WorldWideScience

Sample records for prevent adverse health

  1. e-Prescription: An e-Health System for Preventing Adverse Drug Events in Community Healthcare

    Directory of Open Access Journals (Sweden)

    Irma M. Puspitasari

    2012-03-01

    Full Text Available The paper describes development activities of an e-health system for community health center (Puskesmas with integrated adverse drug events e-prescription module, consist of system design and development, human resource development, e-health system realization, laboratory and implementation test of e-health system. Some e-readiness evaluations were conducted, through a number of field visits and questionnaires. The results had been used in the e-health system design and development, installation of the internet access infrastructure, and implementation of the education and hands-on training for the medical and administrative staff of the healthcare units. After completing the e-health system design and development as well as system realization and laboratory tests stages, a series of field implementation and experiments have been successfully conducted at Puskesmas Babakansari in Bandung. A number of users feed back have been obtained and used for further improvements on both of the software and hardware modules. The e-health system with integrated e-prescription module has successfully developed and shown its expected functions in: patient registration, medical record, paperless prescription, producing the required reports and preventing possible adverse drug events.

  2. [Adverse events prevention ability].

    Science.gov (United States)

    Aparo, Ugo Luigi; Aparo, Andrea

    2007-03-01

    The issue of how to address medical errors is the key to improve the health care system performances. Operational evidence collected in the last five years shows that the solution is only partially linked to future technological developments. Cultural and organisational changes are mandatory to help to manage and drastically reduce the adverse events in health care organisations. Classical management, merely based on coordination and control, is inadequate. Proactive, self-organising network based structures must be put in place and managed using adaptive, fast evolving management tools.

  3. Cypermethrin induced toxicities in fish and adverse health outcomes: Its prevention and control measure adaptation.

    Science.gov (United States)

    Ullah, Sana; Zuberi, Amina; Alagawany, Mahmoud; Farag, Mayada Ragab; Dadar, Maryam; Karthik, Kumaragurubaran; Tiwari, Ruchi; Dhama, Kuldeep; Iqbal, Hafiz M N

    2018-01-15

    Pesticides are being widely employed in the modern agriculture, though in different quantities, across the globe. Although it is useful for crops yield enhancement, however, there are the serious environment, health and safety related concerns for aquatic and terrestrial living biomes that include humans, animals, and plants. Various in practice and emerging pesticides adversely affect the survival, development and biological systems stability. Several research efforts have been made to highlight the bio-safety and toxicological features of toxicants through risk assessment studies using different animal models, e.g., different fish species. Among several pesticides, cypermethrin is extensively used in agriculture and households, and the reported concentrations of this pesticide in different water bodies including rivers and streams, soil and even in rainwater are threatening. Consequently, cypermethrin is considered for risk assessment studies to know about its deep and different level of toxicological effects subject to its dose, exposure time and route. The cypermethrin existence/persistence in the environment is posing a severe threat to humans as well as another non-target terrestrial and aquatic organism. Herein, the toxic effects of pesticides, with special reference to cypermethrin, on fish, the mode of toxicity, concerns regarding public health and harmful impacts on human beings are comprehensively reviewed. The information is also given on their appropriate control and prevention strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Examining Wrong Eye Implant Adverse Events in the Veterans Health Administration With a Focus on Prevention: A Preliminary Report.

    Science.gov (United States)

    Neily, Julia; Chomsky, Amy; Orcutt, James; Paull, Douglas E; Mills, Peter D; Gilbert, Christina; Hemphill, Robin R; Gunnar, William

    2018-03-01

    The study goals were to examine wrong intraocular lens (IOL) implant adverse events in the Veterans Health Administration (VHA), identify root causes and contributing factors, and describe system changes that have been implemented to address this challenge. This study represents collaboration between the VHA's National Center for Patient Safety (NCPS) and the National Surgery Office (NSO). This report includes 45 wrong IOL implant surgery adverse events reported to established VHA NCPS and NSO databases between July 1, 2006, and June 31, 2014. There are approximately 50,000 eye implant procedures performed each year in the VHA. Wrong IOL implant surgery adverse events are reported by VHA facilities to the NCPS and the NSO. Two authors (A.C. and J.N.) coded the reports for event type (wrong lens or expired lens) and identified the primary contributing factor (coefficient κ = 0.837). A descriptive analysis was conducted, which included the reported yearly event rate. The main outcome measure was the reported wrong IOL implant surgery adverse events. There were 45 reported wrong IOL implant surgery adverse events. Between 2011 and June 30, 2014, there was a significant downward trend (P = 0.02, R = 99.7%) at a pace of -0.08 (per 10,000 cases) every year. The most frequently coded primary contributing factor was incomplete preprocedure time-out (n = 12) followed by failure to perform double check of preprocedural calculations based upon original data and implant read-back at the time the surgical eye implant was performed (n = 10). Preventing wrong IOL implant adverse events requires diligence beyond performance of the preprocedural time-out. In 2013, the VHA has modified policy to ensure double check of preprocedural calculations and implant read-back with positive impact. Continued analysis of contributing human factors and improved surgical team communication are warranted.

  5. A national survey of interventions and practices in the prevention of blood culture contamination and associated adverse health care events.

    Science.gov (United States)

    Garcia, Robert A; Spitzer, Eric D; Kranz, Barbara; Barnes, Sue

    2018-01-17

    The scientific literature indicates that blood culture contamination often leads to inappropriate antimicrobial treatment, adverse patient occurrences, and potential reporting of false-positive central line-associated bloodstream infections. The findings of a national infection prevention survey of blood culture practices and related interventions in hospitals support the need for infection preventionists to expand their participation in the review of topics related to the ordering and collection of blood for culture. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Adverse Drug Event Prevention: 2014 Action Plan Conference.

    Science.gov (United States)

    Ducoffe, Aaron R; Baehr, Avi; Peña, Juliet C; Rider, Briana B; Yang, Sandra; Hu, Dale J

    2016-09-01

    Adverse drug events (ADEs) have been highlighted as a national patient safety and public health challenge by the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan), which was released by the Office of Disease Prevention and Health Promotion in August 2014. The following October, the ADE Prevention: 2014 Action Plan Conference provided an opportunity for federal agencies, national experts, and stakeholders to coordinate and collaborate in the initiative to reduce preventable ADEs. The single-day conference included morning plenary sessions focused on the surveillance, evidence-based prevention, incentives and oversights, and additional research needs of the drug classes highlighted in the ADE Action Plan: anticoagulants, diabetes agents, and opioids. Afternoon breakout sessions allowed for facilitated discussions on measures for tracking national progress in ADE prevention and the identification of opportunities to ensure safe and high-quality health care and medication use. © The Author(s) 2015.

  7. Seamless prevention of adverse events from tattooing

    DEFF Research Database (Denmark)

    Serup, Jørgen

    2015-01-01

    The boom in tattooing has been paralleled by more frequent adverse events, which may be localised in the skin or systemic and manifested clinically or latent. Infections, allergic reactions from red-coloured tattoos and papulo-nodular reactions from black tattoos dominate. Mild complaints are very...... common, with 1/5 of all tattooed individuals having acquired sensitivity to sunlight in the tattooed skin. The potential risk of cancer due to potential carcinogens in some tattoo inks has hitherto not manifested in clinical reports, despite the millions of people who have been tattooed over many decades....... A risk of death from tattooing remains associated with severe infection, i.e. sepsis. Preventive strategies may rely on focused preventions, and sterility and preservation of ink is essential, rational and knowledge-based. The chemical and particle contents of ink nanoparticles cannot be unrestricted...

  8. Adverse childhood experiences and health anxiety in adulthood.

    Science.gov (United States)

    Reiser, Sarah J; McMillan, Katherine A; Wright, Kristi D; Asmundson, Gordon J G

    2014-03-01

    Childhood experiences are thought to predispose a person to the development of health anxiety later in life. However, there is a lack of research investigating the influence of specific adverse experiences (e.g., childhood abuse, household dysfunction) on this condition. The current study examined the cumulative influence of multiple types of childhood adversities on health anxiety in adulthood. Adults 18-59 years of age (N=264) completed a battery of measures to assess adverse childhood experiences, health anxiety, and associated constructs (i.e., negative affect and trait anxiety). Significant associations were observed between adverse childhood experiences, health anxiety, and associated constructs. Hierarchical multiple regression analysis indicted that adverse childhood experiences were predictive of health anxiety in adulthood; however, the unique contribution of these experience were no longer significant following the inclusion of the other variables of interest. Subsequently, mediation analyses indicated that both negative affect and trait anxiety independently mediated the relationship between adverse childhood experiences and health anxiety in adulthood. Increased exposure to adverse childhood experiences is associated with higher levels of health anxiety in adulthood; this relationship is mediated through negative affect and trait anxiety. Findings support the long-term negative impact of cumulative adverse childhood experiences and emphasize the importance of addressing negative affect and trait anxiety in efforts to prevent and treat health anxiety. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Adverse health consequences of the Vietnam War.

    Science.gov (United States)

    Levy, Barry S; Sidel, Victor W

    2015-01-01

    The 40th anniversary of the end of the Vietnam War is a useful time to review the adverse health consequences of that war and to identify and address serious problems related to armed conflict, such as the protection of noncombatant civilians. More than 58,000 U.S. servicemembers died during the war and more than 150,000 were wounded. Many suffered from posttraumatic stress disorders and other mental disorders and from the long-term consequences of physical injuries. However, morbidity and mortality, although difficult to determine precisely, was substantially higher among the Vietnamese people, with at least two million of them dying during the course of the war. In addition, more than one million Vietnamese were forced to migrate during the war and its aftermath, including many "boat people" who died at sea during attempts to flee. Wars continue to kill and injure large numbers of noncombatant civilians and continue to damage the health-supporting infrastructure of society, expose civilians to toxic chemicals, forcibly displace many people, and divert resources away from services to benefit noncombatant civilians. Health professionals can play important roles in promoting the protection of noncombatant civilians during war and helping to prevent war and create a culture of peace.

  10. Preventing Medication Error Based on Knowledge Management Against Adverse Event

    OpenAIRE

    Hastuti, Apriyani Puji; Nursalam, Nursalam; Triharini, Mira

    2017-01-01

    Introductions: Medication error is one of many types of errors that could decrease the quality and safety of healthcare. Increasing number of adverse events (AE) reflects the number of medication errors. This study aimed to develop a model of medication error prevention based on knowledge management. This model is expected to improve knowledge and skill of nurses to prevent medication error which is characterized by the decrease of adverse events (AE). Methods: This study consisted of two sta...

  11. Adverse staff health outcomes associated with endoscope reprocessing.

    Science.gov (United States)

    Gutterman, Elane; Jorgensen, Lindsay; Mitchell, Amber; Fua, Sherry

    2013-01-01

    There are occupational challenges associated with cleaning, disinfecting, storing, and transporting flexible endoscopes. Although the Occupational Safety and Health Administration (OSHA) has set standards to protect the safety of health workers in the United States, the standards are not specific to endoscope reprocessing, and the general standards that are in place are not fully implemented. Furthermore, adverse staff outcomes may not be fully preventable. To assess the evidence for adverse outcomes in staff associated with endoscope reprocessing, a literature review was performed in the PubMed database for articles on this topic published between Jan. 1, 2007 and March 7, 2012. Eight studies were identified, mainly European, which reported numerous adverse outcomes to healthcare personnel associated with endoscope reprocessing including respiratory ailments and physical discomfort. More scientifically rigorous studies are required to comprehensively describe adverse health outcomes in personnel engaged in reprocessing, particularly in the United States, and examine whether increased automation of the reprocessing process leads to decreased adverse health outcomes for staff.

  12. Differential Associations of Adverse Childhood Experience on Maternal Health.

    Science.gov (United States)

    Racine, Nicole M; Madigan, Sheri L; Plamondon, Andre R; McDonald, Sheila W; Tough, Suzanne C

    2018-03-01

    The current study examined whether three distinct antecedent factors related to maternal adverse childhood experiences were differentially associated with maternal health and psychosocial outcomes in the antepartum period. It was hypothesized that all three adverse childhood experience factors would be positively associated with poor health prior to pregnancy, poor reproductive health history, and health complications and psychosocial difficulties during pregnancy. Data from 1,994 women (mean age=30.87 years) and their infants were collected from a prospective longitudinal cohort from 2008 to 2011. Pregnant women completed self-report questionnaires and a healthcare professional assessed the mothers' health prior to pregnancy, reproductive history, and pregnancy complications. Data analyses were conducted from December 2016 to March 2017. Path analysis demonstrated that women who had experience with physical/emotional abuse in childhood were significantly more likely to enter pregnancy with a chronic health condition (AOR=1.25, 95% CI=1.02, 1.54) and to have psychosocial difficulties in their pregnancy (AOR=1.60, 95% CI=1.34, 1.89). Women who were exposed to household dysfunction in childhood were also significantly more likely to experience psychosocial difficulties during pregnancy (AOR=2.33, 95% CI=1.49, 3.65). There was no association between exposure to sexual abuse and maternal health or mental health outcomes. Adverse childhood experience categories differentially predicted maternal health and psychosocial outcomes prior to and during pregnancy. The overall variance accounted for by adverse childhood experiences was small (3%-19%), suggesting that factors other than childhood adversity likely contribute to maternal health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Industrial wind turbines and adverse health effects.

    Science.gov (United States)

    Jeffery, Roy D; Krogh, Carmen M E; Horner, Brett

    2014-01-01

    Some people living in the environs of industrial wind turbines (IWTs) report experiencing adverse health and socioeconomic effects. This review considers the hypothesis that annoyance from audible IWTs is the cause of these adverse health effects. We searched PubMed and Google Scholar for articles published since 2000 that included the terms "wind turbine health," "wind turbine infrasound," "wind turbine annoyance," "noise annoyance" or "low frequency noise" in the title or abstract. Industrial wind turbines produce sound that is perceived to be more annoying than other sources of sound. Reported effects from exposure to IWTs are consistent with well-known stress effects from persistent unwanted sound. If placed too close to residents, IWTs can negatively affect the physical, mental and social well-being of people. There is sufficient evidence to support the conclusion that noise from audible IWTs is a potential cause of health effects. Inaudible low-frequency noise and infrasound from IWTs cannot be ruled out as plausible causes of health effects.

  14. Interventions to prevent adverse fetal programming due to maternal obesity during pregnancy.

    Science.gov (United States)

    Nathanielsz, Peter W; Ford, Stephen P; Long, Nathan M; Vega, Claudia C; Reyes-Castro, Luis A; Zambrano, Elena

    2013-10-01

    Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects. There is a consequent need for effective interventions that can be used in the management of human pregnancy to prevent these outcomes. The present review analyzes the dietary and exercise intervention studies performed to date in both altricial and precocial animals, rats and sheep, with the aim of preventing adverse offspring outcomes. The results of these interventions present exciting opportunities to prevent, at least in part, adverse metabolic and other outcomes in obese mothers and their offspring. © 2013 International Life Sciences Institute.

  15. Childhood adversity, mental health, and violent crime.

    Science.gov (United States)

    Brewer-Smyth, Kathleen; Cornelius, Monica E; Pickelsimer, E Elisabeth

    2015-01-01

    Little is understood about childhood traumatic brain injury (TBI) and lifetime violent crime perpetration. The purpose was to evaluate TBI before the age of 15 years and other childhood environmental factors, mental health, and lifetime history of committing a violent crime. A cross-sectional study of 636 male and female offenders from a southeastern state prison population was conducted using Chi-squared tests, t tests, and logistic regression to determine factors associated with ever committing a violent crime. Committing a violent crime was associated with male gender, younger age, greater childhood sexual abuse (CSA), greater childhood emotional abuse, no TBI by the age of 15 years, and greater neighborhood adversity during childhood. Although TBI has been related to violent and nonviolent crime, this study showed that absence of TBI by the age of 15 years was associated with lifetime violent crime when adjusting for CSA, childhood emotional abuse, and neighborhood adversity during childhood. This builds upon neurobehavioral development literature suggesting that CSA and the stress of violence exposure without direct physical victimization may play a more critical role in lifetime violent criminal behavior than childhood TBI. Violence risk reduction must occur during childhood focusing on decreasing adversity, especially violence exposure as a witness as well as a direct victim.

  16. Percentage of Patients with Preventable Adverse Drug Reactions and Preventability of Adverse Drug Reactions – A Meta-Analysis

    Science.gov (United States)

    Petzold, Max; Hägg, Staffan

    2012-01-01

    Background Numerous observational studies suggest that preventable adverse drug reactions are a significant burden in healthcare, but no meta-analysis using a standardised definition for adverse drug reactions exists. The aim of the study was to estimate the percentage of patients with preventable adverse drug reactions and the preventability of adverse drug reactions in adult outpatients and inpatients. Methods Studies were identified through searching Cochrane, CINAHL, EMBASE, IPA, Medline, PsycINFO and Web of Science in September 2010, and by hand searching the reference lists of identified papers. Original peer-reviewed research articles in English that defined adverse drug reactions according to WHO’s or similar definition and assessed preventability were included. Disease or treatment specific studies were excluded. Meta-analysis on the percentage of patients with preventable adverse drug reactions and the preventability of adverse drug reactions was conducted. Results Data were analysed from 16 original studies on outpatients with 48797 emergency visits or hospital admissions and from 8 studies involving 24128 inpatients. No studies in primary care were identified. Among adult outpatients, 2.0% (95% confidence interval (CI): 1.2–3.2%) had preventable adverse drug reactions and 52% (95% CI: 42–62%) of adverse drug reactions were preventable. Among inpatients, 1.6% (95% CI: 0.1–51%) had preventable adverse drug reactions and 45% (95% CI: 33–58%) of adverse drug reactions were preventable. Conclusions This meta-analysis corroborates that preventable adverse drug reactions are a significant burden to healthcare among adult outpatients. Among both outpatients and inpatients, approximately half of adverse drug reactions are preventable, demonstrating that further evidence on prevention strategies is required. The percentage of patients with preventable adverse drug reactions among inpatients and in primary care is largely unknown and should be

  17. Childhood adversity and adult health: Evaluating intervening mechanisms.

    Science.gov (United States)

    Turner, R Jay; Thomas, Courtney S; Brown, Tyson H

    2016-05-01

    Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience - implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences - a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N = 1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP-allostatic load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Incidence and preventability of adverse events requiring intensive care admission: a systematic review.

    Science.gov (United States)

    Vlayen, Annemie; Verelst, Sandra; Bekkering, Geertruida E; Schrooten, Ward; Hellings, Johan; Claes, Neree

    2012-04-01

    Adverse events are unintended patient injuries or complications that arise from health care management resulting in death, disability or prolonged hospital stay. Adverse events that require critical care are a considerable financial burden to the health care system, but also their global impact on patients and society is probably underestimated. The objectives of this systematic review were to synthesize the best available evidence regarding the estimates of the incidence and preventability of adverse events that necessitate intensive care admission, to determine the type and consequences [mortality, length of intensive care unit (ICU) stay and costs] of these adverse events. MEDLINE (from 1966 to present), EMBASE (from 1974 to present) and CENTRAL (version 1-2010) were searched for studies reporting on unplanned admissions on ICUs. Several other sources were searched for additional studies. Only quantitative studies that used chart review for the detection of adverse events requiring intensive care admission were considered for eligibility. For the purposes of this systematic review, ICUs were defined as specialized hospital facilities which provide continuous monitoring and intensive care for acutely ill patients. Studies that were published in the English, Dutch, German, French or Spanish language were eligible for inclusion. Two reviewers independently extracted data and assessed the methodological quality of the included studies. A total of 27 studies were reviewed. Meta-analysis of the data was not appropriate because of methodological and statistical heterogeneity between studies; therefore, results are presented in a descriptive way. The percentage of surgical and medical adverse events that required ICU admission ranged from 1.1% to 37.2%. ICU readmissions varied from 0% to 18.3%. Preventability of the adverse events varied from 17% to 76.5%. Preventable adverse events are further synthesized by type of event. Consequences of the adverse events included a

  19. Identifying and managing adverse environmental health effects: 3. Lead exposure

    Science.gov (United States)

    Sanborn, Margaret D.; Abelsohn, Alan; Campbell, Monica; Weir, Erica

    2002-01-01

    LEAD LEVELS IN NORTH AMERICAN CHILDREN AND ADULTS have declined in the past 3 decades, but lead persists in the environment in lead paint, old plumbing and contaminated soil. There are also a number of occupations and hobbies that carry a high risk of lead exposure. There is no evidence for a threshold below which lead has no adverse health effects. Blood lead levels previously considered safe are now known to cause subtle, chronic health effects. The health effects of lead exposure include developmental neurotoxicity, reproductive dysfunction and toxicity to the kidneys, blood and endocrine systems. Most lead exposures are preventable, and diagnosing lead poisoning is relatively simple compared with diagnosing health effects of exposures to other environmental toxins. Accurate assessment of lead poisoning requires specific knowledge of the sources, high-risk groups and relevant laboratory tests. In this article we review the multiple, systemic toxic effects of lead and provide current information on groups at risk, prevention, diagnosis and clinical treatment. We illustrate how the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) and specific screening questions are useful tools for physicians to quickly obtain an environmental exposure history and identify patients at high risk of lead exposure. By applying effective primary prevention, case-finding and treatment interventions for lead exposure, both the individual patient and the larger community reap the benefits of better health. PMID:12041847

  20. Travel health prevention.

    Science.gov (United States)

    Korzeniewski, Krzysztof

    All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.

  1. Preventable and potentially preventable serious adverse reactions induced by oral protein kinase inhibitors through a database of adverse drug reaction reports.

    Science.gov (United States)

    Egron, Adeline; Olivier-Abbal, Pascale; Gouraud, Aurore; Babai, Samy; Combret, Sandrine; Montastruc, Jean-Louis; Bondon-Guitton, Emmanuelle

    2015-06-01

    Antineoplastic drugs are one of the pharmacological classes more frequently involved in occurrence of "serious" adverse drug reactions. However, few epidemiological data are available regarding the preventability of adverse drug reactions with ambulatory cancer chemotherapy. We assessed the rate and characteristics of "preventable" or "potentially preventable" "serious" adverse drug reactions induced by oral protein kinase inhibitors (PKIs). We performed a retrospective study with all "serious" adverse drug reactions (ADRs) recorded from 1 January 2008 to 31 December 2009 in the French Pharmacovigilance Database with the eight oral protein kinase inhibitors marketed in France: sorafenib, imatinib, erlotinib, sunitinib, dasatinib, lapatinib, nilotinib and everolimus (Afinitor®) using the French adverse drug reactions preventability scale. This study was carried out on 265 spontaneous notifications. Most of adverse drug reactions were "unpreventable" (63.8 %). Around one third were "unevaluable" due to notifications poorly documented (medical history, dosage, use of drugs as first or second intention, concomitant drugs). One (0.4 %) adverse drug reaction was "preventable" with dasatinib (subdural hematoma) and three (1.1 %) were "potentially preventable" (hepatic adverse drug reactions): two with imatinib and one with sorafenib. For these four cases, we identified some characteristics: incorrect dosages, drug interactions and off-label uses. An appropriate prescription could avoid the occurrence of 1.5 % "serious" adverse drug reactions with oral PKIs. This rate is low and further studies are needed to compare our results by using other preventability instruments and to improve the French ADRs Preventability Scale.

