The relationship of the loading-point displacement VS. optical fiber sliding distance and optical loss were measured. Results show that the maximum initial measurement precision of the newly proposed device is 1mm, the corresponding sliding distance is 21 mm, and the dynamic range is 0-20 mm. The fourth-generation transducer can measure the movement direction of loadings, thus making this transducer applicable for landslide monitoring.

  6. [Stress prevention programs--strategies, techniques, effectiveness. Part II. Organizational activities to prevent stress at work].

    Science.gov (United States)

    Małgorzata, W; Merecz, Dorota; Drabek, Marcin

    2010-01-01

    This is the second part of the publication on approaches to occupational stress prevention and a state of the art in different European countries. In this part, stress prevention within an organization is described and discussed. Although there is no one way of tackling stress at work, some recommendations can be formulated to increase the effectiveness of such interventions. The effective stress reducing programs should be aimed both at changes in the organization itself and empowerment of employees' coping with stress resources. It is also important to take the advantage of wide spectrum of methods and techniques (e.g., work redesign, participation, team work, cognitive behavioral methods, relaxation, etc.) remembering that one size does not fit all. The intervention should be carefully planned and adopted to the various branches, an individual organization or department and should be preceded by the identification of stress risks and risk groups. To have the stress prevention program successfully introduced one should also consider factors which may influence (positively or negatively) the process of program implementation.

  7. [Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission].

    Science.gov (United States)

    Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernández, Antonio; Péres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, María Carmen; González Tomé, María Isabel

    2014-05-01

    The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.). Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  8. Enhanced data validation strategy of air quality monitoring network.

    Science.gov (United States)

    Harkat, Mohamed-Faouzi; Mansouri, Majdi; Nounou, Mohamed; Nounou, Hazem

    2017-10-05

    Quick validation and detection of faults in measured air quality data is a crucial step towards achieving the objectives of air quality networks. Therefore, the objectives of this paper are threefold: (i) to develop a modeling technique that can be used to predict the normal behavior of air quality variables and help provide accurate reference for monitoring purposes; (ii) to develop fault detection method that can effectively and quickly detect any anomalies in measured air quality data. For this purpose, a new fault detection method that is based on the combination of generalized likelihood ratio test (GLRT) and exponentially weighted moving average (EWMA) will be developed. GLRT is a well-known statistical fault detection method that relies on maximizing the detection probability for a given false alarm rate. In this paper, we propose to develop GLRT-based EWMA fault detection method that will be able to detect the changes in the values of certain air quality variables; (iii) to develop fault isolation and identification method that allows defining the fault source(s) in order to properly apply appropriate corrective actions. In this paper, reconstruction approach that is based on Midpoint-Radii Principal Component Analysis (MRPCA) model will be developed to handle the types of data and models associated with air quality monitoring networks. All air quality modeling, fault detection, fault isolation and reconstruction methods developed in this paper will be validated using real air quality data (such as particulate matter, ozone, nitrogen and carbon oxides measurement). Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Muna, Walinjom F T

    2013-01-01

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

  10. Proposed national strategies for the prevention of leading work-related diseases and injuries. Part 1

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    Preliminary strategies developed at the National Symposium on the Prevention of Leading Work Related Diseases and Injuries, held in Atlanta, Georgia on May 1 to 3, 1985 were revised, elaborated, and further developed. Strategies were developed for the prevention of occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. Lung diseases considered included silicosis, asbestosis, lung cancer mesothelioma, coal workers' pneumoconiosis, byssinosis, occupational asthma, hypersensitivity pneumonitis, asphyxiation, irritation, pulmonary edema, brucellosis, psitticosis, anthrax, mycobacterioses, histoplasmosis, aspergillosis, and coccidioidomycosis. Occupational cancers were discussed as they occur in the lung, pleura, peritoneum, bladder, kidneys, blood, nasal cavity, skin, nasal sinuses, and liver.

  11. Direct marketing of parenting programs: comparing a promotion-focused and a prevention-focused strategy.

    Science.gov (United States)

    Salari, Raziye; Backman, Anna

    2017-06-01

    : For parenting programs to achieve a public health impact, it is necessary to develop more effective marketing strategies to increase public awareness of these programs and promote parental participation. In this article, we compared a promotion-focused and a prevention-focused strategy via two studies. : We designed two ads inviting parents to participate in a universal parenting program; one ad focused on the program increasing the likelihood of positive outcomes for children (promotion-focused) and the other on the program reducing the likelihood of negative outcomes (prevention-focused). In study I, the two ads were run online simultaneously. Those who clicked on an ad were directed to a website where they could read about and sign up for the program. In study II, a community sample of 706 parents answered a questionnaire about the ads. : In study I, over 85 days, the prevention ad generated more clicks. There was no difference in the number of pages visited on the website nor in the number of parents who signed up for the program. In study II, parents showed a preference for the promotion ad, perceiving it as more relevant and rating it as more effective in getting them interested in the program. : A prevention strategy may be more effective in drawing public attention, in general. However, a promotion strategy is more likely to reach parents, in particular, and inspire them to consider participating in parenting programs. These strategies should be developed further and tested in both general and clinical populations.

  12. Pressure injury prevention strategies in acute medical inpatients: an observational study.

    Science.gov (United States)

    Latimer, Sharon; Chaboyer, Wendy; Gillespie, Brigid

    2016-01-01

    Pressure injuries are a patient safety issue. Despite the suite of prevention strategies, sustained reductions in pressure injury prevalence rates have not been achieved. Generally, nurses are usually responsible for assessing patients' pressure injury risk, and then implementing appropriate prevention strategies. The study aim was to describe five planned and implemented pressure injury prevention strategies (risk assessment, management plan, support surface, repositioning, and education), and determine if a relationship existed between the planning and implementation of support surfaces and regular repositioning. An observational study collecting data using chart audits and semi-structured observations. Data were analysed using descriptive and inferential statistics. This study was set in four medical units across two Australian metropolitan hospitals. The sample comprised adult medical inpatients with reduced mobility. A subsample of participants assessed at pressure injury risk on admission was drawn from this sample. Participants were aged ≥18 years, had a hospital length of stay of ≥3 days prior to recruitment, provided an informed consent, and had reduced mobility. There was suboptimal planning and implementation of pressure injury prevention strategies for the sample and subsample. There was a significant relationship between planned and implemented support surfaces at both hospitals; however, no relationship existed between the planned and implemented of regular repositioning at either site. The planning and implementation of pressure injury strategies is haphazard. Patients received support surfaces; however, gaps exist in pressure injury risk assessment, management planning, regular repositioning, and patient education.

  13. Modulating Dickkopf-1: A Strategy to Monitor or Treat Cancer?

    Science.gov (United States)

    Mazon, Mélody; Masi, Delphine; Carreau, Madeleine

    2016-06-28

    Dickkopf-1 (DKK1) is a secreted Wnt/β-catenin pathway antagonist involved in embryogenesis. It was first described 25 years ago for its function in head induction and limb morphogenesis. Since then, this protein has been widely studied in the context of active Wnt/β-catenin signalling during cellular differentiation and development. Dysregulation of DKK1 has been associated with bone pathologies and has now emerged as a potential biomarker of cancer progression and prognosis for several types of malignancies. Reducing the amount of circulating DKK1 may reveal a simple and efficient strategy to limit or reverse cancer growth. This review will provide an overview of the role of Dickkopf-1 in cancer and explore its potential use as a biomarker and therapeutic target.

  14. Modulating Dickkopf-1: A Strategy to Monitor or Treat Cancer?

    Directory of Open Access Journals (Sweden)

    Mélody Mazon

    2016-06-01

    Full Text Available Dickkopf-1 (DKK1 is a secreted Wnt/β-catenin pathway antagonist involved in embryogenesis. It was first described 25 years ago for its function in head induction and limb morphogenesis. Since then, this protein has been widely studied in the context of active Wnt/β-catenin signalling during cellular differentiation and development. Dysregulation of DKK1 has been associated with bone pathologies and has now emerged as a potential biomarker of cancer progression and prognosis for several types of malignancies. Reducing the amount of circulating DKK1 may reveal a simple and efficient strategy to limit or reverse cancer growth. This review will provide an overview of the role of Dickkopf-1 in cancer and explore its potential use as a biomarker and therapeutic target.

  15. Research progress of monitoring, forecasting, and prevention of rockburst in underground coal mining in China

    Institute of Scientific and Technical Information of China (English)

    Lin ming Dou; Zonglong Mu; Zhenlei Li; Anye Cao; Siyuan Gong

    2014-01-01

    As one of the dynamic disasters of coal mines, rockburst seriously affects underground safe coal mining. Based on the laboratory test, field test, and theoretical analysis, this study proposed the principle of the rock burst induced by the combination of dynamic and static stresses and divided such rock burst into three types, including induced by primary dynamic stress, mainly induced by dynamic stress, and by dynamic stress in low critical stress state. The expressions of the static stress induced by coal mining and dynamic stress induced by mining tremors were obtained. Moreover, theories and technologies at home and abroad were summarized concerning the monitoring, forecasting, and preventing of rockburst. These mainly include the zoning and leveling forecasting method, electromagnetic radiation technology, elastic wave and seismic wave computed tomography technologies in aspect of rockburst monitoring, as well as the intensity weakening theory, the strong-soft-strong structure effect, the directional hydraulic fracturing technology, the roadway support system in regards of rockburst prevention. The prospect of rockburst development suggested that researches concerning the rockburst mechanism should be quantitatively developed around the roadway and coalface surrounding coal-rock mass. It should be focused on the rockburst mechanism and prevention technology of mining with over 1,000 km deep and mining in large tectonic zone. In addition, the monitoring and prevention of rockburst should be based on rockburst mechanism.

  16. Strategies that delay or prevent the timely availability of affordable generic drugs in the United States.

    Science.gov (United States)

    Jones, Gregory H; Carrier, Michael A; Silver, Richard T; Kantarjian, Hagop

    2016-03-17

    High cancer drug prices are influenced by the availability of generic cancer drugs in a timely manner. Several strategies have been used to delay the availability of affordable generic drugs into the United States and world markets. These include reverse payment or pay-for-delay patent settlements, authorized generics, product hopping, lobbying against cross-border drug importation, buying out the competition, and others. In this forum, we detail these strategies and how they can be prevented.

  17. Gastric bypass patients' goal-strategy-monitoring networks for long-term dietary management.

    Science.gov (United States)

    Lynch, Amanda; Bisogni, Carole A

    2014-10-01

    Following gastric bypass surgery, patients must make dramatic dietary changes, but little is known about patients' perspectives on long-term dietary management after this surgery. This grounded theory, qualitative study sought to advance conceptual understanding of food choice by examining how gastric bypass patients constructed personal food systems to guide food and eating behaviors 12 months post-surgery. Two in-depth interviews were conducted with each of 16 adults, purposively sampled from bariatric support groups. Using constant comparative analysis of verbatim interview transcripts, researchers identified participants' goal-strategy-monitoring networks representing how participants used specific food and eating behaviors towards their main goals of: Weight Management, Overall Health, Avoiding Negative Reactions to Eating, and Integrating Dietary Changes with Daily Life. Linked to each main goal was a hierarchy of intermediary goals, strategies, and tactics. Participants used monitoring behaviors to assess strategy effectiveness towards goal achievement. Individuals' Weight Management networks were compared to uncover similarities and differences among strategy use and monitoring methods among those who maintained weight loss and those who regained weight. The complex, multilevel goal-strategy-monitoring networks identified illustrate the "work" involved in constructing new personal food systems after surgery, as well as advance understanding of strategies as a component of people's personal food systems. These findings provide researchers and practitioners with insight into the long-term dietary issues that gastric bypass patients face and a potential method for representing how people relate deliberate dietary behaviors to their goals.

  18. Analysis of real-time reservoir monitoring : reservoirs, strategies, & modeling.

    Energy Technology Data Exchange (ETDEWEB)

    Mani, Seethambal S.; van Bloemen Waanders, Bart Gustaaf; Cooper, Scott Patrick; Jakaboski, Blake Elaine; Normann, Randy Allen; Jennings, Jim (University of Texas at Austin, Austin, TX); Gilbert, Bob (University of Texas at Austin, Austin, TX); Lake, Larry W. (University of Texas at Austin, Austin, TX); Weiss, Chester Joseph; Lorenz, John Clay; Elbring, Gregory Jay; Wheeler, Mary Fanett (University of Texas at Austin, Austin, TX); Thomas, Sunil G. (University of Texas at Austin, Austin, TX); Rightley, Michael J.; Rodriguez, Adolfo (University of Texas at Austin, Austin, TX); Klie, Hector (University of Texas at Austin, Austin, TX); Banchs, Rafael (University of Texas at Austin, Austin, TX); Nunez, Emilio J. (University of Texas at Austin, Austin, TX); Jablonowski, Chris (University of Texas at Austin, Austin, TX)

    2006-11-01

    survivability issues. Our findings indicate that packaging represents the most significant technical challenge associated with application of sensors in the downhole environment for long periods (5+ years) of time. These issues are described in detail within the report. The impact of successful reservoir monitoring programs and coincident improved reservoir management is measured by the production of additional oil and gas volumes from existing reservoirs, revitalization of nearly depleted reservoirs, possible re-establishment of already abandoned reservoirs, and improved economics for all cases. Smart Well monitoring provides the means to understand how a reservoir process is developing and to provide active reservoir management. At the same time it also provides data for developing high-fidelity simulation models. This work has been a joint effort with Sandia National Laboratories and UT-Austin's Bureau of Economic Geology, Department of Petroleum and Geosystems Engineering, and the Institute of Computational and Engineering Mathematics.

  19. Nutrition and Physical Activity Strategies for Cancer Prevention in Current National Comprehensive Cancer Control Program Plans.

    Science.gov (United States)

    Puckett, Mary; Neri, Antonio; Underwood, J Michael; Stewart, Sherri L

    2016-10-01

    Obesity, diet and physical inactivity are risk factors for some cancers. Grantees of the National Comprehensive Cancer Control Program (NCCCP) in US states, tribes, and territories develop plans to coordinate funding and activities for cancer prevention and control. Including information and goals related to nutrition and physical activity (NPA) is a key opportunity for primary cancer prevention, but it is currently unclear to what extent NCCCP plans address these issues. We reviewed 69 NCCCP plans and searched for terms related to NPA. Plans were coded as (1) knowledge of NPA and cancer link; (2) goals to improve NPA behaviors; and (3) strategies to increase healthy NPA activities, environments, or systems changes. NPA content was consistently included in all cancer plans examined across all years. Only 4 (6 %) outlined only the relationship between NPA and cancer without goals or strategies. Fifty-nine plans (89 %) contained goals or strategies related to NPA, with 53 (82 %) including both. However, numbers of goals, strategies, and detail provided varied widely. All programs recognized the importance of NPA in cancer prevention. Most plans included NPA goals and strategies. Increasing the presence of NPA strategies that can be modified or adapted appropriately locally could help with more widespread implementation and measurement of NPA interventions.

  20. STRATEGY AND PLANNING - PROJECT FOR MONITORING STRICTO SENSU POSTGRADUATE ALUMNI

    Directory of Open Access Journals (Sweden)

    Emerson Antonio Maccari

    2014-07-01

    Full Text Available The Coordination of Improvement of Higher Education Personnel (CAPES has been contributing to the development of post-graduate studies in Brazil, through its system of evaluation. Lately, CAPES signaled the importance of follow the professional performance of the alumni as a way to measure the quality of courses. One difficulty reported by institutions that intend to recognize the trajectory of its graduates is to compile a lot of isolated and outdated data. In order to structure the data collection and to assist educational managers in decision making, we propose the development of a system that enables the evolution of the students and alumni professional career, in order to diagnose the influence of the courses. Based on literature review, this study presents an analysis and makes recommendations about the Monitoring Alumni Project planning. As a result, it is expected that the analysis will serve as a driver for conducting the project, aiming to contribute to the academic reflections, and in practice, contribute to improve educational projects quality.

  1. Identifying prevention strategies for adolescents to reduce their risk of depression: A Delphi consensus study.

    Science.gov (United States)

    Cairns, Kathryn E; Yap, Marie B H; Reavley, Nicola J; Jorm, Anthony F

    2015-09-01

    Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. This study employed the Delphi methodology to establish expert consensus on self-help prevention strategies for adolescent depression. A literature search identified 194 recommendations for adolescents. These were presented over three questionnaire rounds to panels of 32 international research and practice experts and 49 consumer advocates, who rated the preventive importance of each recommendation and the feasibility of their implementation by adolescents. 145 strategies were endorsed as likely to be helpful in reducing adolescents׳ risk of developing depression by ≥80% of both panels. Endorsed strategies included messages on mental fitness, personal identity, life skills, healthy relationships, healthy lifestyles, and recreation and leisure. 127 strategies were endorsed as likely to be helpful in reducing risks for depression for both junior and senior adolescents. One strategy was rated as likely to be helpful during the period of junior adolescence only, and 17 strategies were endorsed for the senior adolescent period only. Ratings of the ease of implementing the strategies during the adolescent period accorded by panellists were typically moderate. This study used experts from developed, English-speaking countries; hence the strategies identified may not be for relevant or minority cultures within these countries or for other countries. This study produced a set of self-help preventive strategies for depression that are supported by research evidence and/or international experts, which can now be promoted in developed English-speaking communities to help adolescents reduce their risk of depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Attitudes of serodiscordant couples towards antiretroviral-based HIV prevention strategies in Kenya: a qualitative study.

    Science.gov (United States)

    Fowler, Nikola; Arkell, Paul; Abouyannis, Michael; James, Catherine; Roberts, Lesley

    2015-01-01

    This qualitative study aims to gain in-depth information about the attitudes of HIV-serodiscordant couples towards two new methods of HIV prevention; Pre-Exposure Prophylaxis and Treatment as Prevention, both of which have been recently recommended by the World Health Organisation. Semi-structured interviews were conducted with 38 individuals in a serodiscordant relationship in Western Kenya. Topic guides were used to elicit information on perceived benefits, concerns, and preferences towards Treatment as Prevention and Pre-Exposure Prophylaxis. Data evaluation and thematic generation were developed using framework analysis. Results suggest that the majority of participants, irrespective of gender and HIV status, found Treatment as Prevention the more acceptable strategy. Key factors influencing this decision were HIV-negative participants' limited motivation to take prophylactic antiretrovirals and the likely health improvements Treatment as Prevention offers HIV-positive partners. However, issues were raised concerning the likelihood of low concurrent condom use and poor medication adherence when using these preventative approaches. It was concluded that the adoption of Treatment as Prevention as a method of HIV control in Kenya is likely to be more readily accepted by serodiscordant couples than Pre-exposure Prophylaxis. However, future implementation of either strategy would require measures to address the possibility of risk compensation and poor adherence.

  3. Application of the BLM's assessment, inventory, and monitoring strategy for reclamation and restoration monitoring

    Science.gov (United States)

    Monitoring of reclamation or restoration activities (“restoration monitoring” for brevity) is a crucial step in adaptive management not only to judge effectiveness of a restoration action but also to build evidence for its overall efficacy and context in which it is appropriate. Restoration monitori...

  4. Strategies for the prevention of MP3-induced hearing loss among adolescents : Expert opinions from a Delphi study

    NARCIS (Netherlands)

    Vogel, I.; Brug, J.; Ploeg, C.P.B. van der; Raat, H.

    2009-01-01

    OBJECTIVE. To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. METHODS. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth w

  5. An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students

    Directory of Open Access Journals (Sweden)

    Ana Laura Calderón- Garcidueñas

    2015-01-01

    Conclusions: The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

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

    Science.gov (United States)

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

    2017-01-01

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

  7. Effectiveness of continuous or intermittent vital signs monitoring in preventing adverse events on general wards: a systematic review and meta-analysis.

    Science.gov (United States)

    Cardona-Morrell, M; Prgomet, M; Turner, R M; Nicholson, M; Hillman, K

    2016-10-01

    Vital signs monitoring is an old hospital practice for patient safety but evaluation of its effectiveness is not widespread. We aimed to identify strategies to improve intermittent or continuous vital signs monitoring in general wards; and their effectiveness in preventing adverse events on general hospital wards. Publications searched between 1980 and June 2014 in five databases. Main outcome measures were in-hospital death, cardiac arrest, intensive care unit (ICU) transfers, length of stay, identification of physiological deterioration and activation of rapid response systems. Twenty-two studies assessing the effect of continuous (9) or intermittent monitoring (13) and reporting outcomes on 203,407 patients in-hospital wards across 13 countries were included in this review. Both monitoring practices led to early identification of patient deterioration, increased rapid response activations and improvements in timeliness or completeness of vital signs documentation. Innovative intermittent monitoring approaches are associated with modest reduction in in-hospital mortality over intermittent vital signs monitoring in 'usual care'. However, there was no evidence of significant reduction in ICU transfers or other adverse events with either intermittent or continuous monitoring. This review of heterogeneous monitoring approaches found no conclusive confirmation of improvements in prevention of cardiac arrest, reduction in length of hospital stay, or prevention of other neurological or cardiovascular adverse events. The evidence found to date is insufficient to recommend continuous vital signs monitoring in general wards as routine practice. Future evaluations of effectiveness need to be undertaken with more rigorous methods and homogeneous outcome measurements. © 2016 John Wiley & Sons Ltd.

  8. Job monitoring on the WLCG scope: Current status and new strategy

    CERN Document Server

    Andreeva, J; Belov, S; Casey, J; Dvorak, F; Gaidioz, B; Karavakis, E; Kodolova, O; Kokoszkiewicz, L; Krenek, A; Lanciotti, E; Maier, J; Mulac, M; Rocha Da Cunha Rodrigues, D F; Rocha, R; Saiz, P; Sidorova, I; Sitera, J; Tikhonenko, E; Vaibhav, K; Vocu, M

    2010-01-01

    Job processing and data transfer are the main computing activities on the WLCG infrastructure. Reliable monitoring of the job processing on the WLCG scope is a complicated task due to the complexity of the infrastructure itself and the diversity of the currently used job submission methods. The paper will describe current status and the new strategy for the job monitoring on the WLCG scope, covering primary information sources, job status changes publishing, transport mechanism and visualization.

  9. Monitoring strategies and scale appropriate hydrologic and biogeochemical modelling for natural resource management

    DEFF Research Database (Denmark)

    Bende-Michl, Ulrike; Volk, Martin; Harmel, Daren

    2011-01-01

    -appropriate hydrologic and biogeochemical modelling for natural resource management’ session at the 2008 International Environmental Modelling and Simulation Society conference, Barcelona, Spain. The outcomes of the session and recent international studies exemplify the need for a stronger collaboration...... techniques, and 3) representation of hydrologic and biogeochemical phenomena in model development and practical application for natural resource management.......This short communication paper presents recommendations for developing scale-appropriate monitoring and modelling strategies to assist decision making in natural resource management (NRM). These ideas presented here were discussed in the session (S5) ‘Monitoring strategies and scale...

  10. Eating Issues and Body Image in Elementary School: Detection and Prevention Strategies for School Counselors

    Science.gov (United States)

    Springer, Sarah I.; Levitt, Dana Heller

    2016-01-01

    Body image disturbance continues to be recognized in increasingly younger populations. Eating issues among elementary school children have become more overt and statistically prevalent in recent years. Elementary school counselors are in important positions to provide their communities with early detection information and prevention strategies.…

  11. Experiences of Peer Evaluation of the Leicester Teenage Pregnancy Prevention Strategy

    Science.gov (United States)

    Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison

    2009-01-01

    The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…

  12. Suggested Cognitive and Behavioral Strategies for Coaches to Prevent Drug Abuse in Sport.

    Science.gov (United States)

    Anshel, Mark H.

    In this discussion of the prevalence of drug abuse by athletes, suggestions are made for coaches to prevent or reduce the abusive intake of drugs by athletes who participate on their teams. The following cognitive strategies deal with eliminating unwanted drug use: (1) show concern; (2) articulate ethical issues; (3) set behavior limits; (4)…

  13. Cross-National Perspectives on Early Adolescence: Implications and Strategies for Public Health Prevention and Interventions

    Science.gov (United States)

    Swahn, Monica H.

    2012-01-01

    The current special issue brings together intriguing and important cross-country comparisons of issues pertinent to early adolescence that can inform the design and implementation of broader and relevant public health prevention strategies. The findings illustrate the importance of cross-country analyses for better understanding a range of…

  14. What Would You Do? Strategies for Bystander Intervention to Prevent Sexual Violence by College Students

    Science.gov (United States)

    McMahon, Sarah; Hoffman, Melanie Lowe; McMahon, Sheila M.; Zucker, Sharon; Koenick, Ruth Anne

    2013-01-01

    Bystander education is an increasingly utilized strategy for addressing sexual assault prevention and intervention on U.S. college campuses. Given the paramount importance of peers among college students, what types of pro-social bystander interventions do students themselves deem feasible in the campus context? Drawing on self-reports from…

  15. New Biomedical Technologies and Strategies for Prevention of HIV and Other Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Bonaventura C. T. Mpondo

    2016-01-01

    Full Text Available Sexually transmitted infections remain to be of public health concern in many developing countries. Their control is important, considering the high incidence of acute infections, complications and sequelae, and their socioeconomic impact. This article discusses the new biomedical technologies and strategies for the prevention of HIV and other sexually transmitted infections.

  16. Life skills as a behaviour change strategy in the prevention of HIV ...

    African Journals Online (AJOL)

    2017-09-21

    Sep 21, 2017 ... strategy in the prevention of HIV and AIDS: Perceptions of students in ... to be intensified to ensure that students graduate and enter the world ... The aim of the study was to explore the perceptions of .... Life skills are defined as skills necessary for successful living and ..... guidelines for a course on lifeskills.

  17. Perceived Stressors of Suicide and Potential Prevention Strategies for Suicide among Youths in Malaysia

    Science.gov (United States)

    Kok, Jin Kuan; van Schalkwyk, Gertina J.; Chan, Andrea Huan Wen

    2015-01-01

    The suicide rate among youths in Malaysia has increased over the years, giving rise to considerable public concern. The purpose of this study was to explore and describe potential stressors of suicide and suicide prevention strategies as perceived by youths in Malaysia aged 15-25 years. A qualitative approach was adopted and 625 students from…

  18. What Would You Do? Strategies for Bystander Intervention to Prevent Sexual Violence by College Students

    Science.gov (United States)

    McMahon, Sarah; Hoffman, Melanie Lowe; McMahon, Sheila M.; Zucker, Sharon; Koenick, Ruth Anne

    2013-01-01

    Bystander education is an increasingly utilized strategy for addressing sexual assault prevention and intervention on U.S. college campuses. Given the paramount importance of peers among college students, what types of pro-social bystander interventions do students themselves deem feasible in the campus context? Drawing on self-reports from…

  19. Experiences of Peer Evaluation of the Leicester Teenage Pregnancy Prevention Strategy

    Science.gov (United States)

    Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison

    2009-01-01

    The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…

  20. Children, Teachers, and Families Working Together to Prevent Childhood Obesity: Intervention Strategies

    Science.gov (United States)

    Stegelin, Dolores A.

    2008-01-01

    Obesity rates for children, adolescents, and adults continue to escalate in the United States and globally. Educators, health specialists, psychologists, and sociologists are studying the complex problems related to early obesity. Like other health problems, prevention and early detection are the most effective strategies. The causes and…

  1. Evaluating Community Readiness to Implement Environmental and Policy-Based Alcohol Abuse Prevention Strategies in Wisconsin

    Science.gov (United States)

    Paltzer, Jason; Black, Penny; Moberg, D. Paul

    2013-01-01

    Background: Matching evidence-based alcohol prevention strat- egies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the…

  2. Strategies for Preventing and Resolving Temporary Fossilization in Second Language Acquisition

    Science.gov (United States)

    Qian, Manqiu; Xiao, Zhihong

    2010-01-01

    Based on the practice of college English teaching and learning in China, the paper reviews the phenomenon and causes of the temporary fossilization in second language acquisition and offers some corresponding strategies for preventing and surmounting the obstacles in the hope of promoting the reactivation of the next climax.

  3. Strategies for prevention of urinary tract infections in neurogenic bladder dysfunction.

    Science.gov (United States)

    Goetz, Lance L; Klausner, Adam P

    2014-08-01

    In this article, the problem of urinary tract infections (UTIs) after spinal cord injury and disorders is defined, the relationship of bladder management to UTIs is discussed, and mechanical and medical strategies for UTI prevention in spinal cord injury and disorders are described.

  4. Evaluating Community Readiness to Implement Environmental and Policy-Based Alcohol Abuse Prevention Strategies in Wisconsin

    Science.gov (United States)

    Paltzer, Jason; Black, Penny; Moberg, D. Paul

    2013-01-01

    Background: Matching evidence-based alcohol prevention strat- egies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the implementation of…

  5. Children, Teachers, and Families Working Together to Prevent Childhood Obesity: Intervention Strategies

    Science.gov (United States)

    Stegelin, Dolores A.

    2008-01-01

    Obesity rates for children, adolescents, and adults continue to escalate in the United States and globally. Educators, health specialists, psychologists, and sociologists are studying the complex problems related to early obesity. Like other health problems, prevention and early detection are the most effective strategies. The causes and…

  6. The role and place of medicinal plants in the strategies for disease prevention.

    Science.gov (United States)

    Sofowora, Abayomi; Ogunbodede, Eyitope; Onayade, Adedeji

    2013-08-12

    Medicinal plants have been used in healthcare since time immemorial. Studies have been carried out globally to verify their efficacy and some of the findings have led to the production of plant-based medicines. The global market value of medicinal plant products exceeds $100 billion per annum. This paper discusses the role, contributions and usefulness of medicinal plants in tackling the diseases of public health importance, with particular emphasis on the current strategic approaches to disease prevention. A comparison is drawn between the 'whole population' and 'high-risk' strategies. The usefulness of the common-factor approach as a method of engaging other health promoters in propagating the ideals of medicinal plants is highlighted. The place of medicinal plants in preventing common diseases is further examined under the five core principles of the Primary Health Care (PHC) approach. Medicinal plants play vital roles in disease prevention and their promotion and use fit into all existing prevention strategies. However, conscious efforts need to be made to properly identify, recognise and position medicinal plants in the design and implementation of these strategies. These approaches present interesting and emerging perspectives in the field of medicinal plants. Recommendations are proposed for strategising the future role and place for medicinal plants in disease prevention.

  7. [Integrated strategy for dengue prevention and control in the Region of the Americas].

    Science.gov (United States)

    San Martín, José Luis; Brathwaite-Dick, Olivia

    2007-01-01

    During the last 22 years, the Region of the Americas has seen an upward trend in dengue incidence, with epidemics peaking ever higher and recurring every 3-5 years, almost regularly. A major factor in the spread of the disease has been the diminished capacity of national programs to respond with dengue prevention and control. This paper evaluates the Integrated Strategy for Dengue Prevention and Control-approved by the 44th Directing Council of the Pan American Health Organization in September 2003- and its preliminary results. The Integrated Strategy for Dengue is a management model designed to strengthen national programs, with a focus on reducing morbidity, mortality, and the societal and economic burdens produced by outbreaks and epidemics. Currently, 11 of the countries in the Region have developed a plan for or implemented a national strategy. In addition, a sub-Regional plan has been developed for Central America and the Dominican Republic. The Integrated Strategy for Dengue is expected to produce a qualitative leap forward in prevention and control through stronger partnerships among the State, its various ministries, and governing bodies, at all levels; private companies; and the range of community and civil groups. Once implemented, this strategy will reduce risk factors for dengue transmission, establish an integrated epidemiological surveillance system, decrease Aedes aegypti mosquito populations, prepare laboratories to better detect and identify the virus, optimize diagnosis and treatment, and, as a result, decrease the frequency, magnitude, and severity of dengue outbreaks and epidemics.