  2. Adverse health effects associated with Islamic fasting -A literature review

    Directory of Open Access Journals (Sweden)

    Nania Mohamed Pakkir Maideen

    2017-09-01

    Full Text Available Introduction: Millions of Muslims across the world observe Islamic fasting during the holy month of Ramadan, as well as the other specific dates in the lunar calendar year. While fasting during this month, Muslims refrain from eating or drinking from dawn to dusk. Islamic fasting is similar to alternate day fasting (ADF since it incorporates an average of 12 hours of fasting and 12 hours of feasting periods. This present review study is aimed to find out the common adverse health effects associated with Islamic fasting and the preventive measures to be followed to avoid them. Methods: The literature was reviewed through searching in databases such as PubMed, Google Scholar, and reference lists to identify the related articles. Results: Many health benefits have been attributed to Islamic fasting, including the reduced risk of cardiovascular diseases, diabetes, cancer, hypertension, and asthma. On the other hand, some studies have mentioned a few health problems associated with Islamic fasting, such as headaches, heartburn, constipation, dehydration, decreased sleep quality, and anemia, which may occur in some fasting individuals during Ramadan. Conclusion: Islamic fasting could be beneficial for health if it is performed correctly. During Ramadan, fasting individuals are advised to adhere to a balanced diet that contains sufficient portions of fruits and vegetables, whole grains, pulses, meat, fish, milk, and dairy products. Moreover, fasting individuals must drink adequate fluids, such as water, fresh fruit juices, and soups, in order to prevent the possible adverse health effects associated with Islamic fasting.

  3. National Action Plan for Adverse Drug Event Prevention: Recommendations for Safer Outpatient Opioid Use.

    Science.gov (United States)

    Ducoffe, Aaron R; York, Andrew; Hu, Dale J; Perfetto, Deborah; Kerns, Robert D

    2016-12-01

    Adverse drug events (ADEs) have been highlighted as a major patient safety and public health challenge by the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan), which was released by the Office of Disease Prevention and Health Promotion (ODPHP) in August 2014. The ADE Action Plan focuses on surveillance, evidence-based prevention, incentives, and oversights, additional research needs as well as possible measures and metrics to track progress of ADE prevention within three drug classes: anticoagulants, diabetes agents, and opioids.Objectives and Recommendations. With outpatient opioid prescriptions being a great concern among many healthcare providers, this article focuses on recommendations from the ADE Action Plan to help guide safer opioid use in healthcare delivery settings. Its aim is to discuss current federal methods in place to prevent opioid ADEs while also providing evidence to encourage providers and hospitals to innovate new systems and practices to increase prevention. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

  4. Quality indicators of preventable adverse drug events in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard

    interventions against medication errors. Methods: A systematic literature review of the available literature on preventable adverse A systematic literature review of the available literature on preventable adverse drug events was conducted to describe the incidence and characteristics of preventable adverse......Summary Background: Preventable adverse drug events are caused by errors in the medication use Preventable adverse drug events are caused by errors in the medication use process, and are of particular interest when designing interventions to improve the quality of medication therapy. Type 2...... diabetes became the case because a large proportion of patients are undertreated and not monitored as recommended; yet, the epidemiology of preventable adverse drug events in type 2 diabetes is largely unknown. The aims of the studies were to develop quality indicators for preventable adverse drug events...

  5. Text mining electronic health records to identify hospital adverse events

    DEFF Research Database (Denmark)

    Gerdes, Lars Ulrik; Hardahl, Christian

    2013-01-01

    Manual reviews of health records to identify possible adverse events are time consuming. We are developing a method based on natural language processing to quickly search electronic health records for common triggers and adverse events. Our results agree fairly well with those obtained using manual...... reviews, and we therefore believe that it is possible to develop automatic tools for monitoring aspects of patient safety....

  6. Life Course Pathways From Adverse Childhood Experiences to Adult Physical Health: A Structural Equation Model.

    Science.gov (United States)

    Nurius, Paula S; Fleming, Christopher M; Brindle, Eleanor

    2017-08-01

    This study examines pathways from adverse childhood experiences (ACEs) to physical health, directly and indirectly through lower income, health risk behaviors, social support, and adult adversity within a theoretical framework postulating stress proliferative and biological trajectories of cumulative adversity. Data were obtained from 12,549 adult respondents of a state Behavioral Risk Factor Surveillance System survey. Multigroup structural equation modeling elucidated pathways differentiated by sex and age (older/younger than 45). Good model fit was achieved in each test, indicating consistency with stress theorizing that ACEs significantly contribute to poorer physical health through direct and mediated paths. Younger adults evidenced direct ACE pathway to poor health suggesting early biological erosion, whereas paucity of social support among older adults was directly associated. Findings indicate that stress process roles in eroding physical health and experience of wellness. Addressing early adversity is an important strategy toward reducing preventable health problems.

  7. An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.

    Science.gov (United States)

    Bhise, Viraj; Sittig, Dean F; Vaghani, Viralkumar; Wei, Li; Baldwin, Jessica; Singh, Hardeep

    2018-03-01

    Methods to identify preventable adverse events typically have low yield and efficiency. We refined the methods of Institute of Healthcare Improvement's Global Trigger Tool (GTT) application and leveraged electronic health record (EHR) data to improve detection of preventable adverse events, including diagnostic errors. We queried the EHR data repository of a large health system to identify an 'index hospitalization' associated with care escalation (defined as transfer to the intensive care unit (ICU) or initiation of rapid response team (RRT) within 15 days of admission) between March 2010 and August 2015. To enrich the record review sample with unexpected events, we used EHR clinical data to modify the GTT algorithm and limited eligible patients to those at lower risk for care escalation based on younger age and presence of minimal comorbid conditions. We modified the GTT review methodology; two physicians independently reviewed eligible 'e-trigger' positive records to identify preventable diagnostic and care management events. Of 88 428 hospitalisations, 887 were associated with care escalation (712 ICU transfers and 175 RRTs), of which 92 were flagged as trigger-positive and reviewed. Preventable adverse events were detected in 41 cases, yielding a trigger positive predictive value of 44.6% (reviewer agreement 79.35%; Cohen's kappa 0.573). We identified 7 (7.6%) diagnostic errors and 34 (37.0%) care management-related events: 24 (26.1%) adverse drug events, 4 (4.3%) patient falls, 4 (4.3%) procedure-related complications and 2 (2.2%) hospital-associated infections. In most events (73.1%), there was potential for temporary harm. We developed an approach using an EHR data-based trigger and modified review process to efficiently identify hospitalised patients with preventable adverse events, including diagnostic errors. Such e-triggers can help overcome limitations of currently available methods to detect preventable harm in hospitalised patients. © Article

  8. Systematic review of pediatric health outcomes associated with childhood adversity.

    Science.gov (United States)

    Oh, Debora Lee; Jerman, Petra; Silvério Marques, Sara; Koita, Kadiatou; Purewal Boparai, Sukhdip Kaur; Burke Harris, Nadine; Bucci, Monica

    2018-02-23

    Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected. Mental and behavioral health outcomes were excluded, as were physical health outcomes that were a direct result of adversity (i.e. abusive head trauma). Data were extracted and risk of bias was assessed by 2 independent reviewers. After identifying 15940 records, 35 studies were included in this review. Selected studies indicated that exposure to childhood adversity was associated with delays in cognitive development, asthma, infection, somatic complaints, and sleep disruption. Studies on household dysfunction reported an effect on weight during early childhood, and studies on maltreatment reported an effect on weight during adolescence. Maternal mental health issues were associated with elevated cortisol levels, and maltreatment was associated with blunted cortisol levels in childhood. Furthermore, exposure to childhood adversity was associated with alterations of immune and inflammatory response and stress-related accelerated telomere erosion. Childhood adversity affects brain development and multiple body systems, and the physiologic manifestations can be detectable in childhood. A history of childhood adversity should be considered in the differential diagnosis of developmental delay, asthma, recurrent infections requiring hospitalization, somatic complaints, and sleep disruption. The variability in children's response to adversity suggests complex underlying mechanisms and poses a challenge in the development of uniform diagnostic guidelines. More large longitudinal studies are needed to better

  9. Adverse events recording in electronic health record systems in primary care.

    Science.gov (United States)

    de Hoon, Sabine E M; Hek, Karin; van Dijk, Liset; Verheij, Robert A

    2017-12-06

    Adequate record keeping of medication adverse events in electronic health records systems is important for patient safety. Events that remain unrecorded cannot be communicated from one health professional to another. In the absence of a gold standard, we investigate the variation between Dutch general practices in the extent to which they record medication adverse events. Data were derived from electronic health records (EHR) of Dutch general practices participating in NIVEL Primary Care Database (NIVEL-PCD) in 2014, including 308 general practices with a total practice population of 1,256,049 listed patients. Medication adverse events were defined as recorded ICPC-code A85 (adverse effect medical agent). Between practice variation was studied using multilevel logistic regression analysis corrected for age, gender, number of different medicines prescriptions and number of chronic diseases. In 2014 there were 8330 patients with at least one medication adverse event recorded. This corresponds to 6.9 medication adverse events per 1000 patients and is higher for women, elderly, patients with polypharmacy and for patients with comorbidity. Corrected for these patient characteristics the median odds ratio (MOR = 1.92) suggests an almost twofold difference between general practices in recorded medication adverse events. Our results suggest that improvement in terms of uniformity in recording medication adverse events is possible, preventing potential damage for patients. We suggest that creating a learning health system by individual practice feedback on the number of recordings of adverse events would help practitioners to improve their recording habits.

  10. Basic Versus Supplementary Health Insurance : Moral Hazard and Adverse Selection

    NARCIS (Netherlands)

    Boone, J.

    2014-01-01

    This paper introduces a tractable model of health insurance with both moral hazard and adverse selection. We show that government sponsored universal basic insurance should cover treatments with the biggest adverse selection problems. Treatments not covered by basic insurance can be covered on the

  11. Basic versus supplementary health insurance : Moral hazard and adverse selection

    NARCIS (Netherlands)

    Boone, J.

    This paper introduces a tractable model of health insurance with both moral hazard and adverse selection. We show that government sponsored universal basic insurance should cover treatments with the biggest adverse selection problems. Treatments not covered by basic insurance can be covered on the

  12. Campania preventability assessment committee: a focus on the preventability of the contrast media adverse drug reactions.

    Science.gov (United States)

    Sessa, Maurizio; Rossi, Claudia; Rafaniello, Concetta; Mascolo, Annamaria; Cimmaruta, Daniela; Scavone, Cristina; Fiorentino, Sonia; Grassi, Enrico; Reginelli, Alfonso; Rotondo, Antonio; Sportiello, Liberata

    2016-12-01

    The current study aims to assess the preventability of the contrast media adverse drug reactions reported through the Campania spontaneous reporting system, identifying the possible limitations emerged in this type of evaluation. All the individual case safety reports validated by the Campania Pharmacovigilance Regional Centre from July 2012 to September 2015 were screened to select those that reported contrast media as suspected drug. Campania Preventability Assessment Committee, in collaboration with clinicians specialized in Radiology, assessed the preventability according to the P-Method, through a case-by-case approach. From July 2012 to September 2015, 13798 cases were inserted by pharmacovigilance managers in the Italian Pharmacovigilance Network database (in the geographical contest of the Campania Region), of which 67 reported contrast media as suspected drug. Five preventable cases were found. The most reported causes for preventability were the inappropriate drug use for the case clinical conditions and the absence of the preventive measure administrated prior to the contrast media administration. Several limitations were found in the evaluation of the critical criteria for the preventability assessment. Educational initiatives will be organized directly to the healthcare professionals involved in the contrast media administration, to promote an appropriate use of the contrast media.

  13. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard; Winterstein, Almut G; Søndergaard, Birthe

    2007-01-01

    OBJECTIVE: To estimate the incidence and describe characteristics of preventable adverse drug events (pADEs) in ambulatory care. DATA SOURCES: Studies were searched in PubMed (1966-March 2007), International Pharmaceutical Abstracts (1970-December 2006), the Cochrane database of systematic reviews...... (1993-March 2007), EMBASE (1980-February 2007), and Web of Science (1945-March 2007). Key words included medication error, adverse drug reaction, iatrogenic disease, outpatient, ambulatory care, primary health care, general practice, patient admission, hospitalization, observational study, retrospective....../pADE incidence, (2) clinical outcomes, (3) associated drug groups, and/or (4) underlying medication errors were included. Study country, year and design, sample size, follow-up time, ADE/pADE identification method, proportion of ADEs/pADEs and ADEs/pADEs requiring hospital admission, and frequency distribution...

  14. Women's childhood and adult adverse experiences, mental health, and binge drinking: The California Women's Health Survey

    Directory of Open Access Journals (Sweden)

    Pavao Joanne

    2008-06-01

    Full Text Available Abstract Background This study examined sociodemographic, physical and mental health, and adult and childhood adverse experiences associated with binge drinking in a representative sample of women in the State of California. Materials and methods Data were from the 2003 to 2004 (response rates of 72% and 74%, respectively California Women's Health Survey (CWHS, a population-based, random-digit-dial annual probability survey sponsored by the California Department of Health Services. The sample was 6,942 women aged 18 years or older. Results The prevalence of binge drinking was 9.3%. Poor physical health, and poorer mental health (i.e., symptoms of PTSD, anxiety, and depression, feeling overwhelmed by stress, were associated with binge drinking when demographics were controlled, as were adverse experiences in adulthood (intimate partner violence, having been physically or sexually assaulted, or having experienced the death of someone close and in childhood (living with someone abusing substances or mentally ill, or with a mother vicimized by violence, or having been physically or sexually assaulted. When adult mental health and adverse experiences were also controlled, having lived as a child with someone who abused substances or was mentally ill was associated with binge drinking. Associations between childhood adverse experiences and binge drinking could not be explained by women's poorer mental health status in adulthood. Conclusion Identifying characteristics of women who engage in binge drinking is a key step in prevention and intervention efforts. Binge drinking programs should consider comprehensive approaches that address women's mental health symptoms as well as circumstances in the childhood home.

  15. Adverse Health Effects in Relation to Urban Residential Soundscapes

    Science.gov (United States)

    SKÅNBERG, A.; ÖHRSTRÖM, E.

    2002-02-01

    Noise pollution from road traffic in residential areas is a growing environmental problem. New approaches to turn the negative trend are needed. The programme “Soundscape Support to Health” will achieve new knowledge about the adverse health effects of noise pollution on humans and will investigate the link between well-being and health and perceived soundscapes for optimizing the acoustic soundscapes in urban residential areas. This paper will briefly present the programme and presents preliminary results from the first study of how various adverse health effects are related to individual noise exposures among individuals in residential areas with and without access to a quiet side of the dwelling.

  16. Health Risks and Adverse Reactions to Functional Foods.

    Science.gov (United States)

    Ameratunga, Rohan; Crooks, Christine; Simmons, Greg; Woon, See-Tarn

    2016-01-01

    Functional foods have become increasingly popular with consumers anxious to mitigate the effects of an unhealthy lifestyle or aging. In spite of attractive health claims, these products do not have legal or regulatory status in most countries and are regulated through their health claims. Regulation of functional foods by health claims does not address health risks and adverse effects of these products. In this essay regulatory aspects of functional foods are reviewed along with adverse effects published in the peer-reviewed literature. We detail why the lack of an internationally accepted definition of functional foods places consumers at risk of adverse outcomes. Our review will assist regulatory agencies, manufacturers and consumer groups to assess the benefits and reduce the risks associated with these products.

  17. Childhood Adversity, Religion, and Change in Adult Mental Health.

    Science.gov (United States)

    Jung, Jong Hyun

    2018-02-01

    Research indicates that childhood adversity is associated with poor mental health in adulthood. The purpose of this study is to examine whether the deleterious long-term effects of childhood adversity on adult mental health are reduced for individuals who are involved in religious practices. Using longitudinal data from a representative sample of American adults ( N = 1,635), I find that religious salience and spirituality buffer the noxious effects of childhood abuse on change in positive affect over time. By contrast, these stress-buffering properties of religion fail to emerge when negative affect serves as the outcome measure. These results underscore the importance of religion as a countervailing mechanism that blunts the negative impact of childhood abuse on adult mental health over time. I discuss the theoretical implications of these findings for views about religion, childhood adversity, and mental health.

  18. 40 CFR 350.21 - Adverse health effects.

    Science.gov (United States)

    2010-07-01

    ... PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS TRADE SECRECY CLAIMS FOR EMERGENCY PLANNING AND COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims... adverse health effects associated with each of the chemicals claimed as trade secret and shall make this...

  19. Study of resilience and environmental adversity in midlife health (STREAM)

    NARCIS (Netherlands)

    Velthorst, Eva; Reichenberg, Abraham; Rabinowitz, Jonathan; Levine, Stephen Z.

    2015-01-01

    The Jerusalem study of resilience and environmental adversity in midlife health (STREAM) was established to examine the prevalence of common mental and physical health issues in mid-adulthood in the inner city of Jerusalem, and to examine their association with lifespan psychosocial factors of

  20. Y-90 microsphere therapy: prevention of adverse events.

    Science.gov (United States)

    Schultz, Cheryl C; Campbell, Janice; Bakalyar, Donovan; Beauvais, Michele; Feng, Wenzheng; Savin, Michael

    2009-08-01

    Thirty-three (33) events that were inconsistent with intended treatment for 471 Y-90 microsphere deliveries were analyzed from 2001 to 2007. Each occurrence was categorized, based on root-cause analysis, as a device/product defect and/or operator error event. Events were further categorized, if there was an adverse outcome, as spill/leak, termination, recatheterization, dose deviation, and/or a regulatory medical event. Of 264 Y-90 Therasphere (MDS Nordion, Ottawa, Ontario, Canada) treatments, 15 events were reported (5.7%). Of 207 Y-90 SIR-Spheres (Sirtex, Wilmington, MA) treatments, 18 events were reported (8.7%). Twenty-five (25) of 33 events (76%) were device/product defects: 73% for Therasphere (11 of 15) and 78% for SIR-Spheres (14 of 18). There were 31 adverse outcomes associated with 33 events: 15 were leaks and/or spills, 9 resulted in termination of the dose administration, 3 resulted in recatheterization for dose compensation, 2 were dose deviations (doses differing from the prescribed between 10% and 20%), and 2 were reported as regulatory medical events. Fifty-five (55) corrective actions were taken: 39 (71%) were related to the manufacturer and 16 (29%) were hospital based. This process of analyzing each event and measuring our outcomes has been effective at minimizing adverse events and improving patient safety.

  1. Nonsteroidal anti-inflammatory drugs: adverse effects and their prevention.

    NARCIS (Netherlands)

    Vonkeman, Harald Erwin; van de Laar, Mart A F J

    2010-01-01

    Objectives: To discuss nonsteroidal anti-inflammatory drugs (NSAIDs), their history, development, mode of action, toxicities, strategies for the prevention of toxicity, and future developments. - Methods: Medline search for articles published up to 2007, using the keywords acetylsalicylic acid,

  2. Scanning and vicarious learning from adverse events in health care

    Directory of Open Access Journals (Sweden)

    2001-01-01

    Full Text Available Studies have shown that serious adverse clinical events occur in approximately 3%-10% of acute care hospital admissions, and one third of these adverse events result in permanent disability or death. These findings have led to calls for national medical error reporting systems and for greater organizational learning by hospitals. But do hospitals and hospital personnel pay enough attention to such risk information that they might learn from each other's failures or adverse events? This paper gives an overview of the importance of scanning and vicarious learning from adverse events. In it I propose that health care organizations' attention and information focus, organizational affinity, and absorptive capacity may each influence scanning and vicarious learning outcomes. Implications for future research are discussed.

  3. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    Science.gov (United States)

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  4. Quality indicators of preventable adverse drug events in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard

    population receiving oral antihyperglycaemic treatment (9,791 persons) was set up, and indicator positives identified (Articles no. 2 and 3). The third step in the model consisted of a risk assessment of preventable adverse drug events, including an assessment of clinical areas that need quality improvement...... events are common in primary care, with many resulting in hospitalisation. Projected to a Danish setting, 216,000 patients will experience a preventable adverse drug event each year, and 162,000 of these patients will need hospital admission. Quality improvement interventions should target errors......Summary Background: Preventable adverse drug events are caused by errors in the medication use Preventable adverse drug events are caused by errors in the medication use process, and are of particular interest when designing interventions to improve the quality of medication therapy. Type 2...

  5. 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. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Consequenses of childhood adversity on health concerns in adulthood

    African Journals Online (AJOL)

    This study investigated the extent to which childhood adversity experiences through parental divorce, death or separation, contributed to the health condition of adult Nigerian workers. 440 respondents (mean age = 39.77, SD = 8.66), comprised of 228 males and 212 females, completed and returned the study questionnaire ...

  7. therapeutic non-disclosure of adverse health information to an ...

    African Journals Online (AJOL)

    253 therapeutic non-disclosure of adverse health information to an obstetric patient: case report. o.P. adudu and o.G. adudu. summarY the non-disclosure of foetal exomphalos discovered on intra-uterine ultrasound to the mother and anaesthesiologist in this case report, was based on the obstetricians' assumption that it will.

  8. Categories of adverse health effects from indoor air pollution

    International Nuclear Information System (INIS)

    Weetman, D.F.; Munby, J.

    1994-01-01

    There is a lack of precision in the definition of health, which leads to confusion in the assessment of adverse effects arising from indoor air pollution. Adverse health effects range from annoyance to life-threatening conditions. Survey responses suggest that males and females differ in their perception of a healthy person, but both sexes envisage a male in terms of positive fitness, strength, energy and the possession of an athletic body, rather than how long one was likely to live. Psychological fitness was relatively unimportant in describing the health of others, but was rates as very important with respect to one's own health. Mortality statistics tend to obscure the proportion of the population who suffer chronic illness that is not life threatening. Although health is largely determined by genetic constitution, lifestyle and environmental factors, the morale of an individual is also important. A new classification of the adverse effects on health of indoor air pollution is proposed: this includes 'comfort' responses, such as sick building syndrome (category 1); acute chemical effects, the nature of which depends upon the specific intoxicant (category 2B), and perceived chronic grave risk, including cancer causation (category 3). The magnitude of risk in this latter category is imprecise, because its measurement involves the technique of quantitative risk assessment. (author) 1 fig., 2 tabs., 158 refs

  9. Residential Proximity to Environmental Hazards and Adverse Health Outcomes

    Science.gov (United States)

    Maantay, Juliana A.; Chakraborty, Jayajit

    2011-01-01

    How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. PMID:22028451

  10. Study of resilience and environmental adversity in midlife health (STREAM).

    Science.gov (United States)

    Velthorst, Eva; Reichenberg, Abraham; Rabinowitz, Jonathan; Levine, Stephen Z

    2015-12-01

    The Jerusalem study of resilience and environmental adversity in midlife health (STREAM) was established to examine the prevalence of common mental and physical health issues in mid-adulthood in the inner city of Jerusalem, and to examine their association with lifespan psychosocial factors of vulnerability and resilience. Participants were 811 randomly selected individuals from 7000 individuals who were born and grew up in inner-Jerusalem. Participants were 34-44 years old during first wave of STREAM assessment. Initial telephone surveys took place in 2007-2008 and participants were followed-up for a second survey 1 year later. Upon funding, a new wave is planned for 2017-2018. Survey topics comprised common health problems (e.g., type 2 diabetes/migraine), health markers (e.g., BMI), and psychiatric vulnerabilities (e.g., anxiety, post-traumatic stress, depressive symptoms, psychosis). Other measures included socioeconomic status, creativity, life style behavior (e.g., smoking, exercise), social contact and adaptation to change. Survey data were retrospectively merged with data of national registry sources that included adverse psychosocial factors, psychiatric and social measures assessed across all developmental stages through midlife. This includes data available on birth factors, school achievement and adjustment, cognitive and behavioral functioning during young adulthood, psychiatric hospitalizations, immigration and socioeconomic status. Results on health outcomes of the first STREAM wave indicate that prevalence rates of health problems are comparable to recent World Mental Health Surveys. Apart from measures on adverse psychosocial factors, STREAM provides a cohort to examine resilience to developing health problems and having a poor health and functional outcome.