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

    Science.gov (United States)

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

    2005-01-01

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

  9. Substance-related environmental monitoring strategies regarding soil, groundwater and surface water - an overview.

    Science.gov (United States)

    Kördel, Werner; Garelick, Hemda; Gawlik, Bernd M; Kandile, Nadia G; Peijnenburg, Willie J G M; Rüdel, Heinz

    2013-05-01

    Substance-related monitoring is an essential tool within environmental risk assessment processes. The soundness of policy decisions including risk management measures is often directly related to the reliability of the environmental monitoring programs. In addition, monitoring programs are required for identifying new and less-investigated pollutants of concern in different environmental media. Scientifically sound and feasible monitoring concepts strongly depend on the aim of the study. The proper definition of questions to be answered is thus of pivotal importance. Decisions on sample handling, storage and the analysis of the samples are important steps for the elaboration of problem-oriented monitoring strategies. The same applies to the selection of the sampling sites as being representative for scenarios to be investigated. These steps may become critical to handle for larger international monitoring programs and thus trigger the quality of their results. This study based on the work of an IUPAC (International Union of Pure and Applied Chemistry) task group addresses different kinds and approaches of substance-related monitoring of different compartments of soil, groundwater and surface water, and discusses their advantages and limitations. Further important aspects are the monitoring across policies and the monitoring data management using information systems.

  10. The cost-effectiveness of monitoring strategies for antiretroviral therapy of HIV infected patients in resource-limited settings: software tool.

    Directory of Open Access Journals (Sweden)

    Janne Estill

    Full Text Available The cost-effectiveness of routine viral load (VL monitoring of HIV-infected patients on antiretroviral therapy (ART depends on various factors that differ between settings and across time. Low-cost point-of-care (POC tests for VL are in development and may make routine VL monitoring affordable in resource-limited settings. We developed a software tool to study the cost-effectiveness of switching to second-line ART with different monitoring strategies, and focused on POC-VL monitoring.We used a mathematical model to simulate cohorts of patients from start of ART until death. We modeled 13 strategies (no 2nd-line, clinical, CD4 (with or without targeted VL, POC-VL, and laboratory-based VL monitoring, with different frequencies. We included a scenario with identical failure rates across strategies, and one in which routine VL monitoring reduces the risk of failure. We compared lifetime costs and averted disability-adjusted life-years (DALYs. We calculated incremental cost-effectiveness ratios (ICER. We developed an Excel tool to update the results of the model for varying unit costs and cohort characteristics, and conducted several sensitivity analyses varying the input costs.Introducing 2nd-line ART had an ICER of US$1651-1766/DALY averted. Compared with clinical monitoring, the ICER of CD4 monitoring was US$1896-US$5488/DALY averted and VL monitoring US$951-US$5813/DALY averted. We found no difference between POC- and laboratory-based VL monitoring, except for the highest measurement frequency (every 6 months, where laboratory-based testing was more effective. Targeted VL monitoring was on the cost-effectiveness frontier only if the difference between 1st- and 2nd-line costs remained large, and if we assumed that routine VL monitoring does not prevent failure.Compared with the less expensive strategies, the cost-effectiveness of routine VL monitoring essentially depends on the cost of 2nd-line ART. Our Excel tool is useful for determining optimal

  11. A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement.

    Science.gov (United States)

    Blain, H; Masud, T; Dargent-Molina, P; Martin, F C; Rosendahl, E; van der Velde, N; Bousquet, J; Benetos, A; Cooper, C; Kanis, J A; Reginster, J Y; Rizzoli, R; Cortet, B; Barbagallo, M; Dreinhöfer, K E; Vellas, B; Maggi, S; Strandberg, T

    2016-08-01

    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, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, 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.

  12. A COMPREHENSIVE FRACTURE PREVENTION STRATEGY IN OLDER ADULTS: THE EUROPEAN UNION GERIATRIC MEDICINE SOCIETY (EUGMS) STATEMENT

    Science.gov (United States)

    BLAIN, H.; MASUD, T.; DARGENT-MOLINA, P.; MARTIN, F.C.; ROSENDAHL, E.; VAN DER VELDE, N.; BOUSQUET, J.; BENETOS, A.; COOPER, C.; KANIS, J.A.; REGINSTER, J.Y.; RIZZOLI, R.; CORTET, B.; BARBAGALLO, M.; DREINHÖFER, K.E.; VELLAS, B.; MAGGI, S.; STRANDBERG, T.

    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), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, 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. PMID:27273355

  13. Video exposure monitoring as part of a strategy to assess exposure to nanoparticles

    NARCIS (Netherlands)

    Beurskens-Comuth, P.A.W.V.; Verbist, K.; Brouwer, D.

    2011-01-01

    Objectives: There is a growing awareness of the potential risks for human health of exposure to ultrafine particles or nanoparticles. In that context, workplace air measurements become important, and various strategies have been developed to monitor exposure. In addition, observations and time/activ

  14. Wafer level reliability monitoring strategy of an advanced multi-process CMOS foundry

    NARCIS (Netherlands)

    Scarpa, Andrea; Tao, Guoqiao; Kuper, F.G.

    2000-01-01

    In an advanced multi-process CMOS foundry it is strategically important to make use of an optimum reliability monitoring strategy, in order to be able to run well controlled processes. Philips Semiconductors Business Unit Foundries wafer fab MOS4YOU has developed an end-of-line ultra-fast

  15. Wafer level reliability monitoring strategy of an advanced multi-process CMOS foundry

    NARCIS (Netherlands)

    Scarpa, Andrea; Tao, Guoqiao; Kuper, Fred G.

    2000-01-01

    In an advanced multi-process CMOS foundry it is strategically important to make use of an optimum reliability monitoring strategy, in order to be able to run well controlled processes. Philips Semiconductors Business Unit Foundries wafer fab MOS4YOU has developed an end-of-line ultra-fast reliabilit

  16. Monitoring and depth of strategy use in computer-based learning environments for science and history.

    Science.gov (United States)

    Deekens, Victor M; Greene, Jeffrey A; Lobczowski, Nikki G

    2017-08-12

    Self-regulated learning (SRL) models position metacognitive monitoring as central to SRL processing and predictive of student learning outcomes (Winne & Hadwin, 2008; Zimmerman, 2000). A body of research evidence also indicates that depth of strategy use, ranging from surface to deep processing, is predictive of learning performance. In this study, we investigated the relationships among the frequency of metacognitive monitoring and the utilization of deep and surface-level strategies, and the connections between these SRL processes and learning outcomes across two academic domains, science and history. This was a secondary data analysis of two studies. The first study sample was 170 undergraduate students from a University in the south-eastern United States. The second study sample consisted of 40 US high school students in the same area. We collected think-aloud protocol SRL and knowledge measure data and conducted both structural equation modelling and path analysis to investigate our research questions. Findings showed across both studies and two distinct academic domains, students who enacted more frequent monitoring also enacted more frequent deep strategies resulting in better performance on academic evaluations. These findings suggest the importance of measuring not only what depth of strategies learners use, but also the degree to which they monitor their learning. Attention to both is needed in research and practice. © 2017 The British Psychological Society.

  17. Exercise strategies to optimize glycemic control in type 2 diabetes : a continuing glucose monitoring perspective

    NARCIS (Netherlands)

    van Dijk, Jan-Willem; van Loon, Luc J C

    2015-01-01

    IN BRIEF The introduction of continuous glucose monitoring (CGM) several years ago enabled researchers to investigate the impact of exercise strategies on 24-hour glycemic control. Such unique information on the glucoregulatory properties of exercise will ultimately lead to more effective exercise p

  18. Development of on the machine process monitoring and control strategy in Robot Assisted Polishing

    DEFF Research Database (Denmark)

    Pilny, Lukas; Bissacco, Giuliano

    2015-01-01

    Robot Assisted Polishing (RAP) can be used to polish rotational symmetric and free form components achieving surface roughness down to Sa 10 nm. With the aim to enable unmanned robust and cost efficient application of RAP, this paper presents the development of a monitoring and control strategy f...

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

    Science.gov (United States)

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

    2016-11-01

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

  20. Continuous ECG monitoring for tracking down atrial fibrillation after stroke: Holter or automated analysis strategy?

    Science.gov (United States)

    Suissa, Laurent; Lachaud, Sylvain; Mahagne, Marie-Hélène

    2014-01-01

    Tracking down atrial fibrillation (AF) in the stroke unit is a relevant challenge for the prevention of recurrent AF-related stroke. The optimal terms of use of continuous ECG monitoring (CEM) are unknown. We compared 24-hour routine Holter ECG with two different CEM analysis strategies for AF detection. We prospectively enrolled consecutive ischemic stroke patients. All AF-naïve patients received CEM during hospitalization. Two methods for reading CEM data were compared: manual analysis using the Holter function (hCEM) and semiautomated analysis using software (aCEM). The McNemar test was used to compare AF detection rates. Of the 362 patients included, 58 (16.0%) were non-AF-naïve patients and 304 were AF-naïve patients. AF-Naïve patients underwent CEM with a median duration of 5.3 days (3.4-9.7). We detected 22 new AF cases (7.2%) with first-24-hour hCEM, 31 (10.2%) with aCEM, and 42 (13.8%) with hCEM. hCEM and aCEM both significantly increased the AF detection rate compared to first-24-hour hCEM. hCEM detected more new AF cases than aCEM (+3.6%, p = 0.003). In stroke patients, early and prolonged aCEM and hCEM both increase the AF detection rate compared to first-24-hour hCEM. hCEM gives the best AF detection rate. We suggest that in aCEM, detection based only on the ventricular rhythm analysis explains its lower specificity and sensitivity. © 2014 S. Karger AG, Basel.

  1. Violence Prevention in Austrian Schools: Implementation and Evaluation of a National Strategy

    Directory of Open Access Journals (Sweden)

    Christiane Spiel

    2012-12-01

    Full Text Available A qualitative study of Austria’s national strategy against violence in the public school system introduced in 2008. The national strategy developed by researchers consists of six activity domains with specific goals and projects defined for each. The evaluation (1 analyzes how the realized projects contributed to the six activity domains, (2 evaluates the national strategy at a general level, and (3 provides future recommendations. Eight members of the steering committee were interviewed at two points in the implementation process. The systematic interviews were coded according to the goals of the activity domains. According to the interviewees most of the projects have been satisfactorily implemented. Networking and cooperation with the different actors in the field of violence prevention and cooperation among steering committee members have been improved. However, the national strategy has not achieved the intended public recognition. The lessons learned from the evaluation and its results are discussed.

  2. [Mathematical modelling of an infectious disease in a prison setting and optimal preventative control strategies].

    Science.gov (United States)

    Trujillo-Salazar, Carlos A; Toro-Zapata, Hernán D; Muñoz-Loaiza, Aníbal

    2013-01-01

    A mathematical model was constructed for modelling transmission dynamics and the evolution of an infectious disease in a prison setting, considering asymptomatic infectious people, symptomatic infectious people and isolated infectious people. The model was proposed as a nonlinear differential equation system for describing disease epidemiology. The model's stability was analysed for including a preventative control strategy which would enable finding a suitable basic reproduction number-based control protocol. A cost function related to the system of differential equations was formulated to minimise infectious populations and intervention costs; such function was minimised by using the Pontryagin maximum principle which determines optimum preventative control strategies by minimising both infectious populations and associated costs. A numerical analysis of the model was made, considering preventative control effectiveness levels and different control weighting constants. Conclusions were drawn. The basic reproduction number characterises system stability and leads to determining clear control criteria; a preventative control threshold was defined, based on the controlled basic reproduction number which enabled deducing that disease control requires uniform preventative control involving high rates of effectiveness.

  3. Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities.

    Science.gov (United States)

    Carmeli, Eli; Imam, Bita

    2014-01-01

    The rapid growth in the number of individuals living with intellectual and developmental disabilities (IDD) along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals' health risks, address primary and secondary disease prevention, and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities, and nutrition.

  4. Behavioral change communication strategy vital in malaria prevention interventions in rural communities: Nakasongola district, Uganda.

    Science.gov (United States)

    Mugisa, Margaret; Muzoora, Abel

    2012-01-01

    Malaria is a leading killer disease in Uganda and it accounts for significant morbidity in pregnant women and children. Pregnant women are more susceptible to malaria, which causes adverse effects including abortion, low birth weight and maternal anaemia. Children with severe malaria frequently develop one of these symptoms including: severe anaemia, respiratory distress, Prostration, convulsions and cerebral malaria. Due to the severity of the disease there is need for multiple interventions to reduce the disease burden. African Medical and Research Foundation (AMREF) adopted community based approaches to improve malaria prevention. Behavioral change communication (BCC) was fundamental at every process of Project implementation. This paper shares AMREF's experience in using BCC strategies amidst other interventions in malaria prevention approaches involving use of insecticide treated nets and environment management. AMREF through a Malaria project (2007-2010) in Nakasongola district supported BCC activities through training, community mobilization, mass media, health promotion and advocacy. Program performance was measured through baseline and evaluation surveys in 2007 and 2010. The final project evaluation indicated improvement from baseline values as follows: knowledge on prevention of malaria among school children from 76.6% to 90%, under five children sleeping under bed net the previous night from 51% to 74.7%, and from 24% to 78% among pregnant women. Mobilization of malaria prevention interventions can be successful once BCC approaches are adequately planned and coordinated. Malaria prevention through BCC strategies are likely to be more effective with integration of other malaria interventions, and involvement of community based structures.

  5. Innovative Strategy For Long Term Monitoring Of Metal And Radionuclide Plumes

    Energy Technology Data Exchange (ETDEWEB)

    Eddy-Dilek, Carol; Millings, Margaret R.; Looney, Brian B.; Denham, Miles E.

    2014-01-08

    Many government and private industry sites that were once contaminated with radioactive and chemical wastes cannot be cleaned up enough to permit unrestricted human access. The sites will require long term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality at these "legacy" sites. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site, the larger DOE complex, and many large federal and private sites. There is a need to optimize the performance and manage the cost of long term surveillance and monitoring at their sites. Currently, SRNL is initiating a pilot field test using alternative protocols for long term monitoring of metals and radionuclides. A key component of the approach is that monitoring efforts are focused on measurement of low cost metrics related to hydrologic and chemical conditions that control contaminant migration. The strategy combines careful monitoring of hydrologic boundary conditions with measurement of master variables such as chemical surrogates along with a smaller number of standard well analyses. In plumes contaminated with metals, master variables control the chemistry of the groundwater system, and include redox variables (ORP, DO, chemicals), pH, specific conductivity, biological community (breakdown/decay products), and temperature. Significant changes in these variables will result in conditions whereby the plume may not be stable and therefore can be used to predict possible plume migration. Conversely, concentration measurements for all types of contaminants in groundwater are a lagging indicator plume movement - major changes contaminant concentrations indicate that contamination has migrated. An approach based on measurement of master variables and explicit monitoring of hydrologic boundary conditions combined with traditional metrics should lead

  6. [Social marketing: applying commercial strategies to the prevention of nosocomial infections].

    Science.gov (United States)

    Sax, Hugo; Longtin, Yves; Alvarez-Ceyssat, Raymonde; Bonfillon, Chantal; Cavallero, Sabrina; Dayer, Pierre; Ginet, Claude; Herrault, Pascale

    2009-04-01

    Although a large proportion of healthcare-associated infections are avoidable, healthcare workers do not always practice evidence-based preventive strategies. Marketing technologies might help to improve patient safety. This article presents the basic principles of marketing and its potential use to promote good infection control practices. The marketing mix (Product, Price, Place, and Promotion) should be taken into account to induce behaviour change. By placing the emphasis on the perceived "profits" for healthcare workers the approach might lose its moral aspect and gain in effectiveness. VigiGerme, a non-commercial registered trademark, applies social marketing techniques to infection control and prevention.

  7. Real-time nutrient monitoring in rivers: adaptive sampling strategies, technological challenges and future directions

    Science.gov (United States)

    Blaen, Phillip; Khamis, Kieran; Lloyd, Charlotte; Bradley, Chris

    2016-04-01

    Excessive nutrient concentrations in river waters threaten aquatic ecosystem functioning and can pose substantial risks to human health. Robust monitoring strategies are therefore required to generate reliable estimates of river nutrient loads and to improve understanding of the catchment processes that drive spatiotemporal patterns in nutrient fluxes. Furthermore, these data are vital for prediction of future trends under changing environmental conditions and thus the development of appropriate mitigation measures. In recent years, technological developments have led to an increase in the use of continuous in-situ nutrient analysers, which enable measurements at far higher temporal resolutions than can be achieved with discrete sampling and subsequent laboratory analysis. However, such instruments can be costly to run and difficult to maintain (e.g. due to high power consumption and memory requirements), leading to trade-offs between temporal and spatial monitoring resolutions. Here, we highlight how adaptive monitoring strategies, comprising a mixture of temporal sample frequencies controlled by one or more 'trigger variables' (e.g. river stage, turbidity, or nutrient concentration), can advance our understanding of catchment nutrient dynamics while simultaneously overcoming many of the practical and economic challenges encountered in typical in-situ river nutrient monitoring applications. We present examples of short-term variability in river nutrient dynamics, driven by complex catchment behaviour, which support our case for the development of monitoring systems that can adapt in real-time to rapid environmental changes. In addition, we discuss the advantages and disadvantages of current nutrient monitoring techniques, and suggest new research directions based on emerging technologies and highlight how these might improve: 1) monitoring strategies, and 2) understanding of linkages between catchment processes and river nutrient fluxes.

  8. Report on public health actions and vaccination strategies to monitor measles epidemic in Local Health Unit A in Rome, Italy

    Directory of Open Access Journals (Sweden)

    Antonietta Spadea

    2012-03-01

    Full Text Available

    Abstract:
    Background: between May 2010 and october 2011 the unit of Preventive Medicine for the developmental ages of district IV, Health unit aSL rM/a, received 136 measles case notifications from the unit of Epidemiology and Prophylaxis of Infectious diseases.
    Methods: in accordance with the infectious diseases monitoring protocol, we introduced a series of preventive measures, such as monitoring subjects in contact with measles-infected patients, recommend- ing the administration of two Measles Mumps and rubella (MMr doses four weeks apart, and informing paediatricians, families and school teachers about the measles epidemic.
    Results: all the activities above led to an increased number of MMr doses administered and a significant improvement of measles immunization coverage among residents of the district IV health unit of rome. concerning MMr 1, in a sample cohort consisting of children ≤24 months, the immunization coverage increased from 77% on the 31/12/09 to 88% on the 31/12/11. Instead, for MMr 2, in a cohort of children ≤6 years, the same ratio improved from 51% on the 31/12/09 to 65% on the 31/12/11.
    Discussion: the results indicate a material increase in the immunization coverage once our public health actions and vaccination strategies had been implemented among young residents of district IV aSL rM/a...

  9. Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective.

    Science.gov (United States)

    Carlson, Juliana; Casey, Erin; Edleson, Jeffrey L; Tolman, Richard M; Walsh, Tova B; Kimball, Ericka

    2015-11-01

    This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic, and contextual concerns of the local community, with nuanced messages and appropriate messengers. In addition, respondents reported key principles informing their organizational strategies to deepen men and boys' engagement. Attention is also paid to respondents' caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves.

  10. Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective

    Science.gov (United States)

    Carlson, Juliana; Casey, Erin; Edleson, Jeffrey L.; Tolman, Richard M.; Neugut, Tova B.; Kimball, Ericka

    2014-01-01

    This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic and contextual concerns of the local community, with nuanced messages and appropriate messengers. Additionally, respondents reported key principles informing their organizational strategies to deepen men and boys’ engagement. Attention is also paid to respondents’ caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves. PMID:26202155

  11. Load monitoring and compensation strategies for guided-waves based structural health monitoring using piezoelectric transducers

    Science.gov (United States)

    Roy, Surajit; Ladpli, Purim; Chang, Fu-Kuo

    2015-09-01

    Accurate interpretation of in-situ piezoelectric sensor signals is a challenging task. This paper presents the development of a numerical compensation model based on physical insight to address the influence of structural loads on piezo-sensor signals. The model requires knowledge of in-situ strain and temperature distribution in a structure while acquiring piezoelectric sensor signals. The parameters of the numerical model are obtained using experiments on flat aluminum plate under uniaxial tensile loading. It is shown that the model parameters obtained experimentally can be used for different structures, and sensor layout. Furthermore, the combined effects of load and temperature on the piezo-sensor response are also investigated and it is observed that both of these factors have a coupled effect on the sensor signals. It is proposed to obtain compensation model parameters under a range of operating temperatures to address this coupling effect. An important outcome of this study is a new load monitoring concept using in-situ piezoelectric sensor signals to track changes in the load paths in a structure.

  12. Load monitoring and compensation strategies for guided-waves based structural health monitoring using piezoelectric transducers

    Energy Technology Data Exchange (ETDEWEB)

    Roy, Surajit; Ladpli, Purim; Chang, Fu-Kuo

    2015-09-01

    Accurate interpretation of in-situ piezoelectric sensor signals is a challenging task. This article presents the development of a numerical compensation model based on physical insight to address the influence of structural loads on piezo-sensor signals. The model requires knowledge of in-situ strain and temperature distribution in a structure while acquiring sensor signals. The parameters of the numerical model are obtained using experiments on flat aluminum plate under uniaxial tensile loading. It is shown that the model parameters obtained experimentally can be used for different structures, and sensor layout. Furthermore, the combined effects of load and temperature on the piezo-sensor response are also investigated and it is observed that both of these factors have a coupled effect on the sensor signals. It is proposed to obtain compensation model parameters under a range of operating temperatures to address this coupling effect. An important outcome of this study is a new load monitoring concept using in-situ piezoelectric sensor signals to track changes in the load paths in a structure.

  13. Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices

    Directory of Open Access Journals (Sweden)

    Susan Philliber

    2015-09-01

    Full Text Available This paper reviews the changing strategies for both process and outcome evaluations of teen pregnancy prevention programs over the past few decades. Implementation evaluations have emphasized discovery of what program attributes are most effective in reducing teen pregnancy and its antecedents. Outcome evaluations have moved from collecting data to measure knowledge, attitudes, and program satisfaction to measuring behavior change including postponement of sexual involvement, increased used of contraception, or reduction in teen pregnancy. High quality randomized control trials or quasi-experimental designs are being increasingly emphasized, as are sophisticated analysis techniques using multi-variate analyses, controls for cluster sampling, and other strategies designed to build a more solid knowledge base about how to prevent early pregnancy.

  14. Fouling Issues in Membrane Bioreactors (MBRs for Wastewater Treatment: Major Mechanisms, Prevention and Control Strategies

    Directory of Open Access Journals (Sweden)

    Petros K. Gkotsis

    2014-10-01

    Full Text Available Membrane fouling is one of the most important considerations in the design and operation of membrane systems as it affects pretreatment needs, cleaning requirements, operating conditions, cost and performance. Given that membrane fouling represents the main limitation to membrane process operation, it is unsurprising that the majority of membrane material and process research and development conducted is dedicated to its characterization and amelioration. This work presents the fundamentals of fouling issues in membrane separations, with specific regard to membrane fouling in Membrane Bioreactors (MBRs and the most frequently applied preventive-control strategies. Feed pretreatment, physical and chemical cleaning protocols, optimal operation of MBR process and membrane surface modification are presented and discussed in detail. Membrane fouling is the major obstacle to the widespread application of the MBR technology and, therefore, fouling preventive-control strategies is a hot issue that strongly concerns not only the scientific community, but industry as well.

  15. Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies.

    Science.gov (United States)

    Kanamori, Hajime; Weber, David J; Rutala, William A

    2016-06-01

    Hospital water may serve as a reservoir of healthcare-associated pathogens, and contaminated water can lead to outbreaks and severe infections. The clinical features of waterborne outbreaks and infections as well as prevention strategies and control measures are reviewed. The common waterborne pathogens were bacteria, including Legionella and other gram-negative bacteria, and nontuberculous mycobacteria, although fungi and viruses were occasionally described. These pathogens caused a variety of infections, including bacteremia and invasive and disseminated diseases, particularly among immunocompromised hosts and critically ill adults as well as neonates. Waterborne outbreaks occurred in healthcare settings with emergence of new reported reservoirs, including electronic faucets (Pseudomonas aeruginosa and Legionella), decorative water wall fountains (Legionella), and heater-cooler devices used in cardiac surgery (Mycobacterium chimaera). Advanced molecular techniques are useful for achieving a better understanding of reservoirs and transmission pathways of waterborne pathogens. Developing prevention strategies based on water reservoirs provides a practical approach for healthcare personnel.

  16. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Fonseca Andrade

    2016-01-01

    Full Text Available Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r, Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r, Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    ABSTRACT: BACKGROUND: Statins are increasingly prescribed to prevent cardiovascular disease (CVD) in asymptomatic individuals. Yet, it is unknown whether those at higher CVD risk - i.e. individuals in lower socio-economic position (SEP) - are adequately reached by this high-risk strategy. Aim......: To examine whether the Danish implementation of the strategy to prevent cardiovascular disease (CVD) by initiating statin (HMG-CoA reductase inhibitor) therapy in high-risk individuals is equitable across socioeconomic groups. METHODS: Design: Cohort study. Setting and participants: Applying individual...... statin prescription (N=3.3 mill). Main outcome measures: Stratified by gender, 5-year age-groups and socioeconomic position (SEP), incidence of MI was applied as a proxy for statin need. Need-standardised statin incidence rates were calculated, applying MI incidence rate ratios (IRR) as need...

  18. The Relationship of Abortion and Violence Against Women: Violence Prevention Strategies and Research Needs.

    Science.gov (United States)

    Coyle, Catherine T; Shuping, Martha W; Speckhard, Anne; Brightup, Jennie E

    2015-01-01

    From the perspective of peace psychology, the role of abortion in acts of violence against women is explored, with a focus on violence-prevention strategies. Setting aside the political debate, this task force report takes the conflict-transformation approach of considering all perspectives that have concern for the right of women to avoid being victims of violence. The evidence that victims of Intimate Partner Violence are disproportionately represented in women presenting for abortion suggests a need for screening at clinics. Coerced abortion is a form of violence and has occurred by government policy in China and as a result of other violence against women: sex trafficking and war situations. Sex-selection abortion of female fetuses, referred to as "gendercide," has reached pandemic proportions and caused a gender imbalance in some countries. Psychology, through empirical research, can make unique contributions to understanding the relationship between abortion and violence and in developing prevention strategies.

  19. Etiological Foundation for Practical Strategies to Prevent Exercise-Related Foot Blisters.

    Science.gov (United States)

    Hoffman, Martin D

    2016-01-01

    This work outlines the etiological factors for exercise-related foot blisters and the pertinent prevention strategies related to these causes. Blisters result from shear forces within the epidermis causing cell necrosis. The extent of skin shear is influenced by friction at the skin and other interfaces, various skin characteristics, bony movement, and the shear modulus of the foot ware. The number of shear cycles is another factor in the development of blisters. Key preventative strategies include limiting the number of shear cycles, avoiding moisture and particulate accumulation next to the skin, frequent use of skin lubricants, elimination of pressure points through proper fitting and broken in shoes and callous removal, use of low shear modulus insoles, and induction of skin adaptations through proper training. Other methods requiring further research, but with theoretical support, include the use of taping and low friction patches over high-friction areas, and double-layered or toe socks.

  20. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines1

    Science.gov (United States)

    Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

    2016-01-01

    Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice. PMID:27027676

  1. Priapism in Sickle Cell Anemia: Emerging Mechanistic Understanding and Better Preventative Strategies

    Directory of Open Access Journals (Sweden)

    Genevieve M. Crane

    2011-01-01

    Full Text Available Sickle cell anemia is a common and disabling disorder profoundly affecting mortality as well as quality of life. Up to 35% of men with sickle cell disease are affected by painful, prolonged erections termed ischemic priapism. A priapic episode may result in fibrosis and permanent erectile dysfunction. The severity of sickle cell disease manifestations is variable dependent on a number of contributing genetic factors; however, priapism tends to cluster with other severe vascular complications including pulmonary hypertension, leg ulceration, and overall risk of death. The mechanisms underlying priapism in sickle cell disease have begun to be elucidated including hemolysis-mediated dysregulation of the nitric oxide signaling pathway and dysregulation of adenosine-mediated vasodilation. A better understanding of these mechanisms is leading toward novel preventative strategies. This paper will focus on the mechanisms underlying development of ischemic priapism in sickle cell disease, current acute and preventative treatment strategies, and future directions for improved management of this disorder.

  2. Strategies for prevention of road traffic injuries (RTIs) in Pakistan: situational analysis.

    Science.gov (United States)

    Khan, Adeel Ahmed; Fatmi, Zafar

    2014-05-01

    Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet wearing is poor. National Highway and Motorway Police Ordinance (2000) was one of the few legislative measure so far taken in Pakistan. Using SAF, efforts are required to implement interventions targeting human, vehicle design and also making environment safer for road users.

  3. Systematic review of implementation strategies for risk tables in the prevention of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Ben van Steenkiste

    2008-06-01

    Full Text Available Ben van Steenkiste, Richard Grol, Trudy van der WeijdenCentre for Quality of Care Research, School for Public Health and Primary Care (Caphri, Maastricht University, Maastricht, The NetherlandsBackground: Cardiovascular disease prevention is guided by so-called risk tables for calculating individual’s risk numbers. However, they are not widely used in routine practice and it is important to understand the conditions for their use.Objectives: Systematic review of the literature on professionals’ performance regarding cardiovascular risk tables, in order to develop effective implementation strategies.Selection criteria: Studies were eligible for inclusion if they reported quantitative empirical data on the effect of professional, financial, organizational or regulatory strategies on the implementation of cardiovascular risk tables. Participants were physicians or nurses.Outcome measure: Primary: professionals’ self-reported performance related to actual use of cardiovascular risk tables. Secondary: patients’ cardiovascular risk reduction.Data collection and analysis: An extensive strategy was used to search MEDLINE, EMBASE, CINAHL, and PSYCHINFO from database inception to February 2007.Main results: The review included 9 studies, covering 3 types of implementation strategies (or combinations. Reported effects were moderate, sometimes conflicting and contradictory. Although no clear relation was observed between a particular type of strategy and success or failure of the implementation, promising strategies for patient selection and risk assessment seem to be teamwork, nurse led-clinics and integrated IT support.Conclusions: Implementation strategies for cardiovascular risk tables have been sparsely studied. Future research on implementation of cardiovascular risk tables needs better embedding in the systematic and problem-based approaches developed in implementation science.Keywords: systematic review, implementation, cardiovascular

  4. Obesity in children: risk factors and strategies for its prevention in Peru

    OpenAIRE

    Del Aguila Villar, Carlos M.; Servicio de Endocrinología y Metabolismo, Instituto Nacional de Salud del Niño. Lima, Perú. Facultad de Medicina Hipólito Unanue, Universidad Nacional Federico Villarreal. Lima, Perú. Médico endocrinólogo

    2017-01-01

    The prevalence of overweight and obesity in children and adolescents represents an emerging public health problem in Peru, so it is necessary to be aware of the different risk factors in order to establish suitable and efficient prevention measures. These should contribute to health strategies such as promoting physical activity and a healthy diet to ensure that the infant population reaches adulthood without chronic diseases and with an adequate quality of life. La prevalencia del sobrepe...

  5. Nonsteroidal Anti-Inflammatory Drug-Induced Gastroduodenal Bleeding: Risk Factors and Prevention Strategies

    OpenAIRE

    2010-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely prescribed medications in the World. A frequent complication of NSAID use is gastroduodenal bleeding. Risk factors for gastroduodenal bleeding while on NSAID therapy are age, prior peptic ulcer and co-medication with anti-platelet agents, anticoagulants, glucocorticosteroids and selective serotonin-reuptake inhibitors (SSRI). Prevention strategies for at-risk patients include the use of the lowest effective dose of NSAIDs, co-t...