  11. Musculoskeletal Health and Injury Prevention

    Science.gov (United States)

    2008-07-01

    involving the lateral ankle . • Ankle sprains represent 21 to 53% and 17 to 29% of all basketball and soccer injuries respectively. • Ankle sprains...Musculoskeletal Health and Injury Prevention Francis G. O’Connor, MD, MPH Patricia A. Deuster, PhD, MPH Department of Military and Emergency...DATES COVERED - 4. TITLE AND SUBTITLE Musculoskeletal Health and Injury Prevention 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

  12. Indoor allergens: assessing and controlling adverse health effects

    National Research Council Canada - National Science Library

    Pope, Andrew MacPherson; Patterson, Roy; Burge, Harriet

    1993-01-01

    ... on the Health Effects of Indoor Allergens Division of Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1993 i Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from other this and...

  13. Adverse health effects associated with Islamic fasting -A literature review

    OpenAIRE

    Nania Mohamed Pakkir Maideen; Aََََbdurazak Jumale; Rajkapoor Balasubramaniam

    2017-01-01

    Introduction: Millions of Muslims across the world observe Islamic fasting during the holy month of Ramadan, as well as the other specific dates in the lunar calendar year. While fasting during this month, Muslims refrain from eating or drinking from dawn to dusk. Islamic fasting is similar to alternate day fasting (ADF) since it incorporates an average of 12 hours of fasting and 12 hours of feasting periods. This present review study is aimed to find out the common adverse health effects ass...

  14. Treating periodontal disease for preventing adverse birth outcomes in pregnant women.

    Science.gov (United States)

    Iheozor-Ejiofor, Zipporah; Middleton, Philippa; Esposito, Marco; Glenny, Anne-Marie

    2017-06-12

    Periodontal disease has been linked with a number of conditions, such as cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes, all likely through systemic inflammatory pathways. It is common in women of reproductive age and gum conditions tend to worsen during pregnancy. Some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes. There is need for a comprehensive Cochrane review of randomised trials to assess the effect of periodontal treatment on perinatal and maternal health. To assess the effects of treating periodontal disease in pregnant women in order to prevent or reduce perinatal and maternal morbidity and mortality. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 6 October 2016), Cochrane Pregnancy and Childbirth's Trials Register (to 7 October 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 9) in the Cochrane Library, MEDLINE Ovid (1946 to 6 October 2016), Embase Ovid (1980 to 6 October 2016), and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 6 October 2016). ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials on 6 October 2016. We placed no restrictions on the language or date of publication when searching the electronic databases. We included all randomised controlled trials (RCTs) investigating the effects of periodontal treatment in preventing or reducing perinatal and maternal morbidity and mortality. We excluded studies where obstetric outcomes were not reported. Two review authors independently screened titles and abstracts and extracted data using a prepiloted data extraction form. Missing data were obtained by contacting authors and risk of bias was assessed using Cochrane's 'Risk of bias' tool. Where appropriate

  15. Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data.

    Science.gov (United States)

    Lucenko, Barbara A; Sharkova, Irina V; Huber, Alice; Jemelka, Ron; Mancuso, David

    2015-09-01

    This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12-17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Adverse oral health and cognitive decline: the health, aging and body composition study.

    Science.gov (United States)

    Stewart, Robert; Weyant, Robert J; Garcia, Melissa E; Harris, Tamara; Launer, Lenore J; Satterfield, Suzanne; Simonsick, Eleanor M; Yaffe, Kristine; Newman, Anne B

    2013-02-01

    To investigate the relationship between periodontal disease and cognitive decline. Analysis of a prospective cohort study. The Health, Aging and Body Composition (Health ABC) Study. One thousand fifty-three participants who were administered the Modified Mini-Mental State Examination (3MS) at Year 1 (baseline) and Year 3 and had participated in a comprehensive periodontal examination at Year 2. The prospective association between a range of oral health parameters and cognitive function was examined. Decline in 3MS score from Year 3 to 5 was investigated in 947 (89.9%) participants. Covariates included age, sex, education, race, cardiovascular disease and risk, and depressive symptoms. Most indicators of adverse oral health at Year 2 were associated with cognitive impairment based on averaged 3MS scores less than 80 for Years 1 and 3, but education and race substantially confounded these associations. Higher gingival index, a measure of gingival inflammation, at Year 2 remained independently associated with this definition of cognitive impairment and, in fully adjusted analyses, was also an independent predictor of a more-than-5-point cognitive decline from Year 3 to 5. Periodontitis may be a risk factor for cognitive decline. Gingivitis is reversible, and periodontitis to some degree is preventable and controllable when manifest. Therefore, further research is needed to clarify potential underlying mechanisms and oral health interventions that might ameliorate cognitive decline. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  17. Narghile smoking and its adverse health consequences: a literature review.

    Science.gov (United States)

    Dar-Odeh, N S; Abu-Hammad, O A

    2009-06-13

    Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer.

  18. Stress and resource pathways connecting early socioeconomic adversity to young adults' physical health risk.

    Science.gov (United States)

    Wickrama, Kandauda K A S; Lee, Tae Kyoung; O'Neal, Catherine Walker; Kwon, Josephine A

    2015-05-01

    Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.

  19. Health promotion, primary prevention and secondary prevention in general practice

    OpenAIRE

    Karl, Tatjana

    2013-01-01

    The WHO´s aims regarding healthcare for the European region are mainly based on health promotion and preventive as well as supporting health education. The Ottawa Charta declares health promotion as a process to provide all people with a higher degree of self-determination regarding their health and thereby enabling them to increase it. General practitioners are of major importance regarding the medical area of behaviour oriented prevention by promoting health and acting preventive. ...

  20. Relational aggression and adverse psychosocial and physical health symptoms among urban adolescents.

    Science.gov (United States)

    Williams, Jessica Roberts; Fredland, Nina; Han, Hae-Ra; Campbell, Jacquelyn C; Kub, Joan E

    2009-01-01

    The purpose of this study was to examine relational aggression and its relationship with adverse psychosocial and physical health symptoms among urban, African American youth. Quantitative, cross-sectional survey design. The sample consisted of 185 predominantly African American (95.1%) seventh-grade students (mean age: 13.0; female: 58%) attending 4 urban middle schools. The Children's Social Behavior Scale and Social Experience Questionnaire were used to measure relational aggression and relational victimization. The Pediatric Symptom Checklist was used to assess psychosocial difficulties, including internalizing behaviors, externalizing behaviors, and attention problems. Physical health symptoms were measured with questions about colds/flu, headaches, and stomach aches. 2-way multivariate analysis of variance revealed significant differences in externalizing behavior, with perpetrators reporting higher levels than nonperpetrators. Victims reported more internalizing behavior than nonvictims; however, this was only significant for males. For females, significant negative effects on health outcomes were found, resulting from the interaction of perpetration and victimization. Findings suggest that relational aggression is a common occurrence among urban, minority adolescents and may result in adverse health outcomes. These results provide several avenues for future research and implications for healthcare practice. Intervention strategies are needed to prevent relational aggression and continual or subsequent adverse health symptoms.

  1. Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.

    Science.gov (United States)

    Davis, Cynthia R; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S; Crowell, Judith A

    2014-02-01

    This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of "modifiable" risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities × severity × chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. 210 Black/African Americans and White/European Americans, mean age=45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. © 2013.

  2. Screening for childhood adversity: the what and when of identifying individuals at risk for lifespan health disparities.

    Science.gov (United States)

    Kuhlman, Kate Ryan; Robles, Theodore F; Bower, Julienne E; Carroll, Judith E

    2018-03-30

    Existing research on childhood adversity and health risk across the lifespan lacks specificity regarding which types of exposures to assess and when. The purpose of this study was to contribute to an empirically-supported framework to guide practitioners interested in identifying youth who may be at greatest risk for a lifelong trajectory of health disparities. We also sought to identify the point in childhood at which screening for adversity exposure would capture the largest group of at risk individuals for triage to prevention and intervention services. Participants (n = 4036) collected as part of the Midlife in the United States study reported their medical status and history including physical (cardiovascular disease, hypertension, obesity, diabetes, cancer) and mental health (depression, substance use problems, sleep problems). Participants indicated whether they were exposed to 7 adversities at any point in childhood and their age of exposure to 19 additional lifetime adversities before the age of 18. Parent drug abuse, dropping out or failing out of school, being fired from a job, and sexual assault during childhood exhibited the largest effect sizes on health in adulthood, which were comparable to the effects of childhood maltreatment. Childhood adversity screening in early adolescence may identify the largest proportion of youth at risk for negative health trajectories. The results of this descriptive analysis provide an empirical framework to guide screening for childhood adversity in pediatric populations. We discuss the implications of these observations in the context of prevention science and practice.

  3. Adverse childhood experiences and mental health in young adults: a longitudinal survey

    Directory of Open Access Journals (Sweden)

    Aseltine Robert H

    2007-03-01

    in the very strong association between childhood adversity and depressive symptoms, antisocial behavior, and drug use during the early transition to adulthood. These findings, coupled with evidence that the impact of major childhood adversities persists well into adulthood, indicate the critical need for prevention and intervention strategies targeting early adverse experiences and their mental health consequences.

  4. Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries.

    Science.gov (United States)

    Bellis, Mark A; Hughes, Karen; Leckenby, Nicola; Jones, Lisa; Baban, Adriana; Kachaeva, Margarita; Povilaitis, Robertas; Pudule, Iveta; Qirjako, Gentiana; Ulukol, Betül; Raleva, Marija; Terzic, Natasa

    2014-09-01

    To evaluate the association between adverse childhood experiences - e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration - and the health of young adults in eight eastern European countries. Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10,696 respondents - 59.7% female - aged 18-25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32-2.15) - for physical inactivity - to 48.53 (95% CI: 31.98-76.65) - for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European.

  5. The uses and adverse effects of beryllium on health

    DEFF Research Database (Denmark)

    Cooper, Ross G.; Harrison, Adrian Paul

    2009-01-01

    Context: This review describes the health effects of beryllium exposure in the workplace and the environment. Aim: To collate information on the consequences of occupational and environmental exposure to beryllium on physiological function and well being. Materials and Methods: The criteria used...... published in sources unobtainable through requests at the British Library, and some had no impact factor and were excluded. Conclusion: Beryllium has some useful but undoubtedly harmful effects on health and well-being. Measures needed to be taken to prevent hazardous exposure to this element, making its...... in the current review for selecting articles were adopted from proposed criteria in The International Classification of Functioning, Disability, and Health. Articles were classified based on acute and chronic exposure and toxicity of beryllium. Results: The proportions of utilized and nonutilized articles were...

  6. Noise monitoring and adverse health effects in residents in different functional areas of Luzhou, China.

    Science.gov (United States)

    Han, Zhi-Xia; Lei, Zhang-Heng; Zhang, Chun-Lian; Xiong, Wei; Gan, Zhong-Lin; Hu, Ping; Zhang, Qing-Bi

    2015-03-01

    The purpose of the study was to investigate the noise pollution situation and the resulting adverse effect on residents' health in Luzhou, China, to provide data for noise pollution prevention policies and interventions. Four different functional areas (commercial, construction, residential, and transportation hub areas) were chosen to monitor noise level for 3 months. The survey was performed by questionnaire on the spot on randomly selected individuals; it collected data on the impact of noise on residents' health (quality of sleep, high blood pressure, subjective feeling of nervous system damage, and attention) as well as the knowledge of noise-induced health damage, the degree of adaptation to noise, and their solutions. The noise levels of residential, commercial, transportation, and construction areas exceeded the national standards (P noise; 64.57% of residents have adapted to the current noise environment. Most of them have to close the doors and windows to reduce noise. The noise pollution situation in Luzhou, China, is serious, especially the traffic noise pollution. Residents pay less attention to it and adopt single measures to reduce the noise. We should work toward the prevention and control of traffic noise and improve the residents' awareness to reduce the adverse health effects of noise. © 2014 APJPH.

  7. A Review of Adverse Effects of Road Traffic Noise on Human Health

    Science.gov (United States)

    Singh, Devi; Kumari, Neeraj; Sharma, Pooja

    Noise pollution due to road traffic is a potential threat to human health. Since it is a global hazard, the rapid urbanization and exponential traffic growth have aggravated the problem. Population residing along the busy traffic lanes is continuously exposed to the sound levels which are above the permissible limits. This constant exposure to noise pollution is a cause of concern as it leads to several adverse impacts on human health. Traffic noise causes irritation and annoyance, sleep disturbances, cardiovascular disease, risk of stroke, diabetes, hypertension and loss of hearing. It results in decreased work performance. The present review highlights the serious health hazards of road traffic noise (RTN) which needs to be curbed. Preventive measures of noise pollution can help in combating noise-induced health hazards and increased work performance.

  8. Identifying and managing adverse environmental health effects: 4. Pesticides

    Science.gov (United States)

    Sanborn, Margaret D.; Cole, Donald; Abelsohn, Alan; Weir, Erica

    2002-01-01

    PESTICIDE EXPOSURE CAN CAUSE MANY DIFFERENT HEALTH EFFECTS, from acute problems such as dermatitis and asthma exacerbation to chronic problems such as chronic obstructive pulmonary disease and cancer. The resulting clinical presentations are undifferentiated, and specific knowledge of the links to environmental exposures is often required for effective diagnosis. In this article we illustrate the use of the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Drugs and Diet), a history-taking tool that assists physicians in quickly identifying possible environmental exposures. We also provide clinical information on the epidemiology, clinical presentations, treatment and prevention of pesticide exposures. PMID:12054413

  9. KAP assessment of oral health and adverse pregnancy outcomes among pregnant women in Hyderabad, India.

    Science.gov (United States)

    Avula, Haritha; Mishra, Ashank; Arora, Nupur; Avula, Jayakumar

    2013-01-01

    To conduct a questionnaire-based survey of pregnant women with particular reference to their knowledge, attitudes and practices in relation to oral care and adverse pregnancy outcomes and also to identify the various risk indicators for gingival bleeding during pregnancy. This was a cross-sectional questionnaire-based survey using interviewer-administered, structured questionnaires at three maternity care centres. The study group comprised 359 pregnant women who were assessed for their knowledge, attitudes and practices regarding oral health care during pregnancy and adverse pregnancy outcomes. There were deficits in various areas of the knowledge, attitudes and practices of the pregnant women. The majority (87.2%) were not aware of the importance of oral hygiene and its probable association with adverse pregnancy outcomes. None of the respondents ever used dental floss and only a few (1.4%) had heard about it. Risk indicators that were identified in our study for gingival bleeding during pregnancy were: poor knowledge regarding various parameters, brushing only once daily and infrequent visits to the dentist. Most pregnant women need more information about oral health and disease prevention. It would be prudent to compile and consider their knowledge, attitudes and practices along with sociocultural characteristics, so that health education programmes are customised to different sectors of the population.

  10. Attention-deficit/hyperactivity disorder and adverse health outcomes

    Science.gov (United States)

    Nigg, Joel

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes. PMID:23298633

  11. Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients.

    Science.gov (United States)

    Fortescue, Elizabeth B; Kaushal, Rainu; Landrigan, Christopher P; McKenna, Kathryn J; Clapp, Margaret D; Federico, Frank; Goldmann, Donald A; Bates, David W

    2003-04-01

    Medication errors in pediatric inpatients occur at similar rates as in adults but have 3 times the potential to cause harm. Error prevention strategies in this setting remain largely untested. The objective of this study was to classify the major types of medication errors in pediatric inpatients and to determine which strategies might most effectively prevent them. A prospective cohort study was conducted of 1020 patients who were admitted to 2 academic medical centers during a 6-week period in April and May 1999. Medication errors were characterized by subtype. Physician raters evaluated error prevention strategies and identified those that might be most effective in preventing errors. Of 10 778 medication orders reviewed, 616 contained errors. Of these, 120 (19.5%) were classified as potentially harmful, including 115 potential adverse drug events (18.7%) and 5 preventable adverse drug events (0.8%). Most errors occurred at the ordering stage (74%) and involved errors in dosing (28%), route (18%), or frequency (9%). Three interventions might have prevented most potentially harmful errors: 1) computerized physician order entry with clinical decision support systems (76%); 2) ward-based clinical pharmacists (81%); and 3) improved communication among physicians, nurses, and pharmacists (86%). Interrater reliability of error prevention strategy assignment was good (agreement: 0.92; kappa: 0.82). Of the assessed interventions, computerized physician order entry with clinical decision support systems; ward-based clinical pharmacists; and improved communication among physicians, nurses, and pharmacists had the greatest potential to reduce medication errors in pediatric inpatients. Development, implementation, and assessment of such interventions in the pediatric inpatient setting are needed.

  12. [Description of contributing factors in adverse events related to patient safety and their preventability].

    Science.gov (United States)

    Guerra-García, María Mercedes; Campos-Rivas, Beatriz; Sanmarful-Schwarz, Alexandra; Vírseda-Sacristán, Alicia; Dorrego-López, M Aránzazu; Charle-Crespo, Ángeles

    2017-11-25

    To assess the extent of healthcare related adverse events (AEs), their effect on patients, and their seriousness. To analyse the factors leading to the development of AEs, their relationship with the damage caused, and their degree of preventability. Retrospective descriptive study. Porriño, Pontevedra, Spain, Primary Care Service, from January-2014 to April-2016. Reported AEs were entered into the Patient Safety Reporting and Learning System (SiNASP). The variables measured were: Near Incident (NI) an occurrence with no effect or harm on the patient; Adverse Event (AE) an occurrence that affects or harms a patient. The level of harm is classified as minimal, minor, moderate, critical, and catastrophic. Preventability was classified as little evidence of being preventable, 50% preventable, and sound evidence of being preventable. percentages and Chi-squared test for qualitative variables; P<.05 with SPSS.15. SiNASP. Ethical considerations: approved by the Research Ethics Committee (2016/344). There were 166 recorded AEs (50.6% in males, and 46.4% in women. The mean age was 60.80years). Almost two-thirds 62.7% of AEs affected the patient, with 45.8% causing minimal damage, while 2.4% caused critical damages. Healthcare professionals were a contributing factor in 71.7% of the AEs, with the trend showing that poor communication and lack of protocols were related to the damage caused. Degree of preventability: 96.4%. Most AEs affected the patient, and were related to medication, diagnostic tests, and laboratory errors. The level of harm was related to communication problems, lack of, or deficient, protocols and a poor safety culture. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. Electric fans for reducing adverse health impacts in heatwaves.

    Science.gov (United States)

    Gupta, Saurabh; Carmichael, Catriona; Simpson, Christina; Clarke, Mike J; Allen, Claire; Gao, Yang; Chan, Emily Y Y; Murray, Virginia

    2012-07-11

    Heatwaves are hot weather events, which breach regional or national thresholds, that last for several days. They are likely to occur with increasing frequency in some parts of the world. The potential consequences were illustrated in Europe in August 2003 when there were an estimated 30,000 excess deaths due to a heatwave. Electric fans might be used with the intention of reducing the adverse health effects of a heatwave. Fans do not cool the ambient air but can be used to draw in cooler air from outside when placed at an open window. The aim of the fans would be to increase heat loss by increasing the efficiency of all normal methods of heat loss, but particularly by evaporation and convection methods. However, it should be noted that increased sweating can lead to dehydration and electrolyte imbalances if these fluids and electrolytes are not replaced quickly enough. Research has also identified important gaps in knowledge about the use of fans, which might lead to their inappropriate use. To determine whether the use of electric fans contributes to, or impedes, heat loss at high ambient temperatures during a heatwave, and to contribute to the evidence base for the public health impacts of heatwaves. We sought unpublished and published studies that had been published in any language. The review team were able to assess studies reported in English, Chinese, Dutch, French and German; and reports in other languages would have been translated into English as necessary. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, the Indian biomedical literature (IndMED and MedIND) and databases of Chinese literature (Chinese Journal Net and Digital Periodical of WanFang Data). The most recent electronic searches were done in April 2012. We also checked the reference lists of relevant articles and the websites of relevant national and international organisations, and consulted with researchers and policy makers with experience in

  14. Early childhood adversity and later hypertension : Data from the World Mental Health Survey

    NARCIS (Netherlands)

    Stein, Dan J.; Scott, Kate; Abad, Josep M. Haro; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias; Demytteneare, Koen; de Girolamo, Giovanni; Iwata, Noboru; Posada-Villa, Jose; Kovess, Viviane; Lara, Carmen; Ormel, Johan; Kessler, Ronald C.; Von Korff, Michael

    BACKGROUND: Although many studies have indicated that psychosocial factors contribute to hypertension, and that early childhood adversity is associated with long-term adverse mental and physical health sequelae, the association between early adversity and later hypertension is not well studied.

  15. [Preventive measures against human error based on the classification of the adverse events].

    Science.gov (United States)

    Nishimura, Kenji

    2014-01-01

    It is impossible to entirely eliminate human error; however, systematic attempts have been made to comprehensively minimize accidents originating in human error. It appears that the "work classification" we proposed previously is not able to reduce adverse events, fifty percent of which were duty confirmation failures. We have therefore reviewed and classified the causes of human error from the perspective of working conditions to create a simpler and more preventative strategy. Text-mining analysis was applied to speech part classification to reveal areas with room for improvement. In an objective approach, a conduct code was created and put into practice, based on the common features revealed from a classification of human error in the examples investigated. The average number of accidents per year was reduced from 36 to 24, and those due to human error per year were reduced from 17.6 to 11. This objective approach appears to achieve a reduction of adverse events, including those caused by human error. However, these results were obtained over only one year, in a single-center analysis, and thus, widespread and continuous enforcement would be needed to demonstrate the validity of this objective approach to the prevention of human error.

  16. Adverse Life Events and Mental Health in Middle Adolescence

    Science.gov (United States)

    Flouri, Eirini; Kallis, Constantinos

    2011-01-01

    This study's aim was to search for the appropriate functional form of the effect of proximal cumulative contextual risk (PCCR), measured with number of adverse life events experienced in the last 6 months, on adolescent psychopathology and prosocial behavior, measured with the Strengths and Difficulties Questionnaire. The study sample was 171 year…

  17. Adverse drug reaction reporting among health care workers at ...

    African Journals Online (AJOL)

    Background: Adverse Drug Reactions (ADRs) are an important contributor to patient morbidity and hospitalisation in Uganda. Under-reporting of ADRs may increase medicine-induced morbidity and mortality among patients. This study determined the extent of ADR reporting, and associated factors, among healthcare ...