  6. Risk factors and prevention strategies of non-contact anterior cruciate ligament injuries.

    Science.gov (United States)

    Laible, Catherine; Sherman, Orrin H

    2014-01-01

    In recent years, the number of women playing sports has increased significantly. The passage of Title IX in 1972 had a significant effect in encouraging female participation in sports. This increase in women's sports participation also led to a rise in noncontact anterior cruciate ligament (ACL) injuries. As ACL injuries in young female athletes have be- come a public health issue, much research has been done on risk factors and prevention strategies.

  7. Current Status and Prevention Strategy for Coal-arsenic Poisoning in Guizhou, China

    OpenAIRE

    Li, Dasheng; An, Dong; Zhou, Yunsu; Liu, Jie; Waalkes, Michael P.

    2006-01-01

    Arsenic exposure from burning coal with high arsenic contents occurs in southwest Guizhou, China. Coal in this region contains extremely high concentrations of inorganic arsenic. Arsenic exposure from coal-burning is much higher than exposure from arsenic-contaminated water in other areas of China. The current status and prevention strategies for arsenic poisoning from burning high-arsenic coal in southwest Guizhou, China, is reported here. Over 3,000 arsenic-intoxicated patients were diagnos...

  8. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention

    DEFF Research Database (Denmark)

    Wildgaard, Kim; Ravn, Jesper; Kehlet, Henrik

    2009-01-01

    Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25-60% of patients. Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre-, intra-, and postoperative factors. This review attempts to analyse the metho...... as preventive and treatment strategies. However, intercostal nerve injury seems to be the most important pathogenic factor. Since there is a general agreement on the clinical relevance of PTPS, a proposal for design of future trials is presented....

  9. Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot

    2010-07-01

    Full Text Available Abstract Background Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand. Methods A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY gained were also included. All studies were assessed against quality criteria. Results The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner. Conclusion We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.

  10. Strategies for monitoring and updating clinical practice guidelines: a systematic review

    Directory of Open Access Journals (Sweden)

    Martínez García Laura

    2012-11-01

    Full Text Available Abstract Background Scientific knowledge is in constant change. The flow of new information requires a frequent re-evaluation of the available research results. Clinical practice guidelines (CPGs are not exempted from this phenomenon and need to be kept updated to maintain the validity of their recommendations. The objective of our review is to systematically identify, describe and assess strategies for monitoring and updating CPGs. Study design and setting We conducted a systematic review of studies evaluating one or more methods of updating (with or without monitoring CPGs or recommendations. We searched MEDLINE (PubMed and The Cochrane Methodology Register (The Cochrane Library from 1966 to June 2012. Additionally, we hand-searched reference lists of the included studies and the Guidelines International Network book of abstracts. If necessary, we contacted study authors to obtain additional information. Results We included a total of eight studies. Four evaluated if CPGs were out of date, three updated CPGs, and one continuously monitored and updated CPGs. The most detailed reported phase of the process was the identification of new evidence. As opposed to studies updating guidelines, studies evaluating if CPGs were out of date applied restricted searches. Only one study compared a restricted versus an exhaustive search suggesting that a restricted search is sufficient to assess recommendations’ Validity. One study analyzed the survival time of CPGs and suggested that these should be reassessed every three years. Conclusions There is limited evidence about the optimal strategies for monitoring and updating clinical practice guidelines. A restricted search is likely to be sufficient to monitor new evidence and assess the need to update, however, more information is needed about the timing and type of search. Only the exhaustive search strategy has been assessed for the update of CPGs. The development and evaluation of more efficient

  11. Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis

    Directory of Open Access Journals (Sweden)

    Iraj Sedighi

    2016-06-01

    Full Text Available Context Universal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention. Evidence Acquisition In this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means. Results Primary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups. Conclusions Adding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants.

  12. Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis

    Science.gov (United States)

    Sedighi, Iraj; Karimi, Abdollah; Amanati, Ali

    2016-01-01

    Context Universal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention. Evidence Acquisition In this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means. Results Primary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups. Conclusions Adding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants. PMID:27729960

  13. Wireless sensor networks evaluation for heritage monitoring; in the development of decay detecting techniques for a preventive conservation

    Science.gov (United States)

    Inmaculada Martínez Garrido, María; Fort, Rafael

    2014-05-01

    Monitoring systems using sensor techniques are widely used in the field of cultural heritage. In recent decades, the use of monitoring techniques involving sensors has been evolving in a wide way, because of the increasing importance they have in the observation of decay phenomena in order to establish predictive strategies to promote a preventive conservation. Wireless sensor networks, formed by a group of sensors nodes or monitoring points which have wireless communication, allow us a great number of nonexistent advantages until now since they have an easier way of installation, maintenance and fault detection versus wired networks previously used, with the costs reduction and the increase of reliability in measurement systems that this fact entails. To assess the suitability of wireless sensor networks it is necessary to take into account many factors since heritage is a very demanding field. This paper evaluates the quality of communications in various deployments of heritage interest, both architectural and natural heritage, of a competitive wireless sensor networks platform which has been subjected to different conditions of range in demanding monitoring environments. To measure the communication quality, multiple parameters for the characterization of the received signal and the links were taken into account, such as the RSSI, which measures the power level of the received signal and the percentage of correctly received messages, among others. Additionally, it will be also of relevance to achieve a long-term and low energy monitoring, since measured parameters do not undergo significant variations in short periods of study, so that the evaluation includes energy and consumption aspects of wireless sensor networks systems, establishing a final assessment methodology for this type of technology applied to the heritage monitoring field. Furthermore some design software / hardware aspects are evaluated for an appropriate validation of the system from the point

  14. [Health promotion as a strategy for the prevention of drug use].

    Science.gov (United States)

    Büchele, Fátima; Coelho, Elza Berger Salema; Lindner, Sheila Rubia

    2009-01-01

    This article addresses health promotion and prevention of drug use, reviewing approaches and conceptualizations without specifying determinate classes of drugs and their licitness or illicitness. The objective of this paper is to describe the prevention of drug use and to raise pertinent aspects of drug abuse for the construction of a health promotion strategy. As refers to drug use, Brazil has invested in the formulation of policies for health promotion, protection and recovery, however humanized, inter-sectorial, decentralized, integrated, democratic and active approaches need to be implemented. This review shows the need for more discussions about the prevention of drug use involving educators, parents and the community, in a structured multiple process integrating and involving institutions and sectors in the co-responsibility to promote the health of the population in this sense. This article also shows our concern with finding ways that contribute to the implementation of public policies as refers to drug addiction.

  15. Landscape and bio- geochemical strategy for monitoring transformation and reclamation of the soil mining sites

    Science.gov (United States)

    Korobova, Elena

    2010-05-01

    Sites of active or abandoned mining represent areas of considerable technogenic impact and need scientifically ground organization of their monitoring and reclamation. The strategy of monitoring and reclamation depends on the scale and character of the physical, chemical and biological consequences of the disturbances. The geochemical studies for monitoring and rehabilitation of the career-dump complexes should methodically account of formation of the particular new landforms and the changes in circulation of the remobilized elements of the soil cover. However, the general strategy should account of both the initial and transformed landscape geochemical structure of the area with due regard to the natural and new content of chemical elements in the environmental components. For example the tailings and waste rocks present new geochemical fields with specifically different concentration of chemical elements that cause formation of new geochemical barriers and landscapes. The way of colonization of the newly formed landscapes depends upon the new geochemical features of the technogenic environment and the adaptive ability of local and intrusive flora. The newly formed biogeochemical anomalies need organization of permanent monitoring not only within the anomaly itself but also of its impact zones. Spatial landscape geochemical monitoring combined with bio-geochemical criteria of threshold concentrations seems to be a helpful tool for decision making on reclamation and operation of the soil mining sites to provide a long-term ecologically sustainable development of the impact zone as a whole.

  16. Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods.

    Science.gov (United States)

    Brandt, Mary; Brown, Clive; Burkhart, Joe; Burton, Nancy; Cox-Ganser, Jean; Damon, Scott; Falk, Henry; Fridkin, Scott; Garbe, Paul; McGeehin, Mike; Morgan, Juliette; Page, Elena; Rao, Carol; Redd, Stephen; Sinks, Tom; Trout, Douglas; Wallingford, Kenneth; Warnock, David; Weissman, David

    2006-06-09

    Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.

  17. Effectiveness and cost-effectiveness of behavioural strategies in the prevention of cigarette smoking

    Directory of Open Access Journals (Sweden)

    Willich, Stefan N.

    2008-10-01

    Full Text Available Background: The hazardous health effects of smoking and second hand smoke have been confirmed in numerous studies. For Germany, the mortality attributable to smoking is estimated at 110,000 to 140,000 deaths per year, associated with annual smoking-related costs of 17 to 21 billion euro. Because the majority of smokers initiate this habit early in life, behavioural preventive strategies usually tried to prevent the uptake of smoking among children and youths. Objectives: The goal of this HTA is to summarise the current literature on behavioural strategies for smoking prevention and to evaluate their medical effectiveness/efficacy and cost-effectiveness as well as the ethical, social and legal implications of smoking prevention programs. In addition, this report aims to compare the effectiveness and efficacy of different intervention components and to evaluate the reliability of results in 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 August 2001 and August 2006 targeting youths up to 18 years old. The methodological quality of included studies was assessed according to pre-defined quality criteria, based on the criteria of evidence-based medicine. Results: Among 3,580 publications 37 medical studies met the inclusion criteria. Overall study quality was satisfactory but only half the studies reported smoking uptake as an outcome, while the remaining studies reported alternative outcome parameters. The follow-up duration varied between twelve and 120 months. Although overall effectiveness of prevention programs showed considerable heterogeneity, there was evidence for the long-term effectiveness of behavioural smoking prevention programs. However, the

  18. Performance deterioration modeling and optimal preventive maintenance strategy under scheduled servicing subject to mission time

    Directory of Open Access Journals (Sweden)

    Li Dawei

    2014-08-01

    Full Text Available Servicing is applied periodically in practice with the aim of restoring the system state and prolonging the lifetime. It is generally seen as an imperfect maintenance action which has a chief influence on the maintenance strategy. In order to model the maintenance effect of servicing, this study analyzes the deterioration characteristics of system under scheduled servicing. And then the deterioration model is established from the failure mechanism by compound Poisson process. On the basis of the system damage value and failure mechanism, the failure rate refresh factor is proposed to describe the maintenance effect of servicing. A maintenance strategy is developed which combines the benefits of scheduled servicing and preventive maintenance. Then the optimization model is given to determine the optimal servicing period and preventive maintenance time, with an objective to minimize the system expected life-cycle cost per unit time and a constraint on system survival probability for the duration of mission time. Subject to mission time, it can control the ability of accomplishing the mission at any time so as to ensure the high dependability. An example of water pump rotor relating to scheduled servicing is introduced to illustrate the failure rate refresh factor and the proposed maintenance strategy. Compared with traditional methods, the numerical results show that the failure rate refresh factor can describe the maintenance effect of servicing more intuitively and objectively. It also demonstrates that this maintenance strategy can prolong the lifetime, reduce the total lifetime maintenance cost and guarantee the dependability of system.

  19. Building communication strategy on health prevention through the human-centered design

    Directory of Open Access Journals (Sweden)

    Karine de Mello Freire

    2016-03-01

    Full Text Available It has been identified a latent need for developing efficient communication strategies for prevention of diseases and also, design as a potential agent to create communications artifacts that are able to promote self-care. In order to analyze a design process that develops this kind of artifact, an action research in IAPI Health Center in Porto Alegre was done. The action’s goal was to design a strategy to promote self-care to prevent cervical cancer. The process was conducted from the human centered design approach - HCD, which seeks to create solutions desirable for people and feasible for organizations from three main phases: a Hear, in which inspirations are originated from stories collected from people; b Create, which aims to translate these knowledge into prototypes; and, c Deliver, where the prototypes are tested and developed with users. Communication strategies were supported by design studies about visual-verbal rhetoric. As results, this design approach has shown adequate to create communication strategies targeted at self-care behaviors, aiming to empower users to change their behavior.

  20. The Changing Landscape of HIV Prevention in the United States: Health Department Experiences and Local Adaptations in Response to the National HIV/AIDS Strategy and High-Impact Prevention Approach.

    Science.gov (United States)

    Fisher, Holly H; Essuon, Aba; Hoyte, Tamika; Shapatava, Ekaterine; Shelley, Gene; Rios, Aisha; Beane, Stephanie; Bourgeois, Stacey; Dunbar, Erica; Sapiano, Tobey

    2017-05-10

    HIV prevention has changed substantially in recent years due to changes in national priorities, biomedical advances, and health care reform. Starting in 2010, motivated by the National HIV/AIDS Strategy (NHAS) and the Centers for Disease Control and Prevention's (CDC's) High-Impact Prevention (HIP), health departments realigned resources so that cost-effective, evidence-based interventions were targeted to groups at risk in areas most affected by HIV. This analysis describes how health departments in diverse settings were affected by NHAS and HIP. We conducted interviews and a consultation with health departments from 16 jurisdictions and interviewed CDC project officers who monitored programs in 5 of the jurisdictions. Participants were asked to describe changes since NHAS and HIP and how they adapted. We used inductive qualitative analysis to identify themes of change. Health departments improved their HIV prevention practices in different ways. They aligned jurisdictional plans with NHAS and HIP goals, increased local data use to monitor program performance, streamlined services, and strengthened partnerships to increase service delivery to persons at highest risk for infection/transmission. They shifted efforts to focus more on the needs of people with diagnosed HIV infection, increased HIV testing and routine HIV screening in clinical settings, raised provider and community awareness about preexposure prophylaxis, and used nontraditional strategies to successfully engage out-of-care people with diagnosed HIV infection. However, staff-, provider-, and data-related barriers that could slow scale-up of priority programs were consistently reported by participants, potentially impeding the ability to meet national goals. Findings suggest progress toward NHAS and HIP goals has been made in some jurisdictions but highlight the need to monitor prevention programs in different contexts to identify areas for improvement and increase the likelihood of national success

  1. Strategies for injury prevention in Brazilian football: Perceptions of physiotherapists and practices of premier league teams.

    Science.gov (United States)

    Meurer, Maurício Couto; Silva, Marcelo Faria; Baroni, Bruno Manfredini

    2017-07-25

    To describe the physiotherapists perceptions and the current practices for injury prevention in elite football (soccer) clubs in Brazil. Cross-sectional study. Group of Science in Sports & Exercise, Federal University of Healthy Sciences of Porto Alegre (Brazil). 16 of the 20 football clubs involved in the Brazilian premier league 2015. Physiotherapists answered a structured questionnaire. Most physiotherapists (∼88%) were active in design, testing and application of prevention programs. Previous injury, muscle imbalance, fatigue, hydration, fitness, diet, sleep/rest and age were considered "very important" or "important" injury risk factors by all respondents. The methods most commonly used to detect athletes' injury risk were: monitoring of biochemical markers (100% of teams), isokinetic dynamometry (81%), questionnaires (75%), functional movement screen (56%), fleximetry (56%) and horizontal jump tests (50%). All clubs used strength training, functional training, core exercises and balance/proprioception exercises in their injury prevention program; and Nordic hamstring exercise and other eccentric exercises were used by 94% of clubs. "FIFA 11+" prevention program was adapted by 88% of clubs. Physiotherapists perceptions and current practices of injury prevention within Brazilian elite football clubs were similar to those employed in developed countries. There remains a gap between clinical practice and scientific evidence in high performance football. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Adaptive backstepping sliding mode control with fuzzy monitoring strategy for a kind of mechanical system.

    Science.gov (United States)

    Song, Zhankui; Sun, Kaibiao

    2014-01-01

    A novel adaptive backstepping sliding mode control (ABSMC) law with fuzzy monitoring strategy is proposed for the tracking-control of a kind of nonlinear mechanical system. The proposed ABSMC scheme combining the sliding mode control and backstepping technique ensure that the occurrence of the sliding motion in finite-time and the trajectory of tracking-error converge to equilibrium point. To obtain a better perturbation rejection property, an adaptive control law is employed to compensate the lumped perturbation. Furthermore, we introduce fuzzy monitoring strategy to improve adaptive capacity and soften the control signal. The convergence and stability of the proposed control scheme are proved by using Lyaponov's method. Finally, numerical simulations demonstrate the effectiveness of the proposed control scheme.

  3. Monitor automatic gauge control strategy with a Smith predictor for steel strip rolling

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The simplified transfer function diagram block for a monitor automatic gauge control (Mon-AGC) system of strip steel rolling process was investigated.The new notion of strip sample length was given.In this way,the delay time varying with the rolling speed was evaded.After a Smith predictor was used to monitor the AGC system,the control laws were deduced for both proportional and integral regulators.The control strategies showed that by choosing the controller parameter P=∞ for both control algorithms each regulator could compensate the whole strip gage error in the first control step.The result shows that the integral algorithm is more controllable for the system regulating process and has a better steady-state precision than the proportional regulator.Compared with the traditional control strategy,the new control laws have a faster response speed and a higher steady-state precision.

  4. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

    Science.gov (United States)

    Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

    2014-08-01

    Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

  5. Different strategies for sports injury prevention in an America's Cup yachting crew.

    Science.gov (United States)

    Hadala, Michal; Barrios, Carlos

    2009-08-01

    To analyze the effectiveness in reducing the number of sport injuries after application of different strategies of preventive physiotherapy during competition periods in an America's Cup yachting crew. A prospective physiotherapy intervention study during competition periods for three seasons was conducted on an America's Cup yachting race crew of 30 professional sailors. In the first two acts (2004), athletes did not receive any preventive physiotherapy. In the two acts celebrated in 2005, preventive intervention (phase 1) consisted of stretching exercises before the yacht race and preventative taping. During the four acts corresponding to the 2006 season, the physiotherapy program was implemented adding articular mobilization before competition, ice baths after competition, and kinesiotaping (phase 2). In the last act and the Louis Vuitton Cup (2007), a recovery program with "core stability" exercises, postcompetition stretching exercises, and 12 h of compressive clothing were added (phase 3). In the preintervention phase (2004), the rate of injured sailors/competition day was 1.66, decreasing to 0.60 in 2007 (phase 3). The number of athletes with more than one injury was significantly reduced from 53% (8 of 15) to 6.5% (2 of 12). In the preintervention period, mastmen, grinders, and bowmen showed a rate of 2.88 injuries per competition day. After phase 3, this group only suffered 0.35 injuries per competition day. The implementation of a program of preventive physiotherapy decreased the risk of injuries suffered during competition by an America's Cup yacht crew.

  6. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

    Science.gov (United States)

    Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

    2014-09-01

    Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

  7. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

    Science.gov (United States)

    Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

    2015-07-01

    Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. 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.

  8. The strategy for improving water-quality monitoring in the United States; final report of the Intergovernmental Task Force on Monitoring Water Quality; technical appendices

    Science.gov (United States)

    ,

    1995-01-01

    The Intergovernmental Task Force on Monitoring Water Quality (ITFM) prepared this report in collaboration with representatives of all levels of government and the private sector. The report recommends a strategy for nationwide water-quality monitoring and technical monitoring improvements to support sound water-quality decisionmaking. The strategy is intended to achieve a better return on public and private investments in monitoring, environmental protection, and natural resources management. It is also designed to expand the base of information useful to a variety of users at multiple geographic scales. Institutional and technical changes are needed to improve water-quality monitoring and to meet the full range of monitoring requirements. Monitoring must be incorporated as a critical element of program planning, implementation, and evaluation. The strategy includes recommendations in many key elements, such as the development of goal-oriented monitoring and indicators, institutional collaboration, and methods comparability. Initial actions have been taken to implement the strategy. Several Federal agencies have jointly purchased and shared remotely sensed land-cover information needed for water assessment. Major agency data systems are using common data-element names and reference tables that will ensure easy sharing of data. A number of States have held meetings with collectors of water information to initiate statewide monitoring strategies. New monitoring guidance has been developed for Federal water-quality grants to States. Many State offices have changed monitoring programs to place emphasis on priority watersheds and to improve assessment of water quality. As the competition increases for adequate supplies of clean water, concerns about public health and the environment escalate, and more demands are placed on the water information infrastructure. To meet these demands, the collaborative approach has already produced benefits, which will continue to grow as

  9. Distributed Monitoring for Prevention of Cascading Failures in Operational Power Grids

    CERN Document Server

    Warnier, Martijn; Koç, Yakup; Pauwels, Eric

    2015-01-01

    Electrical power grids are vulnerable to cascading failures that can lead to large blackouts. Detection and prevention of cascading failures in power grids is impor- tant. Currently, grid operators mainly monitor the state (loading level) of individual components in power grids. The complex architecture of power grids, with many interdependencies, makes it difficult to aggregate data provided by local compo- nents in a timely manner and meaningful way: monitoring the resilience with re- spect to cascading failures of an operational power grid is a challenge. This paper addresses this challenge. The main ideas behind the paper are that (i) a robustness metric based on both the topology and the operative state of the power grid can be used to quantify power grid robustness and (ii) a new proposed a distributed computation method with self-stabilizing properties can be used to achieving near real-time monitoring of the robustness of the power grid. Our con- tributions thus provide insight into the resilience wit...

  10. The role of executive function in children’s source monitoring with varying retrieval strategies

    Directory of Open Access Journals (Sweden)

    Becky eEarhart

    2014-05-01

    Full Text Available Previous research on the relationship between executive function and source monitoring in young children has been inconclusive, with studies finding conflicting results about whether working memory and inhibitory control are related to source-monitoring ability. In this study, the role of working memory and inhibitory control in recognition memory after exposure to multiple sources, and in source monitoring with two different retrieval strategies were examined. Children (N = 263 aged 4 to 8 participated in science activities with two sources. They were later given a recognition and source-monitoring test, and completed measures of working memory and inhibitory control. During the source-monitoring test, half of the participants were asked about sources serially (one after the other whereas the other half of the children were asked about sources in parallel (considering both sources simultaneously. Results demonstrated that working memory was a predictor of source-monitoring accuracy in both conditions, but inhibitory control was only related to source accuracy in the parallel condition. When age was controlled, these relationships were no longer significant, suggesting that a more general cognitive development factor is a stronger predictor of source monitoring than executive function alone. Interestingly, the children aged 4 to 6 years made more accurate source decisions in the parallel condition compared to those in the serial condition. The older children (aged 7 to 8 were more accurate than the younger children, and their accuracy did not differ as a function of interview condition. Suggestions are provided to guide further research in this area that will clarify the diverse results of previous studies showing executive function is a cognitive prerequisite for effective source monitoring.

  11. The role of executive function in children's source monitoring with varying retrieval strategies

    Science.gov (United States)

    Earhart, Becky; Roberts, Kim P.

    2014-01-01

    Previous research on the relationship between executive function and source monitoring in young children has been inconclusive, with studies finding conflicting results about whether working memory and inhibitory control are related to source-monitoring ability. In this study, the role of working memory and inhibitory control in recognition memory and source monitoring with two different retrieval strategies were examined. Children (N = 263) aged 4–8 participated in science activities with two sources. They were later given a recognition and source-monitoring test, and completed measures of working memory and inhibitory control. During the source-monitoring test, half of the participants were asked about sources serially (one after the other) whereas the other half of the children were asked about sources in parallel (considering both sources simultaneously). Results demonstrated that working memory was a predictor of source-monitoring accuracy in both conditions, but inhibitory control was only related to source accuracy in the parallel condition. When age was controlled these relationships were no longer significant, suggesting that a more general cognitive development factor is a stronger predictor of source monitoring than executive function alone. Interestingly, the children aged 4–6 years made more accurate source decisions in the parallel condition than in the serial condition. The older children (aged 7–8) were overall more accurate than the younger children, and their accuracy did not differ as a function of interview condition. Suggestions are provided to guide further research in this area that will clarify the diverse results of previous studies examining whether executive function is a cognitive prerequisite for effective source monitoring. PMID:24847302

  12. Breast cancer prevention strategies in lobular carcinoma in situ: A decision analysis.

    Science.gov (United States)

    Wong, Stephanie M; Stout, Natasha K; Punglia, Rinaa S; Prakash, Ipshita; Sagara, Yasuaki; Golshan, Mehra

    2017-07-15

    Women diagnosed with lobular carcinoma in situ (LCIS) have a 3-fold to 10-fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk-reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS. A Markov simulation model was constructed to determine average LE and quality-adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk-reduction strategies. Probabilities for invasive breast cancer, breast cancer-specific mortality, other-cause mortality and the effectiveness of preventive strategies were derived from published studies and from the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Assuming a breast cancer incidence from 1.02% to 1.37% per year under active surveillance, a woman aged 50 years diagnosed with LCIS would have a total LE of 32.78 years and would gain 0.13 years (1.6 months) in LE by adding chemoprevention and 0.25 years (3.0 months) in LE by adding bilateral prophylactic mastectomy. After quality adjustment, chemoprevention resulted in the greatest QALE for women ages 40 to 60 years at LCIS diagnosis, whereas surveillance remained the preferred strategy for optimizing QALE among women diagnosed at age 65 years and older. In this model, among women with a diagnosis of LCIS, breast cancer prevention strategies only modestly affected overall survival, whereas chemoprevention was modeled as the preferred management strategy for optimizing invasive disease-free survival while prolonging QALE form women younger than 65 years. Cancer 2017;123:2609-17. © 2017 American Cancer Society. © 2017 American Cancer Society.

  13. Short-circuit prevention strategies in organic light-emitting diodes and solar cells

    Science.gov (United States)

    Michels, Jasper J.; Jolt Oostra, A.; Blom, Paul W. M.

    2016-08-01

    Short-circuit prevention and repair strategies are essential to allow for upscaled production of organic electronic devices based on thin-film production technology. Occurrence of short circuits is a consequence of manufacturing imperfections and particle contamination. After giving a concise review of short-circuit prevention methods for organic thin-film devices in the open literature of the past decade, this overview article summarizes our recent work on short-circuit prevention in organic light-emitting diodes and organic solar cells by chemical oxidation methods. Our main strategy is based on self-aligned disruption of the conductivity of exposed areas of the typically applied hole transport material poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) by aqueous sodium hypochlorite, prior to cathode deposition. The ten orders of magnitude decrease in local conductivity obtained proves sufficient to let deliberately flawed devices operate at pristine performance levels. We next show that in the case of organic solar cells based on a lithium fluoride/aluminium cathode the shunting junctions can be made sufficiently resistive to allow for near unflawed operation, without applying wet treatment.

  14. Planning cancer prevention strategies based on epidemiologic characteristics: an Egyptian example.

    Science.gov (United States)

    Soliman, A S; Levin, B; El-Badawy, S; Nasser, S S; Raouf, A A; Khaled, H; El-Hattab, O H; Chamberlain, R M

    2001-01-01

    We describe the epidemiology, cancer prevention strategies, and educational messages to be learned from four characteristic cancers in Egypt: urinary bladder, liver, lung, and early-onset colorectal cancers. For bladder cancer, effective and convenient treatment of schistosomiasis, using social marketing and mass media in public and medical education has contributed dramatically to primary prevention of bladder cancer in Egypt. For liver cancer, educating hospital administrators to remove structural barriers to good practice may help the control of hepatitis transmission and related liver cancer. For lung cancer, the 50-year American experience for controlling tobacco smoking, beginning with physicians, could be very effective in Egypt and other countries with increasing smoking rates in the young so as to avert the expected epidemics of lung cancer. For colorectal cancer, more attention to physician and public education about the importance of interviewing colorectal cancer patients about a family history of cancer and the screening of at-risk families could be very effective in early detection of colorectal cancer. Countries with similar cancer epidemiology experience should make use of successful cancer prevention and education strategies that could be translated from the Egyptian experience.

  15. Availability and utilization of malaria prevention strategies in pregnancy in eastern India

    Directory of Open Access Journals (Sweden)

    Yeboah-Antwi Kojo

    2010-09-01

    Full Text Available Abstract Background Malaria in pregnancy in India, as elsewhere, is responsible for maternal anemia and adverse pregnancy outcomes such as low birth weight and preterm birth. It is not known whether prevention and treatment strategies for malaria in pregnancy (case management, insecticide-treated bednets, intermittent preventive therapy are widely utilized in India. Methods This cross-sectional study was conducted during 2006-2008 in two states of India, Jharkhand and Chhattisgarh, at 7 facilities representing a range of rural and urban populations and areas of more versus less stable malaria transmission. 280 antenatal visits (40/site were observed by study personnel coupled with exit interviews of pregnant women to assess emphasis upon, availability and utilization of malaria prevention practices by health workers and pregnant women. The facilities were assessed for the availability of antimalarials, lab supplies and bednets. Results All participating facilities were equipped to perform malaria blood smears; none used rapid diagnostic tests. Chloroquine, endorsed for chemoprophylaxis during pregnancy by the government at the time of the study, was stocked regularly at all facilities although the quantity stocked varied. Availability of alternative antimalarials for use in pregnancy was less consistent. In Jharkhand, no health worker recommended bednet use during the antenatal visit yet over 90% of pregnant women had bednets in their household. In Chhattisgarh, bednets were available at all facilities but only 14.4% of health workers recommended their use. 40% of the pregnant women interviewed had bednets in their household. Only 1.4% of all households owned an insecticide-treated bednet; yet 40% of all women reported their households had been sprayed with insecticide. Antimalarial chemoprophylaxis with chloroquine was prescribed in only 2 (0.7% and intermittent preventive therapy prescribed in only one (0.4% of the 280 observed visits

  16. Provider use of preventive strategies for radiocontrast nephropathy in high-risk patients.

    Science.gov (United States)

    Weisbord, Steven D; Bruns, Frank J; Saul, Melissa I; Palevsky, Paul M

    2004-01-01

    Radiocontrast nephropathy (RCN) is a common and costly form of acute renal failure. Current preventative strategies include the use of intravenous (IV) fluids and the discontinuation of nephrotoxic medications at the time of radiocontrast administration. We sought to determine whether providers employ these strategies in high-risk patients to limit the development of RCN. High-risk patients undergoing procedures using radiocontrast media over a 12-month period were identified. Medical records were reviewed for all subjects who developed RCN and a randomly selected 25% of patients without RCN. Patients with a contraindication to IV volume expansion were excluded. Medical records of the remaining patients were reviewed to determine whether IV fluids were administered and whether NSAIDs or COX-2 inhibitors were prescribed at the time of contrast administration. RCN developed in 8% of patients overall. Of 144 patients eligible for IV volume expansion, 16% failed to receive any IV fluids. When IV fluids were employed, their dose and timing of administration varied significantly by treating specialty and procedure. NSAIDs and COX-2 inhibitors were prescribed to 8% of patients. Commonly accepted strategies for the prevention of RCN are underutilized. Quality improvement efforts are needed to increase the use of these two simple prophylactic measures. Copyright 2004 S. Karger AG, Basel

  17. Current status and prevention strategy for coal-arsenic poisoning in Guizhou, China.

    Science.gov (United States)

    Li, Dasheng; An, Dong; Zhou, Yunsu; Liu, Jie; Waalkes, Michael P

    2006-09-01

    Arsenic exposure from burning coal with high arsenic contents occurs in southwest Guizhou, China. Coal in this region contains extremely high concentrations of inorganic arsenic. Arsenic exposure from coal-burning is much higher than exposure from arsenic-contaminated water in other areas of China. The current status and prevention strategies for arsenic poisoning from burning high-arsenic coal in southwest Guizhou, China, is reported here. Over 3,000 arsenic-intoxicated patients were diagnosed based on skin lesions and urinary arsenic excretion. Non-cancerous toxicities and malignancies were much more common and severe in these patients than in other arsenic-affected populations around the world. The high incidence of cancer and arsenic-related mortality in this cohort is alarming. Chelation therapy was performed but the long-term therapeutic effects are not satisfactory. The best prevention strategy is to eliminate arsenic exposure. Funds from the Chinese Government are currently available to solve this arsenic exposure problem. Strategies include the installation of vented stoves, the use of marsh gas to replace coal, health education, the improvement of nutritional status, and the use of various therapies to treat arsenic-induced skin and liver diseases.

  18. Strategies to prevent hepatitis B virus infection in China: immunization, screening, and standard medical practices.

    Science.gov (United States)

    Zhang, Chunyu; Zhong, Yuesi; Guo, Liping

    2013-02-01

    China has one of the world's highest rates of hepatitis B infection. Over the past 20 years, a series of strategies have been implemented to prevent infection with the hepatitis B virus (HBV) in China. These strategies include hepatitis B (hepB) immunization for susceptible populations such as infants and young children and for high-risk populations such as health care workers and patients, premarital health care for couples of childbearing age, and standard medical practices. A series of measures implemented by the Chinese government caused the HBV infection rate in China to decrease from 9.75% in 1992 to 7.2% in 2006. However, a report on infectious diseases indicated that more than 1 million people in China were infected with hepB in 2011. There is room for improvement. The current work analyzed the current status of and challenges for strategies to prevent HBV infection in China. This work also recommends clear guidance regarding hepB immunization for parents in rural areas, more flexible premarital health care, health education for both patients and health care workers, and routine HBV screening for high-risk health care workers.

  19. Current Status and Prevention Strategy for Coal-arsenic Poisoning in Guizhou, China

    Science.gov (United States)

    An, Dong; Zhou, Yunsu; Liu, Jie; Waalkes, Michael P.

    2006-01-01

    Arsenic exposure from burning coal with high arsenic contents occurs in southwest Guizhou, China. Coal in this region contains extremely high concentrations of inorganic arsenic. Arsenic exposure from coal-burning is much higher than exposure from arsenic-contaminated water in other areas of China. The current status and prevention strategies for arsenic poisoning from burning high-arsenic coal in southwest Guizhou, China, is reported here. Over 3,000 arsenic-intoxicated patients were diagnosed based on skin lesions and urinary arsenic excretion. Non-cancerous toxicities and malignancies were much more common and severe in these patients than in other arsenic-affected populations around the world. The high incidence of cancer and arsenic-related mortality in this cohort is alarming. Chelation therapy was performed but the long-term therapeutic effects are not satisfactory. The best prevention strategy is to eliminate arsenic exposure. Funds from the Chinese Government are currently available to solve this arsenic exposure problem. Strategies include the installation of vented stoves, the use of marsh gas to replace coal, health education, the improvement of nutritional status, and the use of various therapies to treat arsenic-induced skin and liver diseases. PMID:17366768

  20. Multi-Hazards Geophysical Monitoring Through the Eastern Caribbean Islands arc: Strategy, Challenges and Future Development

    Science.gov (United States)

    Fournier, N.; Lynch, L.; Robertson, R.; Latchman, J.; Mohais, R.; Ramsingh, C.

    2007-05-01

    The Seismic Research Unit (SRU), at the University of the West Indies, St Augustine, Trinidad, W.I., is responsible for monitoring and studying geological hazards in the English and Dutch speaking islands nestled along the ocean-ocean plate convergence zone in the Eastern Caribbean. The Unit operates a multi-hazards monitoring network that spans over 15 islands. Geophysical monitoring techniques include 11 broadband and 44 short period seismic stations, 4 accelerometers, 4 continuous GPS stations (cGPS) and over 50 ground-deformation benchmarks. This seismic network caters for general earthquake surveillance and study as well as for volcano early-warning. As part of the recent trust to improve tsunami surveillance capabilities in the Caribbean the unit has embarked on a program to upgrade a subset of the seismograph network. Near real-time satellite communications will be installed to improve the present network that is built around terrestrial Internet and telephone media. Additional strong motion accelerometers will also be operated alongside the broadband sensors at the upgraded stations to provide the necessary specifications for tsunami detection. Through real- time data exchanged with adjacent and global networks that are involved in the effort to establish a Tsunami Warning System for the Caribbean and adjacent regions, the Unit's capacity to monitor multiple hazard via the seismological method will be significantly improved. The geodetic monitoring program is a hybrid of near real-time data acquisition and static field surveys. It is principally geared towards volcano ground deformation monitoring. The main challenge while monitoring volcano ground deformation in small islands is the limited control on the reference station which are often located within the potential deformation field (versus been ideally outside any volcano related deformation field). As a result, SRU's strategy is to control reference stations in every island by long-baselines processing

  1. High parental monitoring prevents adolescents from engaging in risky sexual practices in Harar, Ethiopia

    Directory of Open Access Journals (Sweden)

    Yadeta Dessie

    2014-11-01

    Full Text Available Background: Emerging findings have shown that high parental monitoring of adolescents’ sexual and reproductive health (SRH communications between parents and adolescents and good parenting styles prevent adolescents from engaging in risky sexual practices. Objective: The aim of this study was to examine the associations of parental monitoring, parent–adolescent SRH communications, and parenting styles with risky sexual practices among adolescents in Harar, Ethiopia. Designs: This was a cross-sectional study conducted on adolescents aged 13–18 who had sexual initiations. Adolescents who failed to use any contraceptive method and/or condom during last sexual intercourse and who experienced multiple sexual partners in the 12 months prior to the study were taken as ‘at risk’. In view of these, the adolescents risk count ranged from zero to three – greater number indicates higher count of risky sexual practices. Poisson regression model was used to examine the associations and p<0.05 indicated a statistical significance. Results: It was found out that 301 of 633 (47.55%; 95% CI=43.62%, 51.45% adolescents experienced one or more risky sexual practices. High parental monitoring compared to low decreases the Incidence Rate of engaging in risky sexual practices by 28% (adjusted incidence rate ratio, or IRR=0.72; 95% CI=0.520, 0.986. Those who had a satisfactory level of SRH communications with their parents compared to poor communicators experianced less incidence rate of risky sexual practices which was marginal (adjusted IRR=0.82; 95% CI=0.637, 1.051. Conclusions: A significant proportion of the adolescents engaged in one or more risky sexual practices. Importantly, high parental monitoring decreases the likelihood of these risky practices. Therefore, parents need to be encouraged to keep an eye on their young children.

  2. [A strategy for preventing health injuries due to observing the solar eclipse in Mexico].

    Science.gov (United States)

    Juan-López, M; Peña-Corona, M P

    1993-01-01

    A total solar eclipse was watched by almost [corrected] 50 million people in the Mexican Republic on July 11, 1991. Cases of solar retinitis, which can even lead to permanent loss of visual function, have been reported in the international literature. The institutions of the National Health System employed a strategy for the prevention of risks and health damages caused by direct observation of the phenomenon, which implied the elaboration of a technical norm concerning the manufacturing of sun filters, the diffusion of preventive actions through the use of mass media, the detection and prompt care of cases and the establishment of an ophthalmologic care system and epidemiological surveillance system. The result was the detection of 21 moderate cases of solar retinitis, all of which recovered their full visual function after four months. The present article reports the implemented actions and the details of the cases.

  3. An injury prevention strategy for teen restaurant workers. Washington State's ProSafety project.

    Science.gov (United States)

    Ward, Julie A; de Castro, A B; Tsai, Jenny Hsin-Chun; Linker, Darren; Hildahl, Lyle; Miller, Mary E

    2010-02-01

    High levels of youth employment, workplace hazards, and characteristics unique to adolescents contribute to a relatively high incidence of injuries among teens in the restaurant industry. This article discusses the ProSafety model of injury prevention among teen restaurant workers. Through integration with an existing career and technical education program, the ProSafety project seeks to prevent occupational injuries among the teen worker population through classroom safety education and internship skills reinforcement. ProSafety is the product of an innovative collaboration with occupational health nurses, business professionals, educators, and government. Its approach is derived from Social Cognitive Theory, is consistent with key values and strategies of occupational health nurses, and provides lessons for practitioners seeking to reduce occupational injuries in food service or among other populations of adolescent workers.

  4. ABCs of Evidence-based Anterior Cruciate Ligament Injury Prevention Strategies in Female Athletes

    Science.gov (United States)

    Sugimoto, Dai; Myer, Gregory D.; Micheli, Lyle J.; Hewett, Timothy E.

    2015-01-01

    Context Anterior cruciate ligament (ACL) injury is a major concern in physically active females. Although ACL reconstruction techniques have seen significant advances in recent years, risk associated with re-injury and future osteoarthritis remains a major concern. Thus, prevention of ACL injury is a logical step to protect and preserve healthy knee joints in young athletes. The current report aims to summarize a list of evidence-based prevention strategies to reduce ACL injury in female athletes. A list of six critical principles, which come from documented, large scale clinical trial studies and further analyses, were presented with ABC format including age, biomechanics, compliance, dosage, exercise, and feedback. Also, a grade for evidence and implications of future research is noted. Finally, in the conclusion section, importance of collaborative efforts from healthcare practitioners, researchers, and personnel associated with athletics is addressed. PMID:26042191

  5. Preventive Strategies against Bleeding due to Nonvitamin K Antagonist Oral Anticoagulants

    Directory of Open Access Journals (Sweden)

    Lessire Sarah

    2014-01-01

    Full Text Available Dabigatran etexilate (DE, rivaroxaban, and apixaban are nonvitamin K antagonist oral anticoagulants (NOACs that have been compared in clinical trials with existing anticoagulants (warfarin and enoxaparin in several indications for the prevention and treatment of thrombotic events. All NOACs presented bleeding events despite a careful selection and control of patients. Compared with warfarin, NOACs had a decreased risk of intracranial hemorrhage, and apixaban and DE (110 mg BID had a decreased risk of major bleeding from any site. Rivaroxaban and DE showed an increased risk of major gastrointestinal bleeding compared with warfarin. Developing strategies to minimize the risk of bleeding is essential, as major bleedings are reported in clinical practice and specific antidotes are currently not available. In this paper, the following preventive approaches are reviewed: improvement of appropriate prescription, identification of modifiable bleeding risk factors, tailoring NOAC’s dose, dealing with a missed dose as well as adhesion to switching, bridging and anesthetic procedures.

  6. Are bedtime nutritional strategies effective in preventing nocturnal hypoglycaemia in patients with type 1 diabetes?

    Science.gov (United States)

    Desjardins, K; Brazeau, A-S; Strychar, I; Rabasa-Lhoret, R

    2014-07-01

    Hypoglycaemia remains the major limiting factor for adequate diabetes control for patients with type 1 diabetes (T1D), especially during the night-time. Although nutritional strategies for nocturnal hypoglycaemia (NH) prevention are regularly suggested in clinical practice, there is no evidence-based recommendation for the usefulness and optimal composition of a bedtime snack. The aim of this narrative review was to analyse the current state of knowledge on nutritional strategies to prevent NH in individuals with T1D. A literature search was conducted, using PubMed and Medline (1946 to 2013); 16 studies were retrieved. Overall, the level of evidence was low. Results indicated that a calibrated bedtime snack based on bedtime blood glucose (BG) level could be effective to reduce NH occurrence for patients treated with human or animal insulin (short-acting combined with lente, ultralente and/or intermediate-acting insulin), but there is no evidence for patients treated with insulin analogues as part of multiple daily injections or insulin pump regimen. Some evidence suggests that including uncooked cornstarch or alanine in the bedtime snack composition could provide some benefits for the prevention of NH. Individualized recommendations of a bedtime snack intake for patients or situations at high risk for NH (long standing diabetes, hypoglycaemia unawareness, prior physical activity, alcohol consumption, bedtime BG close to hypoglycaemia threshold) appear as a prudent recommendation. On the basis of the available evidence, a bedtime snack cannot be recommended systematically but it might be useful if prescribed in an individualized fashion; further research is needed to evaluate these strategies.

  7. Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

    Directory of Open Access Journals (Sweden)

    Pan Lianjun

    2012-09-01

    Full Text Available Abstract Background Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China. Methods Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son. Results Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”. The major reason for EIMC was for health (44.8%, followed by doctor’s advice (31.2%. The major reason not to agree to EIMC was concern about pain (50.5%, followed by the risk of the procedure (23.5%. Conclusion The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

  8. Noninvasive Strategy Based on Real-Time in Vivo Cataluminescence Monitoring for Clinical Breath Analysis.

    Science.gov (United States)

    Zhang, Runkun; Huang, Wanting; Li, Gongke; Hu, Yufei

    2017-03-21

    The development of noninvasive methods for real-time in vivo analysis is of great significant, which provides powerful tools for medical research and clinical diagnosis. In the present work, we described a new strategy based on cataluminescence (CTL) for real-time in vivo clinical breath analysis. To illustrate such strategy, a homemade real-time CTL monitoring system characterized by coupling an online sampling device with a CTL sensor for sevoflurane (SVF) was designed, and a real-time in vivo method for the monitoring of SVF in exhaled breath was proposed. The accuracy of the method was evaluated by analyzing the real exhaled breath samples, and the results were compared with those obtained by GC/MS. The measured data obtained by the two methods were in good agreement. Subsequently, the method was applied to real-time monitoring of SVF in exhaled breath from rat models of the control group to investigate elimination pharmacokinetics. In order to further probe the potential of the method for clinical application, the elimination pharmacokinetics of SVF from rat models of control group, liver fibrosis group alcohol liver group, and nonalcoholic fatty liver group were monitored by the method. The raw data of pharmacokinetics of different groups were normalized and subsequently subjected to linear discriminant analysis (LDA). These data were transformed to canonical scores which were visualized as well-clustered with the classification accuracy of 100%, and the overall accuracy of leave-one-out cross-validation procedure is 88%, thereby indicating the utility of the potential of the method for liver disease diagnosis. Our strategy undoubtedly opens up a new door for real-time clinical analysis in a pain-free and noninvasive way and also guides a promising development direction for CTL.

  9. A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain.

    Directory of Open Access Journals (Sweden)

    Mary Jane Brown

    Full Text Available BACKGROUND: Excess gestational weight gain (GWG is an important risk factor for long term obesity in women. However, current interventions aimed at preventing excess GWG appear to have a limited effect. Several studies have highlighted the importance of linking theory with empirical evidence for producing effective interventions for behaviour change. Theorists have demonstrated that goals can be an important source of human motivation and goal setting has shown promise in promoting diet and physical activity behaviour change within non-pregnant individuals. The use of goal setting as a behaviour change strategy has been systematically evaluated within overweight and obese individuals, yet its use within pregnancy has not yet been systematically explored. AIM OF REVIEW: To explore the use of goal setting within healthy lifestyle interventions for the prevention of excess GWG. DATA COLLECTION AND ANALYSIS: Searches were conducted in seven databases alongside hand searching of relevant journals and citation tracking. Studies were included if interventions used goal setting alongside modification of diet and/or physical activity with an aim to prevent excess GWG. The PRISMA guidelines were followed and a two-stage methodological approach was used. Stage one focused on systematically evaluating the methodological quality of included interventions. The second stage assessed intervention integrity and the implementation of key goal setting components. FINDINGS: From a total of 839 citations, 54 full-text articles were assessed for eligibility and 5 studies met the inclusion criteria. Among interventions reporting positive results a combination of individualised diet and physical activity goals, self-monitoring and performance feedback indicators were described as active components. CONCLUSION: Interventions based on goal setting appear to be useful for helping women achieve optimal weight gain during pregnancy. However, overweight and obese women may

  10. A Look at Uganda's Early HIV Prevention Strategies Through a Moderate 'African' Communitarian Lens.

    Science.gov (United States)

    Wathuta, Jane

    2016-12-28

    This paper seeks to highlight the benefits of prioritizing moderate African communitarian principles as partly demonstrated in the HIV prevention strategies implemented in Uganda in the late 1980s. Pertinent lessons could be drawn so as to achieve the HIV prevention targets envisioned in the post-2015 development era. Communitarianism emphasizes the importance of communities as part of healthy human existence. Its core ethical values include the virtues of generosity, compassion, and solidarity. Persuasion through communication, consensus through dialogue, and the awareness and commitment to responsibilities towards other members of the community, are chief practices relied upon to achieve appropriate social behaviour. All these elements signify individual rootedness in communities and contribute to the healthy existence of its members. Communitarianism is usually classified as either authoritarian/radical or responsive/moderate, depending on the primacy given to either community interests or the individual will and rights. Moderate communitarianism recognizes the individual's capacity for moral reasoning, virtue and free choice. The ensuing form of society is deemed more ethical as it relies on education in the virtues, moral persuasion and informal social controls, without stifling individual identity, agency, and capacity for self-determination. If moderate African communitarianism, in particular, can to a certain extent be associated with the significant aspects of Uganda's HIV prevention strategies in the stated period, then its present-day relevance for HIV prevention and other public health interventions may be emphasized accordingly. This applies especially in view of the ongoing efforts to achieve a balance between individual and collective interests in bioethics. © 2016 John Wiley & Sons Ltd.

  11. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report.

    Science.gov (United States)

    Vogelmeier, Claus F; Criner, Gerard J; Martínez, Fernando J; Anzueto, Antonio; Barnes, Peter J; Bourbeau, Jean; Celli, Bartolome R; Chen, Rongchang; Decramer, Marc; Fabbri, Leonardo M; Frith, Peter; Halpin, David M G; López Varela, M Victorina; Nishimura, Masaharu; Roche, Nicolás; Rodríguez-Roisin, Roberto; Sin, Don D; Singh, Dave; Stockley, Robert; Vestbo, Jørgen; Wedzicha, Jadwiga A; Agustí, Alvar

    2017-03-05

    This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: i) the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; ii) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; iii) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; iv) nonpharmacologic therapies are comprehensively presented and; v) the importance of comorbid conditions in managing COPD is reviewed.

  12. Preventive Strategies for Patients at Risk of Medication-related Osteonecrosis of the Jaw.

    Science.gov (United States)

    Goodday, Reginald H

    2015-11-01

    For patients at risk of osteonecrosis of the jaw (ONJ), information can be provided by the pharmaceutical manufacturer, pharmacist, prescribing physician, dentist, and oral and maxillofacial surgeon. Prevention strategies to reduce the incidence of osteonecrosis should be applied as soon as it is determined that a patient will be placed on antiresorptive medication. Proper screening involves a comprehensive oral examination with radiographs followed by oral hygiene instruction and necessary dental treatment; surgical techniques and adjunctive therapies that favor optimum healing of bone and soft tissue decrease the risk of ONJ. No dental procedures are absolutely contraindicated.

  13. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies.

    Science.gov (United States)

    Borg, M A; Waisfisz, B; Frank, U

    2015-05-01

    It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies.

  14. Identification of strategies to prevent death after pesticide self-poisoning using a Haddon matrix

    DEFF Research Database (Denmark)

    Eddleston, M; Buckley, N A; Gunnell, D

    2006-01-01

    and more effective, in particular those limiting the human toxicity and accessibility of the pesticides, and the quality, affordability, and accessibility of health care in the community. Controlled studies are required to identify effective strategies for prevention and harm minimization and to garner......Despite pesticide self-poisoning causing around 300 000 deaths each year in the rural Asia Pacific region, no comprehensive public health response has yet been formulated. The authors have developed a Haddon matrix to identify factors that increase the risk of fatal rather than non-fatal pesticide...

  15. Detection and monitoring of volatile and semivolatile pollutants in soil through different sensing strategies

    Science.gov (United States)

    De Cesare, Fabrizio; Macagnano, Antonella

    2013-04-01

    Pollutants in environments are more and more threatening the maintenance of health of habitats and their inhabitants. A proper evaluation of the impact of contaminants from several different potential sources on soil quality and health and then on organisms living therein, and the possible and sometime probable related risk of transfer of pollutants, with their toxic effects, to organisms living in different environmental compartments, through the trophic chain up to humans is strongly required by decision makers, in order to promptly take adequate actions to prevent environmental and health damages and monitor the exposure rate of individuals to toxicants. Then, a reliable detection of pollutants in environments and the monitoring of dynamics and fate of contaminants therein are of utmost importance to achieve this goal. In soil, chemical and physical techniques to detect pollutants have been well known for decades, but can often drive to both over- and underestimations of the actual bioavailable (and then toxic) fraction of contaminants, and then of the real risk for organisms, deriving from their presence therein. The use of bioindicators (both living organisms and enzyme activities somehow derived from them) can supply more reliable information about the quantification of the bioavailable fraction of soil pollutants. In the last decades, a physicochemical technique, such as SPME (solid phase microextraction) followed by GC-MS analysis, has been demonstrated to provide similar results to those obtained from some pedofaunal populations, used as bioindicators, as concerns the bioavailable pollutant quantification in soil. More recently, we have applied a sensing technology, namely electronic nose (EN), which comprises several unspecific sensors arranged in an array and that is capable of providing more qualitative than quantitative information about complex air samples, to the study of soils contaminated with semivolatile (SVOCs) pollutants, such as polycyclic

  16. Performance deterioration modeling and optimal preventive maintenance strategy under scheduled servicing subject to mission time

    Institute of Scientific and Technical Information of China (English)

    Li Dawei; Zhang Zhihua; Zhong Qianghui; Zhai Yali

    2014-01-01

    Servicing is applied periodically in practice with the aim of restoring the system state and prolonging the lifetime. It is generally seen as an imperfect maintenance action which has a chief influ-ence on the maintenance strategy. In order to model the maintenance effect of servicing, this study analyzes the deterioration characteristics of system under scheduled servicing. And then the deterio-ration model is established from the failure mechanism by compound Poisson process. On the basis of the system damage value and failure mechanism, the failure rate refresh factor is proposed to describe the maintenance effect of servicing. A maintenance strategy is developed which combines the benefits of scheduled servicing and preventive maintenance. Then the optimization model is given to determine the optimal servicing period and preventive maintenance time, with an objective to minimize the sys-tem expected life-cycle cost per unit time and a constraint on system survival probability for the dura-tion of mission time. Subject to mission time, it can control the ability of accomplishing the mission at any time so as to ensure the high dependability. An example of water pump rotor relating to scheduled servicing is introduced to illustrate the failure rate refresh factor and the proposed maintenance strat-egy. Compared with traditional methods, the numerical results show that the failure rate refresh factor can describe the maintenance effect of servicing more intuitively and objectively. It also demonstrates that this maintenance strategy can prolong the lifetime, reduce the total lifetime maintenance cost and guarantee the dependability of system.

  17. [Reciprocal teaching and self-monitoring of strategy use: effects on reading comprehension].

    Science.gov (United States)

    Soriano Ferrer, Manuel; Chebaani, Fatma; Soriano Ayala, Encarnación; Descals Tomás, Adela

    2011-02-01

    Reciprocal teaching (RT) is an instructional procedure to teach students cognitive strategies that might lead to improved reading comprehension. However, self-monitoring (SM) strategy use can optimize instruction of comprehension. Thus, the present study analyzed: (a) the efficacy of RT in regular classes and (b) the efficacy of RT + SM of strategy use. A sample of 59 students in the fourth year of primary education was selected: 19 children were selected as an RT condition, 18 as an RT + SM condition, while the remaining 22 made up the comparison group. Two types of comprehension measures were used: tasks of specific effects (getting the main idea, writing a summary, comprehension-monitoring test) and transfer effect measures (standardised tests, word meaning inference, and free recall). Thus, the results show that both the RT condition and the RT + SM condition benefited from the instruction, performing better than the comparison group in measures of specific effects and in some of the transfer effect measures. This result shows that SM is not a necessary component in the instruction of reading comprehension with RT.

  18. Prioritising prevention strategies for patients in Antiretroviral Treatment Programmes in Resource-Limited Settings

    Science.gov (United States)

    SPAAR, A.; GRABER, C.; DABIS, F.; COUTSOUDIS, A; BACHMANN, L.; MCINTYRE, J.; SCHECHTER, M.; PROZESKY, H.W.; TUBOI, S.; DICKINSON, D.; KUMARASAMY, N.; PUJDADES-RODRIQUEZ, M.; SPRINZ, E.; SCHILTHUIS, H.J.; CAHN, P.; LOW, N.; EGGER, M.

    2010-01-01

    Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; 8 (36%) from South Africa, 2 from Brazil, 2 from Zambia and 1 each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe. Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, 7 (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to-child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI, and reduction of stigma in the community, have not been implemented widely. PMID:20473792

  19. Make a Difference at Your School! CDC Resources Can Help You Implement Strategies to Prevent Obesity Among Children and Adolescents

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2008

    2008-01-01

    The Centers for Disease Control and Prevention (CDC) reviews scientific evidence to determine which school-based policies and practices are most likely to improve key health behaviors among young people, including physical activity and healthy eating. In this document, the CDC identifies ten strategies to help schools prevent obesity by promoting…

  20. Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline.

    Science.gov (United States)

    Armenian, Saro H; Lacchetti, Christina; Barac, Ana; Carver, Joseph; Constine, Louis S; Denduluri, Neelima; Dent, Susan; Douglas, Pamela S; Durand, Jean-Bernard; Ewer, Michael; Fabian, Carol; Hudson, Melissa; Jessup, Mariell; Jones, Lee W; Ky, Bonnie; Mayer, Erica L; Moslehi, Javid; Oeffinger, Kevin; Ray, Katharine; Ruddy, Kathryn; Lenihan, Daniel

    2016-12-05

    Purpose Cardiac dysfunction is a serious adverse effect of certain cancer-directed therapies that can interfere with the efficacy of treatment, decrease quality of life, or impact the actual survival of the patient with cancer. The purpose of this effort was to develop recommendations for prevention and monitoring of cardiac dysfunction in survivors of adult-onset cancers. Methods Recommendations were developed by an expert panel with multidisciplinary representation using a systematic review (1996 to 2016) of meta-analyses, randomized clinical trials, observational studies, and clinical experience. Study quality was assessed using established methods, per study design. The guideline recommendations were crafted in part using the Guidelines Into Decision Support methodology. Results A total of 104 studies met eligibility criteria and compose the evidentiary basis for the recommendations. The strength of the recommendations in these guidelines is based on the quality, amount, and consistency of the evidence and the balance between benefits and harms. Recommendations It is important for health care providers to initiate the discussion regarding the potential for cardiac dysfunction in individuals in whom the risk is sufficiently high before beginning therapy. Certain higher risk populations of survivors of cancer may benefit from prevention and screening strategies implemented during cancer-directed therapies. Clinical suspicion for cardiac disease should be high and threshold for cardiac evaluation should be low in any survivor who has received potentially cardiotoxic therapy. For certain higher risk survivors of cancer, routine surveillance with cardiac imaging may be warranted after completion of cancer-directed therapy, so that appropriate interventions can be initiated to halt or even reverse the progression of cardiac dysfunction.

  1. [Preventive human rights monitoring in child and adolescent psychiatry and welfare institutions].

    Science.gov (United States)

    Berger, Ernst; Paar, Caroline

    2017-08-30

    Since 1 July 2012 the Austrian Ombudsman Board (AOB) together with its six regional expert commissions form the so called "National Prevention Mechanism" implementing the UN Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). The commissions are mandated to conduct regular, unrestricted and unannounced visits to all types of places in which there is or can be a deprivation or restriction of personal liberty, such as prisons, police stations, but also psychiatric hospitals or residential homes/groups for children and juveniles supervised by youth welfare services. 20 monitoring visits have been held in departments for Child- and Adolescent Psychiatry between 2012 and 2016. In the field of residential groups for young people 40 visiting protocols (out of a total of 176 between 2015 and 2016) have been chosen for this analysis. The following article overviews the legal sources and key issues of the monitoring process in this field as well as the commissions' findings and recommendations.

  2. Tools for in service monitoring and testing of riser to prevent failure and extend service life

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Haakon; Bondevik, Jon Olav; Skjerve, Haavard; Tveit, Oeyvind [SeaFlex AS, Asker (Norway)

    2005-07-01

    Exploration and development of new oil and gas fields is heavily dependant on use of flexible pipes and many field developments would not have been possible without them. The number of flexible risers in service is constantly increasing since relatively few offshore projects have reached the estimated operational life and the operational lifetime of several fields in-service has been extended due to new and improved technology. Many risers have been in service over a large number of years. Some risers have been operated under demanding conditions such as severe dynamic loads, high pressure and temperatures. One may in some cases find that risers actually have shorter service life than estimated in the design phase due to the severe operational conditions. In order to extend the use of the riser, some risers may have to be modified and re-terminated and prepared for a new and less demanding application. In order to operate risers safely, it is important to re-assess the fatigue life in order to prevent potential riser failure. The operator should implement methods and tools for in-service monitoring and testing. This paper addresses efficient and reliable methods and tools for monitoring of critical operational parameters as well as in-service riser testing. A brief description of structural failure modes will also be given in order to understand how to interpret test results in view of potential failure modes. (author)

  3. Promotion and Prevention Focused Feeding Strategies: Exploring the Effects on Healthy and Unhealthy Child Eating.

    Science.gov (United States)

    Melbye, Elisabeth L; Hansen, Håvard

    2015-01-01

    There is a general lack of research addressing the motivations behind parental use of various feeding practices. Therefore, the present work aims to extend the current literature on parent-child feeding interactions by integrating the traditional developmental psychological perspective on feeding practices with elements of Regulatory Focus Theory (RFT) derived from the field of motivational psychology. In this paper, we seek to explain associations between parental feeding practices and child (un)healthy eating behaviors by categorizing parental feeding practices into promotion and prevention focused strategies, thus exploring parent-child feeding interactions within the framework of RFT. Our analyses partly supported the idea that (1) child healthy eating is positively associated with feeding practices characterized as promotion focused, and (2) child unhealthy eating is negatively associated with feeding practices characterized as prevention focused. However, a general observation following from our results suggests that parents' major driving forces behind reducing children's consumption of unhealthy food items and increasing their consumption of healthy food items are strategies that motivate rather than restrict. In particular, parents' provision of a healthy home food environment seems to be essential for child eating.

  4. Internet and people with intellectual disability: an approach to caregivers’ concerns, prevention strategies and training needs

    Directory of Open Access Journals (Sweden)

    Esther Chiner

    2017-07-01

    Full Text Available The aim of this study was to explore caregivers’ views about the risks of the Internet for people with intellectual disabilities and their preparation and ability to use prevention strategies to address them. The participants (20 family members and 24 staff members belonged to a non-profit association working with people with developmental and intellectual disabilities and were asked to respond to a questionnaire about Internet safety and risks. Findings show some concerns from caregivers with regard to the use of the Internet by people with intellectual disabilities and suggest that this group is more vulnerable to online risks. Participants use different kinds of strategies to prevent the risks but they have not received any formal training. They think that this training should come from the Administration and other organisations. Some differences were found between family and staff members’ responses. Training programmes for all the groups involved in this process (i.e. people with intellectual disabilities, staff and family members should be designed, implemented and assessed to promote the inclusion of people with intellectual disabilities in the digital arena.

  5. Human activity response and prevention strategies on soil and water loss in Sichuan Province

    Institute of Scientific and Technical Information of China (English)

    FANG Yiping; CHEN Guojie

    2003-01-01

    Ten major factors have been selected to judge the degree of disturbance from human activity and the corresponding relationship of the impact on soil and water loss in Sichuan Province. Correlation analysis has demonstrated that stock-carrying capacity, percentage of land reclamation, population density, GDP per capita, mineral modulus and percentage of forest coverage are the 6 most relevant human activity factors. The analysis on the degree of disturbance has shown that population pressure, excessive or unreasonable activities in development of resources and destructive behavior of humans are the main causes of soil and water loss. Consequently, solving the various problems in the negative activity of humans and regulating human behavior are the first tasks that should be tackled in the conservation of water and soil. In the new era, the prevention and rectification of soil and water loss are measures based on the foundation of the ecosystem, which is a kind of management strategy for sustainable development. The foundation of this method is made up of the system innovations and breakthroughs in terms of aims, philosophy, measures, and aspects of the prevention and rectification of soil and water loss, simultaneous advance from the conceptual, policy, spatial, technical and mode levels and system integration on the treatment strategies.

  6. Incidence of human papillomavirus contamination of transvaginal probes in Japan and possible contamination prevention strategy.