  18. Mobile phone messaging for preventive health care.

    Science.gov (United States)

    Vodopivec-Jamsek, Vlasta; de Jongh, Thyra; Gurol-Urganci, Ipek; Atun, Rifat; Car, Josip

    2012-12-12

    , characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third author. Primary outcomes of interest were health status and health behaviour outcomes. We also considered patients' and providers' evaluation of the intervention, perceptions of safety, health service utilisation and costs, and potential harms or adverse effects. Because the included studies were heterogeneous in type of condition addressed, intervention characteristics and outcome measures, we did not consider that it was justified to conduct a meta-analysis to derive an overall effect size for the main outcome categories; instead, we present findings narratively. We included four randomised controlled trials involving 1933 participants.For the primary outcome category of health, there was moderate quality evidence from one study that women who received prenatal support via mobile phone messages had significantly higher satisfaction than those who did not receive the messages, both in the antenatal period (mean difference (MD) 1.25, 95% confidence interval (CI) 0.78 to 1.72) and perinatal period (MD 1.19, 95% CI 0.37 to 2.01). Their confidence level was also higher (MD 1.12, 95% CI 0.51 to 1.73) and anxiety level was lower (MD -2.15, 95% CI -3.42 to -0.88) than in the control group in the antenatal period. In this study, no further differences were observed between groups in the perinatal period. There was low quality evidence that the mobile phone messaging intervention did not affect pregnancy outcomes (gestational age at birth, infant birth weight, preterm delivery and route of delivery).For the primary outcome category of health behaviour, there was moderate quality evidence from one study that mobile phone message reminders to take vitamin C for preventive reasons resulted in higher adherence (risk ratio (RR) 1.41, 95% CI 1.14 to 1.74). There was high quality evidence from another study that participants receiving mobile phone

  19. Injury prevention and public health

    Directory of Open Access Journals (Sweden)

    David A. Sleet

    2010-06-01

    Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering [1]. Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts [1].

  20. Menopause: Prevention and Health Promotion

    Directory of Open Access Journals (Sweden)

    Ana Mª Rivas Hidalgo

    2009-01-01

    Full Text Available Taking into account that climacteric constitutes a physiological state in woman’s life, which covers a large stage of her life cycle, it is important that nursery professionals will develop an Action Plan, whose main objective will be health. Covering, then, this stage from a multidisciplinary and holistic field is going to contribute to both: the adoption of healthy life habits and the repercussions that symptoms and physiological processes associated with menopause have on women. Another objective for nurses there must be to provide all our knowledge in a detailed and focused on the individual needs that may come up way. That way, we lay the foundations for facing climacteric with the minimum deterioration of the quality of life and well being.This article is an analysis of the etiology of every one of the most prevalent menopause problems, the predisposing factors to suffer them or to make them get worse, and the habits that are going to prevent larger spill-over effects of those problems. Furthermore, a revision about how nutrition, exercise, toxic substances consumption, etc. have repercussions on musculoskeletal problems, vascular symptoms, urogenital problems, psychological alterations, and gynaecological and breast cancer is made.

  1. Development and implementation of a critical pathway for prevention of adverse reactions to contrast media for computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Keun Jo [Presbyterian Medical Center, Seoul (Korea, Republic of); Kweon, Dae Cheol; Kim, Myeong Goo [Seoul National University Hospital, Seoul (Korea, Republic of); Yoo, Beong Gyu [Wonkwang Health Science College, Iksan (Korea, Republic of)

    2007-03-15

    The purpose of this study is to develop a critical pathway (CP) for the prevention of adverse reactions to contrast media for computed tomography. The CP was developed and implemented by a multidisciplinary group is Seoul National University Hospital. The CP was applied to CT patients. Patients who underwent CT scanning were included in the CP group from March in 2004. The satisfaction of the patients with CP was compared with non-CP groups. We also investigated the degree of satisfaction among the radiological technologists and nurses. The degree of patient satisfaction with the care process increased patient information (24%), prevention of adverse reactions to contrast media (19%), pre-cognitive effect of adverse reactions to contrast media (39%) and information degree of adverse reactions to contrast media (19%). This CP program can be used as one of the patient care tools for reducing the adverse reactions to contrast media and increasing the efficiency of care process in CT examination settings.

  2. Development and implementation of a critical pathway for prevention of adverse reactions to contrast media for computed tomography

    International Nuclear Information System (INIS)

    Jang, Keun Jo; Kweon, Dae Cheol; Kim, Myeong Goo; Yoo, Beong Gyu

    2007-01-01

    The purpose of this study is to develop a critical pathway (CP) for the prevention of adverse reactions to contrast media for computed tomography. The CP was developed and implemented by a multidisciplinary group is Seoul National University Hospital. The CP was applied to CT patients. Patients who underwent CT scanning were included in the CP group from March in 2004. The satisfaction of the patients with CP was compared with non-CP groups. We also investigated the degree of satisfaction among the radiological technologists and nurses. The degree of patient satisfaction with the care process increased patient information (24%), prevention of adverse reactions to contrast media (19%), pre-cognitive effect of adverse reactions to contrast media (39%) and information degree of adverse reactions to contrast media (19%). This CP program can be used as one of the patient care tools for reducing the adverse reactions to contrast media and increasing the efficiency of care process in CT examination settings

  3. Risky music listening, permanent tinnitus and depression, anxiety, thoughts about suicide and adverse general health.

    Directory of Open Access Journals (Sweden)

    Ineke Vogel

    Full Text Available OBJECTIVE: To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. METHODS: A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. RESULTS: About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. CONCLUSIONS: Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people's health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed.

  4. Risky music listening, permanent tinnitus and depression, anxiety, thoughts about suicide and adverse general health.

    Science.gov (United States)

    Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

    2014-01-01

    To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people's health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed.

  5. Prevention and Management of Adverse Reactions Induced by Iodinated Contrast Media.

    Science.gov (United States)

    Wu, Yi Wei; Leow, Kheng Song; Zhu, Yujin; Tan, Cher Heng

    2016-04-01

    Iodinated radiocontrast media (IRCM) is widely used in current clinical practice. Although IRCM is generally safe, serious adverse drug reactions (ADRs) may still occur. IRCM-induced ADRs may be subdivided into chemotoxic and hypersensitivity reactions. Several factors have been shown to be associated with an increased risk of ADRs, including previous contrast media reactions, history of asthma and allergic disease, etc. Contrast media with lower osmolality is generally recommended for at-risk patients to prevent ADRs. Current premedication prophylaxis in at-risk patients may reduce the risk of ADRs. However, there is still a lack of consensus on the prophylactic role of premedication. Contrast-induced nephropathy (CIN) is another component of IRCM-related ADRs. Hydration remains the mainstay of CIN prophylaxis in at-risk patients. Despite several preventive measures, ADRs may still occur. Treatment strategies for potential contrast reactions are also summarised in this article. This article summarises the pathophysiology, epidemiology and risk factors of ADRs with emphasis on prevention and treatment strategies. This will allow readers to understand the rationale behind appropriate patient preparation for diagnostic imaging involving IRCM.

  6. Prevalence, adverse health, and risk factors in association with sensory impairments: data from a prospective cohort study of older Japanese

    OpenAIRE

    Michikawa, Takehiro

    2016-01-01

    Sensory impairments, mainly of vision and hearing, are prevalent among the older adults, and are the leading causes of disability in people aged 60 years and above around the world. However, epidemiological data on sensory impairments (prevalence, association with adverse health outcomes, risk and preventive factors, etc.) in community-dwelling older people are sparse in Japan. Using data from the Kurabuchi Study, a community-based prospective cohort study of adults aged 65 years or older, th...

  7. Maternal Adverse Childhood Experience and Infant Health: Biomedical and Psychosocial Risks as Intermediary Mechanisms.

    Science.gov (United States)

    Madigan, Sheri; Wade, Mark; Plamondon, Andre; Maguire, Jonathon L; Jenkins, Jennifer M

    2017-08-01

    To assess the mechanisms accounting for the transfer of risk from one generation to the next, especially as they relate to maternal adverse childhood experiences and infant physical and emotional health outcomes. Participants were 501 community mother-infant dyads recruited shortly after the birth and followed up at 18 months. Mothers retrospectively reported on their adverse childhood experiences. The main outcome measures were parent-reported infant physical health and emotional problems. Potential mechanisms of intergenerational transmission included cumulative biomedical risk (eg, prenatal and perinatal complications) and postnatal psychosocial risk (eg, maternal depression, single parenthood, marital conflict). Four or more adverse childhood experiences were related to a 2- and 5-fold increased risk of experiencing any biomedical or psychosocial risk, respectively. There was a linear association between number of adverse childhood experiences and extent of biomedical and psychosocial risk. Path analysis revealed that the association between maternal adverse childhood experiences and infant physical health operated specifically through cumulative biomedical risk, while the relationship between adverse childhood experiences and infant emotional health operated specifically through cumulative psychosocial risk. This pattern was not explained by maternal childhood disadvantage or current neighborhood poverty. Maternal adverse childhood experiences confer vulnerability to prenatal, perinatal, and postnatal psychosocial health. The association between adverse childhood experiences and offspring physical and emotional health operates through discrete intermediary mechanisms. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

    Directory of Open Access Journals (Sweden)

    Gouttebarge Vincent

    2015-12-01

    Full Text Available To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction. Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players’ unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01 were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population.

  9. Oral health status and adverse pregnancy outcomes among pregnant women in Haryana, India: A prospective study

    Directory of Open Access Journals (Sweden)

    Puneet Singh Talwar

    2015-01-01

    Full Text Available Background: Women′s oral health is affected by certain conditions such as pregnancy, puberty, menstrual cycle, menopause and nonphysiological conditions such as hormonal contraception and hormonal therapy. This study was conducted to assess the oral health status and treatment needs of pregnant women and to correlate periodontal health with adverse pregnancy outcomes like preterm birth (PTB and low birth weight (LBW. Materials and Methods: A prospective study was undertaken at a Government Hospital in Haryana. Pregnant women who were in their third trimester of pregnancy and visited the hospital for routine ante-natal check-up constituted the final sample size (223. Dental caries and periodontal status were assessed using a WHO Proforma-1997. None of the subjects were in the habit of taking alcohol, chewing and smoking tobacco. The main outcome measures were gestational age and weight of the newborn. Data were analyzed using SPSS package version 13. Results: Decayed, missing and filled teeth index of the subjects was 2.87. Extraction was indicated in younger subjects when compared to the older ones. Bleeding was the main finding, which was present in 47.5% of the study subjects, followed by calculus. 63 more than 60% of subjects of subjects with 4-5 mm attachment loss belonged to 20-24 years age-group. There was a statistically significant association of probing depths and attachment loss with adverse pregnancy outcomes (P < 0.05 (PTB and LBW. Conclusion: There is a significant association between maternal periodontitis and pregnancy outcomes in the present study. It is recommended that suitable measures be undertaken by various health organizations to prevent periodontal problems among this particular group.

  10. Childhood adversity and traumatic exposures during deployment as predictors of mental health in Australian military veterans.

    Science.gov (United States)

    Zheng, Wu Yi; Kanesarajah, Jeeva; Waller, Michael; McGuire, Annabel C; Treloar, Susan A; Dobson, Annette J

    2016-02-01

    To examine whether the relationship between traumatic exposure on deployment and poor mental health varies by the reported level of childhood adversity experienced in Australian military veterans deployed to the Bougainville or East Timor military operations. Cross-sectional self-reported survey data were collected in 2008 from 3,564 Australian military veterans who deployed to East Timor or Bougainville on their deployment experiences, health and recall of childhood events. Multivariable logistic regression was used to investigate the association between childhood adversity, deployment exposures and mental health. The most common childhood adversity reported was 'not having a special teacher, youth worker or family friend who looked out for them while growing up'. On average, responders reported experiencing 3.5 adverse childhood experiences (SD 2.7) and averaged 5.3 (SD 4.9) traumatic exposures on deployment. Both childhood adversity and traumatic exposures on deployment were associated with higher odds of poorer mental health. However, there was no evidence that level of childhood adversity modified the association between traumatic exposure and mental health. These findings suggest that military personnel who recalled a higher level of childhood adversity may need to be monitored for poor mental health and, if required, provided with appropriate support. © 2015 Public Health Association of Australia.

  11. Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.

    Science.gov (United States)

    Mueller, Stephanie K; Schnipper, Jeffrey L; Giannelli, Kyla; Roy, Christopher L; Boxer, Robert

    2016-09-01

    Dispersion of inpatient care teams across different medical units impedes effective team communication, potentially leading to adverse events (AEs). To regionalize 3 inpatient general medical teams to nursing units and examine the association with communication and preventable AEs. Pre-post cohort analysis. A 700-bed academic medical center. General medicine patients on any of the participating nursing units before and after implementation of regionalized care. Regionalizing 3 general medical physician teams to 3 corresponding nursing units. Concordance of patient care plan between nurse and intern, and adjusted odds of preventable AEs. Of the 414 included nurse and intern paired surveys, there were no significant differences pre- versus postregionalization in total mean concordance scores (0.65 vs 0.67, P = 0.26), but there was significant improvement in agreement on expected discharge date (0.56 vs 0.68, P = 0.003), knowledge of the other provider's name (0.56 vs 0.86,P communication and lead to patient safety improvements. Journal of Hospital Medicine 2016;11:620-627. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  12. Adverse Childhood Experiences, Coping Resources, and Mental Health Problems among Court-Involved Youth

    Science.gov (United States)

    Logan-Greene, Patricia; Tennyson, Robert L.; Nurius, Paula S.; Borja, Sharon

    2017-01-01

    Background: Mental health problems are gaining attention among court-involved youth with emphasis on the role of childhood adversity, but assessment lags. Objective: The present study uses a commonly delivered assessment tool to examine mental health problems (current mental health problem, mental health interfered with probation goals, and…

  13. Alcohol and cannabis: Comparing their adverse health effects and regulatory regimes.

    Science.gov (United States)

    Hall, Wayne

    2017-04-01

    The claim that the adverse health effects of cannabis are much less serious than those of alcohol has been central to the case for cannabis legalisation. Regulators in US states that have legalised cannabis have adopted regulatory models based on alcohol. This paper critically examines the claim about adverse health effects and the wisdom of regulating cannabis like alcohol. First, it compares what we know about the adverse health effects of alcohol and cannabis. Second, it discusses the uncertainties about the long term health effects of sustained daily cannabis use. Third, it speculates about how the adverse health effects of cannabis may change after legalisation. Fourth, it questions the assumption that alcohol provides the best regulatory model for a legal cannabis market. Fifth, it outlines the major challenges in regulating cannabis under the liberal alcohol-like regulatory regimes now being introduced. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Preventing drug-related adverse events following hospital discharge: the role of the pharmacist

    Directory of Open Access Journals (Sweden)

    Nicholls J

    2017-02-01

    Full Text Available Justine Nicholls,1 Craig MacKenzie,1 Rhiannon Braund2 1Dunedin Hospital Pharmacy, 2School of Pharmacy, University of Otago, Dunedin, New Zealand Abstract: Transition of care (ToC points, and in particular hospital admission and discharge, can be associated with an increased risk of adverse drug events (ADEs and other drug-related problems (DRPs. The growing recognition of the pharmacist as an expert in medication management, patient education and communication makes them well placed to intervene. There is evidence to indicate that the inclusion of pharmacists in the health care team at ToC points reduces ADEs and DRPs and improves patient outcomes. The objectives of this paper are to outline the following using current literature: 1 the increased risk of medication-related problems at ToC points; 2 to highlight some strategies that have been successful in reducing these problems; and 3 to illustrate how the role of the pharmacist across all facets of care can contribute to the reduction of ADEs, particularly for patients at ToC points. Keywords: pharmacist, adverse drug events, drug-related problems, transitions of care, hospital discharge

  15. Child hunger and long-term adverse consequences for health.

    Science.gov (United States)

    Kirkpatrick, Sharon I; McIntyre, Lynn; Potestio, Melissa L

    2010-08-01

    To examine the effects of hunger, an extreme manifestation of food insecurity, on subsequent health outcomes using data from the Canadian National Longitudinal Survey of Children and Youth (NLSCY). Longitudinal survey, 1994-2004/2005. Canada. A total of 5809 children aged 10 to 15 years and 3333 youth aged 16 to 21 years. Longitudinal survey data spanning a 10-year period were analyzed using logistic regression. Measures of hunger from NLSCY cycles 1 through 5 were used to differentiate participants who were ever hungry from those who were never hungry. A 3-level variable was created to assess the effect of repeated episodes of hunger. Covariates included participants' age, sex, baseline health, and household sociodemographic characteristics. Stratified models were used to examine the relation between hunger and health among boys and girls separately. The NLCSY cycle 6 outcomes included poor general health, chronic health conditions, and asthma. Among children, both ever being hungry and multiple episodes of hunger were associated with poorer general health but not with chronic conditions or asthma. Higher odds of chronic conditions and of asthma were observed among youth who experienced multiple episodes of hunger compared with those who were never hungry. Associations between hunger and poorer health outcomes persisted among girls in stratified analyses. Children and youth who experience hunger are more likely to have poorer health, and repeated exposure appears to be particularly toxic. Our findings point to the relevance of food insecurity in childhood as a marker of vulnerability, with implications for clinical practice and advocacy.

  16. Mental Health Workers’ Views About Their Suicide Prevention Role

    OpenAIRE

    Virginia Ross; Anoop Sankaranarayanan; Terry J. Lewin; Mick Hunter

    2016-01-01

    AimMental Health workers bear responsibility for preventing suicide in their client group. Survey studies have indicated that staff can be seriously adversely affected when a client suicides. The aim of the current study is to describe and evaluate the effects on mental health (MH) workers of their ongoing role in managing suicidal behaviours and to identify the thoughts and feelings associated with this role.MethodA survey was administered to 135 MH workers via an on-line self-report vehicle...

  17. Relationship among adverse childhood experiences, history of active military service, and adult outcomes: homelessness, mental health, and physical health.

    Science.gov (United States)

    Montgomery, Ann Elizabeth; Cutuli, J J; Evans-Chase, Michelle; Treglia, Dan; Culhane, Dennis P

    2013-12-01

    We determined whether a report of adverse childhood experiences predicts adult outcomes related to homelessness, mental health, and physical health and whether participation in active military service influences the relationship between childhood and adult adversity. Using data from the 2010 Washington State Behavioral Risk Factor Surveillance System, we tested by means of logistic regression the relationship between adverse childhood experiences and 3 adult outcomes--homelessness, mental health, and physical health--as well as differences among those with a history of active military service. Adverse childhood experiences separately predicted increased odds of experiencing homelessness as an adult and mental health and physical health problems. Childhood adversity increased the likelihood of adult homelessness and poor physical health among individuals with no history of active military service and the likelihood of mental health problems among individuals with a history of active military service. The relationship between childhood adversity and adult adversity changes in degree when history of active military service is controlled, which has implications for Armed Forces recruitment strategies and postmilitary service risk assessment.

  18. Early childhood adversity and later hypertension: data from the World Mental Health Survey.

    Science.gov (United States)

    Stein, Dan J; Scott, Kate; Haro Abad, Josep M; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias; Demytteneare, Koen; de Girolamo, Giovanni; Iwata, Noboru; Posada-Villa, José; Kovess, Viviane; Lara, Carmen; Ormel, Johan; Kessler, Ronald C; Von Korff, Michael

    2010-02-01

    Although many studies have indicated that psychosocial factors contribute to hypertension, and that early childhood adversity is associated with long-term adverse mental and physical health sequelae, the association between early adversity and later hypertension is not well studied. Data from 10 countries participating in the World Health Organization (WHO) World Mental Health (WHM) Surveys (N = 18,630) were analyzed to assess the relationship between childhood adversity and adult-onset hypertension, as ascertained by self-report. The potentially mediating effect of early-onset depression-anxiety disorders, as assessed by the WHM Survey version of the International Diagnostic Interview (WMH-CIDI), on the relationship between early adversity and hypertension was also examined. Two or more early childhood adversities, as well as early-onset depression-anxiety, were significantly associated with hypertension. A range of specific childhood adversities, as well as early-onset social phobia and panic/agoraphobia, were significantly associated with hypertension. In multivariate analyses, the presence of 3 or more childhood adversities was associated with hypertension, even when early-onset depression-anxiety or current depression-anxiety was included in the model. Although caution is required in the interpretation of self-report data on adult-onset hypertension, the results of this study further strengthen the evidence base regarding the role of psychosocial factors in the pathogenesis of hypertension.

  19. Measured moisture in buildings and adverse health effects: a review.

    Science.gov (United States)

    Mendell, Mark J; Macher, Janet M; Kumagai, Kazukiyo

    2018-04-23

    It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support the setting of health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified three eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK. Both reported dose-related increases in asthma exacerbation with higher measured moisture, with one study reporting an adjusted odds ratio (OR) of 7.0 for night-time asthma symptoms with higher bedroom moisture. The third study assessed relationships between infrared camera-determined wall moisture and atopic dermatitis in South Korea, reporting an adjusted OR of 14.5 for water-damaged homes and moderate or severe atopic dermatitis. Measuring building moisture has, despite extremely limited available findings, potential promise for detecting unhealthy D/M in homes and merits more research attention. Further research to validate these findings should include measured "water activity," which directly assesses moisture availability for microbial growth. Ultimately, evidence-based, health-related thresholds for building moisture, across specific materials and measurement devices, could better guide assessment and remediation of D/M in buildings. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Looking for capacities rather than vulnerabilities: The moderating effect of health assets on the associations between adverse social position and health.

    Science.gov (United States)

    Roy, Mathieu; Levasseur, Mélanie; Doré, Isabelle; St-Hilaire, France; Michallet, Bernard; Couturier, Yves; Maltais, Danielle; Lindström, Bengt; Généreux, Mélissa

    2018-05-01

    To increase capacities and control over health, it is necessary to foster assets (i.e. factors enhancing abilities of individuals or communities). Acting as a buffer, assets build foundations for overcoming adverse conditions and improving health. However, little is known about the distribution of assets and their associations with social position and health. In this study, we documented the distribution of health assets and examined whether these assets moderate associations between adverse social position and self-reported health. A representative population-based cross-sectional survey of adults in the Eastern Townships, Quebec, Canada (n = 8737) was conducted in 2014. Measures included assets (i.e. resilience, sense of community belonging, positive mental health, social participation), self-reported health (i.e. perceived health, psychological distress), and indicators of social position. Distribution of assets was studied in relation to gender and social position. Logistic regressions examined whether each asset moderated associations between adverse social position and self-reported health. Different distributions of assets were observed with different social positions. Women were more likely to participate in social activities while men were more resilient. Resilience and social participation were moderators of associations between adverse social position (i.e. living alone, lower household income) and self-reported health. Having assets contributes to better health by increasing capacities. Interventions that foster assets and complement current public health services are needed, especially for people in unfavorable situations. Health and social services decision-makers and practitioners could use these findings to increase capacities and resources rather than focusing primarily on preventing diseases and reducing risk factors. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. [Prevention and Treatment of Common Acute Adverse Effects With Antipsychotic Use in Adults With Schizophrenia Diagnosis].