    Science.gov (United States)

    Kuwata, Tomoyuki; Takahashi, Hironori; Koibuchi, Harumi; Ichizuka, Kiyotake; Natori, Michiya; Matsubara, Shigeki

    2016-10-01

    To clarify the present status of human papillomavirus (HPV) contamination of transvaginal probes in Japan and propose a preventive method. This study was performed at three institutes: a tertiary center, secondary hospital, and primary facility. To identify contamination rates, probes were disinfected and covered with probe covers and condoms; the cover was changed for each patient. The probes were tested for HPV, and those with HPV detected were analyzed to identify the type of HPV. Next, nurses put on new gloves before covering the probe for each patient, and the probes were similarly tested for HPV. A total of 120 probes were tested, and HPV was detected from a total of five probes, a contamination rate of 4.2 % (5/120). HPV was detected in all three institutes. Importantly, high-risk HPV, i.e., HPV-52, 56, and 59, was detected. After the "glove change strategy" was implemented, HPV was not detected on any of 150 probes tested at any of the three institutions. In Japan, the HPV contamination rate of vaginal probes in routine practice was 4.2 %. There was no HPV contamination of probes after changing the gloves for cover exchange for each patient. This strategy may prevent HPV probe contamination.

  7. Should player fatigue be the focus of injury prevention strategies for international rugby sevens tournaments?

    Science.gov (United States)

    Fuller, Colin W; Taylor, Aileen E; Raftery, Martin

    2016-06-01

    To assess the incidence, severity and nature of injuries, to determine risk factors for injury and to identify potential injury prevention strategies in men's international Rugby-7s tournaments. A prospective cohort study. Players from core teams competing in matches at 6 Sevens World Series from 2008/2009 to 2014/2015. The incidence of injury across all Series was 108.3 injuries/1000 player-match-hours (backs: 121.0; forwards: 91.5) with a mean severity of 44.2 days (backs: 46.1; forwards: 40.9) and a median severity of 28 days (backs: 29; forwards: 26). The proportion of injuries sustained in the second half was significantly higher (60%; pRugby-7s suggests that teams require squads of around 20 players for a Sevens World Series. The higher incidence of injury in the second half of matches is probably the result of player fatigue; therefore, injury prevention strategies for teams and the Governing Body should address this issue. The results presented support the World Rugby trial allowing 'rolling substitutes' during Sevens World Series matches, as this approach may help to mitigate the effects of player fatigue during the second half of matches. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Comparison of strategies of preventive and corrective maintenance of uninterruptible power supply

    Directory of Open Access Journals (Sweden)

    B. Y. Volochiy

    2013-09-01

    Full Text Available Introduction. The comparison of the reliability of two variants of the fault-tolerant N+M redundant configurations for uninterruptible power supply with corrective and preventive maintenance is given in this paper. Formulation of the problem. Different variants of fault-tolerant redundant configurations and maintenance strategies provide equivalent mean time to failure indexes, but at the same time have different values of the probability of failure-free operation at given operation time value. Description of object under consideration. Fault-tolerant system consists of main and hot reserve modules and has two accumulator batteries. Reliability model for fault-tolerant system with N+M redundant configuration. Carrying out this research was made possible after the development of models of fault-tolerant systems as Kolmogorov - Chapman differential equation systems. Comparison of the reliability of uninterruptible power supply with different fault-tolerant configurations. There is shown quantitative difference between reliability indexes (operation time where probability of failure-free operation is not less than 0.99 of corrective and preventive maintenance. Conclusions. Reliability analysis of fault-tolerant systems shows that the strategy of corrective maintenance has higher values of operation time where probability of failure-free operation is not less than 0.99.

  9. Preventing Violence Among High-Risk Youth and Communities with Economic, Policy, and Structural Strategies.

    Science.gov (United States)

    Massetti, Greta M; David-Ferdon, Corinne

    2016-02-12

    Youth violence is preventable, and the reduction of health disparities is possible with evidence-based approaches. Achieving community-wide reductions in youth violence and health disparities has been limited in part because of the lack of prevention strategies to address community risk factors. CDC-supported research has resulted in three promising community-level approaches: Business Improvement Districts (BIDs) in Los Angeles, California; alcohol policy to reduce youth access in Richmond, Virginia; and the Safe Streets program in Baltimore, Maryland. Evaluation findings indicated that BIDs in Los Angeles were associated with a 12% reduction in robberies (one type of violent crime) and an 8% reduction in violent crime overall. In Richmond's alcohol policy program, investigators found that the monthly average of ambulance pickups for violent injuries among youth aged 15-24 years had a significantly greater decrease in the intervention (19.6 to 0 per 1,000) than comparison communities (7.4 to 3.3 per 1,000). Investigators of Safe Streets found that some intervention communities experienced reductions in homicide and/or nonfatal shootings, but results were not consistent across communities. Communitywide rates of violence can be changed in communities with disproportionately high rates of youth violence associated with entrenched health disparities and socioeconomic disadvantage. Community-level strategies are a critical part of comprehensive approaches necessary to achieve broad reductions in violence and health disparities.

  10. Promotion and Prevention Focused Feeding Strategies: Exploring the Effects on Healthy and Unhealthy Child Eating

    Directory of Open Access Journals (Sweden)

    Elisabeth L. Melbye

    2015-01-01

    Full Text Available There is a general lack of research addressing the motivations behind parental use of various feeding practices. Therefore, the present work aims to extend the current literature on parent-child feeding interactions by integrating the traditional developmental psychological perspective on feeding practices with elements of Regulatory Focus Theory (RFT derived from the field of motivational psychology. In this paper, we seek to explain associations between parental feeding practices and child (unhealthy eating behaviors by categorizing parental feeding practices into promotion and prevention focused strategies, thus exploring parent-child feeding interactions within the framework of RFT. Our analyses partly supported the idea that (1 child healthy eating is positively associated with feeding practices characterized as promotion focused, and (2 child unhealthy eating is negatively associated with feeding practices characterized as prevention focused. However, a general observation following from our results suggests that parents’ major driving forces behind reducing children’s consumption of unhealthy food items and increasing their consumption of healthy food items are strategies that motivate rather than restrict. In particular, parents’ provision of a healthy home food environment seems to be essential for child eating.

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

    Science.gov (United States)

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

    2014-08-12

    The prevention of cardiovascular disease (CVD) by using a polypill has gained increasing momentum as a strategy to contain progression of the disease. Since its initial conception just over a decade ago, only a handful of trials have been completed assessing the efficacy and safety of this innovative concept. The results of these trials have supported the viability of the polypill in CVD prevention and management, albeit with a few caveats, essentially related to the lack of evidence on the effect of the polypill to effectively reduce cardiovascular events. The polypill has the potential to control the global health epidemic of CVD by effectively reaching underdeveloped regions of the world, simplifying healthcare delivery, improving cost-effectiveness, increasing medication adherence, and supporting a comprehensive prescription of evidence-based cardioprotective drugs. Major trials underway will provide definitive evidence on the efficacy of the polypill in reducing cardiovascular events in a cost-effective manner. The results of these studies will determine whether a polypill strategy can quell the burgeoning public health challenge of CVD and will potentially provide the evidence to implement an effective, simple, and innovative solution to restrain the global CVD pandemic. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. The Effective Ransomware Prevention Technique Using Process Monitoring on Android Platform

    Directory of Open Access Journals (Sweden)

    Sanggeun Song

    2016-01-01

    Full Text Available Due to recent indiscriminate attacks of ransomware, damage cases including encryption of users’ important files are constantly increasing. The existing vaccine systems are vulnerable to attacks of new pattern ransomware because they can only detect the ransomware of existing patterns. More effective technique is required to prevent modified ransomware. In this paper, an effective method is proposed to prevent the attacks of modified ransomware on Android platform. The proposed technique specifies and intensively monitors processes and specific file directories using statistical methods based on Processor usage, Memory usage, and I/O rates so that the process with abnormal behaviors can be detected. If the process running a suspicious ransomware is detected, the proposed system will stop the process and take steps to confirm the deletion of programs associated with the process from users. The information of suspected and exceptional processes confirmed by users is stored in a database. The proposed technique can detect ransomware even if you do not save its patterns. Its speed of detection is very fast because it can be implemented in Android source code instead of mobile application. In addition, it can effectively determine modified patterns of ransomware and provide protection with minimum damage.

  13. Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation.

    Science.gov (United States)

    McGrath, Susan P; Taenzer, Andreas H; Karon, Nancy; Blike, George

    2016-07-01

    The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring). In late 2007, a patient surveillance monitoring system was piloted on the basis of a structured design and implementation approach in a 36-bed orthopedics unit. Beginning in early 2009, it was expanded to cover more than 200 inpatient beds in all medicine and surgical units, except for psychiatry and labor and delivery. Improvements in clinical outcomes (reduction of unplanned transfers by 50% and reduction of rescue events by more than 60% in 2008) and approximately two alarms per patient per 12-hour nursing shift in the original pilot unit have been sustained across most D-H general care units in spite of increasing patient acuity and unit occupancy. Sample analysis of pager notifications indicates that more than 85% of all alarm conditions are resolved within 30 seconds and that more than 99% are resolved before escalation is triggered. The D-H surveillance monitoring system employs several important, generalizable features to manage alarms in a general care setting: alarm delays, static thresholds set appropriately for the prevalence of events in this setting, directed alarm annunciation, and policy-driven customization of thresholds to allow clinicians to respond to needs of individual patients. The systematic approach to design, implementation, and performance management has been key to the success of the system.

  14. Clinicians' perceptions and recognition of practice improvement strategies to prevent harms to older people in acute care hospitals.

    Science.gov (United States)

    McGrath, Michele; Botti, Mari; Redley, Bernice

    2017-08-03

    Explore clinicians' perceptions of practice improvement strategies used to prevent harms to older people during acute hospitalisation. Older people are vulnerable to many interrelated preventable harms during acute care hospitalisation. Improvement strategies recommend standardisation of practices to assist healthcare staff mitigate risk, however, older people continue to suffer preventable harms in acute hospitals. A qualitative exploratory descriptive design was used to collect data using focus groups and individual interviews from a purposive sample of 33 participants. Participants represented a wide range of clinicians from four diverse healthcare organisations. Qualitative content analysis used a framework informed by common preventable harms derived from key literature and policy documents. Participants' perceptions of practice improvement strategies varied depending on their role within their organisational hierarchy. Recognition of preventable harms was guided by standard risk assessment and management tools used in their organisations. Preventable harms relating to skin integrity and falls were universally recognised across all sites and roles. Alternatively, there was variability in participant recognition of preventable harms related to nutrition, continence, medications and cognition; pain was consistently overlooked as a contributor to preventable harms. Hospital staff perceived standard clinical risk assessment and management tools as the main practice improvement strategy to prevent harms. These tools prompted staff recognition of preventable harms to older people during acute hospitalisation. Variability in the recognition of some preventable harms was attributed to variable use of standard assessment tools. Pain was unlikely to be recognised as contributing to preventable harms. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. [Recent prevention strategies and occupational risk analysis: Control Banding and Sobane].

    Science.gov (United States)

    Ghittori, S; Ferrari, M; Negri, S; Serranti, P; Sacco, P; Biffi, R; Imbriani, M

    2006-01-01

    Employers are responsible for the prevention of risks and must provide for the safety and health of their workers. They are obliged to apply the general principles of prevention: to avoid, where possible, any risk; to characterize and hence to estimate residual risks; to eliminate risks at the source; to adjust jobs to the needs of workers and not workers to the jobs. When we pass to the practical performance of these shared principles we introduce many problems: problems concerning terminology; problems in estimating the nature of the risks that are faced; coordination problems between the subjects that preside over prevention; problems arising from the different typology of the companies investigated In order to answer these questions the "Industrial Hygienists" have long since created various strategies for the prevention and control of risks. Among different models the methods Control Banding and Sobane-Deparis are undoubtedly the most promising. Control Banding is designed to assist especially Small and Medium Enterprises in complying with the chemical safety regulations, the scheme uses the R phrases that in Europe must be assigned to potentially harmful chemicals by the manufacturer of the chemical. R phrases describe the most important harmful effects of a chemical and have been adopted in many non European countries also. The combination of the hazard classification of the chemical and assessment of the exposure potential will allow understanding of the level of risk thus leading the person carrying out the assessment to an appropriate control method. Occupational hygienists with experience of assessing occupational exposure to chemicals agreed parameters that could be used to give reasonable indications of exposure potential. One of them is quantity being used and three categories--small, medium and large--are defined. The likelihood of the chemical becoming airborne has been addressed by defining solids according to levels of dustiness and liquids

  16. Exercise and Life-Satisfactory-Fitness: Complementary Strategies in the Prevention and Rehabilitation of Illnesses

    Directory of Open Access Journals (Sweden)

    Christiane Jennen

    2004-01-01

    Full Text Available Moderate training of an endurance nature, but also other exercise activities, not only has a preventive effect on various illnesses and pre-illness states such as the metabolic syndrome and cancer, but is also effective in treating patients in the rehabilitation phase after illness, e.g. cardiovascular or cancer. Our investigation demonstrates that even low level physical activity has a very good preventive effect too, which is enhanced when it is accompanied by mental activity and psychological well-being. In total, we investigated 13 000 people on the basis of socio-economic panel polls with respect to life contentment, health status and leisure-time activities. Life contentment is positively linked to contentment with labor, which seems to be an essential aspect with regard to the increasing number of unemployed people in Europe. The second important factor is health-promoting activities during leisure time. Exercise, especially, has a significant influence on life satisfaction as a feeling of physical fitness feeling is regarded as synonymous with good health. The results underline the psycho-neuroimmunological network, which stabilizes our health and shows that different activities in older adults have a significant effect on the aging process and age-related illnesses. Besides the various activities that are important in this arena, namely muscle and mental mobility (‘brawn and brain’, a third component must be taken into consideration: life contentment in the form of a successful retrospective view and a positive outlook, embedded in a psychosocial family environment (‘brood’ and integrated in a stress-free biotope, where life does make sense. Alternative and complementary strategies should be considered in light of these three aspects when we think about additional anti-inflammatory strategies in preventing diseases or treating them and their relapses.

  17. Building healthy bones throughout life: an evidence-informed strategy to prevent osteoporosis in Australia.

    Science.gov (United States)

    Ebeling, Peter R; Daly, Robin M; Kerr, Deborah A; Kimlin, Michael G

    2013-10-07

    Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis and 6.3 million have osteopenia. In the 2007–08 financial year, 82 000 Australians suffered fragility fractures, of which > 17 000 were hip fractures. In the 2000–01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolescence to prevent premature bone loss and improve or maintain muscle mass, strength and functional capacity in healthy adults to prevent and treat osteoporosis in order to minimise the risk of suffering fragility fractures, and reduce falls risk, in older people. The recommendations focus on three affordable and important interventions — to ensure people have adequate calcium intake, vitamin D levels and appropriate physical activity throughout their lives. Recommendations relevant to all stages of life include: daily dietary calcium intakes should be consistent with Australian and New Zealand guidelines serum levels of vitamin D in the general population should be above 50nmol/L in winter or early spring for optimal bone health regular weight-bearing physical activity, muscle strengthening exercises and challenging balance/mobility activities should be conducted in a safe environment.

  18. Current strategies for preventing the recurrence of hepatocellular carcinoma after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Zhuo-Yi Wang; Lei Geng; Shu-Sen Zheng

    2015-01-01

    BACKGROUND:Liver transplantation is the optimal treat-ment for a selected group of patients with moderate to severe cirrhosis and hepatocellular carcinoma (HCC). Despite the strict selection of candidates, post-transplant recurrence often occurs and markedly reduces the long-term survival of patients with HCC. The present review focuses on the current strategies on preventing the recurrence of HCC after liver transplantation. DATA SOURCES:Relevant articles were identiifed by exten-sive searching of PubMed using the keywords "hepatocellular carcinoma", "recurrence" and "liver transplantation" between January 1996 and January 2014. Additional papers were searched manually from the references in key articles. RESULTS:The current theories of HCC recurrence after liver transplantation are: (i) the growth of pre-transplant occult metastases; (ii) the engraftment of circulating tumor cells re-leased at the time of transplantation. Pre-transplant treatment aims to control local tumor by radiofrequency ablation, tran-sarterial embolization and transarterial chemoembolization. The main objective during the operation is to prevent tumor cell dissemination. Post-transplant treatment includes sys-temic anticancer therapy, antiviral therapy, and most recently, immunotherapy. These strategies concentrate on the control of the tumor when the patients are waiting for transplant, to reduce the release of HCC cells during surgical procedures and to clear the occult HCC cells after transplantation. CONCLUSIONS:Much can be done to prevent HCC recurrence after liver transplantation. In future, effort is likely to be di-rected towards combining multidisciplinary approaches and various treatment modalities.

  19. Development of an effective communication strategy for the prevention of burns in children: the PRIUS project.

    Science.gov (United States)

    Cedri, S; Briguglio, E; Cedri, C; Masellis, A; Crenca, A; Pitidis, A

    2015-06-30

    This study has developed a learning kit for the prevention of domestic burns in childhood. The main objective was to trial an educational package for children (nursery and primary classes), for the prevention of burns, to be implemented through education in schools. The educational kit comprises posters, information leaflets, comic books, and pre and post education evaluation materials for school children, parents and teachers. Recipients of the preliminary study were the students of nine schools in the eight Italian cities where Burn Centers are located. In order to reach the target groups of children, it was necessary to identify the most effective communication strategy to convey the burn prevention message. For nursery school children, it was not possible to use tools with written texts alone, as they were not yet literate. Moreover, even for older children, it was necessary to find an attractive tool to catch their attention and interest, promoting the understanding and memorization of lessons learned. The most suitable means was found to be comic strips, allowing the messages to be conveyed through images as well as words. A total of 370 children (195 from nurseries and 175 from primary schools) participated in the trial of the educational kit. Overall, for every environment represented in the evaluation table, the ability to recognize the dangers among both the pre-school and primary school children increased significantly after the training activity. In conclusion, the educational kit has been positively assessed.

  20. NASA's NI-SAR Observing Strategy and Data Availability for Agricultural Monitoring and Assessment

    Science.gov (United States)

    Siqueira, P.; Dubayah, R.; Kellndorfer, J. M.; Saatchi, S. S.; Chapman, B. D.

    2014-12-01

    The monitoring and characterization of global crop development by remote sensing is a complex task, in part, because of the time varying nature of the target and the diversity of crop types and agricultural practices that vary worldwide. While some of these difficulties are overcome with the availability of national and market-derived resources (e.g. publication of crop statistics by the USDA and FAO), monitoring by remote sensing has the ability of augmenting those resources to better identify changes over time, and to provide timely assessments for the current year's production. Of the remote sensing techniques that are used for agricultural applications, optical observations of NDVI from Landsat, AVHRR, MODIS and similar sensors have historically provided the majority of data that is used by the community. In addition, radiometer and radar sensors, are often used for estimating soil moisture and structural information for these agricultural regions. The combination of these remote sensing datasets and national resources constitutes the state of the art for crop monitoring and yield forecasts. To help improve these crop monitoring efforts in the future, the joint NASA-ISRO SAR mission known as NI-SAR is being planned for launch in 2020, and will have L- and S-band fully polarimetric radar systems, a fourteen day repeat period, and a swath width on the order of several hundred kilometers. To address the needs of the science and applications communities that NI-SAR will support, the systems observing strategy is currently being planned such that data rate and the system configuration will address the needs of the community. In this presentation, a description of the NI-SAR system will be given along with the currently planned observing strategy and derived products that will be relevant to the overall GEOGLAM initiative.

  1. Spatial scan statistics to assess sampling strategy of antimicrobial resistance monitoring programme

    DEFF Research Database (Denmark)

    Vieira, Antonio; Houe, Hans; Wegener, Henrik Caspar

    2009-01-01

    , one high sampling rate Cluster was detected (RR: 2.56, p = 0.01). These findings allowed subsequent investigation to clarify the source of the sampling clusters. Overall, the detected Clusters presented different spatial locations over the years and we can conclude that they were more associated...... to temporary sampling problems than to a failure in the sampling strategy adopted by the monitoring program. Spatial scan statistics proved to be a useful tool for assessment of the randomness of the sampling distribution, which is important when evaluating the validity of the results obtained...

  2. Association of negotiation strategies with consistent use of male condoms by women receiving an HIV prevention intervention in Zimbabwe.

    Science.gov (United States)

    O'Leary, Ann; Moore, Janet S; Khumalo-Sakutukwa, Gertrude; Loeb, Lisa; Cobb, Daphne; Hruschka, Dan; Khan, Rizwana; Padian, Nancy

    2003-07-25

    One of the fundamental aspects of HIV counselling for women is condom negotiation strategy development. The present research sought to identify condom request strategies used by Zimbabwean women and to determine which were most effective in persuading male partners to use condoms. Of six types of strategies used by women after a prevention intervention, one was significantly associated with consistent condom use 2 months later. Implications for the development of counselling and testing protocols are discussed.

  3. Changes in physical therapy providers' use of fall prevention strategies following a multicomponent behavioral change intervention.

    Science.gov (United States)

    Brown, Cynthia J; Gottschalk, Margaret; Van Ness, Peter H; Fortinsky, Richard H; Tinetti, Mary E

    2005-05-01

    An abundance of evidence suggests that interventions targeting fall risk factors are effective; however, it remains unknown whether, or to what extent, this body of evidence has affected the clinical practice of physical therapy providers. The purposes of this study were: (1) to describe knowledge of, and attitudes toward, fall risk factors and fall reduction strategies; (2) to assess self-reported use of fall reduction strategies with patients; and (3) to identify factors associated with increased use of fall reduction strategies with patients among physical therapy providers exposed to a behavioral change strategy. A cross-sectional survey of physical therapy providers from hospital-based and freestanding outpatient physical therapy facilities throughout north-central Connecticut was conducted between October 2002 and April 2003. The participants were 94 physical therapy providers who had been exposed to the Connecticut Collaboration for Fall Prevention (CCFP) behavioral change effort. The CCFP program uses multicomponent professional behavioral change strategies to embed fall risk factor assessment and management, based on evidence from randomized controlled trials, into the clinical care of older patients. A telephone questionnaire--focusing on fall risk factor knowledge and attitudes and self-reported fall risk factor assessment and management practices before and after exposure to the CCFP efforts--was administered to consenting physical therapy providers. Environmental hazards and gait and balance deficits were named as fall risk factors by 86 (91%) and 73 (78%) participants, respectively. All of the targeted risk factors were mentioned by at least 30% of the participants. Sixty-four participants (68%) reported increased fall reduction practice behaviors. The area of multiple medications was noted most frequently, with 77 participants (82%) noting new practices related to medication use. Only knowledge of fall risk factors and pre-CCFP behaviors were

  4. Importance and satisfaction of preventive health strategies in institutions for people with intellectual disabilities: a perspective of institutional directors.

    Science.gov (United States)

    Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling

    2005-01-01

    To explore the perceptions of institutional directors on the preventive health strategies for people with intellectual disabilities in institutions. A structured questionnaire was conducted by a cross-sectional postal survey in all registered institutions in Taiwan in 2002. A total of 157 questionnaires were mailed, of which 121 valid questionnaire were analyzed in this study. The respondents indicated important perception to the preventive health strategies across the 17 criteria, the mean score of importance in preventive health strategies was from 8.4 to 9.7 (score 1-10). But the analysis found that there were many gaps of 'importance' compared with 'satisfactory' to implementation of preventive health strategies, particularly in the issues of 'thyroid screening for intellectual disabilities (ID) with Down syndrome', 'prevention and treatment of osteoporosis', and 'diagnosis and treatment of mental disorders', these health issues need to be improved in institutions. The present study found that the size and ownership of institutions were not related to the perceptions of importance and satisfaction toward preventive health strategies. The institutions should explore the reasons of why the failure to carry through important health plans into practice to ensure quality of health services for people with ID who living in institutions.

  5. CDC's Prevention Status Reports: Monitoring the Status of Public Health Policies and Practices for Improved Performance and Accountability.

    Science.gov (United States)

    Young, Andrea C; Lowry, Garry; Mumford, Karen; Graaf, Christine

    2017-02-03

    Increasing the adoption and implementation of evidence-based policies and practices is a key strategy for improving public health. Although there is widespread agreement about the importance of implementing evidence-based public health policies and practices, there are gaps between what has been shown to be effective and what is implemented at the state level. The Centers for Disease Control and Prevention (CDC) developed the Prevention Status Reports (PSRs), a performance measurement system, to highlight evidence-based public health policies and practices and catalyze state performance and quality improvement efforts across the nation. CDC selected a set of 10 topics representing some of the most important public health challenges in the nation. Stakeholders, including state health departments and other partners, helped conceptualize the PSRs and informed the development of the PSR framework, which provides an organizational structure for the system. CDC subject matter experts developed criteria for selecting policies and practices, indicators for each policy and practice, and a criteria-based rating system for each indicator. The PSRs were developed for all 50 states and the District of Columbia. The PSRs were developed and serve as a performance measurement system for monitoring the adoption, reach, and implementation fidelity of evidence-based public health policies and practices nationwide. The PSRs include 33 policy and practice indicators across the 10 health topics. They use a simple 3-level rating system-green, yellow, and red-to report the extent to which each state (and the District of Columbia) has implemented the policy or practice in accordance with supporting evidence or expert recommendations. Results from aggregate analyses show positive change or improvement. The PSRs are a unique part of CDC's work to improve the performance and accountability of the public health system, serving as both a monitoring tool and a call to action to improve health

  6. Enhanced surveillance strategies for detecting and monitoring chronic wasting disease in free-ranging cervids

    Science.gov (United States)

    Walsh, Daniel P.

    2012-01-01

    experiences implementing disease-monitoring programs to present the important questions to consider, potential tools, and various strategies for those wildlife management agencies endeavoring to create or maintain a CWD monitoring program. Its intent is to aid readers in creating efficient and cost-effective monitoring programs, while avoiding potential pitfalls. It is hoped that these three chapters will be useful tools for wildlife managers struggling to implement efficient and effective CWD disease management programs.

  7. Enhanced surveillance strategies for detecting and monitoring chronic wasting disease in free-ranging cervids

    Science.gov (United States)

    Walsh, Daniel P.

    2012-01-01

    experiences implementing disease-monitoring programs to present the important questions to consider, potential tools, and various strategies for those wildlife management agencies endeavoring to create or maintain a CWD monitoring program. Its intent is to aid readers in creating efficient and cost-effective monitoring programs, while avoiding potential pitfalls. It is hoped that these three chapters will be useful tools for wildlife managers struggling to implement efficient and effective CWD disease management programs.

  8. Use of the Self-Monitoring Strategy among Students with Attention Deficit Hyperactivity Disorder: A Systematic Review

    Science.gov (United States)

    Alsalamah, Areej

    2017-01-01

    This article provides a systematic review of self-monitoring studies published between 2000 and 2016 in order to investigate the effectiveness of implementing a self-monitoring strategy to improve the outcomes of students with Attention Deficit Hyperactivity Disorder (ADHD). A total of nine articles and dissertations were located and reviewed. The…

  9. A cost-effective strategy for primary prevention of acute rheumatic fever and rheumatic heart disease in children with pharyngitis.

    Science.gov (United States)

    Irlam, James H; Mayosi, Bongani M; Engel, Mark E; Gaziano, Thomas A

    2013-09-03

    Primary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in children depends on prompt and effective diagnosis and treatment of pharyngitis at the primary level of care. Cost-effectiveness modeling shows that the most cost-effective strategy for primary prevention in South Africa (SA) is to use a simple symptomatic clinical decision rule (CDR) to diagnose pharyngitis in children presenting at the primary level of care and then to treat them with a single dose of intramuscular penicillin. Treat All and CDR2+ strategies are affordable and simple and miss few cases of streptococcal pharyngitis at the primary level of care. The CDR2+ strategy is the most cost-effective for primary prevention of ARF and RHD in urban SA and should complement primordial and secondary prevention efforts.

  10. Factors influencing the implementation of anterior cruciate ligament injury prevention strategies by girls soccer coaches.

    Science.gov (United States)

    Joy, Elizabeth A; Taylor, John R; Novak, Melissa A; Chen, Michael; Fink, Barbara P; Porucznik, Christina A

    2013-08-01

    Women are 3 times more likely to injure their anterior cruciate ligament (ACL) while playing soccer than men. ACL injury prevention programs (IPPs) involving stretching and strengthening drills can reduce the incidence of ACL injury when incorporated into routine training. The rate of implementation among coaches is largely unknown. The purpose of this study was to determine the rate of implementation of ACL IPP, to identify factors that influence implementation, and to acquire information to assist in design dissemination and implementation strategies. Study subjects were coaches of woman soccer players aged 11-22 years in Utah (n = 756). Data were gathered using a Web-based survey followed by a qualitative study in which "best practice coaches"-coaches who met criteria for successful implementation of ACL IPP-were interviewed via telephone. A minority of survey respondents, 19.8% (27/136), have implemented ACL IPP. Factors associated with successful implementation include length of coaching experience and presence of additional support staff such as a strength and conditioning coach or athletic trainer. Best practice coaches (14/136) unanimously agreed on the following: (a) there are performance-enhancing benefits of ACL IPP, (b) education on ACL injury prevention should be required for licensure, and (c) dissemination and implementation will require soccer associations to enact policies that require IPPs. In conclusion, a minority of girls soccer coaches have implemented ACL IPP and those that have do so because they believe that prevention improves performance and that soccer organizations should enact policies requiring ACL injury prevention education and implementation. Efforts to implement ACL IPP should be driven by soccer organizations, emphasize performance-enhancing benefits, and engage additional coaching staff.

  11. Promising strategies for advancement in knowledge of suicide risk factors and prevention.

    Science.gov (United States)

    Sareen, Jitender; Isaak, Corinne; Katz, Laurence Y; Bolton, James; Enns, Murray W; Stein, Murray B

    2014-09-01

    Suicide is an important public health problem. Although there have been advances in our knowledge of suicide, gaps remain in knowledge about suicide risk factors and prevention. Here, we discuss research pathways that have the potential to rapidly advance knowledge in suicide risk assessment and reduction of suicide deaths over the next decade. We provide a concise overview of the methodologic approaches that have the capacity to rapidly increase knowledge and change practice, which have been successful in past work in psychiatry and other areas of medicine. We suggest three specific pathways to advance knowledge of suicide risk factors and prevention. First, analysis of large-scale epidemiologic surveys and administrative data sets can advance the understanding of suicide. Second, given the low base rate of suicide, there is a need for networks/consortia of investigators in the field of suicide prevention. Such consortia have the capacity to analyze existing epidemiologic data sets, create multi-site cohort studies of high-risk groups to increase knowledge of biological and other risk factors, and create a platform for multi-site clinical trials. Third, partnerships with policymakers and researchers would facilitate careful scientific evaluation of policies and programs aimed at reducing suicide. Suicide intervention policies are often multifaceted, expensive, and rarely evaluated. Using quasi-experimental methods or sophisticated analytic strategies such as propensity score-matching techniques, the impact of large-scale interventions on suicide can be evaluated. Furthermore, such partnerships between policymakers and researchers can lead to the design and support of prospective RCTs (e.g., cluster randomized trials, stepped wedge designs, waiting list designs) in high-risk groups (e.g., people with a history of suicide attempts, multi-axial comorbidity, and offspring of people who have died by suicide). These research pathways could lead to rapid knowledge uptake

  12. Victor and Erika Webnovela: An Innovative Generation @ Audience Engagement Strategy for Prevention.

    Science.gov (United States)

    Andrade, Elizabeth L; Evans, W Douglas; Edberg, Marc C; Cleary, Sean D; Villalba, Ricardo; Batista, Idalina Cubilla

    2015-01-01

    Entertainment-education (E-E) approaches for young audiences continue to evolve in order to keep stride with younger generations' affinity for technology. E-E and novelas have been used with a wide variety of audiences in the United States, in particular hard-to-reach Latino populations, and have demonstrated effectiveness in disseminating culturally relevant prevention information for a wide variety of health-related risk factors and behaviors. This study discusses the formative research and active engagement of Latino youth living in Langley Park, Maryland, for the development and filming of an innovative 6-episode webnovela titled Victor and Erika (V&E). V&E is part of a larger branding strategy of the Adelante Positive Youth Development intervention that seeks to prevent substance abuse, sexual risk, and interpersonal violence among Latino youth; V&E is also an intervention component. The V&E webnovela is a dramatic portrayal of the lives of 2 immigrant Latino teenagers that also disseminates risk prevention messages. The storyline represents the turning the corner (to a better life) theme that underlies the Adelante intervention brand. Formative research was conducted for character development (n = 20) and creative development of the episodes (n = 14). Results of the formative research showed that youth recommended inclusion of the following topics in V&E episodes: sex, unintended pregnancy, fidelity, trust, family dynamics, immigration status, violence, school dropout, respect, home life, and poverty. Detailed character and episode descriptions are provided, and the implications of using the V&E series as a tool for in-person and online engagement of youth and the dissemination of prevention messages are also discussed.