    Science.gov (United States)

    Arenas Borrero, Álvaro Enrique; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Vélez Traslaviña, Ángela; Castro Díaz, Sergio Mario; Jaramillo González, Luis Eduardo; García Valencia, Jenny

    2014-01-01

    To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The non-pharmacological interventions such as nutritional counseling by a nutritionist, exercise and psychotherapy are effective in preventing weight gain with the use of antipsychotics. (Kg Weight reduction in DM of -3.05 (-4.16, -1.94)). The antipsychotic change from olanzapine to aripiprazole showed weight loss and decreased BMI (decreased weight in KG DM -3.21 (-9.03, -2.61). The use of beta blockers was ineffective in reducing akathisia induced by antipsychotic; using as outcome the 50% reduction of symptoms of akathisia comparing beta-blockers with placebo RR was 1.4 (0.59, 1.83). It is recommended to make psychotherapeutic accompaniment and nutrition management of overweight for patients with weight gain. If these alternatives are ineffective is suggested to change the antipsychotic or consider starting metformin. For the management of drug-induced akathisia it is recommended to decrease the dose of the drug and the addition of lorazepam. It is recommended using 5mg biperiden IM or trihexyphenidyl 5mg orally in case of secondary acute dystonia and for the treatment of antipsychotic-induced parkinsonism to decrease the dose of antipsychotic or consider using 2 - 4mg/day of biperiden or diphenhydramine 50mg once daily. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Early Adversity, Elevated Stress Physiology, Accelerated Sexual Maturation, and Poor Health in Females

    Science.gov (United States)

    Belsky, Jay; Ruttle, Paula L.; Boyce, W. Thomas; Armstrong, Jeffrey M.; Essex, Marilyn J.

    2015-01-01

    Evolutionary-minded developmentalists studying predictive-adaptive-response processes linking childhood adversity with accelerated female reproductive development and health scientists investigating the developmental origins of health and disease (DOoHaD) may be tapping the same process, whereby longer-term health costs are traded off for…

  3. Knowledge of health care workers on corticosteroid adverse drug ...

    African Journals Online (AJOL)

    Background: Corticosteroids form the cornerstone of management for a myriad of rheumatological, dermatological and chronic respiratory tract diseases. Whereas these drugs are crucial in reducing morbidity and mortality, they are not without inherent grave risks. Health Care Workers (HCWs) providing care to patients on ...

  4. Adverse drug reaction reporting among health care workers at ...

    African Journals Online (AJOL)

    Mbarara University of Science and Technology, Mbarara, Uganda & University of Kent, UK. 2. Makerere University College of Health Sciences, Kampala, Uganda. 3. Pharmaceutical .... a pre-tested, semi-structured questionnaire. This hospital is located on Mulago Hill, in the northern part of Kampala city. Being Uganda's.

  5. Mental Health Workers’ Views About Their Suicide Prevention Role

    Directory of Open Access Journals (Sweden)

    Virginia Ross

    2016-03-01

    Full Text Available AimMental Health workers bear responsibility for preventing suicide in their client group. Survey studies have indicated that staff can be seriously adversely affected when a client suicides. The aim of the current study is to describe and evaluate the effects on mental health (MH workers of their ongoing role in managing suicidal behaviours and to identify the thoughts and feelings associated with this role.MethodA survey was administered to 135 MH workers via an on-line self-report vehicle. The survey comprised standardised measures of anxiety and burnout as well as a questionnaire developed for this study concerning perceptions and attitudes to suicide and suicide prevention.ResultsFactor analysis of 12 retained items of the questionnaire identified three factors: 1 preventability beliefs (beliefs about suicide being always and/or permanently preventable; 2 associated distress (stress/anxiety about managing suicidal behaviour; and 3 the prevention role (covering views about personal roles and responsibilities in preventing suicidal behaviours. Analysis of these factors found that many MH workers experience an elevation of stress/anxiety in relation to their role in managing suicidal behaviours. This distress was associated with the emotional exhaustion component of burnout. Measures showed adverse responses were higher for outpatient than inpatient workers; for those who had received generic training in suicide prevention: and for those who had experienced a workplace related client suicide.ConclusionThere is a need for the development of appropriate self-care strategies to alleviate stress in MH workers exposed to suicide.

  6. Workplace Safety and Health Topics: Safety & Prevention

    Science.gov (United States)

    ... Safety Motor Vehicle Safety Motor-Vehicle Safety of Law Enforcement Officers Nail Gun Safety National Occupational Mortality Surveillance (NOMS) Noise and Hearing Loss Prevention Occupational Health Safety Network (OHSN) Occupational Hearing Loss Surveillance Occupational ...

  7. Office of Disease Prevention and Health Promotion

    Science.gov (United States)

    ... Healthy People healthfinder Office of Disease Prevention and Health Promotion Spotlight: This Diabetes Month, Don’t Forget About the Importance of Exercise for People with Type 1 Diabetes In honor ...

  8. GIS, Pollution Prevention and Public Health

    Science.gov (United States)

    Using examples of preventing pollution and reducing risk of exposure to communities, this guide answers basic interest and start-up questions, addresses benefits and limitations and illustrates the value of GIS for local health departments.

  9. Arsenic exposure and adverse health effects: A review of recent findings from arsenic and health studies in Matlab, Bangladesh

    Directory of Open Access Journals (Sweden)

    Mohammad Yunus

    2011-09-01

    Full Text Available The recent discovery of large-scale arsenic (As contamination of groundwater has raised much concern in Bangladesh. Reliable estimates of the magnitude of As exposure and related health problems have not been comprehensively investigated in Bangladesh. A large population-based study on As and health consequences in Matlab (AsMat was done in Matlab field site where International Centre for Diarrhoeal Disease Research, Bangladesh has maintained a health and demographic surveillance system registering prospectively all vital events. Taking advantage of the health and demographic surveillance system and collecting data on detailed individual level As exposure using water and urine samples, AsMat investigated the morbidity and mortality associated with As exposure. Reviews of findings to date suggest the adverse effects of As exposure on the risk of skin lesions, high blood pressure, diabetes mellitus, chronic disease, and all-cause infant and adult disease mortality. Future studies of clinical endpoints will enhance our knowledge gaps and will give directions for disease prevention and mitigations.

  10. Movement Behaviors in Children and Indicators of Adverse Health

    DEFF Research Database (Denmark)

    Hjorth, Mads Fiil

    in physical activity was associated with increased fat mass index and cardio-metabolic risk over a 200-day follow-up period. Results indicated that low physical activity and high sedentary time was the result of fatness rather than its cause. Finally, combined negative levels of physical activity, sedentary......The prevalence of overweight children is high and increasing numbers of children now show features of metabolic syndrome. Various aspects of physical activity, sedentary behavior, and lack of good-quality sleep have all been linked to this recent development of overweight and cardio-metabolic risk...... among children. Early puberty is a period characterized by rapid changes in body composition and movement behaviors. As movement behaviors, obesity, and cardio-metabolic risk appear to track from childhood to adulthood, this may be a critical period for implementing preventive strategies aimed...

  11. Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects.

    Science.gov (United States)

    Karakurt, Gunnur; Patel, Vishal; Whiting, Kathleen; Koyutürk, Mehmet

    2017-01-01

    Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems.

  12. [Breastfeeding: health, prevention, and environment].

    Science.gov (United States)

    Giusti, Angela

    2015-01-01

    Recently, a great deal of research in the field of neuroscience and human microbiome indicates the primal period (from preconceptional up to the early years of a child's life) as crucial to the future of the individual, opening new scenarios for the understanding of the processes underlying the human health. In recent decades, the social representation of infant feeding moved in fact from the normality of breastfeeding to the normal use of artificial formulas and bottle-feeding. Even the scientific thinking and the research production have been influenced by this phenomenon. In fact, a clear dominance of studies aimed to show the benefits of breast milk compared to formula milk rather than the risks of the latter compared to the biological norm of breastfeeding. Mother milk affects infant health also through his/her microbiome. Microbial colonisation startes during intrauterine life and continues through the vaginal canal at birth, during skin to skin contact immediately after birth, with colostrum and breastfeeding. The microbial exposure of infants delivered by the mother influences the development of the child microbiota, by programming his/her future health. However, rewriting the biological normality implies also a health professional paradigm shift such as departing from the systematic separation mother-child at birth, sticking at fixed schedules for breastfeeding time and duration, as it still happens in many birth centres. Breastfeeding has economic implications and the increase of its prevalence is associated with significant reduction of avoidable hospital admissions and medical care costs, both for the child and for the mother. Success in breastfeeding is the result of complex social interactions and not simply of an individual choice. However, any successful strategy must be oriented to the mother empowerment. Therefore, health professionals and community stakeholders have to learn and practice the health promotion approach, particularly avoiding

  13. Design of the Anti-tuberculosis Drugs induced Adverse Reactions in China National Tuberculosis Prevention and Control Scheme Study (ADACS

    Directory of Open Access Journals (Sweden)

    He Ping

    2010-05-01

    Full Text Available Abstract Background More than 1 million tuberculosis (TB patients are receiving the standard anti-TB treatment provided by China National Tuberculosis Prevention and Control Scheme (CNTS in China every year. Adverse reactions (ADRs induced by anti-TB drugs could both do harm to patients and lead to anti-TB treatment failure. The ADACS aimed to explore ADRs' incidences, prognoses, economical and public health impacts for TB patients and TB control, and build a DNA bank of TB patients. Methods/Design Multiple study designs were adopted. Firstly, a prospective cohort with 4488 sputum smears positive pulmonary tuberculosis patients was established. Patients were followed up for 6-9 months in 52 counties of four regions. Those suspected ADRs should be checked and confirmed by Chinese State Food and Drug Administration (SFDA. Secondly, if the suspected ADR was anti-TB drug induced liver injury (ATLI, a nested case-control study would be performed which comprised choosing a matched control and doing a plus questionnaire inquiry. Thirdly, health economical data of ADRs would be collected to analyze financial burdens brought by ADRs and cost-effectiveness of ADRs' treatments. Fourthly, a drop of intravenous blood for each patient was taken and saved in FTA card for DNA banking and genotyping. Finally, the demographic, clinical, environmental, administrative and genetic data would be merged for the comprehensive analysis. Discussion ADACS will give an overview of anti-TB drugs induced ADRs' incidences, risk factors, treatments, prognoses, and clinical, economical and public health impacts for TB patients applying CNTS regimen in China, and provide suggestions for individualized health care and TB control policy.

  14. The health care work environment and adverse health and safety consequences for nurses.

    Science.gov (United States)

    Geiger-Brown, Jeanne; Lipscomb, Jane

    2010-01-01

    Nurses' working conditions are inextricably linked to the quality of care that is provided to patients and patients' safety. These same working conditions are associated with health and safety outcomes for nurses and other health care providers. This chapter describes aspects of the nursing work environment that have been linked to hazards and adverse exposures for nurses, as well as the most common health and safety outcomes of nursing work. We include studies from 2000 to the present by nurse researchers, studies of nurses as subjects, and studies of workers under similar working conditions that could translate to nurses' work environment. We explore a number of work organization factors including shift work and extended work hours, safety climate and culture, teamwork, and communication. We also describe environmental hazards, including chemical hazards (e.g., waste anesthetics, hazardous drugs, cleaning compounds) and airborne and bloodborne pathogen exposure. Nurses' health and safety outcomes include physical (e.g., musculoskeletal disorders, gastrointestinal, slips, trips and falls, physical assault) and psychosocial outcomes (e.g., burnout, work-family conflict). Finally, we present recommendations for future research to further protect nurses and all health care workers from a range of hazardous working conditions.

  15. Factors influencing consumer dietary health preventative behaviours

    Directory of Open Access Journals (Sweden)

    Ritson Christopher

    2006-09-01

    Full Text Available Abstract Background The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB and investigate their influence in the context of an adapted health cognition model. Methods A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Results and discussion Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. Conclusion The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly

  16. Factors influencing consumer dietary health preventative behaviours.

    Science.gov (United States)

    Petrovici, Dan A; Ritson, Christopher

    2006-09-01

    The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet) regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB) and investigate their influence in the context of an adapted health cognition model. A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels) is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly sources and risks associated with dietary fat and cholesterol) may induce people to

  17. Adverse effects of methylmercury: environmental health research implications

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Satoh, Hiroshi; Murata, Katsuyuki

    2010-01-01

    BACKGROUND: The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning. OBJECTIVE: Our aim was to examine how...... knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research. DATA SOURCES AND EXTRACTION: We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential...... the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until...

  18. Adverse health effects of air pollutants in a nonsmoking population.

    Science.gov (United States)

    Pope, C A

    1996-07-17

    Utah Valley has provided an interesting and unique opportunity to evaluate the health effects of respirable particulate air pollution (PM10). Residents of this valley are predominantly nonsmoking members of the Church of Jesus Christ of Latter-day Saints (Mormons). The area has moderately high average PM10 levels with periods of highly elevated PM10 concentrations due to local emissions being trapped in a stagnant air mass near the valley floor during low-level temperature inversion episodes. Due to a labor dispute, there was intermittent operation of the single largest pollution source, an old integrated steel mill. Levels of other common pollutants including sulfur dioxide, ozone, and acidic aerosol are relatively low. Studies specific to Utah Valley have observed that elevated PM10 concentrations are associated with: (1) decreased lung function; (2) increased incidence of respiratory symptoms; (3) increased school absenteeism; (4) increased respiratory hospital admissions; and (5) increased mortality, especially respiratory and cardiovascular mortality.

  19. Bullying Prevention for Public Health Practitioners

    Centers for Disease Control (CDC) Podcasts

    2012-01-19

    This podcast discusses bullying as a public health problem, and provides information and resources for public health practitioners.  Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 1/19/2012.

  20. Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: a pilot study.

    Science.gov (United States)

    Almuneef, Maha; Qayad, Mohammed; Aleissa, Majid; Albuhairan, Fadia

    2014-11-01

    Adverse childhood experiences (ACEs) have been linked with risky health behaviors and the development of chronic diseases in adulthood. This study examined associations between ACEs, chronic diseases, and risky behaviors in adults living in Riyadh, Saudi Arabia in 2012 using the ACE International Questionnaire (ACE-IQ). A cross-sectional design was used, and adults who were at least 18 years of age were eligible to participate. ACEs event scores were measured for neglect, household dysfunction, abuse (physical, sexual, and emotional), and peer and community violence. The ACE-IQ was supplemented with questions on risky health behaviors, chronic diseases, and mood. A total of 931 subjects completed the questionnaire (a completion rate of 88%); 57% of the sample was female, 90% was younger than 45 years, 86% had at least a college education, 80% were Saudi nationals, and 58% were married. One-third of the participants (32%) had been exposed to 4 or more ACEs, and 10%, 17%, and 23% had been exposed to 3, 2, or 1 ACEs respectively. Only 18% did not have an ACE. The prevalence of risky health behaviors ranged between 4% and 22%. The prevalence of self-reported chronic diseases ranged between 6% and 17%. Being exposed to 4 or more ACEs increased the risk of having chronic diseases by 2-11 fold, and increased risky health behaviors by 8-21 fold. The findings of this study will contribute to the planning and development of programs to prevent child maltreatment and to alleviate the burden of chronic diseases in adults. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. 25 CFR 170.110 - How can State and local governments prevent discrimination or adverse impacts?

    Science.gov (United States)

    2010-04-01

    ... and adverse effects on tribes and Native American populations. (b) Examples of adverse effects include..., trust resources, tribal businesses, religious, and cultural sites; (4) Harming indigenous plants and animals; and (5) Impairing the ability of tribal members to engage in commercial, cultural, and religious...

  2. Knowledge graph prediction of unknown adverse drug reactions and validation in electronic health records.

    Science.gov (United States)

    Bean, Daniel M; Wu, Honghan; Iqbal, Ehtesham; Dzahini, Olubanke; Ibrahim, Zina M; Broadbent, Matthew; Stewart, Robert; Dobson, Richard J B

    2017-11-27

    Unknown adverse reactions to drugs available on the market present a significant health risk and limit accurate judgement of the cost/benefit trade-off for medications. Machine learning has the potential to predict unknown adverse reactions from current knowledge. We constructed a knowledge graph containing four types of node: drugs, protein targets, indications and adverse reactions. Using this graph, we developed a machine learning algorithm based on a simple enrichment test and first demonstrated this method performs extremely well at classifying known causes of adverse reactions (AUC 0.92). A cross validation scheme in which 10% of drug-adverse reaction edges were systematically deleted per fold showed that the method correctly predicts 68% of the deleted edges on average. Next, a subset of adverse reactions that could be reliably detected in anonymised electronic health records from South London and Maudsley NHS Foundation Trust were used to validate predictions from the model that are not currently known in public databases. High-confidence predictions were validated in electronic records significantly more frequently than random models, and outperformed standard methods (logistic regression, decision trees and support vector machines). This approach has the potential to improve patient safety by predicting adverse reactions that were not observed during randomised trials.

  3. An overview of adverse health effects caused by mycotoxins and bioassays for their detection

    NARCIS (Netherlands)

    Wijnands LM; Leusden van FM; MGB

    2000-01-01

    Exposure to moulds and their (toxic) metabolites (mycotoxins) is a menace to human and animal health. A risk analysis can shed light on the actual risk of adverse health effects. In a previously published RIVM report (nr. 257852 002) on hazard identification the genera, Aspergillus, Penicillium,

  4. The Relationship between Adverse Childhood Events, Resiliency and Health among Children with Autism

    Science.gov (United States)

    Rigles, Bethany

    2017-01-01

    Previous research has shown a negative relationship between adverse childhood events (ACEs) and health and resiliency among the general population, but has not examined these associations among children with autism. Purpose: To determine the prevalence of ACEs among children with autism and how ACEs are associated with resiliency and health.…

  5. Cumulative Adverse Financial Circumstances: Associations with Patient Health Status and Behaviors

    Science.gov (United States)

    Bisgaier, Joanna; Rhodes, Karin V.

    2011-01-01

    This article examines associations between cumulative adverse financial circumstances and patient health in a sample of 1,506 urban emergency department (ED) patients. Study participants completed a previously validated Social Health Survey between May and October 2009. Five categories of economic deprivation were studied: food insecurity, housing…

  6. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    Science.gov (United States)

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. AQUASPINING AS ANTI-STRESS HEALTH PREVENTION

    Directory of Open Access Journals (Sweden)

    Dimitar Trendafilov

    2013-07-01

    Full Text Available In a nutshell SPA is something old and good, but nowadays enriched with the miraculous impact of the water culture and aqua practices. But in our opinion is very important to know that the SPA is the health prevention of a healthy people for their recovery from social and professional everyday stress. In most European countries and it became another kind of SPA effects called a short - Medical SPA. Our working hypothesis is based on the assumption that the development of modules for practicing aquaspinning will allow to optimize the proposed relaxing and procreative prevention programs and promoting the health and beauty. The aim of this study was to determine the specificity of the effects aquaspinning through the application of current methods of prevention and health promotion.

  8. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery.

    Science.gov (United States)

    Bailey, Jonathan G; Davis, Philip J B; Levy, Adrian R; Molinari, Michele; Johnson, Paul M

    2016-06-01

    Postoperative complications have been identified as an important and potentially preventable cause of increased hospital costs. While older adults are at increased risk of experiencing complications and other adverse events, very little research has specifically examined how these events impact inpatient costs. We sought to examine the association between postoperative complications, hospital mortality and loss of independence and direct inpatient health care costs in patients 70 years or older who underwent nonelective abdominal surgery. We prospectively enrolled consecutive patients 70 years or older who underwent nonelective abdominal surgery between July 1, 2011, and Sept. 30, 2012. Detailed patient-level data were collected regarding demographics, diagnosis, treatment and outcomes. Patient-level resource tracking was used to calculate direct hospital costs (2012 $CDN). We examined the association between complications, hospital mortality and loss of independence cost using multiple linear regression. During the study period 212 patients underwent surgery. Overall, 51.9% of patients experienced a nonfatal complication (32.5% minor and 19.4% major), 6.6% died in hospital and 22.6% experienced a loss of independence. On multivariate analysis nonfatal complications (p abdominal surgery in older adults and accounted for 44% of overall costs. This represents a substantial opportunity for better patient outcomes and cost savings with quality improvement strategies tailored to the needs of this high-risk surgical population.

  10. Prevention of health care-associated infections.

    Science.gov (United States)

    Hsu, Vincent

    2014-09-15

    Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin.

  11. Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

    Science.gov (United States)

    Antonsen,Erik

    2017-01-01

    The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

  12. [Health and environment, prevention or precaution?

    Science.gov (United States)

    Bard, Denis

    2018-03-01

    The health status of the populations of developed countries has never been as satisfactory, but will it stay that way? Research on the subject is difficult due to the complex interactions between our environment and our health, with risks inherent to each noxious agent. Preventing the risks proven to be linked to the quality of our living environments is usually the responsibility of authorities, but individuals can also adopt precautionary practices. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Energy drinks and their adverse health effects: A systematic review of the current evidence.

    Science.gov (United States)

    Ali, Fahad; Rehman, Hiba; Babayan, Zaruhi; Stapleton, Dwight; Joshi, Divya-Devi

    2015-04-01

    With the rising consumption of so-called energy drinks over the last few years, there has been a growing body of literature describing significant adverse health events after the ingestion of these beverages. To gain further insight about the clinical spectrum of these adverse events, we conducted a literature review. Using PubMed and Google-Scholar, we searched the literature from January 1980 through May 2014 for articles on the adverse health effects of energy drinks. A total of 2097 publications were found. We then excluded molecular and industry-related studies, popular media reports, and case reports of isolated caffeine toxicity, yielding 43 reports. Energy drink consumption is a health issue primarily of the adolescent and young adult male population. It is linked to increased substance abuse and risk-taking behaviors. The most common adverse events affect the cardiovascular and neurological systems. The most common ingredient in energy drinks is caffeine, and it is believed that the adverse events are related to its effects, as well as potentiating effects of other stimulants in these drinks. Education, regulation, and further studies are required.

  14. The Development of Countermeasures for Space Radiation Induced Adverse Health Effects

    Science.gov (United States)

    Kennedy, Ann

    The Development of Countermeasures for Space Radiation Induced Adverse Health Effects Ann R. Kennedy Department of Radiation Oncology, University of Pennsylvania School of Medicine, 195 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA, United States 19104-6072 The development of countermeasures for radiation induced adverse health effects is a lengthy process, particularly when the countermeasure/drug has not yet been evaluated in human trials. One example of a drug developed from the bench to the clinic is the soybean-derived Bowman-Birk inhibitor (BBI), which has been developed as a countermeasure for radiation induced cancer. It was originally identified as a compound/drug that could prevent the radiation induced carcinogenic process in an in vitro assay system in 1975. The first observation that BBI could inhibit carcinogenesis in animals was in 1985. BBI received Investigational New Drug (IND) Status with the U.S. Food and Drug Administration (FDA) in 1992 (after several years of negotiation with the FDA about the potential IND status of the drug), and human trials began at that time. Phase I, II and III human trials utilizing BBI have been performed under several INDs with the FDA, and an ongoing Phase III trial will be ending in the very near future. Thus, the drug has been in development for 35 years at this point, and it is still not a prescription drug on the market which is available for human use. A somewhat less time-consuming process is to evaluate compounds that are on the GRAS (Generally Recognized as Safe) list. These compounds would include some over-the-counter medications, such as antioxidant vitamins utilized in human trials at the levels for which Recommended Dietary Allowances (RDAs) have been established. To determine whether GRAS substances are able to have beneficial effects on radiation induced adverse health effects, it is still likely to be a lengthy process involving many years to potentially decades of human trial work. The

  15. A patient-reported spectrum of adverse health care experiences: harms, unnecessary care, medication illness, and low health confidence.