  13. Stress Prevention@Work : A study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

    NARCIS (Netherlands)

    Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-vlasveld, M.C.; Anema, J.R.; van der Beek, A.J.; Boot, C.R.L.

    2018-01-01

    Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative

  14. Comparison among monitoring strategies to assess water flow dynamic and soil hydraulic properties in agricultural soils

    Directory of Open Access Journals (Sweden)

    Javier Valdes-Abellan

    2015-03-01

    Full Text Available Abstract Irrigated agriculture is usually performed in semi-arid regions despite scarcity of water resources. Therefore, optimal irrigation management by monitoring the soil is essential, and assessing soil hydraulic properties and water flow dynamics is presented as a first measure. For this purpose, the control of volumetric water content, θ, and pressure head, h, is required. This study adopted two types of monitoring strategies in the same experimental plot to control θ and h in the vadose zone: i non-automatic and more time-consuming; ii automatic connected to a datalogger. Water flux was modelled with Hydrus-1D using the data collected from both acquisition strategies independently (3820 daily values for the automatic; less than 1000 for the non-automatic. Goodness-of-fit results reported a better adjustment in case of automatic sensors. Both model outputs adequately predicted the general trend of θ and h, but with slight differences in computed annual drainage (711 mm and 774 mm. Soil hydraulic properties were inversely estimated from both data acquisition systems. Major differences were obtained in the saturated volumetric water content, θs, and the n and α van Genuchten model shape parameters. Saturated hydraulic conductivity, Ks, shown lower variability with a coefficient of variation range from 0.13 to 0.24 for the soil layers defined. Soil hydraulic properties were better assessed through automatic data acquisition as data variability was lower and accuracy was higher.

  15. Formulation of a strategy for monitoring control integrity in critical digital control systems

    Science.gov (United States)

    Belcastro, Celeste M.; Fischl, Robert; Kam, Moshe

    1991-01-01

    Advanced aircraft will require flight critical computer systems for stability augmentation as well as guidance and control that must perform reliably in adverse, as well as nominal, operating environments. Digital system upset is a functional error mode that can occur in electromagnetically harsh environments, involves no component damage, can occur simultaneously in all channels of a redundant control computer, and is software dependent. A strategy is presented for dynamic upset detection to be used in the evaluation of critical digital controllers during the design and/or validation phases of development. Critical controllers must be able to be used in adverse environments that result from disturbances caused by an electromagnetic source such as lightning, high intensity radiated field (HIRF), and nuclear electromagnetic pulses (NEMP). The upset detection strategy presented provides dynamic monitoring of a given control computer for degraded functional integrity that can result from redundancy management errors and control command calculation error that could occur in an electromagnetically harsh operating environment. The use is discussed of Kalman filtering, data fusion, and decision theory in monitoring a given digital controller for control calculation errors, redundancy management errors, and control effectiveness.

  16. Comparison among monitoring strategies to assess water flow dynamic and soil hydraulic properties in agricultural soils

    Energy Technology Data Exchange (ETDEWEB)

    Valdes-Abellan, J.; Jiménez-Martínez, J.; Candela, L.; Tamoh, K.

    2015-07-01

    Irrigated agriculture is usually performed in semi-arid regions despite scarcity of water resources. Therefore, optimal irrigation management by monitoring the soil is essential, and assessing soil hydraulic properties and water flow dynamics is presented as a first measure. For this purpose, the control of volumetric water content, θ, and pressure head, h, is required. This study adopted two types of monitoring strategies in the same experimental plot to control θ and h in the vadose zone: i) non-automatic and more time-consuming; ii) automatic connected to a datalogger. Water flux was modelled with Hydrus-1D using the data collected from both acquisition strategies independently (3820 daily values for the automatic; less than 1000 for the non-automatic). Goodness-of-fit results reported a better adjustment in case of automatic sensors. Both model outputs adequately predicted the general trend of θ and h, but with slight differences in computed annual drainage (711 mm and 774 mm). Soil hydraulic properties were inversely estimated from both data acquisition systems. Major differences were obtained in the saturated volumetric water content, θs, and the n and α van Genuchten model shape parameters. Saturated hydraulic conductivity, Ks, shown lower variability with a coefficient of variation range from 0.13 to 0.24 for the soil layers defined. Soil hydraulic properties were better assessed through automatic data acquisition as data variability was lower and accuracy was higher. (Author)

  17. The environment, international standards, asset health management and condition monitoring: An integrated strategy

    Energy Technology Data Exchange (ETDEWEB)

    Roe, S. [CSD, British Institute of Non-Destructive Testing (BINDT) (United Kingdom); Mba, D. [School of Engineering, Cranfield University, MK43 0AL, Bedfordshire (United Kingdom)], E-mail: d.mba@cranfield.ac.uk

    2009-02-15

    Asset Health Management (AHM), supported by condition monitoring (CM) and performance measuring technologies, together with trending, modelling and diagnostic frameworks, is not only critical to the reliability of high-value machines, but also to a companies Overall Equipment Efficiency (OEE), system safety and profitability. In addition these protocols are also critical to the global concern of the environment. Industries involved with monitoring key performances indicators (KPI) to improve OEE would benefit from a standardised qualification and certification scheme for their personnel, particularly if it is based on internationally accepted procedures for the various CM technologies that also share the same objectives as AH and CM. Furthermore, the development of 'models' for implementation of a Carbon tax is intrinsically dependent on the integrity and accuracy of measurements contributing to these indicators. This paper reviews the global picture of condition monitoring, the environment and related international standards and then considers their relationship and equivalent global objectives. In addition, it presents the methods behind the development of such standards for certification of competence in personnel involved with data collection, modelling and measurements of KPIs. Two case studies are presented that highlight the integrated strategy in practise.

  18. Nonsteroidal Anti-Inflammatory Drug-Induced Gastroduodenal Bleeding: Risk Factors and Prevention Strategies

    Directory of Open Access Journals (Sweden)

    Thomas Wex

    2010-07-01

    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are the most widely prescribed medications in the World. A frequent complication of NSAID use is gastroduodenal bleeding. Risk factors for gastroduodenal bleeding while on NSAID therapy are age, prior peptic ulcer and co-medication with anti-platelet agents, anticoagulants, glucocorticosteroids and selective serotonin-reuptake inhibitors (SSRI. Prevention strategies for at-risk patients include the use of the lowest effective dose of NSAIDs, co-therapy with proton-pump inhibitors and/or the use of a COX-2 selective agent. Treatment of Helicobacter pylori infection is beneficial for primary prophylaxis of NSAID-induced gastroduodenal bleeding in NSAID-naive patients. For patients with cardiovascular risk factors requiring NSAIDs, naproxen should be selected. In very high risk patients for both gastrointestinal and cardiovascular complications NSAID therapy should be avoided altogether.

  19. Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira

    Full Text Available Abstract OBJECTIVE To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. METHOD An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. RESULTS In 90 days, 188 actions were observed, of these, 36.70% (n=69 were related to catheter dressing. In 81.15% (n=56 of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. CONCLUSION Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care.

  20. Methods and Strategies for Overvoltage Prevention in Low Voltage Distribution Systems with PV

    DEFF Research Database (Denmark)

    Hashemi Toghroljerdi, Seyedmostafa; Østergaard, Jacob

    2016-01-01

    , the overvoltage caused by high PV penetration is described, solutions to facilitate higher PV penetration are classified, and their effectiveness, advantages, and disadvantages are illustrated. The investigated solutions include the grid reinforcement, electrical energy storage application, reactive power......The rapid development of photovoltaic (PV) systems in electrical grids brings new challenges in the control and operation of power systems. A considerable share of already installed PV units are small-scale units, usually connected to low voltage (LV) distribution systems that were not designed...... to handle a high share of PV power. This paper provides an in-depth review of methods and strategies proposed to prevent overvoltage in LV grids with PV, and discusses the effectiveness, advantages, and disadvantages of them in detail. Based on the mathematical framework presented in the paper...

  1. Physical Exercise-Induced Adult Neurogenesis: A Good Strategy to Prevent Cognitive Decline in Neurodegenerative Diseases?

    Directory of Open Access Journals (Sweden)

    Suk-yu Yau

    2014-01-01

    Full Text Available Cumulative evidence has indicated that there is an important role for adult hippocampal neurogenesis in cognitive function. With the increasing prevalence of cognitive decline associated with neurodegenerative diseases among the ageing population, physical exercise, a potent enhancer of adult hippocampal neurogenesis, has emerged as a potential preventative strategy/treatment to reduce cognitive decline. Here we review the functional role of adult hippocampal neurogenesis in learning and memory, and how this form of structural plasticity is altered in neurodegenerative diseases known to involve cognitive impairment. We further discuss how physical exercise may contribute to cognitive improvement in the ageing brain by preserving adult neurogenesis, and review the recent approaches for measuring changes in neurogenesis in the live human brain.

  2. Passive immune neutralization strategies for prevention and control of influenza A infections.

    Science.gov (United States)

    Ye, Jianqiang; Shao, Hongxia; Perez, Daniel R

    2012-02-01

    Although vaccination significantly reduces influenza severity, seasonal human influenza epidemics still cause more than 250,000 deaths annually. Vaccine efficacy is limited in high-risk populations such as infants, the elderly and immunosuppressed individuals. In the event of an influenza pandemic (such as the 2009 H1N1 pandemic), a significant delay in vaccine availability represents a significant public health concern, particularly in high-risk groups. The increasing emergence of strains resistant to the two major anti-influenza drugs, adamantanes and neuraminidase inhibitors, and the continuous circulation of avian influenza viruses with pandemic potential in poultry, strongly calls for alternative prophylactic and treatment options. In this review, we focus on passive virus neutralization strategies for the prevention and control of influenza type A viruses.

  3. Percutaneous blood exposure among Danish doctors: exposure mechanisms and strategies for prevention

    DEFF Research Database (Denmark)

    Nelsing, S; Nielsen, T L; Nielsen, Jens Ole

    1997-01-01

    The objective of this study was to describe the mechanisms of percutaneous blood exposure (PCE) among doctors and discuss rational strategies for prevention. Data were obtained as part of a nation-wide questionnaire survey of occupational blood exposure among hospital employed doctors in Denmark.......5% of all PCE. Use of fingers rather than instruments was a major cause of injury in surgical specialities and was a contributing cause of 36.9% PCE on suture needles. Common contributing causes when fingers were used (n = 199) were poor space in (30.2%) or view of (18.6%) the operation field. It was often...... and 'acute situation' were common, especially in the case of PCE on i.v.-catheter-stylets. It is concluded that the exposure mechanisms of PCE reflect both unsafe routines, difficult working conditions and unsafe devices. Education in safer working routines are needed in all specialties. Introduction...

  4. Seasonal and pandemic influenza: the role of communication and preventive strategies.

    Science.gov (United States)

    Boccia, A; Di Thiene, D; De Giusti, M; La Torre, G

    2011-09-01

    Appropriate, timely, and data-driven health information is a very important issue in preventive strategies against influenza. Intuitively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this vaccine. International and national literature reviews suggest that progress has been made in order to incorporate and disseminate crisis risk communication principles into public health practice, as such investments in public health could be important for building capacity and practice which aid in the realization of countermeasures in response to a future pandemic and epidemic situation. This study emphasizes the lack of perception by Health Care Workers (HCWs) of the importance of being immunized against seasonal and pandemic influenza and the doubts concerning safety. In the future, particular efforts are needed during vaccination campaigns, to provide more information to HCWs and the general population regarding role and safety of such vaccines.

  5. Preventive strategy in response to climate change and infrastructural failures for Jakarta slum dwellers

    Directory of Open Access Journals (Sweden)

    V. Pooroe

    2012-08-01

    Full Text Available Jakarta is a city with unpredictable yet annual water shortages, both during the dry and wet season, which disproportionately affect the urban poor. One possible solution is to redevelop the existing water supply system which is now working in one of the largest slum area in Penjaringan, North Jakarta. This system is equipped with a large meter, the Master Meter, to record the communal water consumption and individual meters to record household consumptions. The Community Based Organization uses, operates, and maintains the system based on agreement with water users. Improvement of the Master Meter is achieved by harvesting uncollected rain water during the wet season with its high rainfall intensity, modifying the water storage system and improving the influent water quality. This paper aims to provide a preventive strategy in response to climate change and infrastructural failures based on a case study of community-based water supply project in Penjaringan, Jakarta.

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

    Science.gov (United States)

    Farrell, Todd Charles; Keeping-Burke, Lisa

    2014-01-01

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

  7. Oscillatory hydraulic testing as a strategy for NAPL source zone monitoring: Laboratory experiments

    Science.gov (United States)

    Zhou, YaoQuan; Cardiff, Michael

    2017-05-01

    Non-aqueous phase liquids (NAPLs) have a complex mode of transport in heterogeneous aquifers, which can result in pools and lenses of NAPLs (the ;source zone;) that are difficult to detect and can cause long-term contamination via slow dissolution into groundwater (the ;dissolved plume;). Characterizing the extent and evolution of NAPL contamination within the source zone is a useful strategy for designing and adapting appropriate remedial actions at many contaminated sites. As a NAPL flows into a given aquifer volume, the effective hydraulic conductivity (K) and specific storage (Ss) of the volume changes associated with the viscosity and compressibility of the impinging fluid, meaning that NAPL movement may be detectable with hydraulic testing. Recently, the use of oscillatory pumping tests - in which sinusoidal pumping variations are implemented and oscillatory pressure changes are detected at monitoring locations - has been suggested as a low-impact hydraulic testing strategy for characterizing aquifer properties (Cardiff et al., 2013; Zhou et al., 2016). Here, we investigate this strategy in an experimental laboratory sandbox where dyed vegetable oil is injected and allowed to migrate as a NAPL. Initial qualitative analyses demonstrate that measurable changes in pressure signal amplitude and phase provide clear evidence for NAPL plume emplacement and migration. Using the approach developed in Zhou et al. (2016), we then apply tomographic analyses to estimate the location of effective K changes (representing fluid changes) and their movement throughout time. This approach provides a method for monitoring ongoing NAPL movement without net extraction or injection of fluid, making it advantageous in field remediation applications.

  8. Stabilizing ER Ca2+ channel function as an early preventative strategy for Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Shreaya Chakroborty

    Full Text Available Alzheimer's disease (AD is a devastating neurodegenerative condition with no known cure. While current therapies target late-stage amyloid formation and cholinergic tone, to date, these strategies have proven ineffective at preventing disease progression. The reasons for this may be varied, and could reflect late intervention, or, that earlier pathogenic mechanisms have been overlooked and permitted to accelerate the disease process. One such example would include synaptic pathology, the disease component strongly associated with cognitive impairment. Dysregulated Ca(2+ homeostasis may be one of the critical factors driving synaptic dysfunction. One of the earliest pathophysiological indicators in mutant presenilin (PS AD mice is increased intracellular Ca(2+ signaling, predominantly through the ER-localized inositol triphosphate (IP(3 and ryanodine receptors (RyR. In particular, the RyR-mediated Ca(2+ upregulation within synaptic compartments is associated with altered synaptic homeostasis and network depression at early (presymptomatic AD stages. Here, we offer an alternative approach to AD therapeutics by stabilizing early pathogenic mechanisms associated with synaptic abnormalities. We targeted the RyR as a means to prevent disease progression, and sub-chronically treated AD mouse models (4-weeks with a novel formulation of the RyR inhibitor, dantrolene. Using 2-photon Ca(2+ imaging and patch clamp recordings, we demonstrate that dantrolene treatment fully normalizes ER Ca(2+ signaling within somatic and dendritic compartments in early and later-stage AD mice in hippocampal slices. Additionally, the elevated RyR2 levels in AD mice are restored to control levels with dantrolene treatment, as are synaptic transmission and synaptic plasticity. Aβ deposition within the cortex and hippocampus is also reduced in dantrolene-treated AD mice. In this study, we highlight the pivotal role of Ca(2+ aberrations in AD, and propose a novel strategy to

  9. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies.

    Directory of Open Access Journals (Sweden)

    Siqi Zhao

    Full Text Available The study's objectives were to: 1 use social support theory to examine factors influencing healthcare workers' opinions about workplace violence (WPV prevention strategies, and 2 to determine the types of support that general practitioners (GPs and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention.

  10. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies

    Science.gov (United States)

    Liu, He; Gao, Lijun; Jiao, Mingli; Liu, Jinghua; Liang, Libo; Zhao, Yanming; Wu, Qunhong

    2016-01-01

    The study’s objectives were to: 1) use social support theory to examine factors influencing healthcare workers’ opinions about workplace violence (WPV) prevention strategies, and 2) to determine the types of support that general practitioners (GPs) and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention. PMID:27326460

  11. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies.

    Science.gov (United States)

    Zhao, Siqi; Qu, Lijun; Liu, He; Gao, Lijun; Jiao, Mingli; Liu, Jinghua; Liang, Libo; Zhao, Yanming; Wu, Qunhong

    2016-01-01

    The study's objectives were to: 1) use social support theory to examine factors influencing healthcare workers' opinions about workplace violence (WPV) prevention strategies, and 2) to determine the types of support that general practitioners (GPs) and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention.

  12. Monitoring stress and recovery : New insights for the prevention of injuries and illnesses in elite youth soccer players

    NARCIS (Netherlands)

    Brink, M.S.; Visscher, C.; Arends, S.; Zwerver, Hans; Post, Wendy; Lemmink, K.A.

    Objective Elite youth soccer players have a relatively high risk for injuries and illnesses due to increased physical and psychosocial stress. The aim of this study is to investigate how measures to monitor stress and recovery, and its analysis, provide useful information for the prevention of

  13. Monitoring stress and recovery : New insights for the prevention of injuries and illnesses in elite youth soccer players

    NARCIS (Netherlands)

    Brink, M.S.; Visscher, C.; Arends, S.; Zwerver, Hans; Post, Wendy; Lemmink, K.A.

    2010-01-01

    Objective Elite youth soccer players have a relatively high risk for injuries and illnesses due to increased physical and psychosocial stress. The aim of this study is to investigate how measures to monitor stress and recovery, and its analysis, provide useful information for the prevention of injur

  14. Monitoring stress and recovery : New insights for the prevention of injuries and illnesses in elite youth soccer players

    NARCIS (Netherlands)

    Brink, M.S.; Visscher, C.; Arends, S.; Zwerver, Hans; Post, Wendy; Lemmink, K.A.

    2010-01-01

    Objective Elite youth soccer players have a relatively high risk for injuries and illnesses due to increased physical and psychosocial stress. The aim of this study is to investigate how measures to monitor stress and recovery, and its analysis, provide useful information for the prevention of injur

  15. Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

    Science.gov (United States)

    2012-01-01

    Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care

  16. Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

    Directory of Open Access Journals (Sweden)

    Lay Barbara

    2012-09-01

    Full Text Available Abstract Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be

  17. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  18. Urban Fluxes Monitoring and Development of Planning Strategies to Reduce Ghg Emissions in AN European City

    Science.gov (United States)

    Marras, S.; Sirca, C.; Bellucco, V.; Falk, M.; Pyles, R. D.; Snyder, R. L.; Paw U, K.; Duce, P.; Blecic, I.; Trunfio, G. A.; Cecchini, A.; Spano, D.

    2013-12-01

    Cities and human settlements in general are a primary source of emissions that contribute to human-induced climate change. To investigate the impact of an urbanized area on urban metabolism components, an eddy covariance (EC) tower will be set up in a city (Sassari) located in the center of the Mediterranean basin (Sardinia, Italy). The EC tower, as well as a meteorological station and radiometers, will be set up to monitor energy, water, and carbon fluxes in the city center. A GHG emissions inventory will be also compiled to identify the main emission sources. In addition, a modeling framework will be used to study the impact of different urban planning strategies on carbon emission rates. The modeling framework consists of four models to analyze fluxes both at local and municipality scale: (i) a land surface model ACASA (Advanced Canopy-Atmosphere-Soil Algorithm, ACASA) to simulate the urban metabolism components at local scale; (ii) a Cellular Automata model to simulate the urban land-use dynamics in the near future (20-30 years); (iii) a transportation model to estimate the variation of the transportation network load, and (iv) the coupled model WRF-ACASA will be finally used to simulate the urban metabolism components at municipality scale. The participation of local stakeholders will allow the definition of future planning strategies with the aim to identify low carbon emissions strategies. The projects activities, methodologies applied, as well as the preliminary results will be reported here.

  19. Prevention of Age-Related Cognitive Decline: Which Strategies, When, and for Whom?

    Science.gov (United States)

    Shatenstein, Bryna; Barberger-Gateau, Pascale; Mecocci, Patrizia

    2015-01-01

    Brain aging is characterized by the progressive and gradual accumulation of detrimental changes in structure and function, which increase risk of age-related cognitive decline and dementia. This devastating chronic condition generates a huge social and economic burden and accounts for 11.2% of years of disability. The increase in lifespan has contributed to the increase in dementia prevalence; however, there is currently no curative treatment for most causes of dementias. This paper reviews evidence-based strategies to build, enhance, and preserve cognition over the lifespan by examining approaches that work best, proposing when in the life course they should be implemented, and in which population group(s). Recent work shows a tendency to decreased age-specific prevalence and incidence of cognitive problems and dementia among people born later in the first half of the 20th century, citing higher educational levels, improvements in lifestyle, and better handling of vascular risk factors. This implies that we can target modifiable environmental, lifestyle, and health risk factors to modify the trajectory of cognitive decline before the onset of irreversible dementia. Because building cognitive reserve and prevention of cognitive decline are of critical importance, interventions are needed at every stage of the life course to foster cognitive stimulation, and enable healthy eating habits and physical activity throughout the lifespan. Preventive interventions to decrease and delay cognitive decline and its consequences in old age will also require collaboration and action on the part of policy-makers at the political and social level.

  20. The burden of type 2 diabetes: strategies to prevent or delay onset

    Directory of Open Access Journals (Sweden)

    Nayyar Iqbal

    2007-09-01

    Full Text Available Nayyar IqbalDepartment of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Pennsylvania, Philadelphia VA Medical Center, PA, USAAbstract: Type 2 diabetes is widespread and its prevalence is increasing rapidly. In the US alone, approximately 41 million individuals have prediabetes, placing them at high risk for the development of diabetes. The pathogenesis of type 2 diabetes involves inadequate insulin secretion and resistance to the action of insulin. Suggestive data link insulin resistance and accompanying hyperglycemia to an excess of abdominal adipose tissue, a link that appears to be mediated partially by adipocyte secretion of multiple adipokines that mediate inflammation, thrombosis, atherogenesis, hypertension, and insulin resistance. The adipokine adiponectin has reduced expression in obesity and appears to be protective against the development of type 2 diabetes. Current recommendations to prevent type 2 diabetes center on lifestyle modifications, such as diet and exercise. Clinical trials have established the efficacy of lifestyle intervention, as well as pharmacologic interventions that target glycemic control or fat metabolism. However, diabetes did develop in a substantial percentage of individuals who received intensive intervention in these trials. Thus there is an unmet need for additional strategies in high-risk individuals. Recent data suggest thiazolidinediones and blockade of the endocannabinoid system represent novel therapeutic approaches that may be used for the prevention of diabetes.Keywords: cardiometabolic risk, abdominal obesity, dyslipidemia, diabetes, insulin resistance, endocannabinoid system

  1. Novel therapeutic strategy to prevent chemotherapy-induced persistent sensory neuropathy by TRPA1 blockade.

    Science.gov (United States)

    Trevisan, Gabriela; Materazzi, Serena; Fusi, Camilla; Altomare, Alessandra; Aldini, Giancarlo; Lodovici, Maura; Patacchini, Riccardo; Geppetti, Pierangelo; Nassini, Romina

    2013-05-15

    Chemotherapy-induced peripheral neuropathy (CIPN) is a severe and painful adverse reaction of cancer treatment in patients that is little understood or treated. Cytotoxic drugs that cause CIPN exert their effects by increasing oxidative stress, which activates the ion channel TRPA1 expressed by nociceptors. In this study, we evaluated whether TRPA1 acted as a critical mediator of CIPN by bortezomib or oxaliplatin in a mouse model system. Bortezomib evoked a prolonged mechanical, cold, and selective chemical hypersensitivity (the latter against the TRPA1 agonist allyl isothiocyanate). This CIPN hypersensitivity phenotype that was stably established by bortezomib could be transiently reverted by systemic or local treatment with the TRPA1 antagonist HC-030031. A similar effect was produced by the oxidative stress scavenger α-lipoic acid. Notably, the CIPN phenotype was abolished completely in mice that were genetically deficient in TRPA1, highlighting its essential role. Administration of bortezomib or oxaliplatin, which also elicits TRPA1-dependent hypersensitivity, produced a rapid, transient increase in plasma of carboxy-methyl-lysine, a by-product of oxidative stress. Short-term systemic treatment with either HC-030031 or α-lipoic acid could completely prevent hypersensitivity if administered before the cytotoxic drug. Our findings highlight a key role for early activation/sensitization of TRPA1 by oxidative stress by-products in producing CIPN. Furthermore, they suggest prevention strategies for CIPN in patients through the use of early, short-term treatments with TRPA1 antagonists.

  2. A holistic food labelling strategy for preventing obesity and dental caries.

    Science.gov (United States)

    Cinar, A B; Murtomaa, H

    2009-05-01

    Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts of the whole body (standing side by side supporting each other as close friends), both happy and protected because of consumption of healthy food for the whole body, can promote the foods that are friendly to health of the whole body, implementing the common risk factor approach under a single theme. Labelling healthy food as 'health-friendly' based on an international consensus will provide a clear and uniform picture of what is healthy to eat and result in an international integrated programme for prevention of obesity and caries.

  3. Acute viral bronchiolitis in South Africa: Strategies for management and prevention.

    Science.gov (United States)

    Zar, H J; Madhi, S A; White, D A; Masekela, R; Risenga, S; Lewis, H; Feldman, C; Morrow, B; Jeena, P

    2016-04-01

    Management of acute viral bronchiolitis is largely supportive. There is currently no proven effective therapy other than oxygen for hypoxic children. The evidence indicates that there is no routine benefit from inhaled, rapid short-acting bronchodilators, adrenaline or ipratropium bromide for children with acute viral bronchiolitis. Likewise, there is no demonstrated benefit from routine use of inhaled or oral corticosteroids, inhaled hypertonic saline nebulisation, montelukast or antibiotics. The last should be reserved for children with severe disease, when bacterial co-infection is suspected. Prevention of respiratory syncytial virus (RSV) disease remains a challenge. A specific RSV monoclonal antibody, palivizumab, administered as an intramuscular injection, is available for children at risk of severe bronchiolitis, including premature infants, young children with chronic lung disease, immunodeficiency, or haemodynamically significant congenital heart disease. Prophylaxis should be commenced at the start of the RSV season and given monthly during the season. The development of an RSV vaccine may offer a more effective alternative to prevent disease, for which the results of clinical trials are awaited. Education of parents or caregivers and healthcare workers about diagnostic and management strategies should include the following: bronchiolitis is caused by a virus; it is seasonal; it may start as an upper respiratory tract infection with low-grade fever; symptoms are cough and wheeze, often with fast breathing; antibiotics are generally not needed; and the condition is usually self limiting, although symptoms may occur for up to four weeks in some children.

  4. Pancreatic fistula after pancreatectomy: Evolving definitions, preventive strategies and modern management

    Institute of Scientific and Technical Information of China (English)

    Shailesh V Shrikhande; Melroy A D'Souza

    2008-01-01

    Pancreatic resection is the treatment of choice for pancreatic malignancy and certain benign pancreatic disorders. However, pancreatic resection is technically a demanding procedure and whereas mortality after a pancreaticoduodenectomy is currently <3%-5% in experienced high-volume centers, post-operative morbidity is considerable, about 30%-50%. At present, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and procedures, and can result in life-threatening complications. There is no universally accepted definition of PF that would allow standardized reporting and proper comparison of outcomes between different centers. However, early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating consequences. The present article, reviews the evolution of post resection pancreatic fistula as a concept, and discusses evolving definitions, the current preventive strategies and the management of this problem.

  5. Nonpharmacological, Blood Conservation Techniques for Preventing Neonatal Anemia—Effective and Promising Strategies for Reducing Transfusion

    Science.gov (United States)

    Carroll, Patrick D.; Widness, John A.

    2012-01-01

    The development of anemia after birth in very premature, critically ill newborn infants is a universal well-described phenomenon. Although preventing anemia in this population, along with efforts to establish optimal red blood cell (RBC) transfusion and pharmacologic therapy continue to be actively investigated, the present review focuses exclusively on nonpharmacological approaches to the prevention and treatment of neonatal anemia. We begin with an overview of topics relevant to nonpharmacological techniques. These topics include neonatal and fetoplacental hemoglobin levels and blood volumes, clinical and laboratory practices applied in critically ill neonates, and current RBC transfusion practice guidelines. This is followed by a discussion of the most effective and promising nonpharmacological blood conservation strategies and techniques. Fortunately, many of these techniques are feasible in most neonatal intensive care units. When applied together, these techniques are more effective than existing pharmacotherapies in significantly decreasing neonatal RBC transfusions. They include increasing hemoglobin endowment and circulating blood volume at birth; removing less blood for laboratory testing; and optimizing nutrition. PMID:22818543

  6. Nonpharmacological, blood conservation techniques for preventing neonatal anemia--effective and promising strategies for reducing transfusion.

    Science.gov (United States)

    Carroll, Patrick D; Widness, John A

    2012-08-01

    The development of anemia after birth in very premature, critically ill newborn infants is a universal well-described phenomenon. Although preventing anemia in this population, along with efforts to establish optimal red blood cell (RBC) transfusion and pharmacologic therapy continue to be actively investigated, the present review focuses exclusively on nonpharmacological approaches to the prevention and treatment of neonatal anemia. We begin with an overview of topics relevant to nonpharmacological techniques. These topics include neonatal and fetoplacental hemoglobin levels and blood volumes, clinical and laboratory practices applied in critically ill neonates, and current RBC transfusion practice guidelines. This is followed by a discussion of the most effective and promising nonpharmacological blood conservation strategies and techniques. Fortunately, many of these techniques are feasible in most neonatal intensive care units. When applied together, these techniques are more effective than existing pharmacotherapies in significantly decreasing neonatal RBC transfusions. They include increasing hemoglobin endowment and circulating blood volume at birth; removing less blood for laboratory testing; and optimizing nutrition. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Review of the evidence base of strategies to prevent ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Mathur, Raj; Kailasam, Chandra; Jenkins, Julian

    2007-06-01

    The English-language literature was reviewed to examine the evidence base for strategies that have been used to prevent ovarian hyperstimulation syndrome (OHSS). Prediction of OHSS by pretreatment patient characteristics and ovarian response parameters is unreliable, with a significant number of OHSS cases occurring in patients not thought to be high risk, while the majority of 'high-risk' cycles do not result in OHSS. Alternatives to ovarian stimulation should always be considered, depending on the clinical situation. Monofollicular ovulation induction with a cautious step-up regime carries a lower risk of overstimulation than step-down regimes. In in vitro fertilization (IVF) cycles, a low starting dose of follicle-stimulating hormone (FSH) and the use of 5000 iu human chorionic gonadotrophin (hCG) for final follicular maturation may benefit patients at high risk of OHSS. The role of GnRH antagonists is unclear. In women with polycystic ovaries, who are undergoing ovarian stimulation for IVF, metformin co-treatment may reduce the risk of OHSS. Coasting of cycles with over-response is associated with a reduced risk of OHSS, although precise criteria for initiating and ending coasting are not definable at present. Elective cryopreservation of all embryos prevents late OHSS, but its value has been poorly researched. The literature does not support a role for intravenous albumin, administered around the time of oocyte retrieval, in preventing OHSS. Evidence is insufficient regarding a possible role for hexa-ethyl starch. hCG should not be used for luteal support, as it is associated with a higher risk of OHSS, and equivalent pregnancy rates are obtained with the use of progesterone.