    Science.gov (United States)

    Wasson, John H

    2013-01-01

    As part of a health "checkup," a large national sample of adults used an Internet technology that also asks about adverse experiences. About half of all respondents do not feel very confident they can manage and control most of their health problems, almost 30% consider that their hospital or emergency department use was unnecessary, 20% believe that their medications may be causing illness, and 1.5% report a medical-related harm. Routine measures across a spectrum of adverse experiences are easy to obtain as part of everyday practice. Attention to these measures by health professionals should make care safer and less wasteful.

  16. Stress, Health Behavior, and Sleep as Mediators of the Association between Loneliness and Adverse Health Conditions among Older People

    DEFF Research Database (Denmark)

    Christiansen, Julie

    was significantly associated with poor self-rated health, cardiovascular disease, diabetes, and migraine. In addition, high perceived stress, physical inactivity, problems with alcohol, and poor sleep demonstrated an indirect effect on the association between loneliness and adverse health conditions. The findings...

  17. [Art, health and prevention: initial collaborations].

    Science.gov (United States)

    Avila, Noemí; Orellana, Ana; Cano, Marta G; Antúnez, Noelia; Claver, Dolores

    2014-01-01

    This article presents a summary of the first 2 years of the collaboration between the Faculty of Fine Arts of the Universidad Complutense in Madrid and Madrid Health, an autonomous organism of Madrid Council. This collaboration has allowed the development of joint experiences and projects among distinct professionals with highly diverse profiles: health professionals (sexologists, psychiatrists, nurses, etc.), and teachers, researchers, artists and students in the Faculty of Fine Arts. As a result, these experiences could be the beginning of future collaborations between the arts, health and prevention. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Utilization of healthcare services and renewal of health insurance membership : evidence of adverse selection in Ghana

    NARCIS (Netherlands)

    Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

    2016-01-01

    Background: Utilization of healthcare in Ghana’s novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme’s financial sustainability. This paper investigates the presence of adverse selection by assessing the effect

  19. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

    NARCIS (Netherlands)

    Gouttebarge, Vincent; Aoki, Haruhito; Kerkhoffs, Gino

    2015-01-01

    To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep

  20. Adverse Childhood Experiences (ACE) and Health-Risk Behaviors among Adults in a Developing Country Setting

    Science.gov (United States)

    Ramiro, Laurie S.; Madrid, Bernadette J.; Brown, David W.

    2010-01-01

    Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the…

  1. Adverse health effects of cigarette smoke: aldehydes Crotonaldehyde, butyraldehyde, hexanal and malonaldehyde

    NARCIS (Netherlands)

    Andel I van; Sleijffers A; Schenk E; Rambali B; Wolterink G; Werken G van de; Aerts LAGJM van; Vleeming W; Amsterdam JGC van; TOX

    2006-01-01

    Crotonaldehyde in cigarette smoke can be concluded to induce airway damage in humans. This is one conclusion derived from the existing data found in the literature and reported here in the discussion on adverse health effects and possible addictive effects due to the exposure of crotonaldehyde,

  2. The economic cost of adverse health effects from wildfire-smoke exposure: A review

    Science.gov (United States)

    Ikuho Kochi; Geoffrey H. Donovan; Patricia A. Champ; John B. Loomis

    2010-01-01

    The economic costs of adverse health effects associated with exposure to wildfire smoke should be given serious consideration in determining the optimal wildfire management policy. Unfortunately, the literature in this research area is thin. In an effort to better understand the nature of these economic costs, we review and synthesise the relevant literature in three...

  3. Adverse effects of radical vaginal surgery and radiotherapy on ureteral function, their prevention and therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pockrandt, H.; Jorde, A.

    1973-03-01

    The adverse effects of carcinoma therapy on ureteral function are described and placed in relationship to each other. The most essential precautions in prophylaxis and therapy before, during, and after surgery are described in detail. A delayed prophylaxis of a urological study in conjunction with recidivism study must be made. (JSR)

  4. An Educational Program to Prevent Adverse Events in Neonates : a Randomised Trial.

    Science.gov (United States)

    2016-10-20

    Intensive Care Units, Neonatal; Misadventures to Patients During Surgical and Medical Care; Catheter-related Bloodstream Infection (CRBSI) Nos; Quality of Healthcare; Ventilator Adverse Event; Nosocomial Pneumonia; Immature Newborn; Skin Lesion; Extravasation Injury; Nasal Injury; Intubation Complication; Medication Administered in Error; IV Catheter Nos Deep Venous Thrombosis

  5. Adverse health effects due to arsenic exposure: modification by dietary supplementation of jaggery in mice.

    Science.gov (United States)

    Singh, Nrashant; Kumar, D; Lal, Kewal; Raisuddin, S; Sahu, Anand P

    2010-02-01

    Populations of villages of eastern India and Bangladesh and many other parts of the world are exposed to arsenic mainly through drinking water. Due to non-availability of safe drinking water they are compelled to depend on arsenic-contaminated water. Generally, poverty level is high in those areas and situation is compounded by the lack of proper nutrition. The hypothesis that the deleterious health effects of arsenic can be prevented by modification of dietary factors with the availability of an affordable and indigenous functional food jaggery (sugarcane juice) has been tested in the present study. Jaggery contains polyphenols, vitamin C, carotene and other biologically active components. Arsenic as sodium-m-arsenite at low (0.05 ppm) and high (5 ppm) doses was orally administered to Swiss male albino mice, alone and in combination with jaggery feeding (250 mg/mice), consecutively for 180 days. The serum levels of total antioxidant, glutathione peroxidase and glutathione reductase were substantially reduced in arsenic-exposed groups, while supplementation of jaggery enhanced their levels in combined treatment groups. The serum levels of interleukin-1beta, interleukin-6 and TNF-alpha were significantly increased in arsenic-exposed groups, while in the arsenic-exposed and jaggery supplemented groups their levels were normal. The comet assay in bone marrow cells showed the genotoxic effects of arsenic, whereas combination with jaggery feeding lessened the DNA damage. Histopathologically, the lung of arsenic-exposed mice showed the necrosis and degenerative changes in bronchiolar epithelium with emphysema and thickening of alveolar septa which was effectively antagonized by jaggery feeding. These results demonstrate that jaggery, a natural functional food, effectively antagonizes many of the adverse effects of arsenic. Copyright 2009 Elsevier Inc. All rights reserved.

  6. Adverse Health Events Related to Self-Medication Practices Among Elderly: A Systematic Review.

    Science.gov (United States)

    Locquet, Médéa; Honvo, Germain; Rabenda, Véronique; Van Hees, Thierry; Petermans, Jean; Reginster, Jean-Yves; Bruyère, Olivier

    2017-05-01

    Older adults often resort to self-medication to relieve symptoms of their current illnesses; however, the risks of this practice are multiplied in old age. In particular, this age group is more vulnerable to adverse drug events because of the physiological changes that occur due to senescence. The aim of the study was to obtain an overview of the adverse health events related to self-medication among subjects aged 60 years and over through a systematic review of the literature. A study of relevant articles was conducted among databases (MEDLINE, PsycINFO, and EBM Reviews-Cochrane Database of Systematic Reviews). Eligibility criteria were established and applied by two investigators to include suitable studies. The results and outcomes of interest were detailed in a descriptive report. The electronic search identified 4096 references, and the full texts of 74 were reviewed, of which four were retained in the analysis: three had a cross-sectional design and one prospectively followed elderly subjects. The first study showed a 26.7% prevalence of adverse drug reactions (ADRs) among elders, the second study found a 75% prevalence of side effects, and, finally, a prospective study showed an ADR incidence of 4.5% among self-medicated elders. These studies showed that adverse health events related to self-medication are relatively frequently reported. They also highlighted that analgesics and anti-inflammatory drugs are the most self-medicated products, while vitamins and dietary supplements also appear to be frequently self-administered, but by older individuals. Studies on self-medication in the elderly and its adverse health effects are clearly lacking. There is a need to perform prospective studies on this topic to gain a clear understanding of the extent of this problem and to enhance the awareness of health professionals to better inform seniors.

  7. JADE: a tool for medical researchers to explore adverse drug events using health claims data.

    Science.gov (United States)

    Edlinger, D; Sauter, S K; Rinner, C; Neuhofer, L M; Wolzt, M; Grossmann, W; Endel, G; Gall, W

    2014-01-01

    The objective of our project was to create a tool for physicians to explore health claims data with regard to adverse drug reactions. The Java Adverse Drug Event (JADE) tool should enable the analysis of prescribed drugs in connection with diagnoses from hospital stays. We calculated the number of days drugs were taken by using the defined daily doses and estimated possible interactions between dispensed drugs using the Austria Codex, a database including drug-drug interactions. The JADE tool was implemented using Java, R and a PostgreSQL database. Beside an overview of the study cohort which includes selection of gender and age groups, selected statistical methods like association rule learning, logistic regression model and the number needed to harm have been implemented. The JADE tool can support physicians during their planning of clinical trials by showing the occurrences of adverse drug events with population based information.

  8. Leukocytes and transfusion related adverse events: the effects of leuko-reduction process in the prevention of adverse reactions resulted from the transfusion of blood components: review article

    Directory of Open Access Journals (Sweden)

    Ehteramolsadat Hosseini

    2017-05-01

    Full Text Available Blood transfusion is commonly implemented to manage life and health-threatening conditions on a rapid and short-term basis. Over the years, ongoing technical advances have dramatically improved transfusion medicine to provide more safety and effectiveness. However, transfusion is still complicated with different adverse events that mainly induced by the presence of allogeneic leukocytes in the blood products. Several lines of evidence have shown that leukocytes in blood components are involved in the induction of febrile nonhemolytic transfusion reactions (FNHTRs, HLA alloimmunization and platelet refractoriness as well as the increased risk of the infectious diseases transmitted by leukotropic viruses including cytomegalovirus (CMV, human T-lymphotropic virus (HTLV-I/II and Epstein-Barr virus (EBV. During current decades, introducing various leuko-reduction techniques have shown to be associated with less transfusion related adverse events and improved clinical outcomes. The lower incidence and severity of febrile transfusion reactions; reduced risk of transfusion related transmission of CMV or other leukocyte-associated infections, lowered incidence of alloimmune platelet refractoriness in addition to reducing risk of mortality and morbidity in patients are considered as clinical benefits of leuko-reduced products. Currently, by the use of 3rd and 4th generation of filters, the highest levels of leukoreduction in blood components have been achieved. Filtration techniques have also the advantages of being performed shortly after preparation of components (pre-storage or post-storage even at the patient’s bedside. However, it seems that pre-storage depletion of leukocytes provides better protection than post-storage techniques due to the elimination of leukocyte-derived cytokines effects which are increasingly released during storage. Particularly in platelet products, the earlier depletion of leukocyte also favors less platelet

  9. Stress, Health Behavior, and Sleep as Mediators of the Association between Loneliness and Adverse Health Conditions among Older People

    DEFF Research Database (Denmark)

    Christiansen, Julie

    Prior research has established an association between loneliness and a variety of negative health conditions among older people. However, little is known about the mechanisms underlying the association. The Loneliness Model seeks to explain the mechanisms through which chronic loneliness might...... affect the development of adverse health conditions. The present study was designed to test the explanation proposed by the Loneliness Model. The sample consisted of 8.593 elderly ranging from 65 to 103 years participating in the 2013 Public Health Survey; “How are you?”. Results showed that loneliness...... was significantly associated with poor self-rated health, cardiovascular disease, diabetes, and migraine. In addition, high perceived stress, physical inactivity, problems with alcohol, and poor sleep demonstrated an indirect effect on the association between loneliness and adverse health conditions. The findings...

  10. Preventing childhood obesity: health in the balance

    National Research Council Canada - National Science Library

    Koplan, Jeffrey; Liverman, Catharyn T; Kraak, Vivica I

    2005-01-01

    ... for the report were chosen for their special competences and with regard for appropriate balance. The study was supported by Contract No. 200-2000-00629, T.O. #14 between the National Academy of Sciences and the Centers for Disease Control and Prevention; by Contract No. N01-OD-4-2139, T.O. #126 with the National Institutes of Health; and by Grant No. 04...

  11. Adverse Health Consequences of Performance-Enhancing Drugs: An Endocrine Society Scientific Statement

    Science.gov (United States)

    Pope, Harrison G.; Wood, Ruth I.; Rogol, Alan; Nyberg, Fred; Bowers, Larry

    2014-01-01

    Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs. PMID:24423981

  12. 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.

  13. The association between type and number of adverse working conditions and mental health during a time of economic crisis (2010-2012).

    Science.gov (United States)

    ten Have, Margreet; van Dorsselaer, Saskia; de Graaf, Ron

    2015-06-01

    Many studies have been published on the association between adverse psychosocial working conditions and mental health, but only a few related types of adverse job conditions and a count of these adversities to workers' mental health, using standardized diagnostic interviews. This study addresses this issue. Data were used from the second wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face survey of the general population, including 3,672 workers, 166 unemployed and 239 disabled persons. Among workers, psychosocial working conditions (decision latitude, psychological job demands, job security and co-worker support) were assessed with the Job Content Questionnaire. Mental health symptoms were assessed with the Mental Health Inventory (MHI)-5 and DSM-IV diagnoses/syndromes with the Composite International Diagnostic Interview 3.0. Adverse psychosocial job conditions were related to workers' mental health. The strongest association was found for low job security which increased the chance of mental health symptoms and mental disorders by twofold. Workers in the poorest quality jobs, i.e. experiencing at least three adverse working conditions, had a 3 to almost 5 times higher chance of mental disorders than those in the most optimal jobs. Having a poor quality job was not associated with better mental health compared to being unemployed or disabled. In general, similar relations were found for mood, anxiety and substance use disorders. In planning future strategies to prevent mental disorders at the workplace, the focus should be on workers who experience job insecurity and on those who report several adversities.

  14. The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood

    Science.gov (United States)

    Wolitzky-Taylor, Kate; Sewart, Amy; Vrshek-Schallhorn, Suzanne; Zinbarg, Richard; Mineka, Susan; Hammen, Constance; Bobova, Lyuba; Adam, Emma K.; Craske, Michelle G.

    2016-01-01

    Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents (N = 457; Female 68.9%) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits. PMID:27613006

  15. The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood.

    Science.gov (United States)

    Wolitzky-Taylor, Kate; Sewart, Amy; Vrshek-Schallhorn, Suzanne; Zinbarg, Richard; Mineka, Susan; Hammen, Constance; Bobova, Lyuba; Adam, Emma K; Craske, Michelle G

    2017-01-01

    Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents (N = 457; Female 68.9 %) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits.

  16. Patient-reported health as a prognostic factor for adverse events following percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Biering K

    2014-01-01

    Full Text Available Karin Biering,1 Hans Erik Bøtker,2 Troels Niemann,3 Niels Henrik Hjollund4,51Department of Occupational Medicine, Regional Hospital West Jutland, Herning, 2Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, 3Department of Cardiology, Regional Hospital West Jutland, Herning, 4WestChronic, Regional Hospital West Jutland, Herning, 5Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkObjective: A relation may exist between self-reported health and adverse events in coronary heart disease. Previous studies have been vulnerable to possible selection bias. In the study reported here, we examined the association between self-rated health and adverse events in terms of cardiac events, cardiac readmissions, and all-cause mortality in a complete cohort of patients treated with percutaneous coronary intervention (PCI.Study design and setting: A cohort of patients with coronary heart disease treated with PCI was followed up with questionnaires 4 weeks after PCI to measure self-rated health and in registers to identify adverse events. Of 1,752 eligible patients under 67 years, 26 died during the first 4 weeks. A total of 224 patients were excluded from the analysis because they were readmitted with a cardiac diagnosis before answering the first questionnaire. We received complete SF-12 Health Survey component summaries from 984 of the remaining 1,502 patients. We used multiple imputation to establish a complete cohort, including nonrespondents.Results: During follow-up, 83 patients died, 220 patients experienced a new cardiac event, and 526 patients experienced a hospital readmission related to coronary heart disease. Poor self-rated health was related to cardiac events, cardiac readmission, and all-cause mortality. The associations were stronger for all-cause mortality than for events and readmissions. Physical health was more important than mental health, but both revealed an exposure–response pattern

  17. A value set for documenting adverse reactions in electronic health records.

    Science.gov (United States)

    Goss, Foster R; Lai, Kenneth H; Topaz, Maxim; Acker, Warren W; Kowalski, Leigh; Plasek, Joseph M; Blumenthal, Kimberly G; Seger, Diane L; Slight, Sarah P; Wah Fung, Kin; Chang, Frank Y; Bates, David W; Zhou, Li

    2017-12-14

    To develop a comprehensive value set for documenting and encoding adverse reactions in the allergy module of an electronic health record. We analyzed 2 471 004 adverse reactions stored in Partners Healthcare's Enterprise-wide Allergy Repository (PEAR) of 2.7 million patients. Using the Medical Text Extraction, Reasoning, and Mapping System, we processed both structured and free-text reaction entries and mapped them to Systematized Nomenclature of Medicine - Clinical Terms. We calculated the frequencies of reaction concepts, including rare, severe, and hypersensitivity reactions. We compared PEAR concepts to a Federal Health Information Modeling and Standards value set and University of Nebraska Medical Center data, and then created an integrated value set. We identified 787 reaction concepts in PEAR. Frequently reported reactions included: rash (14.0%), hives (8.2%), gastrointestinal irritation (5.5%), itching (3.2%), and anaphylaxis (2.5%). We identified an additional 320 concepts from Federal Health Information Modeling and Standards and the University of Nebraska Medical Center to resolve gaps due to missing and partial matches when comparing these external resources to PEAR. This yielded 1106 concepts in our final integrated value set. The presence of rare, severe, and hypersensitivity reactions was limited in both external datasets. Hypersensitivity reactions represented roughly 20% of the reactions within our data. We developed a value set for encoding adverse reactions using a large dataset from one health system, enriched by reactions from 2 large external resources. This integrated value set includes clinically important severe and hypersensitivity reactions. This work contributes a value set, harmonized with existing data, to improve the consistency and accuracy of reaction documentation in electronic health records, providing the necessary building blocks for more intelligent clinical decision support for allergies and adverse reactions. © The

  18. Changing disease profile and preventive health care in India: Issues of economy, equity and effectiveness

    Directory of Open Access Journals (Sweden)

    Salma Kaneez

    2015-01-01

    Full Text Available The importance of preventive health care practices has increasingly been recognized in the wake of changing disease profile in India. The disease burden has been shifting from communicable to non-communicable diseases as a result of greater focus on achieving competitiveness in a fast globalizing economy. The rapid pace of social and technological changes has led to adverse life style choices resulting in higher incidence of heart diseases, diabetes, obesity, cancer, and deteriorating inter-personal relations and psychological well-being among individuals. Most of these health risks can considerably be reduced through disseminating science-based information on health promotion and disease prevention including exercise, nutrition, smoking and tobacco cessation, immunization, counseling, fostering good habits of health and hygiene, disease screening and preventive medicine. Prior evidences indicate that preventive health interventions can improve health outcomes in a great deal. In a regressive health delivery system of India where major health expenses on curative health is met by out-of-pocket money, preventive health services hold promise to be cost efficient, clinically effective and equity promoting. This article, therefore, examines in depth the issues and prospects of preventive and promotive health care services in realizing optimum health care needs of the people.

  19. Asymmetric Information in Iranian’s Health Insurance Market: Testing of Adverse Selection and Moral Hazard

    Science.gov (United States)

    Lotfi, Farhad; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Hadian, Mohammad

    2015-01-01

    Background: Asymmetric information is one of the most important issues in insurance market which occurred due to inherent characteristics of one of the agents involved in insurance contracts; hence its management requires designing appropriate policies. This phenomenon can lead to the failure of insurance market via its two consequences, namely, adverse selection and moral hazard. Objective: This study was aimed to evaluate the status of asymmetric information in Iran’s health insurance market with respect to the demand for outpatient services. Materials/sPatients and Methods: This research is a cross sectional study conducted on households living in Iran. The data of the research was extracted from the information on household’s budget survey collected by the Statistical Center of Iran in 2012. In this study, the Generalized Method of Moment model was used and the status of adverse selection and moral hazard was evaluated through calculating the latent health status of individuals in each insurance category. To analyze the data, Excel, Eviews and stata11 software were used. Results: The estimation of parameters of the utility function of the demand for outpatient services (visit, medicine, and Para-clinical services) showed that households were more risk averse in the use of outpatient care than other goods and services. After estimating the health status of households based on their health insurance categories, the results showed that rural-insured people had the best health status and people with supplementary insurance had the worst health status. In addition, the comparison of the conditional distribution of latent health status approved the phenomenon of adverse selection in all insurance groups, with the exception of rural insurance. Moreover, calculation of the elasticity of medical expenses to reimbursement rate confirmed the existence of moral hazard phenomenon. Conclusions: Due to the existence of the phenomena of adverse selection and moral hazard

  20. Asymmetric Information in Iranian's Health Insurance Market: Testing of Adverse Selection and Moral Hazard.

    Science.gov (United States)

    Lotfi, Farhad; Abolghasem Gorji, Hassan; Mahdavi, Ghadir; Hadian, Mohammad

    2015-04-19

    Asymmetric information is one of the most important issues in insurance market which occurred due to inherent characteristics of one of the agents involved in insurance contracts; hence its management requires designing appropriate policies. This phenomenon can lead to the failure of insurance market via its two consequences, namely, adverse selection and moral hazard. This study was aimed to evaluate the status of asymmetric information in Iran's health insurance market with respect to the demand for outpatient services. This research is a cross sectional study conducted on households living in Iran. The data of the research was extracted from the information on household's budget survey collected by the Statistical Center of Iran in 2012. In this study, the Generalized Method of Moment model was used and the status of adverse selection and moral hazard was evaluated through calculating the latent health status of individuals in each insurance category. To analyze the data, Excel, Eviews and stata11 software were used. The estimation of parameters of the utility function of the demand for outpatient services (visit, medicine, and Para-clinical services) showed that households were more risk averse in the use of outpatient care than other goods and services. After estimating the health status of households based on their health insurance categories, the results showed that rural-insured people had the best health status and people with supplementary insurance had the worst health status. In addition, the comparison of the conditional distribution of latent health status approved the phenomenon of adverse selection in all insurance groups, with the exception of rural insurance. Moreover, calculation of the elasticity of medical expenses to reimbursement rate confirmed the existence of moral hazard phenomenon. Due to the existence of the phenomena of adverse selection and moral hazard in most of health insurances categories, policymakers need to adjust contracts so

  1. The Role of Nurses in Community Awareness and Preventive Health

    Directory of Open Access Journals (Sweden)

    Marjaneh M. Fooladi

    2015-10-01

    as a theoretical framework within that community should be considered to help explain how communities address adversity.2 In a British study, researchers established the importance of the role of nursing in preventive health when nurses added significant improvement to reduce the major risk factors for cardiovascular disease in middle aged patients. Nurses, compared to other healthcare providers, were able to provide health screening and doubled the recorded blood pressure, quadrupled identification of smoking habit, and increased documented weight related issues by fivefold in a primary care setting.3 Community health nursing theory addresses collective concepts of nursing domains in an attempt to rectify environmental, resiliency, and community abilities for healthcare issues among diverse population and avoids simple groupings of aggregates. Conceptual frameworks are introduced to help urban and rural communities implement preventative measures for health and wellbeing of residents through rural-based community health nursing programs.1,4 With this awareness, Iranian nurses in any practice area will find a golden opportunity to encourage, motivate, inform and guide the public to consider health screening, annual check-ups, childhood and adult immunizations and offer health education to patients across the lifespan. The role of nursing does not begin or end in a hospital-based or clinical facility. It is important to remember “Once a nurse, Always a nurse”, which means a nurse can guide and educate the public every minute and in all places, for the mere fact that medicine does NOT. Community health is a major part of nursing profession as Sarah, who graduated from a baccalaureate nursing program 5 years ago, demonstrates her role as a spiritual journey with a firm belief to bring health awareness through motivation. Her usual day begins by telling a 45 year-old male cashier in a supermarket to go for a prostate cancer screening; a 50 year-old woman sitting in

  2. Orthopedic Health: Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... version of this page please turn Javascript on. Prevention Regular exercise, a balanced diet, and a healthful weight can help you reduce your risk of developing osteoarthritis, especially in the hips and knees, or suffering sports injuries. Exercise helps bone density, improves muscle strength and ...