  8. Monitoring rationale, strategy, issues, and methods: UMRR-EMP LTRMP fish component

    Science.gov (United States)

    Ickes, Brian S.; Sauer, Jennifer S.; Rogala, James T.

    2014-01-01

    The Long Term Resource Monitoring Program (LTRMP), an element of the multiagency partnership Upper Mississippi River Restoration-Environmental Management Program, has been monitoring fishes in the Upper Mississippi River System (UMRS) for over two decades, using scientific and highly standardized methods. Today, the LTRMP’s data assets represent one of the world’s largest and most extensive datasets on a great river. Methods and procedures used over the past two decades have been documented and have proven a key tool towards gaining data that are (a) scientifically valid, (b) comparable over time, and (c) comparable over space. These procedures manuals coordinate and standardize methods, procedures, and field behaviors in the execution of long-term monitoring, permitting the informed management and control of important sources of error actually under program control. As LTRMP databases have matured in scope and accumulated more years' worth of data, their utility in research and management in the UMRS basin has increased notably. To maximize their utility, data users need not only be aware of “how the data were collected,” as portrayed in the procedures manuals, but also “why the data were collected in the way they were, at the scales they were, and in the manner that they were.” Whereas the procedures manuals contribute information as to the “how” the data were gained, this document seeks to contribute information as to the “why.” As such, this document is intended to be a companion document to the procedures manuals. Herein, we present information on the rationale for monitoring nearly one-fifth of the entire North American freshwater fish fauna (representing the greatest freshwater fish diversity on the planet at temperate latitudes); strategies employed and their reasoning; and discussions on issues associated with the sampling design itself, data arising therefrom, and uses of those data in different contexts.

  9. A genetic strategy to identify targets for the development of drugs that prevent bacterial persistence.

    Science.gov (United States)

    Kim, Jee-Hyun; O'Brien, Kathryn M; Sharma, Ritu; Boshoff, Helena I M; Rehren, German; Chakraborty, Sumit; Wallach, Joshua B; Monteleone, Mercedes; Wilson, Daniel J; Aldrich, Courtney C; Barry, Clifton E; Rhee, Kyu Y; Ehrt, Sabine; Schnappinger, Dirk

    2013-11-19

    Antibacterial drug development suffers from a paucity of targets whose inhibition kills replicating and nonreplicating bacteria. The latter include phenotypically dormant cells, known as persisters, which are tolerant to many antibiotics and often contribute to failure in the treatment of chronic infections. This is nowhere more apparent than in tuberculosis caused by Mycobacterium tuberculosis, a pathogen that tolerates many antibiotics once it ceases to replicate. We developed a strategy to identify proteins that Mycobacterium tuberculosis requires to both grow and persist and whose inhibition has the potential to prevent drug tolerance and persister formation. This strategy is based on a tunable dual-control genetic switch that provides a regulatory range spanning three orders of magnitude, quickly depletes proteins in both replicating and nonreplicating mycobacteria, and exhibits increased robustness to phenotypic reversion. Using this switch, we demonstrated that depletion of the nicotinamide adenine dinucleotide synthetase (NadE) rapidly killed Mycobacterium tuberculosis under conditions of standard growth and nonreplicative persistence induced by oxygen and nutrient limitation as well as during the acute and chronic phases of infection in mice. These findings establish the dual-control switch as a robust tool with which to probe the essentiality of Mycobacterium tuberculosis proteins under different conditions, including those that induce antibiotic tolerance, and NadE as a target with the potential to shorten current tuberculosis chemotherapies.

  10. Evaluating Infection Prevention Strategies in Out-Patient Dialysis Units Using Agent-Based Modeling.

    Directory of Open Access Journals (Sweden)

    Joanna R Wares

    Full Text Available Patients receiving chronic hemodialysis (CHD are among the most vulnerable to infections caused by multidrug-resistant organisms (MDRO, which are associated with high rates of morbidity and mortality. Current guidelines to reduce transmission of MDRO in the out-patient dialysis unit are targeted at patients considered to be high-risk for transmitting these organisms: those with infected skin wounds not contained by a dressing, or those with fecal incontinence or uncontrolled diarrhea. Here, we hypothesize that targeting patients receiving antimicrobial treatment would more effectively reduce transmission and acquisition of MDRO. We also hypothesize that environmental contamination plays a role in the dissemination of MDRO in the dialysis unit. To address our hypotheses, we built an agent-based model to simulate different treatment strategies in a dialysis unit. Our results suggest that reducing antimicrobial treatment, either by reducing the number of patients receiving treatment or by reducing the duration of the treatment, markedly reduces overall colonization rates and also the levels of environmental contamination in the dialysis unit. Our results also suggest that improving the environmental decontamination efficacy between patient dialysis treatments is an effective method for reducing colonization and contamination rates. These findings have important implications for the development and implementation of future infection prevention strategies.

  11. An Optimal Number-Dependent Preventive Maintenance Strategy for Offshore Wind Turbine Blades Considering Logistics

    Directory of Open Access Journals (Sweden)

    Mahmood Shafiee

    2013-01-01

    Full Text Available In offshore wind turbines, the blades are among the most critical and expensive components that suffer from different types of damage due to the harsh maritime environment and high load. The blade damages can be categorized into two types: the minor damage, which only causes a loss in wind capture without resulting in any turbine stoppage, and the major (catastrophic damage, which stops the wind turbine and can only be corrected by replacement. In this paper, we propose an optimal number-dependent preventive maintenance (NDPM strategy, in which a maintenance team is transported with an ordinary or expedited lead time to the offshore platform at the occurrence of the Nth minor damage or the first major damage, whichever comes first. The long-run expected cost of the maintenance strategy is derived, and the necessary conditions for an optimal solution are obtained. Finally, the proposed model is tested on real data collected from an offshore wind farm database. Also, a sensitivity analysis is conducted in order to evaluate the effect of changes in the model parameters on the optimal solution.

  12. Targeting estrogen receptor β as preventive therapeutic strategy for Leber's hereditary optic neuropathy.

    Science.gov (United States)

    Pisano, Annalinda; Preziuso, Carmela; Iommarini, Luisa; Perli, Elena; Grazioli, Paola; Campese, Antonio F; Maresca, Alessandra; Montopoli, Monica; Masuelli, Laura; Sadun, Alfredo A; d'Amati, Giulia; Carelli, Valerio; Ghelli, Anna; Giordano, Carla

    2015-12-15

    Leber's hereditary optic neuropathy (LHON) is a maternally inherited blinding disease characterized by degeneration of retinal ganglion cells (RGCs) and consequent optic nerve atrophy. Peculiar features of LHON are incomplete penetrance and gender bias, with a marked male prevalence. Based on the different hormonal metabolism between genders, we proposed that estrogens play a protective role in females and showed that these hormones ameliorate mitochondrial dysfunction in LHON through the estrogen receptors (ERs). We also showed that ERβ localize to the mitochondria of RGCs. Thus, targeting ERβ may become a therapeutic strategy for LHON specifically aimed at avoiding or delaying the onset of disease in mutation carriers. Here, we tested the effects of ERβ targeting on LHON mitochondrial defective metabolism by treating LHON cybrid cells carrying the m.11778G>A mutation with a combination of natural estrogen-like compounds that bind ERβ with high selectivity. We demonstrated that these molecules improve cell viability by reducing apoptosis, inducing mitochondrial biogenesis and strongly reducing the levels of reactive oxygen species in LHON cells. These effects were abolished in cells with ERβ knockdown by silencing receptor expression or by using specific receptor antagonists. Our observations support the hypothesis that estrogen-like molecules may be useful in LHON prophylactic therapy. This is particularly important for lifelong disease prevention in unaffected LHON mutation carriers. Current strategies attempting to combat degeneration of RGCs during the acute phase of LHON have not been very effective. Implementing a different and preemptive approach with a low risk profile may be very helpful.

  13. [Platelet allo-antibodies identification strategies for preventing and managing platelet refractoriness].

    Science.gov (United States)

    Basire, A; Picard, C

    2014-11-01

    Platelet refractoriness is a serious complication for patients receiving recurrent platelet transfusions, which can be explained by non-immune and immune causes. Human Leukocyte Antigens (HLA) allo-immunization, especially against HLA class I, is the major cause for immune platelet refractoriness. To a lesser extent, allo-antibodies against specific Human Platelet Antigen (HPA) are also involved. Pregnancy, transplantation and previous transfusions can lead to allo-immune reaction against platelet antigens. After transfusion, platelet count is decreased by accelerated platelet destruction related to antibodies fixation on incompatible platelet antigens. New laboratory tests for allo-antibodies identification were developed to improve sensibility and specificity, especially with the LUMINEX(®) technology. The good use and interpretation of these antibodies assays can improve strategies for platelet refractoriness prevention and management with a patient adapted response. Compatible platelets units can be selected according to their identity with recipient typing or immune compatibility regarding HLA or HPA antibodies or HLA epitope compatibility. Prospective studies are needed to further confirm the clinical benefit of new allo-antibodies identification methods and consensus strategies for immune platelet refractoriness management.

  14. Concerns about partner infidelity are a barrier to adoption of HIV-prevention strategies among young South African couples.

    Science.gov (United States)

    Parker, Lisa; Pettifor, Audrey; Maman, Suzanne; Sibeko, Jabu; MacPhail, Catherine

    2014-01-01

    As part of a larger study to examine the feasibility and acceptability of a couples-based HIV-prevention intervention, we conducted formative in-depth interviews with 10 couples to explore topics such as challenges in practising safer sex, HIV-prevention strategies, gender power and violence, and issues of trust and infidelity. In this study, both men and women perceived infidelity as ubiquitous in their social context and were therefore unable to discuss HIV risk and prevention without suspicions of infidelity in their own relationship. This impacted couples' ability openly and effectively to discuss strategies to prevent HIV and thus may have contributed to the limited uptake of HIV-prevention strategies, such as condom use and HIV testing. The contentious nature of safe-sex discussions placed both members of the couple at a higher risk for HIV acquisition within the partnership. This study sheds light on how existing relationship norms in South Africa influence HIV-prevention communication within couples and suggests that new ways of approaching conflictual issues such as mistrust and infidelity are vital in order for HIV-prevention programmes to succeed.

  15. Design Concept of Human Interface System for Risk Monitoring for Proactive Trouble Prevention

    Energy Technology Data Exchange (ETDEWEB)

    Yoshikawa, Hidekazu; Yang, Ming; Zhang, Zhijian; Hashim, Muhammad [Harbin Engineering University, Harbin (China); Lind, Morten [Technical University of Denmark, Kongens Lyngby (Djibouti); Tamayama, Kiyoshi; Okusa, Kyoichi [Japan Atomic Energy Agency, Tsuruga (Japan)

    2011-08-15

    A new concept is first proposed of distributed human interface system to integrate both operation and maintenance of nuclear power plant. Then, a method of constructing human interface system is introduced by integrating the plant knowledge database system based on Multilevel Flow Model (MFM) with the risk monitor to watch Defense-in Depth plant safety functions. The proposed concept is applied for a liquid metal fast reactor Monju and necessary R and D subjects are reviewed to realize human interface system for the maintenance work in Monju plant. Because of using high temperature liquid sodium as reactor coolant in Monju plant, the maintenance for Monju should utilize more automated equipment of remote control and robotics than that of light water reactor. It is necessary to design optimum task allocation between human and automated machine as the requisites for good communication design of human interface systems to support the collaboration work between workers at local workplace and the main control room. In this paper, the general issues are reviewed on how to configure the whole human interface system for helping proactive trouble prevention and risk evaluation on the basis of the presented target plant model before the concrete proposition of the hardware and software systems development to be used by both the staffs of operation and maintenance of NPP.

  16. Efficacy of a Maternal Depression Prevention Strategy in Head Start: A Randomized Clinical Trial.

    Science.gov (United States)

    Silverstein, Michael; Diaz-Linhart, Yaminette; Cabral, Howard; Beardslee, William; Hegel, Mark; Haile, Winta; Sander, Jenna; Patts, Gregory; Feinberg, Emily

    2017-08-01

    Low-income and minority mothers experience a disproportionate incidence of depression and lack access to treatment services. Development of prevention strategies in accessible community-based venues is a potentially important public health strategy. To determine the efficacy of a depression prevention strategy embedded in Head Start. This randomized clinical trial was performed from February 15, 2011, through May 9, 2016, at 6 Head Start agencies serving families at or below the federal poverty level. Participants included mothers with depressed mood, anhedonia, or depression history but who were not in a current major depressive episode. Participants were followed up for 12 months with masked outcome assessments. Final follow-up was completed on May 9, 2016. Participants were randomized to a problem-solving education (PSE) intervention (n = 111) or usual Head Start services (n = 119). Primary outcomes were problem-solving skills and depressive symptoms. To capture the chronicity and intensity of symptoms, the Quick Inventory of Depressive Symptoms was administered bimonthly, and rates of clinically significant symptom elevations were compared across groups. Secondarily, the presence of a major depressive episode was assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Among the 230 participants, 152 (66.1%) were Hispanic, with a mean (SD) age of 31.4 (7.3) years. An intention-to-treat analysis among 223 participants contributing follow-up data found no differences in problem-solving skills across groups. The mean (SD) number of depressive symptom elevations among the PSE participants was 0.84 (1.39) compared with 1.12 (1.47) among the usual service participants (adjusted incident rate ratio [aIRR], 0.60; 95% CI, 0.41-0.90). In analyses stratified according to baseline depressive symptoms, PSE exerted a preventive effect among those with lower-level baseline symptoms, with a mean (SD) of 0.39 (0.84) elevations among PSE participants

  17. Emergency monitoring strategy and radiation measurements document of the NKS project emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD)

    Energy Technology Data Exchange (ETDEWEB)

    Lahtinen, J. [Radiation and Nuclear Safety Authority (STUK) (Finland)

    2006-04-15

    This report is one of the deliverables of the NKS Project Emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD) (20022005). The project and the overall results are briefly described in the NKS publication 'Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents. Summary Report on the NKS Project EMARAD' (NKS-137, April 2006). In a nuclear or radiological emergency, all radiation measurements must be performed efficiently and the results interpreted correctly in order to provide the decision-makers with adequate data needed in analysing the situation and carrying out countermeasures. Managing measurements in different situations in a proper way requires the existence of pre-prepared emergency monitoring strategies. Preparing a comprehensive yet versatile strategy is not an easy task to perform because there are lots of different factors that have to be taken into account. The primary objective of this study was to discuss the general problematics concerning emergency monitoring strategies and to describe a few important features of an efficient emergency monitoring system as well as factors affecting measurement activities in practise. Some information concerning the current situation in the Nordic countries has also been included. (au)

  18. Emergency monitoring strategy and radiation measurements document of the NKS project emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD)

    Energy Technology Data Exchange (ETDEWEB)

    Lahtinen, J. [Radiation and Nuclear Safety Authority (STUK) (Finland)

    2006-04-15

    This report is one of the deliverables of the NKS Project Emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD) (20022005). The project and the overall results are briefly described in the NKS publication 'Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents. Summary Report on the NKS Project EMARAD' (NKS-137, April 2006). In a nuclear or radiological emergency, all radiation measurements must be performed efficiently and the results interpreted correctly in order to provide the decision-makers with adequate data needed in analysing the situation and carrying out countermeasures. Managing measurements in different situations in a proper way requires the existence of pre-prepared emergency monitoring strategies. Preparing a comprehensive yet versatile strategy is not an easy task to perform because there are lots of different factors that have to be taken into account. The primary objective of this study was to discuss the general problematics concerning emergency monitoring strategies and to describe a few important features of an efficient emergency monitoring system as well as factors affecting measurement activities in practise. Some information concerning the current situation in the Nordic countries has also been included. (au)

  19. Attitudes of serodiscordant couples towards antiretroviral-based HIV prevention strategies in Kenya: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nikola Fowler

    2014-11-01

    Full Text Available Introduction: Transmission in serodiscordant couples (SDCs accounts for approximately half of all new HIV infections, both in Kenya and the wider sub-Saharan region (1. With evidence to suggest inconsistent condom use within this population (2, the World Health Organization has recommended two new methods of HIV prevention for SDCs: Treatment as Prevention (TasP and Pre-Exposure Prophylaxis (PrEP. However, there has been little research about the attitudes of SDCs towards these strategies (3, 4; knowledge that is paramount for successfully predicting the acceptability and efficacy of each method, as well as for informing decisions regarding HIV policy changes in Kenya. Methods: An exploratory, qualitative study was conducted in the Muhoroni constituency of Nyando district, Kenya from January to March 2013. Purposive sampling was predominately used to recruit 21 HIV-positive and 17 HIV-negative individuals in a serodiscordant relationship from four hospitals and health centres. During face-to-face semi-structured interviews, topic guides were used to elicit information about participants’ attitudes and preferences towards TasP and PrEP. Collected data underwent framework analysis, allowing the development of overarching categories, sub-themes and inductive interpretation. Results: The majority of participants, irrespective of gender and HIV status, found TasP more acceptable than PrEP. A key factor influencing this decision was HIV-negative participants’ limited motivation to take and adhere to antiretrovirals (ARVs, primarily due to a predominantly external health locus of control, a lack of cultural acceptance of prophylactic medication and concerns about side effects. In addition to this, the likely health improvements TasP offers HIV-positive partners, as well as the attitude that the sick individual should be the first to receive HIV medication, also contributed to this conclusion. Issues of risk compensation were raised, with some HIV

  20. Economics of place-based monitoring under the safe drinking water act, part III: performance evaluation of place-based monitoring strategies.

    Science.gov (United States)

    Brands, Edwin; Rajagopal, R

    2008-08-01

    The goals of environmental legislation and associated regulations are to protect public health, natural resources, and ecosystems. In this context, monitoring programs should provide timely and relevant information so that the regulatory community can implement legislation in a cost-effective and efficient manner. The Safe Drinking Water Act (SDWA) of 1974 attempts to ensure that public water systems (PWSs) supply safe water to its consumers. As is the case with many other federal environmental statutes, SDWA monitoring has been implemented in relatively uniform fashion across the USA. In this three part series, we present over 30 years of evidence to demonstrate unique patterns in water quality contaminants over space and time, develop alternative place-based monitoring approaches that exploit such patterns, and evaluate the economic performance of such approaches to current monitoring practice. Part III: Place-based (PBA) and current SDWA monitoring approaches were implemented on test datasets (1995-2001) from 19 water systems and evaluated based on the following criteria: percent of total detections, percent detections above threshold values (e.g. 20, 50, 90% of MCL), and cost. The PBA outperformed the current SDWA monitoring requirements in terms of total detections, missed only a small proportion of detections below the MCL, and captured all detections above 50% of the MCL. Essentially the same information obtained from current compliance monitoring requirements can be gained at approximately one-eighth the cost by implementing the PBA. Temporal sampling strategies were implemented on test datasets (1995-2001) from four water systems and evaluated by the following criteria: parameter estimation, percent deviation from "true" 90th, 95th, and 99th percentiles, and number of samples versus accuracy of the estimate. Non event-based (NEB) strategies were superior in estimating percentiles 1-50, but underestimated the higher percentiles. Event-based strategies were

  1. Economics of place-based monitoring under the safe drinking water act, part II: design and development of place-based monitoring strategies.

    Science.gov (United States)

    Brands, Edwin; Rajagopal, R

    2008-08-01

    The goals of environmental legislation and associated regulations are to protect public health, natural resources, and ecosystems. In this context, monitoring programs should provide timely and relevant information so that the regulatory community can implement legislation in a cost-effective and efficient manner. The Safe Drinking Water Act (SDWA) of 1974 attempts to ensure that public water systems (PWSs) supply safe water to its consumers. As is the case with many other federal environmental statutes, SDWA monitoring has been implemented in relatively uniform fashion across the United States. In this three part series, spatial and temporal patterns in water quality data are utilized to develop, compare, and evaluate the economic performance of alternative place-based monitoring approaches to current monitoring practice. Part II: Several factors affect the performance of monitoring strategies, including: measurable objectives, required precision in estimates, acceptable confidence levels of such estimates, available budget for sampling. In this paper, we develop place-based monitoring strategies based on extensive analysis of available historical water quality data (1960-1994) of 19 Iowa community water systems. These systems supply potable water to over 350,000 people. In the context of drinking water, the objective is to protect public health by utilizing monitoring resources to characterize contaminants that are detectable, and are close to exceeding health standards. A place-based monitoring strategy was developed in which contaminants were selected based on their historical occurrence, rather than their appearance on the SDWA contaminant list. In a subset of the water systems, the temporal frequency of monitoring for one ubiquitous contaminant, nitrate, was tailored to patterns in its historical occurrence and concentration. Three sampling allocation models (linear, quadratic, and cubic) based on historic patterns in peak occurrence were developed and

  2. From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control

    Directory of Open Access Journals (Sweden)

    Tanner Marcel

    2008-07-01

    Full Text Available Abstract Background Achieving the Millennium Development Goals for health requires a massive scaling-up of interventions in Sub Saharan Africa. Intermittent Preventive Treatment in infants (IPTi is a promising new tool for malaria control. Although efficacy information is available for many interventions, there is a dearth of data on the resources required for scaling up of health interventions. Method We worked in partnership with the Ministry of Health and Social Welfare (MoHSW to develop an IPTi strategy that could be implemented and managed by routine health services. We tracked health system and other costs of (1 developing the strategy and (2 maintaining routine implementation of the strategy in five districts in southern Tanzania. Financial costs were extracted and summarized from a costing template and semi-structured interviews were conducted with key informants to record time and resources spent on IPTi activities. Results The estimated financial cost to start-up and run IPTi in the whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were incurred at the national level, mainly on the development of Behaviour Change Communication (BCC materials, stakeholders' meetings and other consultations. The annual running cost at national level for intervention management and monitoring and drug purchase was estimated at US$459,096. Start-up costs at the district level were US$7,885 per district, mainly expenditure on training. Annual running costs were US$170 per district, mainly for printing of BCC materials. There was no incremental financial expenditure needed to deliver the intervention in health facilities as supplies were delivered alongside routine vaccinations and available health workers performed the activities without working overtime. The economic cost was estimated at 23 US cents per IPTi dose delivered. Conclusion The costs presented here show the order of magnitude of expenditures needed to initiate and to

  3. From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control.

    Science.gov (United States)

    Manzi, Fatuma; Hutton, Guy; Schellenberg, Joanna; Tanner, Marcel; Alonso, Pedro; Mshinda, Hassan; Schellenberg, David

    2008-07-31

    Achieving the Millennium Development Goals for health requires a massive scaling-up of interventions in Sub Saharan Africa. Intermittent Preventive Treatment in infants (IPTi) is a promising new tool for malaria control. Although efficacy information is available for many interventions, there is a dearth of data on the resources required for scaling up of health interventions. We worked in partnership with the Ministry of Health and Social Welfare (MoHSW) to develop an IPTi strategy that could be implemented and managed by routine health services. We tracked health system and other costs of (1) developing the strategy and (2) maintaining routine implementation of the strategy in five districts in southern Tanzania. Financial costs were extracted and summarized from a costing template and semi-structured interviews were conducted with key informants to record time and resources spent on IPTi activities. The estimated financial cost to start-up and run IPTi in the whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were incurred at the national level, mainly on the development of Behaviour Change Communication (BCC) materials, stakeholders' meetings and other consultations. The annual running cost at national level for intervention management and monitoring and drug purchase was estimated at US$459,096. Start-up costs at the district level were US$7,885 per district, mainly expenditure on training. Annual running costs were US$170 per district, mainly for printing of BCC materials. There was no incremental financial expenditure needed to deliver the intervention in health facilities as supplies were delivered alongside routine vaccinations and available health workers performed the activities without working overtime. The economic cost was estimated at 23 US cents per IPTi dose delivered. The costs presented here show the order of magnitude of expenditures needed to initiate and to implement IPTi at national scale in settings with high Expanded

  4. Common pathways toward informing policy and environmental strategies to promote health: a study of CDC's Prevention Research Centers.

    Science.gov (United States)

    Neri, Elizabeth M; Stringer, Kate J; Spadaro, Antonia J; Ballman, Marie R; Grunbaum, Jo Anne

    2015-03-01

    This study examined the roles academic researchers can play to inform policy and environmental strategies that promote health and prevent disease. Prevention Research Centers (PRCs) engage in academic-community partnerships to conduct applied public health research. Interviews were used to collect data on the roles played by 32 PRCs to inform policy and environmental strategies that were implemented between September 2009 and September 2010. Descriptive statistics were calculated in SAS 9.2. A difference in roles played was observed depending on whether strategies were policy or environmental. Of the policy initiatives, the most common roles were education, research, and partnership. In contrast, the most prevalent roles the PRCs played in environmental approaches were research and providing health promotion resources. Academic research centers play various roles to help inform policy and environmental strategies.

  5. An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students

    Science.gov (United States)

    Calderón- Garcidueñas, Ana Laura; Flores-Peña, Yolanda; De León-Leal, Silvia; Vázquez-Martínez, Carlos Alberto; Farías-Calderón, Ana Gabriela; Melo-Santiesteban, Guadalupe; Elizondo-Zapién, Rosa María; Hernandez-Hernandez, Dulce María; Garza-Moya, Rubén; Cerda-Flores, Ricardo Martín

    2015-01-01

    Introduction Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. Methodology An educational strategy for high school students in Mexico (2011–2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test–Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. Results An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = − 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. Conclusions The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way. PMID:26844079

  6. An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students.

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Flores-Peña, Yolanda; De León-Leal, Silvia; Vázquez-Martínez, Carlos Alberto; Farías-Calderón, Ana Gabriela; Melo-Santiesteban, Guadalupe; Elizondo-Zapién, Rosa María; Hernandez-Hernandez, Dulce María; Garza-Moya, Rubén; Cerda-Flores, Ricardo Martín

    2015-01-01

    Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

  7. Three years monitoring survey of pesticide residues in Sardinia wines following integrated pest management strategies.

    Science.gov (United States)

    Angioni, Alberto; Dedola, Fabrizio

    2013-05-01

    This paper reports the results of a pesticide monitoring survey on wine grapes from the 2008-2010 vintage from vineyards grown according to integrated pest management strategies. A multi-residue gas chromatography-mass spectrometry method in electron ionization and chemical ionization mode has been used for the determination of 30 pesticides in wine samples. The analytical method showed good recoveries and allowed a good separation of the selected pesticides. Repeatability and intermediate precision showed good results with CV < 20 %. The instrumental method limits of determination (LOD) and of quantification (LOQ) were below the maximum residue levels set in wine. The analysis of the wines showed that pesticide residues were below the instrumental LOQ, and most of them were undetectable (

  8. Application of Novel Exploration and Monitoring Strategies for Sustainable Managed Aquifer Recharge Operation

    Science.gov (United States)

    Vienken, T.; Werban, U.; Cisotto, A.; Rossetto, R.; Dietrich, P.

    2015-12-01

    Water scarcity and drought have led to a strong decline of water availability in many semiarid countries with resulting ecological and economic impacts. Managed aquifer recharge (MAR), e.g. river bank infiltration or storm water infiltration basins and trenches, represents a promising technique to replenish water resources, and in combination with awareness raising, is an important step towards sustainable water management. However, choice of type and positioning large scale MAR infrastructure is challenging as it requires a detailed understanding of the subsurface. Furthermore, MAR site maintenance can be time intensive and costly as effects, such as bio clogging or colmation can lead to a strong decrease in infiltration capacity. In our work we will show examples of successful implementation of novel strategies of MAR site characterization and monitoring on different scales.

  9. Monitoring strategies of stream phosphorus under contrasting climate-driven flow regimes

    DEFF Research Database (Denmark)

    Goyenola, Guillermo; Meerhoff, Marianna; Teixeira-de Mello, Franco;

    2015-01-01

    and the performance of alternative monitoring strategies in streams under contrasting climate-driven flow regimes. We compared a set of paired streams draining lowland micro-catchments under temperate climate and stable discharge conditions (Denmark) and under sub-tropical climate and flashy conditions (Uruguay). We...... phosphorus export from diffuse sources in streams in Uruguay streams, mostly as a consequence of higher variability in flow regime (higher flashiness). Contrarily, we found a higher contribution of dissolved P in flashy streams. We did not find a notably poorer performance of the low-frequency sampling...... program to estimate P exports in flashy streams compared to the less variable streams. We also found signs of interaction between climate/hydrology and land use intensity, in particular in the presence of point sources of P, leading to a bias towards underestimation of P in hydrologically stable streams...

  10. Multi-mode process monitoring based on a novel weighted local standardization strategy and support vector data description

    Institute of Scientific and Technical Information of China (English)

    赵付洲; 宋冰; 侍洪波

    2016-01-01

    There are multiple operating modes in the real industrial process, and the collected data follow the complex multimodal distribution, so most traditional process monitoring methods are no longer applicable because their presumptions are that sampled-data should obey the single Gaussian distribution or non-Gaussian distribution. In order to solve these problems, a novel weighted local standardization (WLS) strategy is proposed to standardize the multimodal data, which can eliminate the multi-mode characteristics of the collected data, and normalize them into unimodal data distribution. After detailed analysis of the raised data preprocessing strategy, a new algorithm using WLS strategy with support vector data description (SVDD) is put forward to apply for multi-mode monitoring process. Unlike the strategy of building multiple local models, the developed method only contains a model without the prior knowledge of multi-mode process. To demonstrate the proposed method’s validity, it is applied to a numerical example and a Tennessee Eastman (TE) process. Finally, the simulation results show that the WLS strategy is very effective to standardize multimodal data, and the WLS-SVDD monitoring method has great advantages over the traditional SVDD and PCA combined with a local standardization strategy (LNS-PCA) in multi-mode process monitoring.

  11. Arctic ecosystem functional zones: identification and quantification using an above and below ground monitoring strategy

    Science.gov (United States)

    Hubbard, Susan S.; Ajo-Franklin, Jonathan B.; Dafflon, Baptiste; Dou, Shan; Kneafsey, Tim J.; Peterson, John E.; Tas, Neslihan; Torn, Margaret S.; Phuong Tran, Anh; Ulrich, Craig; Wainwright, Haruko; Wu, Yuxin; Wullschleger, Stan

    2015-04-01

    Although accurate prediction of ecosystem feedbacks to climate requires characterization of the properties that influence terrestrial carbon cycling, performing such characterization is challenging due to the disparity of scales involved. This is particularly true in vulnerable Arctic ecosystems, where microbial activities leading to the production of greenhouse gasses are a function of small-scale hydrological, geochemical, and thermal conditions influenced by geomorphology and seasonal dynamics. As part of the DOE Next-Generation Ecosystem Experiment (NGEE-Arctic), we are advancing two approaches to improve the characterization of complex Arctic ecosystems, with an initial application to an ice-wedge polygon dominated tundra site near Barrow, AK, USA. The first advance focuses on developing a new strategy to jointly monitor above- and below- ground properties critical for carbon cycling in the tundra. The strategy includes co-characterization of properties within the three critical ecosystem compartments: land surface (vegetation, water inundation, snow thickness, and geomorphology); active layer (peat thickness, soil moisture, soil texture, hydraulic conductivity, soil temperature, and geochemistry); and permafrost (mineral soil and ice content, nature, and distribution). Using a nested sampling strategy, a wide range of measurements have been collected at the study site over the past three years, including: above-ground imagery (LiDAR, visible, near infrared, NDVI) from various platforms, surface geophysical datasets (electrical, electromagnetic, ground penetrating radar, seismic), and point measurements (such as CO2 and methane fluxes, soil properties, microbial community composition). A subset of the coincident datasets is autonomously collected daily. Laboratory experiments and new inversion approaches are used to improve interpretation of the field geophysical datasets in terms of ecosystem properties. The new strategy has significantly advanced our ability

  12. Rib stress fractures among rowers: definition, epidemiology, mechanisms, risk factors and effectiveness of injury prevention strategies.

    Science.gov (United States)

    McDonnell, Lisa K; Hume, Patria A; Nolte, Volker

    2011-11-01

    Rib stress fractures (RSFs) can have serious effects on rowing training and performance and accordingly represent an important topic for sports medicine practitioners. Therefore, the aim of this review is to outline the definition, epidemiology, mechanisms, intrinsic and extrinsic risk factors, injury management and injury prevention strategies for RSF in rowers. To this end, nine relevant books, 140 journal articles, the proceedings of five conferences and two unpublished presentations were reviewed after searches of electronic databases using the keywords 'rowing', 'rib', 'stress fracture', 'injury', 'mechanics' and 'kinetics'. The review showed that RSF is an incomplete fracture occurring from an imbalance between the rate of bone resorption and the rate of bone formation. RSF occurs in 8.1-16.4% of elite rowers, 2% of university rowers and 1% of junior elite rowers. Approximately 86% of rowing RSF cases with known locations occur in ribs four to eight, mostly along the anterolateral/lateral rib cage. Elite rowers are more likely to experience RSF than nonelite rowers. Injury occurrence is equal among sweep rowers and scullers, but the regional location of the injury differs. The mechanism of injury is multifactorial with numerous intrinsic and extrinsic risk factors contributing. Posterior-directed resultant forces arising from the forward directed force vector through the arms to the oar handle in combination with the force vector induced by the scapula retractors during mid-drive, or repetitive stress from the external obliques and rectus abdominis in the 'finish' position, may be responsible for RSF. Joint hypomobility, vertebral malalignment or low bone mineral density may be associated with RSF. Case studies have shown increased risk associated with amenorrhoea, low bone density or poor technique, in combination with increases in training volume. Training volume alone may have less effect on injury than other factors. Large differences in seat and handle

  13. Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies

    Directory of Open Access Journals (Sweden)

    Dale W. Litzenberg

    2012-01-01

    Full Text Available The purpose of this work is to determine appropriate radiation therapy beam margins to account for intrafraction prostate translations for use with real-time electromagnetic position monitoring and correction strategies. Motion was measured continuously in 35 patients over 1157 fractions at 5 institutions. This data was studied using van Herk's formula of (αΣ+γσ' for situations ranging from no electromagnetic guidance to automated real-time corrections. Without electromagnetic guidance, margins of over 10 mm are necessary to ensure 95% dosimetric coverage while automated electromagnetic guidance allows the margins necessary for intrafraction translations to be reduced to submillimeter levels. Factors such as prostate deformation and rotation, which are not included in this analysis, will become the dominant concerns as margins are reduced. Continuous electromagnetic monitoring and automated correction have the potential to reduce prostate margins to 2-3 mm, while ensuring that a higher percentage of patients (99% versus 90% receive a greater percentage (99% versus 95% of the prescription dose.

  14. Geochemical landscape strategy in monitoring the areas contaminated by the Chernobyl radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Korobova, E.M.; Linnik, V.G. (Department of Geoinformation Investigations, Russian Scientific-Practical and Expert-Analytical Centre (RNEC), Moscow (Russian Federation))

    1993-12-01

    The Chernobyl accident led to radionuclide contamination of vast areas that now need to be monitored; the development of a regional land use strategy is now needed. Landscape geochemistry enables us to structure, classify and map the environmental factors responsible for the redistribution of radionuclides (i.e. soil-forming rocks and soil properties, vegetation cover, types of ground water migration, and vertical and lateral geochemical barriers). Combined with land use information, regional geochemical landscape maps serve as the basis to map in toposequence conditions of mass migration and accumulation in natural and cultivated landscapes. Such mapping makes it easier to choose representative monitoring sites. This type of mapping is also helpful to interrelate and extrapolate the data already obtained on radionuclides' environmental migration for different groups of geochemical landscapes with similar types of contamination, migration and accumulation patterns. A geochemical landscape approach is demonstrated using the example of part of the Bryansk region (Russia), which is considerably contaminated with [sup 134]Cs and [sup 137]Cs.

  15. An integrated climate service strategy for African drought monitoring and prediction: linking information to action

    Science.gov (United States)

    Funk, C.; Verdin, J. P.; Rowland, J.; Budde, M.

    2008-12-01

    For 23 years, the US Agency for International Development's Famine Early Warning Systems Network (FEWS NET) has applied climate data analysis in support of timely food insecurity mitigation and adaptation in Africa. FEWS NET, therefore, provides a compelling example of a sector-specific climate service. We briefly review the phases, successes and shortcomings of the FEWS NET climate service, describe an improved long term climate service strategy, and present new research supporting an improved, integrated drought monitoring approach. Our new monitoring system emphasizes seamless links between historical precipitation archives, near real-time rainfall estimates, and 1-to-4 month statistical predictions. Assessment of forecast skill shows useful levels of accuracy for many regions during key periods of the growing season. Integrating these forecasts with near real time blended satellite-gauge precipitation observations facilitates early identification of mid-season agricultural drought. Integrated historical climate archives (1979-present) permit analysis of observed and forecast climate conditions in terms of historical probabilities and analogs. Tools specific to staple crops and pastoralist settings are then used to assess the likely impacts of hydrometeorological anomalies. These are geographically integrated with livelihoods information and interpreted in terms of current food security conditions and timelines to determine human consequences. A client-server web-mapping data portal will allow users to dynamically access the climate anomaly information, and visualize the results in conjunction with livelihood information.

  16. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  17. Strategically Timed Preventive Education and Media Strategies Reduce Seasonal Trends in Adolescent Conception.

    Science.gov (United States)

    Gauster, A; Waddington, A; Jamieson, M A

    2015-08-01

    This study sought to analyze the effect of strategically timed local preventive education on reducing teen conception rates during known seasonal peaks in March and April. All teen conceptions (age ≤ 19) from March and April 2010, 2011, and 2012 were identified using medical records data. Teen conceptions occurring in January 2010, 2011, and 2012 were also identified to control for any new trends in the community. A city of 160,000 with 1 tertiary care centre. Pregnant adolescents (age ≤ 19). During the month of February 2012, preventive education and media awareness strategies were aimed at parents, teachers, and teens. Adolescent conceptions in March and April 2012. Conception rates in teens ≤18 years old were significantly reduced in March and April 2012 compared to March and April 2010 and 2011 (RR = 0.53, 95% CI = 0.32 - 0.88, P = .0132). There was an increase in conceptions in March and April 2012 compared to 2010 and 2011 among 19-year-olds (RR = 1.57, 95% CI = 0.84-2.9, P = .1500). Effect modification revealed our ≤18-year-old group and our 19-year-old group were distinct groups with different risk estimates (P = .0075). Educational sessions were poorly attended and contraception clinic volume was static. We propose increased parental supervision in response to media reminders as a possible explanation for the reduction in adolescent conceptions (≤18 years old) seen in March 2012. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  18. A new live-cell reporter strategy to simultaneously monitor mitochondrial biogenesis and morphology.

    Science.gov (United States)

    Hodneland Nilsson, Linn Iren; Nitschke Pettersen, Ina Katrine; Nikolaisen, Julie; Micklem, David; Avsnes Dale, Hege; Vatne Røsland, Gro; Lorens, James; Tronstad, Karl Johan

    2015-11-24

    Changes in mitochondrial amount and shape are intimately linked to maintenance of cell homeostasis via adaptation of vital functions. Here, we developed a new live-cell reporter strategy to simultaneously monitor mitochondrial biogenesis and morphology. This was achieved by making a genetic reporter construct where a master regulator of mitochondrial biogenesis, nuclear respiratory factor 1 (NRF-1), controls expression of mitochondria targeted green fluorescent protein (mitoGFP). HeLa cells with the reporter construct demonstrated inducible expression of mitoGFP upon activation of AMP-dependent protein kinase (AMPK) with AICAR. We established stable reporter cells where the mitoGFP reporter activity corresponded with mitochondrial biogenesis both in magnitude and kinetics, as confirmed by biochemical markers and confocal microscopy. Quantitative 3D image analysis confirmed accordant increase in mitochondrial biomass, in addition to filament/network promoting and protecting effects on mitochondrial morphology, after treatment with AICAR. The level of mitoGFP reversed upon removal of AICAR, in parallel with decrease in mtDNA. In summary, we here present a new GFP-based genetic reporter strategy to study mitochondrial regulation and dynamics in living cells. This combinatorial reporter concept can readily be transferred to other cell models and contexts to address specific physiological mechanisms.

  19. Atmospheric water vapor monitoring from local GNSS networks: comparisons of GNSS data adjustment strategies

    Science.gov (United States)

    Capponi, Martina; Fermi, Alessandro; Monti Guarnieri, Andrea; Realini, Eugenio; Venuti, Giovanna

    2016-04-01

    Since many years GNSS has been regarded by the meteorological community as one of the systems for atmospheric water vapor remote sensing. Time series of GNSS wet delays are estimated as by-products of accurate positioning. Their assimilation into numerical weather prediction (NWP) models is being investigated at both research and operational levels, although typically at coarse space resolutions (e.g. few tens of km). A dedicated use of this system for water vapor monitoring at higher resolutions is still under investigation. Ad hoc networks have been designed and implemented to collect data at a high spatial resolution (station inter-distances of 1-10 km), to have an insight into the spatial distribution of GNSS derived wet delays and/or into the impact of such information on high resolution NWP models. Within this research framework the paper reports the comparisons carried out between ZWD time series obtained from the data collected by an Italian and a Japanese dense networks of permanent geodetic GNSS receivers. Tropospheric delays have been estimated by applying different data adjustment strategies: relative positioning and PPP (precise point positioning). For this last strategy two different solutions have been analyzed and compared: the Bernese software batch solution, and the RTNet software Kalman filter solution. Assessment of the results were performed against IGS GNSS delays as well as by comparison with radiosonde-derived precipitable water vapor (PWV).

  20. Monitoring screen use: a qualitative exploration of family strategies in Swiss homes.

    Science.gov (United States)

    Piguet, Claire; Barrense-Dias, Yara; Ramelet, Anne-Sylvie; Suris, Joan-Carles

    2017-07-14

    Background Digital technologies make family managing more complicated, as parents are worried about their children's well-being and want to protect them from excessive Internet use. Objective The objective of this study was to investigate both youths' and parents' views on strategies and rules set at home to regulate and monitor Internet use. Subjects Thirty-five adolescents (19 females), aged between 11 and 18 years, and 27 parents (17 mothers) from the French-speaking part of Switzerland participated in different focus groups. Methods Using a qualitative approach, results were analyzed using the grounded theory. Results Eight different mediation strategies emerged. One relevant finding is that rules regarding problematic content were never mentioned, while rules about screen time and location of use were numerous. This might indicate that parents are more worried about the time spent in front of the screen than about the actual activities their children engage in. Conclusions It could be recommended to parents to keep striving for an environment contributing to open discussion and exchange on Internet use, even if their digital literacy is lower than their youngsters' are.

  1. A Health Surveillance Software Framework to deliver information on preventive healthcare strategies.

    Science.gov (United States)

    Macedo, Alessandra Alaniz; Pollettini, Juliana Tarossi; Baranauskas, José Augusto; Chaves, Julia Carmona Almeida

    2016-08-01

    A software framework can reduce costs related to the development of an application because it allows developers to reuse both design and code. Recently, companies and research groups have announced that they have been employing health software frameworks. This paper presents the design, proof-of-concept implementations and experimentation of the Health Surveillance Software Framework (HSSF). The HSSF is a framework that tackles the demand for the recommendation of surveillance information aiming at supporting preventive healthcare strategies. Examples of such strategies are the automatic recommendation of surveillance levels to patients in need of healthcare and the automatic recommendation of scientific literature that elucidates epigenetic problems related to patients. HSSF was created from two systems we developed in our previous work on health surveillance systems: the Automatic-SL and CISS systems. The Automatic-SL system aims to assist healthcare professionals in making decisions and in identifying children with developmental problems. The CISS service associates genetic and epigenetic risk factors related to chronic diseases with patient's clinical records. Towards evaluating the HSSF framework, two new systems, CISS+ and CISS-SW, were created by means of abstractions and instantiations of the framework (design and code). We show that HSSF supported the development of the two new systems given that they both recommend scientific papers using medical records as queries even though they exploit different computational technologies. In an experiment using simulated patients' medical records, we show that CISS, CISS+, and CISS-SW systems recommended more closely related and somewhat related documents than Google, Google Scholar and PubMed. Considering recall and precision measures, CISS+ surpasses CISS-SW in terms of precision.

  2. Chronic respiratory diseases in developing countries: the burden and strategies for prevention and management.

    Science.gov (United States)

    Aït-Khaled, N; Enarson, D; Bousquet, J

    2001-01-01

    In developing countries, chronic respiratory diseases represent a challenge to public health because of their frequency, severity, projected trends, and economic impact. Health care planners, for example, are faced with a dramatic increase in tobacco use and must establish priorities for the allocation of limited resources. Nevertheless, smoking prevention and standardized management programmes for asthma and chronic obstructive pulmonary disease should be implemented in developing countries whenever possible. International measures will be required to reverse tobacco smoking trends, and international agencies could define essential drugs and equipment and encourage the use of generic drugs, particularly for corticosteroids inhaled at high dosages. For such programmes to be effective, producers of high-quality generics will need to be identified, and the medications added to national lists of essential drugs and included in procurement procedures. Other recommendations for alleviating the burden of chronic respiratory diseases in developing countries are: adapting guidelines to local contexts and ensuring their distribution; upgrading equipment at district level; purchasing high-quality drugs at low prices; routine training and supervision of health services personnel; and regular monitoring of performance. Social mobilization by professional societies, nongovernmental organizations, and the mass media will also increase government commitment to tobacco control and standardized case management.

  3. Weight-Gain in Psychiatric Treatment: Risks, Implications, and Strategies for Prevention and Management

    Directory of Open Access Journals (Sweden)

    Shrivastava Amresh

    2010-01-01

    Full Text Available Weight-gain in psychiatric populations is a common clinical challenge. Many patients suffering from mental disorders, when exposed to psychotropic medications, gain significant weight with or without other side-effects. In addition to reducing the patients′ willingness to comply with treatment, this weight-gain may create added psychological or physiological problems that need to be addressed. Thus, it is critical that clinicians take precautions to monitor and control weight-gain and take into account and treat all problems facing an individual. In this review, we examine some of the key issues surrounding weight-gain in individuals suffering from mental disorders for contemporary practitioners in community clinics. We describe some factors known to make certain patients more susceptible to treatment-induced weight-gain and mechanisms implicated in this process. We also highlight a few psychological and pharmacological interventions that have proven effective in weight management. Importantly, we provide critical steps for management and prevention of weight-gain and related issues in the clinical practice of psychopharmacology.

  4. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  5. Reducing the health impact of infectious agents: the significance of preventive strategies.

    Science.gov (United States)

    Sattar, Syed A

    2007-09-13

    them to become more resistant?We need an effective combination of treatment and vaccination strategies, together with a consistent prevention policy. Unlike drugs and vaccinations, disinfectants can be used in a consistent manner; they can simultaneously eliminate a vast range of pathogenic microorganisms, without having any major side effects.

  6. A complex geo-scientific strategy for landslide hazard mitigation ─ from airborne mapping to ground monitoring

    Directory of Open Access Journals (Sweden)

    W. Jaritz

    2008-01-01

    Full Text Available After a large landslide event in Sibratsgfäll/Austria several exploration methods were evaluated on their applicability to investigate and monitor landslide areas. The resulting optimised strategy consists of the combined application of airborne electromagnetics, ground geoelectrical measurements and geoelectrical monitoring combined with hydrological and geological mapping and geotechnical modelling. Interdisciplinary communication and discussion was the primary key to assess this complicated hazard situation.

  7. Update on epidemiology of and preventive strategies for invasive fungal infections in cancer patients.

    Science.gov (United States)

    Perfect, John R; Hachem, Ray; Wingard, John R

    2014-11-15

    Changes in antineoplastic treatments and transplant practices are driving shifts in the epidemiology of invasive fungal diseases (IFDs). Patients with acute myelogenous leukemia (AML) and those undergoing bone marrow transplant (BMT) are at greatest risk for contracting IFDs. Unfortunately, there are few large population studies that can be used to track trends and help us to better understand why certain individuals within recognized high-risk groups are at greater risks than others for contracting IFDs. The growing use of antifungals in prophylaxis and treatment influences which species will cause an IFD as well as the resistance patterns of these fungi. On the one hand, antifungal prophylaxis has mitigated, but not eliminated, the threat of candidiasis. Furthermore, prophylaxis trials have shown trends of reduced aspergillosis in BMT patients; however, no survival benefits were seen, and 1 trial indicated a lower rate of aspergillosis and survival benefits in patients with AML. Future prophylaxis trials should reduce the heterogeneity of risk in study participants in order to better assess benefit; these trials should also incorporate fungal biomarkers into their design. The threat of emerging fungal resistance in prophylaxis strategies is real and must be monitored.

  8. Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial.

    Science.gov (United States)

    Hoek, Rianne J A; Havermans, Bo M; Houtman, Irene L D; Brouwers, Evelien P M; Heerkens, Yvonne F; Zijlstra-Vlasveld, Moniek C; Anema, Johannes R; van der Beek, Allard J; Boot, Cécile R L

    2017-07-17

    Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1) the effects of the strategy on perceived stress and work-related outcomes, and 2) the barriers and facilitators for implementation of the strategy. The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees' perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). Secondary outcome measures are job demands, job resources and the number

  9. Life-Cycle Monitoring of Long-Span PSC Box Girder Bridges through Distributed Sensor Network: Strategies, Methods, and Applications

    Directory of Open Access Journals (Sweden)

    Zheheng Chen

    2015-01-01

    Full Text Available Structural health monitoring (SHM has attracted much attention in recent years, which enables early warnings of structural failure, condition assessments, and rational maintenance/repair strategies. In the context of bridges, many long-span steel bridges in China have been installed with the SHM systems; however, the applications of the SHM in prestressed concrete (PSC bridges are still rather limited. On the other hand, the PSC box girder bridges are extensively used in highway and railway systems and premature damage of these bridges is often reported, resulting in considerable maintenance and/or replacement costs. First, this paper presents a state-of-art review on the SHM of long-span PSC bridges. Monitoring strategies, methods, and previous applications for these bridges are summarized and discussed. In order to well capture the behavior of the bridge during its whole life and to maximize the use of sensors, a life-cycle monitoring strategy is proposed, in which the sensor layout is determined according to requirements for construction monitoring, completion test, and in-service monitoring. A case study is made on a three-span PSC box girder bridge in China. The system configuration, sensor layout, and data communications, and so forth, are presented. The up-to-date monitored structural responses are analyzed and compared with the design values.

  10. The impact of HIV treatment as prevention in the presence of other prevention strategies: lessons learned from a review of mathematical models set in resource-rich countries.

    Science.gov (United States)

    Paquette, Dana; Schanzer, Dena; Guo, Hongbin; Gale-Rowe, Margaret; Wong, Tom

    2014-01-01

    We aimed to assess the potential prevention benefits of HIV treatment as prevention (TasP) in resource-rich countries and examine the potential interactions between TasP and other prevention strategies by reviewing mathematical models of TasP. Multiple databases were searched for mathematical models published in the previous 5 years (from July 2007 to July 2012). The nine models located were set in Canada, Australia and the United States. These models' predictions suggested that the impact of expanding treatment rates on expected new infections could range widely, from no decrease to a decrease of 76%, depending on the time horizon, assumptions and the form of TasP modeled. Increased testing, reducing sexually transmitted infections and reducing risky practices were also predicted to be important strategies for decreasing expected new infections. Sensitivity analysis suggests that current uncertainties such as the effectiveness of highly active antiretroviral therapy outside of heterosexual transmission, less than ideal adherence, and risk compensation, could impact on the success of TasP at the population level. The results from large scale pilots and community randomized controlled trials will be useful in demonstrating how well this prevention approach works in real world settings, and in identifying the factors that are needed to support its effectiveness. © 2013.

  11. Deliberate Establishment of Asymptomatic Bacteriuria-A Novel Strategy to Prevent Recurrent UTI.

    Science.gov (United States)

    Wullt, Björn; Svanborg, Catharina

    2016-07-29

    We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.

  12. Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI

    Directory of Open Access Journals (Sweden)

    Björn Wullt

    2016-07-01

    Full Text Available We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI, where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.

  13. Patterns of intimate partner homicide suicide in later life: Strategies for prevention

    Directory of Open Access Journals (Sweden)

    Sonia Salari

    2007-10-01

    Full Text Available Sonia SalariDepartment Family and Consumer Studies, University of Utah, Salt Lake City, UT, USAAbstract: Intimate partner homicide suicide (IPHS constitutes the most violent domestic abuse outcome, devastating individuals, families, neighborhoods and communities. This research used content analysis to analyze 225 murder suicide events (444 deaths among dyads with at least one member 60 or older. Data were collected from newspaper articles, television news transcripts, police reports and obituaries published between 1999 and 2005. Findings suggest the most dangerous setting was the home and the majority of perpetrators were men. Firearms were most often employed in the violence. Relationship strife was present in some cases, but only slightly higher than the divorce rate for that age group. Illness was cited in just over half of the cases, but 30% of sick elderly couples had only a perpetrator who was ill. Evidence of suicide pacts and mercy killings were very rare and practitioners are encouraged to properly investigate these events. Suicidal men in this age range must be recognized as a potential threat to others, primarily their partner. Homicide was sometimes the primary motive, and the perpetrators in those cases resembled the “intimate terrorist.” Victims in those cases were often terrorized before the murder. Clinicians are educated about the patterns of fatal violence in later life dyads and provided with strategies for prevention.Keywords: murder-suicide, domestic violence, elder abuse, self abuse

  14. Haemodialysis catheter-related bloodstream infections: current treatment options and strategies for prevention.

    Science.gov (United States)

    Saxena, Anil K; Panhotra, Bodh R

    2005-03-05

    Regardless of the repeated reservations raised by countless researchers with reference to the use of catheters as vascular access for haemodialysis (HD), central venous catheters (CVCs) remain irreplaceable tools of the modern dialysis delivery system as a reliable option for the clinical situations requiring instant access to circulation, for various reasons. Patients on long-term haemodialysis are therefore at a significantly high risk for catheterrelated bloodstream infections (CRBSI) and ensuing serious complications. Although early systemic antibiotic treatment should include the coverage for Staphylococcus aureus, the pathogen with most devastating consequences including bacterial endocarditis; optimal treatment of CRBSI while preserving the catheter site, remains contentious. Nonetheless, catheter exchange over a guide wire and antimicrobial-anticoagulant "locks" have shown promising results as novel access salvage techniques. Despite the fact that a number of novel potentially useful strategies for the prevention of CRBSI are in the pipeline; equally essential however, remains the role of rigorous implementation of standard infection control measures for hygiene and aseptic handling of CVCs in long-term HD patients. The policy of increasing the AVF (arteriovenous fistula) prevalence beyond 50% while minimising the use of CVCs, dependent largely upon the timely referrals and prudently implemented pre-ESRD program - ought to have a positive impact on long-term HD outcomes.

  15. Risk Prevention Strategies and the SWOT Analysis for the Implementation of the SMEs’ Business Plan

    Directory of Open Access Journals (Sweden)

    Ionica Oncioiu

    2014-10-01

    Full Text Available This theme is targeting the importance of implementing the business plan of a small and medium company that has as aim the creation of the added value through research and innovation in the management of human resources performance based on information technology domain. The objective is to increase the economic competitiveness and development of knowledge-based economy whereas by the implementation of the project, it increases the company‟s profitability, creating a competitive advantage resulting in innovative products, as well as the effectiveness of companies that use human resources evaluation platform. The need identified on the market to which the SMEs wish to answer by implementing the plan is represented by the nationwide lack of a complex solution covering both the evaluation and the management of human resources performances. The used methodology can be found in the analysis, developing a strategy for preventing financial, human, market, marketing - image risks and also the physical ones. With the SWOT analysis it was observed one of the strengths i.e. the existence of a single management system of employee performance that includes assessment specific features. In conclusion, there are no software solutions at national level, which would assess the human resources of an organization, following specific indicators of that organization, which could combine the assessment methods in order to achieve more a more efficient and versatile assessment.

  16. Anatomy of power system blackouts and preventive strategies by rational supervision and control of protection systems

    Energy Technology Data Exchange (ETDEWEB)

    Phadke, A.G. [Virginia Polytechnic Institute and State Univ., Blacksburg, VA (United States); Horowitz, S.H.; Thorp, J.S.

    1995-01-01

    This report establishes the concept of hidden failures in relays and associated devices used for the protection of electric power systems. A hidden failure is a defect such as a component failure, inappropriate setting or incorrect external connection that remains undetected until some other system event causes the hidden failure to initiate a cascading outage. Associated with the study of hidden failures, this report examines the impact such defects might have by defining regions of vulnerability. A region of vulnerability is the area of the system in which a hidden failure will be activated. To determine such areas we have established criteria associated with load flows and steady-state stability, such as lack of convergence, and employed a technique known as importance sampling in which the simulation is done with the probabilities altered so that the rare event happens more frequently. Our purpose is to provide a framework for further research into relay vulnerability, possibly using adaptive techniques to eliminate hidden defects. We believe control strategies can be developed to prevent cascading normal operations from developing into severe outages by extending the present criteria using steady-state stability and load flow studies into the area of transient stability, and further research into importance sampling would provide significant benefits in evaluating corrective actions.

  17. Rational strategy for the atmospheric icing prevention based on chemically functionalized carbon soot coatings

    Science.gov (United States)

    Esmeryan, Karekin D.; Bressler, Ashton H.; Castano, Carlos E.; Fergusson, Christian P.; Mohammadi, Reza

    2016-12-01

    Although the superhydrophobic surfaces are preferable for passive anti-icing systems, as they provide water shedding before initiation of ice nucleation, their practical usage is still under debate. This is so, as the superhydrophobic materials are not necessarily icephobic and most of the synthesis techniques are characterized with low fabrication scalability. Here, we describe a rational strategy for the atmospheric icing prevention, based on chemically functionalized carbon soot, suitable for large-scale fabrication of superhydrophobic coatings that exhibit and retain icephobicity in harsh operational conditions. This is achieved through a secondary treatment with ethanol and aqueous fluorocarbon solution, which improves the coating's mechanical strength without altering its water repellency. Subsequent experimental analyses on the impact dynamics of icy water droplets on soot coated aluminum and steel sheets show that these surfaces remain icephobic in condensate environments and substrate temperatures down to -35 °C. Furthermore, the soot's icephobicity and non-wettability are retained in multiple icing/de-icing cycles and upon compressed air scavenging, spinning and water jetting with impact velocity of ∼25 m/s. Finally, on frosted soot surfaces, the droplets freeze in a spherical shape and are entirely detached by adding small amount of thermal energy, indicating lower ice adhesion compared to the uncoated metal substrates.

  18. Patterns of intimate partner homicide suicide in later life: Strategies for prevention

    Science.gov (United States)

    Salari, Sonia

    2007-01-01

    Intimate partner homicide suicide (IPHS) constitutes the most violent domestic abuse outcome, devastating individuals, families, neighborhoods and communities. This research used content analysis to analyze 225 murder suicide events (444 deaths) among dyads with at least one member 60 or older. Data were collected from newspaper articles, television news transcripts, police reports and obituaries published between 1999 and 2005. Findings suggest the most dangerous setting was the home and the majority of perpetrators were men. Firearms were most often employed in the violence. Relationship strife was present in some cases, but only slightly higher than the divorce rate for that age group. Illness was cited in just over half of the cases, but 30% of sick elderly couples had only a perpetrator who was ill. Evidence of suicide pacts and mercy killings were very rare and practitioners are encouraged to properly investigate these events. Suicidal men in this age range must be recognized as a potential threat to others, primarily their partner. Homicide was sometimes the primary motive, and the perpetrators in those cases resembled the “intimate terrorist.” Victims in those cases were often terrorized before the murder. Clinicians are educated about the patterns of fatal violence in later life dyads and provided with strategies for prevention. PMID:18044194

  19. Spermine inhibits Endoplasmic Reticulum Stress - induced Apoptosis: a New Strategy to Prevent Cardiomyocyte Apoptosis

    Directory of Open Access Journals (Sweden)

    Can Wei

    2016-02-01

    Full Text Available Background/Aims: Endoplasmic reticulum stress (ERS plays an important role in the progression of acute myocardial infarction (AMI, in part by mediating apoptosis. Polyamines, including putrescine, spermidine, and spermine, are polycations with anti-oxidative, anti-aging, and cell growth-promoting activities. This study aimed to determine the mechanisms by which spermine protects against ERS-induced apoptosis in rats following AMI. Methods and Results: AMI was established by ligation of the left anterior descending coronary artery (LAD in rats, and exogenous spermine was administered by intraperitoneal injection (2.5 mg/ml daily for 7 days pre-AMI. Spermine treatment limited infarct size, attenuated cardiac troponin I and creatinine kinase-MB release, improved cardiac function, and decreased ERS and apoptosis related protein expression. Isolated cardiomyocytes subjected to hypoxia showed significant increase in reactive oxygen species (ROS and the expression of apoptosis and ERS related proteins; these effects occurred through PERK and eIF2α phosphorylation. The addition of spermine attenuated cardiomyocyte apoptosis, suppressed the production of ROS, and inhibited ERS related pathways. Conclusions: Spermine was an effective pre-treatment strategy to attenuate cardiac ERS injury in rats, and the cardioprotective mechanism occurring through inhibition of ROS production and down regulation of the PERK-eIF2α pathway. These findings provide a novel target for the prevention of apoptosis in the setting of AMI.

  20. Strengthening healthy resistance and courage in children: a gender-based strategy for preventing youth violence.

    Science.gov (United States)

    Gilligan, Carol

    2004-12-01

    Beginning with the distinction between core consciousness or a core sense of self and a self that is wedded to a story about itself, this paper suggests that we have collectively been wedded to a false story about ourselves, a story that the core self resists. The gender disparity with respect to times in development when children's resilience is at heightened risk highlights the costs of an initiation that occurs for boys in early childhood and for girls at adolescence. Because of this difference in the timing, girls can become informants about a process of psychic splitting and dissociation that impedes the relational capacities of children and opens the way to violence. The articulateness of girls' resistance to losses that are psychologically and socially consequential illuminates a resistance in boys that may otherwise be overlooked. Evidence drawn from studies of girls' development leads to the suggestion that by joining a healthy resistance in children, we can act to prevent youth violence. The paper ends with a case study of a suicidal adolescent girl to illustrate how a relational framework shifts the interpretation of violent behavior and informs a strategy of response.