  3. Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol

    Science.gov (United States)

    2014-01-01

    Background Chronic diseases, such as cardiovascular disease and type 2 diabetes, impose significant burden to public health. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, blood glucose, and lipids, physical inactivity, excessive sedentary behaviours, overweight and obesity, and tobacco usage. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in adults is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case-control studies, and nested case-control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will

  4. Childhood adversity and subsequent mental health status in adulthood: screening for associations using two linked surveys.

    Science.gov (United States)

    Patten, S B; Wilkes, T C R; Williams, J V A; Lavorato, D H; El-Guebaly, N; Wild, T C; Colman, I; Bulloch, A G M

    2016-04-01

    Accumulating evidence links childhood adversity to negative health outcomes in adulthood. However, most of the available evidence is retrospective and subject to recall bias. Published reports have sometimes focused on specific childhood exposures (e.g. abuse) and/or specific outcomes (e.g. major depression). Other studies have linked childhood adversity to a large and diverse number of adult risk factors and health outcomes such as cardiovascular disease. To advance this literature, we undertook a broad examination of data from two linked surveys. The goal was to avoid retrospective distortion and to provide a descriptive overview of patterns of association. A baseline interview for the Canadian National Longitudinal Study of Children and Youth collected information about childhood adversities affecting children aged 0-11 in 1994. The sampling procedures employed in a subsequent study called the National Population Health Survey (NPHS) made it possible to link n = 1977 of these respondents to follow-up data collected later when respondents were between the ages of 14 and 27. Outcomes included major depressive episodes (MDE), some risk factors and educational attainment. Cross-tabulations were used to examine these associations and adjusted estimates were made using the regression models. As the NPHS was a longitudinal study with multiple interviews, for most analyses generalized estimating equations (GEE) were used. As there were multiple exposures and outcomes, a statistical procedure to control the false discovery rate (Benjamini-Hochberg) was employed. Childhood adversities were consistently associated with a cluster of potentially related outcomes: MDE, psychotropic medication use and smoking. These outcomes may be related to one another since psychotropic medications are used in the treatment of major depression, and smoking is strongly associated with major depression. However, no consistent associations were observed for other outcomes examined: physical

  5. Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana

    OpenAIRE

    Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

    2016-01-01

    Background Utilization of healthcare in Ghana?s novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme?s financial sustainability. This paper investigates the presence of adverse selection by assessing the effect of healthcare utilization and frequency of use on NHIS renewal. Method Routine enrolment and utilization data from 2008 to 2013 in two regions in Ghana was analyzed. Pearson Chi-square test was per...

  6. Utilization of healthcare services and renewal of health insurance membership: Evidence of adverse selection in Ghana

    OpenAIRE

    Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

    2016-01-01

    Background: Utilization of healthcare in Ghana's novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme's financial sustainability. This paper investigates the presence of adverse selection by assessing the effect of healthcare utilization and frequency of use on NHIS renewal. Method: Routine enrolment and utilization data from 2008 to 2013 in two regions in Ghana was analyzed. Pearson Chi-square test was p...

  7. Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city

    Directory of Open Access Journals (Sweden)

    Ameel F Al-Shawi

    2015-01-01

    Full Text Available Background: Studies have revealed a powerful relationship between adverse childhood experiences (ACEs and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life. Objective: The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city. Subjects and Methods: A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases. Results: Logistic regression model showed that a higher level of bonding to family (fourth quartile is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57 and exposure to a high level of household dysfunction and abuse (fourth quartile is expected to increase the risk of chronic physical diseases by 81%. Conclusion: Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life.

  8. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

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

    2010-01-01

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

  9. A reader on applying statistics in public health and prevention

    NARCIS (Netherlands)

    Rijckevorsel, J.L.A. van; Bijleveld, C.C.J.H.

    1992-01-01

    Contributions to this volume discuss the application of statistics in public health and prevention, dealing with subjects in the field of working conditions and occupational health, sexually transmissible disease, dental health, public health tables, the geographical distribution of diseases,

  10. [Fundamental and applied aspects of preventing the adverse effects of aviation noise].

    Science.gov (United States)

    Zhdan'ko, I M; Zinkin, V N; Soldatov, S K; Bogomolov, A V; Sheshegov, P M

    2014-01-01

    In the article, aviation noise is discussed as a harmful physical factor with ecological, hygienic, clinical and social implications. Noise contributes to development of general and occupational pathologies, chronic diseases, and reduction of professional longevity. The present-day knowledge of aviation noise sources and dynamics, and effects on environment, population, and aviation personnel is overviewed, as well as strategies to prevent noise consequences, muffling techniques being the key ones.

  11. [Health issues and preventive health strategies for adolescent girls].

    Science.gov (United States)

    Ma, Wei-Fen; Chao, Fen-Hao; Chang, Hsiu-Ju; Liou, Yiing-Mei; Chiang, Li-Chi

    2009-12-01

    As adolescent girls have specific healthcare needs, this paper was designed to provide a better understanding of their healthcare needs in both physical and psychosocial terms. After conducting a targeted review of the literature on children and adolescents, we identified factors of importance to physical health as body weight, physical activity, menstruation, sexual knowledge and attitude and to psychosocial health as anxiety, interpersonal relationships, depression, and suicide behavior. Reflecting these factors, this paper presents four preventive suggestions to clinical practice, education, and research to facilitate improvements in adolescent girl's health. These suggestions include: 1) strengthening health education and media responsibility with regard to adolescent girl health; 2) improving awareness of the needs of adolescent girls within healthcare and education organizations; 3) making health guidelines for promoting proper health behavior in adolescent girls; and 4) mobilizing nurses to assert the health of adolescent girls in clinical, education, and research fields. This is the first paper that focuses on the health needs of adolescent Taiwanese girls. The authors hope that more people become involved in the care of adolescent girl's health in Taiwan.

  12. Bigger, Brighter, Bluer-Better?Current light-emitting devices- adverse sleep properties and preventative strategies.

    Directory of Open Access Journals (Sweden)

    Paul eGringras

    2015-10-01

    Full Text Available ObjectiveIn an effort to enhance the efficiency, brightness and contrast of light-emitting (LE devices during the day, displays often generate substantial short-wavelength (blue-enriched light emissions that can adversely affect sleep. We set out to verify the extent of such short-wavelength emissions, produced by a tablet (iPad Air, e-reader (Kindle Paperwhite 1st generation and smartphone (iPhone 5s and to determine the impact of strategies designed to reduce these light emissions. SettingUniversity of Surrey dedicated chronobiology facility.MethodsFirstly, the spectral power of all the light-emitting (LE devices was assessed when displaying identical text. Secondly, we compared the text output with that of ‘Angry Birds’-a popular top 100 ‘App Store’ game. Finally we measured the impact of two strategies that attempt to reduce the output of short-wavelength light emissions. The first strategy employed an inexpensive commercially available pair of orange-tinted ‘blue-blocking’ glasses. The second tested an app designed to be ‘sleep-aware’ whose designers deliberately attempted to reduce blue-enriched light emissions.ResultsAll the LE devices shared very similar enhanced blue-light peaks when displaying text. This included the output from the backlit Kindle Paperwhite device. The spectra when comparing text to the Angry Birds game were also very similar, although the

  13. Capitalizing on Advances in Science to Reduce the Health Consequences of Early Childhood Adversity.

    Science.gov (United States)

    Shonkoff, Jack P

    2016-10-01

    Advances in biology are providing deeper insights into how early experiences are built into the body with lasting effects on learning, behavior, and health. Numerous evaluations of interventions for young children facing adversity have demonstrated multiple, positive effects but they have been highly variable and difficult to sustain or scale. New research on plasticity and critical periods in development, increasing understanding of how gene-environment interaction affects variation in stress susceptibility and resilience, and the emerging availability of measures of toxic stress effects that are sensitive to intervention provide much-needed fuel for science-informed innovation in the early childhood arena. This growing knowledge base suggests 4 shifts in thinking about policy and practice: (1) early experiences affect lifelong health, not just learning; (2) healthy brain development requires protection from toxic stress, not just enrichment; (3) achieving breakthrough outcomes for young children facing adversity requires supporting the adults who care for them to transform their own lives; and (4) more effective interventions are needed in the prenatal period and first 3 years after birth for the most disadvantaged children and families. The time has come to leverage 21st-century science to catalyze the design, testing, and scaling of more powerful approaches for reducing lifelong disease by mitigating the effects of early adversity.

  14. Physical activity to overcome the adversity of widowhood: Benefits beyond physical health.

    Science.gov (United States)

    Li, Chu-Shiu; Lee, June Han; Chang, Ly-Yun; Liu, Chwen-Chi; Chan, Yan-Lan; Wen, Christopher; Chiu, Mu-Lin; Tsai, Min Kuang; Tsai, Shan Pou; Wai, Jackson Pui Man; Tsao, Chwen Keng; Wu, Xifeng; Wen, Chi Pang

    2016-08-01

    Widowhood has been increasingly encountered because of increasing longevity of women, often characterized by social stigmatization and poor physical and mental health. However, applied research to overcome its adversity has been quite limited. The goal of this study is to explore the role of physical activity in improving the health of widows.A cohort of 446,582 adults in Taiwan who successively participated in a comprehensive medical screening program starting in 1994, including 232,788 women, was followed up for mortality until 2008. Each individual provided detailed health history, and extensive lab tests results.The number of widows increased with time trend. Every other woman above age 65 was a widow (44%). Widows were less active, more obese, and smoked and drank more, had sleep problems, were more depressed with taking sedatives or psychoactive drugs, leading to more suicides. In the global development of health policies by World Health Organization (WHO), physical activity is one of the main factors to reverse poor health. The poor health of inactive widow was mitigated when becoming fully active in this study. Exercise not only reduced the observed 18% increase in all-cause mortality, but also gained 4 years and as much as 14% mortality advantage over the married but inactive. More importantly, becoming physically active energized their mental status, improved sleep quality and quantity, reduced depressions and the need for psychoactive drugs, and increased socialization circles.Widows, a rapidly growing and socially stigmatized group, suffered from social and financial inequality and tended to develop poorer health. Sustained physical activity could be one of the ways for them to overcome and reverse some of the physical and mental adversities of widowhood, and improve their quality and quantity of life.

  15. Ongoing adverse mental health impact of the earthquake sequence in Christchurch, New Zealand.

    Science.gov (United States)

    Spittlehouse, Janet K; Joyce, Peter R; Vierck, Esther; Schluter, Philip J; Pearson, John F

    2014-08-01

    In September 2010 Christchurch, New Zealand, was struck by a 7.1 magnitude earthquake, followed by a prolonged sequence of significant aftershocks including a fatal aftershock in February 2011. Christchurch City has experienced widespread damage, ongoing disruption and building demolitions resulting in many difficulties for the residents of the Christchurch area. We explore what impact the earthquakes have had on the mental and physical health of a random sample of 50-year-olds who live in the Christchurch area. The 295 participants were selected from the electoral rolls for participation in the CHALICE study, a longitudinal study of ageing. Self-reported health status was assessed using the standardised Short Form 36 version 2 health survey (SF-36v2), a 36-item questionnaire, and results from the eight subscales compared to a national health survey. Mood disorders were assessed and the results were compared to other local and national studies. Since the onset of the earthquakes and throughout the study period, participating middle-aged Christchurch residents have mean SF-36v2 scores significantly lower than population norms in the mental health, vitality, social functioning and role-emotional subscales (Cohen's d ranged from -0.270 to -0.357, all p earthquake survivors compared to 5.1% and 3.7% in other historical, local and national surveys. Similarly, bipolar disorder prevalence was 2.8% in the earthquake survivors compared to 2.2% and 1.4% in other studies. Eighteen months after the first earthquake the significant adverse impact on mental health clearly continues. The ongoing provision of additional mental health services and consideration of these adverse mental health effects in relation to other social policies remains necessary and fundamental. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  16. Do stress, health behavior, and sleep mediate the association between loneliness and adverse health conditions among older people?

    Science.gov (United States)

    Christiansen, Julie; Larsen, Finn Breinholt; Lasgaard, Mathias

    2016-03-01

    Prior research has established an association between loneliness and a variety of negative health conditions among older people. However, little is known about the mechanisms underlying this association. Building on the Loneliness Model, Hawkley and Cacioppo (2010) identified possible pathways through which loneliness may affect the development of adverse health conditions. The present study was designed to test the pathways proposed by Hawkley and Cacioppo. The sample consisted of 8593 elderly ranging from 65 to 102 years of age participating in the 2013 Public Health Survey "How are you?". Findings show that loneliness was significantly associated with cardiovascular disease, diabetes, and migraine. In addition high perceived stress, physical inactivity, daily smoking, and poor sleep mediated the association between loneliness and adverse health conditions. Moreover, findings demonstrate several gender differences in the association between loneliness and various adverse condition and the indirect mechanisms affecting these associations. The findings largely support the pathways proposed by Hawkley and Cacioppo. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Mercury, phthalates, and ionizing radiations in neonatal intensive care controls. Adverse effects and preventive measures

    International Nuclear Information System (INIS)

    Zarlenga, Mercedes; Somaruga, Luis

    2006-01-01

    Studies realized by important institutions in the world have demonstrated that the load of illnesses associated with environmental and occupational conditions are affected by the current generation, especially to the most vulnerable populations as are the newborn babies. In the present work, the effects of the mercury, the phthalates and the ionizing radiations on the neonates health are described [es

  18. Adverse events during and after per-oral endoscopic myotomy: prevention, diagnosis, and management.

    Science.gov (United States)

    Nabi, Zaheer; Reddy, D Nageshwar; Ramchandani, Mohan

    2018-01-01

    Per-oral endoscopic myotomy (POEM) has surfaced as an effective endoscopic treatment modality for achalasia cardia (AC). Promising results in short- and mid-term follow-up studies have increased the use of POEM for the management of AC. POEM can be safely performed in an endoscopy suit, and major adverse events (AEs) are uncommon. AEs encountered during POEM or during the perioperative period principally include insufflation-related AEs, mucosal injuries, bleeding, pain, and aspiration pneumonia. Most insufflation-related AEs do not require an active intervention and therefore should not be considered as AEs in the true sense. When management of AEs is required, most intraoperative AEs can be managed at the same time without untoward consequences. Occurrences of AEs lessen after completion of the learning curve. However, experience alone does not ensure "zero" incidence of AEs, and early recognition remains essential. Postoperative AEs, like leaks, delayed bleeding, and delayed mucosal perforations, may pose special challenges for diagnosis and management. There is no standardized classification system for grading the severity of AEs associated with POEM, resulting in wide variation in their reported occurrences. Uniform reporting of AEs is not only crucial to comprehensively analyze the safety of POEM but also for comparison with other established treatment modalities like Heller's myotomy. GERD is an important long-term AE after POEM. Unlike the perioperative AEs, little is known regarding the intraoperative or patient-related factors that influence the occurrence of post-POEM GERD. Large prospective studies with long-term follow-up are required to determine the procedural factors associated with GERD after POEM. Copyright © 2018. Published by Elsevier Inc.

  19. Incorporating Persistent Pain in Phenotypic Frailty Measurement and Prediction of Adverse Health Outcomes.

    Science.gov (United States)

    Lohman, Matthew C; Whiteman, Karen L; Greenberg, Rebecca L; Bruce, Martha L

    2017-02-01

    Frailty, a syndrome of physiological deficits, is prevalent among older adults and predicts elevated risk of adverse health outcomes. Although persistent pain predicts similar risk, it is seldom considered in frailty measurement. This article evaluated the construct and predictive validity of including persistent pain in phenotypic frailty measurement. Frailty and persistent pain were operationalized using data from the Health and Retirement Study (2006-2012 waves). Among a subset of adults aged 65 and older (n = 3,652), we used latent class analysis to categorize frailty status and to evaluate construct validity. Using Cox proportional hazards models, we compared time to incident adverse outcomes (death, fall, hospitalization, institutionalization, and functional disability) between frailty classes determined by either including or excluding persistent pain as a frailty component. In latent class models, persistent pain occurred with other frailty components in patterns consistent with a medical syndrome. Frail and intermediately frail classes determined by including persistent pain were more strongly associated with all adverse outcomes compared with frail and intermediately frail classes determined excluding persistent pain. Frail respondents had significantly greater risk of death compared with nonfrail respondents when frailty models included rather than excluded persistent pain (respectively, hazard ratio [HR] = 3.87, 95% confidence interval [CI] = 2.99-5.00 (including pain); HR = 2.10, 95% CI = 1.71-2.59 (excluding pain). Findings support consideration of persistent pain as a component of the frailty phenotype. Persistent pain assessment may provide an expedient method to enhance frailty measurement and improve prediction of adverse outcomes. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Mercury exposure from dental amalgam fillings: absorbed dose and the potential for adverse health effects.

    Science.gov (United States)

    Mackert, J R; Berglund, A

    1997-01-01

    This review examines the question of whether adverse health effects are attributable to amalgam-derived mercury. The issue of absorbed dose of mercury from amalgam is addressed first. The use of intra-oral Hg vapor measurements to estimate daily uptake must take into account the differences between the collection volume and flow rate of the measuring instrument and the inspiratory volume and flow rate of air through the mouth during inhalation of a single breath. Failure to account for these differences will result in substantial overestimation of the absorbed dose. Other factors that must be considered when making estimates of Hg uptake from amalgam include the accurate measurement of baseline (unstimulated) mercury release rates and the greater stimulation of Hg release afforded by chewing gum relative to ordinary food. The measured levels of amalgam-derived mercury in brain, blood, and urine are shown to be consistent with low absorbed doses (1-3 micrograms/day). Published relationships between the number of amalgam surfaces and urine levels are used to estimate the number of amalgam surfaces that would be required to produce the 30 micrograms/g creatinine urine mercury level stated by WHO to be associated with the most subtle, pre-clinical effects in the most sensitive individuals. From 450 to 530 amalgam surfaces would be required to produce the 30 micrograms/g creatinine urine mercury level for people without any excessive gum-chewing habits. The potential for adverse health effects and for improvement in health following amalgam removal is also addressed. Finally, the issue of whether any material can ever be completely exonerated of claims of producing adverse health effects is considered.

  1. Disease Prevention and Health Promotion: How Integrative Medicine Fits

    OpenAIRE

    Ali, Ather; Katz, David L.

    2015-01-01

    As a discipline, preventive medicine has traditionally been described to encompass primary, secondary, and tertiary prevention. The fields of preventive medicine and public health share the objectives of promoting general health, preventing disease, and applying epidemiologic techniques to these goals. This paper discusses a conceptual approach between the overlap and potential synergies of integrative medicine principles and practices with preventive medicine in the context of these levels o...

  2. Development of a 'ready-to-use' tool that includes preventability, for the assessment of adverse drug events in oncology.

    Science.gov (United States)

    Hébert, Guillaume; Netzer, Florence; Kouakou, Sylvain Landry; Lemare, François; Minvielle, Etienne

    2018-02-14

    Background Adverse drug events (ADEs) occur frequently in oncology and justify continuous assessment and monitoring. There are several methods for detecting them, but the trigger tool method seems the most appropriate. Although a generic tool exists, its use for ADEs in oncology has not been convincing. The development of a focused version is therefore necessary. Objective To provide an oncology-focused trigger tool that evaluates the prevalence, harm, and preventability in a standardised method for pragmatic use in ADE surveillance. Setting Hospitals with cancer care in France. Method The tool has been constructed in two steps: (1) constitution of an oncology-centred list of ADEs; 30 pharmacists/practitioners in cancer care from nine hospitals selected a list of ADEs using a method of agreement adapted from the RAND/UCLA Appropriateness Method; and (2) construction of three standardised dimensions for the characterisation of each ADE (including causality, severity, and preventability). Main outcome measure The main outcome measure was validation of the tool, including preventability criteria. Results The tool is composed of a final list of 15 ADEs. For each ADE, a 'reviewer form' has been designed and validated by the panel. It comprises (1) the trigger(s), (2) flowcharts to guide the reviewer, (3) criteria for grading harm, and (4) a standardised assessment of preventability with 6-14 closed sentences for each ADE in terms of therapeutic management and/or prevention of side-effects. Conclusion A complete 'ready-to-use' tool for ADE monitoring in oncology has been developed that allows the assessment of three standardised dimensions.

  3. The moderating impact of childhood adversity profiles and conflict on psychological health and suicidal behaviour in the Northern Ireland population.

    Science.gov (United States)

    McLafferty, Margaret; O'Neill, Siobhan; Murphy, Sam; Armour, Cherie; Ferry, Finola; Bunting, Brendan

    2018-04-01

    Childhood adversities are key etiological factors in the onset and persistence of psychopathology. In Northern Ireland the Troubles also impacted on the population's psychological health. This study used data from the Northern Ireland Study of Health and Stress a collaborative epidemiological study which used the WMH-CIDI to assess mental health disorders in a nationally representative sample (Part 2, n = 1986). The aims of the study were to assess co-occurrences of childhood adversities and investigate the impact of adversity profiles and conflict experience on psychopathology and suicidal behaviour. Latent Class Analysis uncovered 3 discrete childhood adversity profiles, a low, medium, and high risk class. Individuals from higher risk adversity profiles displayed significantly increased odds of having psychological problems, with conflict exposure also impacting on psychopathology. However, the study revealed that the impact of conflict exposure on suicidal behaviour was moderated by latent class membership and that some adversity may actually be protective. The findings highlight the need to consider that, while adversity can have a negative impact on psychopathology, a lack of adversity early in life may hinder some people from developing adequate coping strategies. Further research is required to identify adversity patterns and other interacting factors that are protective. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Mouth breathing: adverse effects on facial growth, health, academics, and behavior.

    Science.gov (United States)

    Jefferson, Yosh

    2010-01-01

    The vast majority of health care professionals are unaware of the negative impact of upper airway obstruction (mouth breathing) on normal facial growth and physiologic health. Children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features, such as skeletal Class II or Class III facial profiles. These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity. It is important for the entire health care community (including general and pediatric dentists) to screen and diagnose for mouth breathing in adults and in children as young as 5 years of age. If mouth breathing is treated early, its negative effect on facial and dental development and the medical and social problems associated with it can be reduced or averted.

  5. The Role of Public Health in the Prevention of War: Rationale and Competencies

    Science.gov (United States)

    Barker, Kathy; Arya, Neil; Rohde, Jon; Donohoe, Martin; White, Shelley; Lubens, Pauline; Gorman, Geraldine; Hagopian, Amy

    2014-01-01

    In 2009 the American Public Health Association approved the policy statement, “The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War.” Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health’s ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes. A working group grew out of the American Public Health Association’s Peace Caucus to build upon the 2009 policy by proposing competencies to understand and prevent the political, economic, social, and cultural determinants of war, particularly militarism. The working group recommends that schools of public health and public health organizations incorporate these competencies into professional preparation programs, research, and advocacy. PMID:24825229

  6. A comprehensive review of regulatory test methods for endocrine adverse health effects.

    Science.gov (United States)

    Manibusan, M K; Touart, L W

    2017-07-01

    Development of new endocrine disruption-relevant test methods has been the subject of intensive research efforts for the past several decades, prompted in part by mandates in the 1996 Food Quality Protection Act (FQPA). While scientific understanding and test methods have advanced, questions remain on whether current scientific methods are capable of adequately addressing the complexities of the endocrine system for regulatory health and ecological risk assessments. The specific objective of this article is to perform a comprehensive, detailed evaluation of the adequacy of current test methods to inform regulatory risk assessments of whether a substance has the potential to perturb endocrine-related pathways resulting in human adverse effects. To that end,  approximately 42 existing test guidelines (TGs) were considered in the evaluation of coverage for endocrine-related adverse effects. In addition to evaluations of whether test methods are adequate to capture endocrine-related effects, considerations of further enhancements to current test methods, along with the need to develop novel test methods to address existing test method gaps are described. From this specific evaluation, up to 35 test methods are capable of informing whether a chemical substance perturbs known endocrine related biological pathways. Based on these findings, it can be concluded that current validated test methods are adequate to discern substances that may perturb the endocrine system, resulting in an adverse health effect. Together, these test methods predominantly form the core data requirements of a typical food-use pesticide registration submission. It is recognized, however, that the current state of science is rapidly advancing and there is a need to update current test methods to include added enhancements to ensure continued coverage and public health and environmental protection.

  7. Adverse Childhood Experiences and Child Health Outcomes: Comparing Cumulative Risk and Latent Class Approaches.

    Science.gov (United States)

    Lanier, Paul; Maguire-Jack, Kathryn; Lombardi, Brianna; Frey, Joseph; Rose, Roderick A

    2018-03-01

    Objectives This study seeks to further the work exploring adverse childhood experiences (ACEs) by proposing a novel approach to understanding the impact of ACEs through applying advanced analytical methods to examine whether combinations of ACEs differentially impact child health outcomes. Methods Using National Survey of Children's Health data, we use latent class analysis to estimate associations between classes of ACEs and child health outcomes. Results Class membership predicts child poor health, with differences found for specific ACE combinations. A subgroup of children exposed to poverty and parental mental illness are at higher risk for special healthcare needs than all other groups, including children exposed to 3 or more ACEs. Conclusions Different combinations of ACEs carry different risk for child health. Interventions tailored to specific ACEs and ACE combinations are likely to have a greater effect on improving child health. Our findings suggest children who experience specific ACE combinations (e.g., poverty and parental mental illness) are at particularly high risk for poor health outcomes. Therefore, clinicians should routinely assess for ACEs to identify children exposed to the most problematic ACE combinations; once identified, these children should be given priority for supportive interventions tailored to their specific ACE exposure and needs.

  8. Adverse Childhood Experiences (ACEs), Stress and Mental Health in College Students.

    Science.gov (United States)

    Karatekin, Canan

    2018-02-01

    The goal of this short-term longitudinal study was to examine whether adverse childhood experiences (ACEs) could be used to identify college students at risk for mental health problems and whether current level of stress mediates the relationship between ACEs and mental health. Data on ACEs and mental health (depression, anxiety and suicidality) were collected at the beginning of the semester, and data on current stressors and mental health were collected toward the end of the semester (n = 239). Findings indicated that ACEs predicted worsening of mental health over the course of a semester and suggested current number of stressors as a mediator of the relationship between ACEs and mental health. Results suggest that screening for ACEs might be useful to identify students at high risk for deterioration in mental health. Results further suggest that stress-related interventions would be beneficial for students with high levels of ACEs and point to the need for more research and strategies to increase help-seeking in college students. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Air pollution in India and related adverse respiratory health effects: past, present, and future directions.

    Science.gov (United States)

    Khilnani, Gopi C; Tiwari, Pawan

    2018-03-01

    The review describes current status of air pollution in India, summarizes recent research on adverse health effects of ambient and household air pollution, and outlines the ongoing efforts and future actions required to improve air quality and reduce morbidity and mortality because of air pollution in India. Global burden of disease data analysis reveals more than one million premature deaths attributable to ambient air pollution in 2015 in India. More than one million additional deaths can be attributed to household air pollution. Particulate matter with diameter 2.5 μm or less has been causatively linked with most premature deaths. Acute respiratory tract infections, asthma, chronic obstructive pulmonary disease, exacerbations of preexisting obstructive airway disease and lung cancer are proven adverse respiratory effects of air pollution. Targeting air quality standards laid by WHO can significantly reduce morbidity and mortality because of air pollution in India. India is currently exposed to high levels of ambient and household air pollutants. Respiratory adverse effects of air pollution are significant contributors to morbidity and premature mortality in India. Substantial efforts are being made at legislative, administrative, and community levels to improve air quality. However, much more needs to be done to change the 'status quo' and attain the target air quality standards. VIDEO ABSTRACT: http://links.lww.com/COPM/A24.

  10. Adverse childhood experiences: assessing the impact on health and school engagement and the mitigating role of resilience.

    Science.gov (United States)

    Bethell, Christina D; Newacheck, Paul; Hawes, Eva; Halfon, Neal

    2014-12-01

    The ongoing longitudinal Adverse Childhood Experiences Study of adults has found significant associations between chronic conditions; quality of life and life expectancy in adulthood; and the trauma and stress associated with adverse childhood experiences, including physical or emotional abuse or neglect, deprivation, or exposure to violence. Less is known about the population-based epidemiology of adverse childhood experiences among US children. Using the 2011-12 National Survey of Children's Health, we assessed the prevalence of adverse childhood experiences and associations between them and factors affecting children's development and lifelong health. After we adjusted for confounding factors, we found lower rates of school engagement and higher rates of chronic disease among children with adverse childhood experiences. Our findings suggest that building resilience-defined in the survey as "staying calm and in control when faced with a challenge," for children ages 6-17-can ameliorate the negative impact of adverse childhood experiences. We found higher rates of school engagement among children with adverse childhood experiences who demonstrated resilience, as well as higher rates of resilience among children with such experiences who received care in a family-centered medical home. We recommend a coordinated effort to fill knowledge gaps and translate existing knowledge about adverse childhood experiences and resilience into national, state, and local policies, with a focus on addressing childhood trauma in health systems as they evolve during ongoing reform. Project HOPE—The People-to-People Health Foundation, Inc.

  11. The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2011-05-01

    Full Text Available Abstract Background We need to know the scale and underlying causes of surgical adverse events (AEs in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rapidly. The objective of this study was to provide more recent data on the incidence, consequences, preventability, causes and potential strategies to prevent AEs among hospitalized patients in surgical units. Methods A structured record review study of 7,926 patient records was carried out by trained nurses and medical specialist reviewers in 21 Dutch hospitals. The aim was to determine the presence of AEs during hospitalizations in 2004 and to consider how far they could be prevented. Of all AEs, the consequences, responsible medical specialty, causes and potential prevention strategies were identified. Surgical AEs were defined as AEs attributable to surgical treatment and care processes and were selected for analysis in detail. Results Surgical AEs occurred in 3.6% of hospital admissions and represented 65% of all AEs. Forty-one percent of the surgical AEs was considered to be preventable. The consequences of surgical AEs were more severe than for other types of AEs, resulting in more permanent disability, extra treatment, prolonged hospital stay, unplanned readmissions and extra outpatient visits. Almost 40% of the surgical AEs were infections, 23% bleeding, and 22% injury by mechanical, physical or chemical cause. Human factors were involved in the causation of 65% of surgical AEs and were considered to be preventable through quality assurance and training. Conclusions Surgical AEs occur more often than other types of AEs, are more often preventable and their consequences are more severe. Therefore, surgical AEs have a major impact on the burden of AEs during hospitalizations

  12. Use and perceived benefits of mobile devices by physicians in preventing adverse drug events in the nursing home.

    Science.gov (United States)

    Handler, Steven M; Boyce, Richard D; Ligons, Frank M; Perera, Subashan; Nace, David A; Hochheiser, Harry

    2013-12-01

    Although mobile devices equipped with drug reference software may help prevent adverse drug events (ADEs) in the nursing home (NH) by providing medication information at the point of care, little is known about their use and perceived benefits. The goal of this study was to conduct a survey of a nationally representative sample of NH physicians to quantify the use and perceived benefits of mobile devices in preventing ADEs in the NH setting. We surveyed physicians who attended the 2010 American Medical Directors Association Annual Symposium about their use of mobile devices, and beliefs about the effectiveness of drug reference software in preventing ADEs. The overall net valid response rate was 70% (558/800) with 42% (236/558) using mobile devices to assist with prescribing in the NH. Physicians with 15 or fewer years of clinical experience were 67% more likely to be mobile device users, compared with those with more than 15 years of clinical experience (odds ratio = 1.68; 95% confidence interval = 1.17-2.41; P = .005). For those who used a mobile device to assist with prescribing, almost all (98%) reported performing an average of 1 or more drug look-ups per day, performed an average of 1 to 2 lookups per day for potential drug-drug interactions (DDIs), and most (88%) believed that drug reference software had helped to prevent at least 1 potential ADE in the preceding 4-week period. The proportion of NH physicians who use mobile devices with drug reference software, although significant, is lower than in other clinical environments. Our results suggest that NH physicians who use mobile devices equipped with drug reference software believe they are helpful for reducing ADEs. Further research is needed to better characterize the facilitators and barriers to adoption of the technology in the NH and its precise impact on NH ADEs. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  13. ACTUAL WAYS FOR OVERCOMING THE FACTORS ADVERSELY AFFECTING THE CHILDREN AND ADOLESCENTS’ HEALTH IN EDUCATIONAL INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    N. N. Malyarchuk

    2014-01-01

    Full Text Available The paper analyzes a widely discussed problem of the negative health dynamics of the growing generation, and points out the necessity of complex consideration of all the factors adversely affecting children’s health. The special emphasis is on the fallowing harmful factors: intensification of training process; discrepancy between the applied training methods and techniques on the one side, and children’s age, sex and functional specifics and capabilities on the other side; shortcomings in organizing children’s physical activities; limitations of the expositive illustrative methods for developing the healthy lifestyle habits. The other group of factors is related to the teaching style and professional characteristics of the teachers. They include the common practice of «stress» tactics; incompetence in health saving technologies; personal indisposition and psychological drawbacks. The situation is exacerbated by the absence of psychologists and pediatricians in educational institutions. The multilevel approach to solving the problems of students’ health preservation and promotion involves the elicitation of objective, subjective, inschool and out-of-school health determining factors. The paper denotes the actual ways of children’s health preservation at the level of related ministries, departments, and educational institutions.

  14. Adverse or acceptable: negotiating access to a post-apartheid health care contract.

    Science.gov (United States)

    Harris, Bronwyn; Eyles, John; Penn-Kekana, Loveday; Thomas, Liz; Goudge, Jane

    2014-05-15

    As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering - negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Although South Africa's right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Building health in fragile and post-conflict societies requires

  15. Organophosphate pesticides exposure among farmworkers: pathways and risk of adverse health effects.

    Science.gov (United States)

    Suratman, Suratman; Edwards, John William; Babina, Kateryna

    2015-01-01

    Organophosphate (OP) compounds are the most widely used pesticides with more than 100 OP compounds in use around the world. The high-intensity use of OP pesticides contributes to morbidity and mortality in farmworkers and their families through acute or chronic pesticides-related illnesses. Many factors contributing to adverse health effects have been investigated by researchers to determine pathways of OP-pesticide exposure among farmers in developed and developing countries. Factors like wind/agricultural pesticide drift, mixing and spraying pesticides, use of personal protective equipment (PPE), knowledge, perceptions, washing hands, taking a shower, wearing contaminated clothes, eating, drinking, smoking, and hot weather are common in both groups of countries. Factors including low socioeconomic status areas, workplace conditions, duration of exposure, pesticide safety training, frequency of applying pesticides, spraying against the wind, and reuse of pesticide containers for storage are specific contributors in developing countries, whereas housing conditions, social contextual factors, and mechanical equipment were specific pathways in developed countries. This paper compares existing research in environmental and behavioural exposure modifying factors and biological monitoring between developing and developed countries. The main objective of this review is to explore the current depth of understanding of exposure pathways and factors increasing the risk of exposure potentially leading to adverse health effects specific to each group of countries.

  16. Standard practice for labeling ceramic art materials for chronic adverse health hazards

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This practice describes a procedure for developing precautionary labels for ceramic art materials and provides hazard and precautionary statements based upon knowledge that exists in the scientific and medical communities. This practice concerns those chronic adverse health hazards known to be associated with a product or product component(s), when the component(s) is present in a physical form, volume, or concentration that in the opinion of a toxicologist has the potential to produce a chronic adverse health effect(s). 1.2 This practice is intended to apply exclusively to ceramic art materials which are packaged in sizes intended for use by artists or crafts people, either individually, or in a small group or class. 1.3 This practice applies to developing precautionary labeling for ceramic art materials intended for adult usage. Conformance to this practice does not imply that ceramic art materials will necessarily be labeled adequately or safe for use by children. Labeling determinations should conside...

  17. Diagnostic criteria for adverse health effects in the environs of wind turbines

    Science.gov (United States)

    Krogh, Carmen ME

    2014-01-01

    Summary In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

  18. Oculocutaneous albinism in sub-Saharan Africa: adverse sun-associated health effects and photoprotection.

    Science.gov (United States)

    Wright, Caradee Y; Norval, Mary; Hertle, Richard W

    2015-01-01

    Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition. Individuals with OCA lack melanin and therefore are susceptible to the harmful effects of solar ultraviolet radiation, including extreme sun sensitivity, photophobia and skin cancer. OCA is a grave public health issue in sub-Saharan Africa with a prevalence as high as 1 in 1000 in some tribes. This article considers the characteristics and prevalence of OCA in sub-Saharan African countries. Sun-induced adverse health effects in the skin and eyes of OCA individuals are reviewed. Sun exposure behavior and the use of photoprotection for the skin and eyes are discussed to highlight the major challenges experienced by these at-risk individuals and how these might be best resolved. © 2014 The American Society of Photobiology.

  19. Evidence Report: Risk of Crew Adverse Health Event Due to Altered Immune Response

    Science.gov (United States)

    Crucian, Brian; Sams, Clarence F.

    2013-01-01

    The Risk of Crew Adverse Health Event Due to Altered Immune Response is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. It is known that human immune function is altered in- and post-flight, but it is unclear at present if such alterations lead to increased susceptibility to disease. Reactivation of latent viruses has been documented in crewmembers, although this reactivation has not been directly correlated with immune changes or with observed diseases. As described in this report, further research is required to better characterize the relationships between altered immune response and susceptibility to disease during and after spaceflight. This is particularly important for future deep-space exploration missions.

  20. Diagnostic criteria for adverse health effects in the environs of wind turbines.

    Science.gov (United States)

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

    In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed.

  1. 75 FR 33983 - Establishing the National Prevention, Health Promotion, and Public Health Council

    Science.gov (United States)

    2010-06-16

    ... 13544 of June 10, 2010 Establishing the National Prevention, Health Promotion, and Public Health Council... of Health and Human Services, the National Prevention, Health Promotion, and Public Health Council..., the public health system, and integrative health care in the United States; (b) develop, after...

  2. Adverse inpatient outcomes during the transition to a new electronic health record system: observational study

    Science.gov (United States)

    Barnett, Michael L; Mehrotra, Ateev

    2016-01-01

    Objective To assess the short term association of inpatient implementation of electronic health records (EHRs) with patient outcomes of mortality, readmissions, and adverse safety events. Design Observational study with difference-in-differences analysis. Setting Medicare, 2011-12. Participants Patients admitted to 17 study hospitals with a verifiable “go live” date for implementation of inpatient EHRs during 2011-12, and 399 control hospitals in the same hospital referral region. Main outcome measures All cause readmission within 30 days of discharge, all cause mortality within 30 days of admission, and adverse safety events as defined by the patient safety for selected indicators (PSI)-90 composite measure among Medicare beneficiaries admitted to one of these hospitals 90 days before and 90 days after implementation of the EHRs (n=28 235 and 26 453 admissions), compared with the control group of all contemporaneous admissions to hospitals in the same hospital referral region (n=284 632 and 276 513 admissions). Analyses were adjusted for beneficiaries’ sociodemographic and clinical characteristics. Results Before and after implementation, characteristics of admissions were similar in both study and control hospitals. Among study hospitals, unadjusted 30 day mortality (6.74% to 7.15%, P=0.06) and adverse safety event rates (10.5 to 11.4 events per 1000 admissions, P=0.34) did not significantly change after implementation of EHRs. There was an unadjusted decrease in 30 day readmission rates, from 19.9% to 19.0% post-implementation (P=0.02). In difference-in-differences analysis, however, there was no significant change in any outcome between pre-implementation and post-implementation periods (all P≥0.13). Conclusions Despite concerns that implementation of EHRs might adversely impact patient care during the acute transition period, we found no overall negative association of such implementation on short term inpatient mortality, adverse safety

  3. Unintended adverse consequences of introducing electronic health records in residential aged care homes.

    Science.gov (United States)

    Yu, Ping; Zhang, Yiting; Gong, Yang; Zhang, Jiajie

    2013-09-01

    The aim of this study was to investigate the unintended adverse consequences of introducing electronic health records (EHR) in residential aged care homes (RACHs) and to examine the causes of these unintended adverse consequences. A qualitative interview study was conducted in nine RACHs belonging to three organisations in the Australian Capital Territory (ACT), New South Wales (NSW) and Queensland, Australia. A longitudinal investigation after the implementation of the aged care EHR systems was conducted at two data points: January 2009 to December 2009 and December 2010 to February 2011. Semi-structured interviews were conducted with 110 care staff members identified through convenience sampling, representing all levels of care staff who worked in these facilities. Data analysis was guided by DeLone and McLean Information Systems Success Model, in reference with the previous studies of unintended consequences for the introduction of computerised provider order entry systems in hospitals. Eight categories of unintended adverse consequences emerged from 266 data items mentioned by the interviewees. In descending order of the number and percentage of staff mentioning them, they are: inability/difficulty in data entry and information retrieval, end user resistance to using the system, increased complexity of information management, end user concerns about access, increased documentation burden, the reduction of communication, lack of space to place enough computers in the work place and increasing difficulties in delivering care services. The unintended consequences were caused by the initial conditions, the nature of the EHR system and the way the system was implemented and used by nursing staff members. Although the benefits of the EHR systems were obvious, as found by our previous study, introducing EHR systems in RACH can also cause adverse consequences of EHR avoidance, difficulty in access, increased complexity in information management, increased documentation

  4. Adverse Childhood Experiences and Health in Adulthood in a Rural Population-Based Sample.

    Science.gov (United States)

    Iniguez, Kristen C; Stankowski, Rachel V

    2016-12-01

    Adverse childhood experiences (ACEs), including emotional abuse, substance abuse in the household, separation or divorce, physical abuse, violence between adults, mental illness in the household, sexual abuse, or incarceration of a household member, have the potential to profoundly impact health and well-being in adulthood. To assess whether previously reported relationships between ACEs and health outcomes withstand validation, we conducted a community-based ACE study with the unique capacity to link self-reported ACEs and other survey results to validated health data in an electronic medical record (EMR). Information regarding ACEs and health outcomes was captured from 2013-2014 via a telephone survey of residents of the predominantly rural northern and central regions of Wisconsin and electronic abstraction of EMR data. ACE score was calculated by counting each exposure as one point. We examined the relationship between ACE score, type, and self-reported and validated health outcomes. A total of 800 participants completed the telephone survey. Overall, 62% reported at least one ACE and 15% reported experiencing four or more. All self-reported measures of poor health were associated with increased ACE score. EMR data were positively correlated with ACE score for increased body mass index and diagnoses of depression, anxiety, and asthma. In contrast, diagnoses of hypertension, hypercholesterolemia, myocardial infarction, and skin and other cancers were inversely related to ACE score. Emotional abuse was the most common ACE reported followed by substance abuse in the household. ACEs tended to cluster so that people who reported at least one ACE were likely to have experienced multiple ACEs. There was no clear correlation between abuse type (e.g., direct abuse vs. household dysfunction) and health outcomes. In the first community-based study to link self-reported ACEs to comprehensive health measures documented in the medical record, we observed previously reported

  5. Association of adverse oral health outcomes with socioeconomic inequalities and dental needs in Brazilian adolescents.

    Science.gov (United States)

    Figueiredo, Daniela de Rossi; Bastos, João Luiz; Peres, Karen Glazer

    2017-06-05

    This study aimed to explore the relations between adverse oral outcomes and socioeconomic, demographic, and self-rated oral health variables and to describe their distribution. Principal component analysis was conducted on data from adolescents in the Brazilian National Oral Health Survey (N = 5,445). Higher loadings were found for crowding (0.6), maxillary and mandibular irregularities (0.5), and count of communitary periodontal index (CPI) sextants with bleeding and dental calculus (0.5). The mean rates for periodontal and occlusal disorders were at least two times higher in adolescents from lower income families and those reporting the need for dental prostheses, as well as those dissatisfied with their dental and overall oral health. Increased mean rates of occlusal disorders were associated with schooling delay and history of toothache in the previous six months. The mean scores suggested accumulation of at least one of the negative oral health indicators in the lower income strata, among adolescents with schooling delay, and in those reporting dental needs. The results suggest priorities for planning and monitoring as a function of oral health requirements.

  6. Association of adverse oral health outcomes with socioeconomic inequalities and dental needs in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Daniela de Rossi Figueiredo

    Full Text Available Abstract: This study aimed to explore the relations between adverse oral outcomes and socioeconomic, demographic, and self-rated oral health variables and to describe their distribution. Principal component analysis was conducted on data from adolescents in the Brazilian National Oral Health Survey (N = 5,445. Higher loadings were found for crowding (0.6, maxillary and mandibular irregularities (0.5, and count of communitary periodontal index (CPI sextants with bleeding and dental calculus (0.5. The mean rates for periodontal and occlusal disorders were at least two times higher in adolescents from lower income families and those reporting the need for dental prostheses, as well as those dissatisfied with their dental and overall oral health. Increased mean rates of occlusal disorders were associated with schooling delay and history of toothache in the previous six months. The mean scores suggested accumulation of at least one of the negative oral health indicators in the lower income strata, among adolescents with schooling delay, and in those reporting dental needs. The results suggest priorities for planning and monitoring as a function of oral health requirements.

  7. Phenazepam abuse in the UK: an emerging problem causing serious adverse health problems, including death.

    Science.gov (United States)

    Corkery, John Martin; Schifano, Fabrizio; Ghodse, Abdol Hamid

    2012-05-01

    Phenazepam (fenazepam; 7-bromo-5-(2-chlorophenyl)-1,3-dihydro-2H-1,4-benzodiazepin-2-one; PNZ, 'Bonsai') is a benzodiazepine developed in the former Soviet Union during the 1970s to treat neurological disorders, epilepsy, and alcohol withdrawal syndrome. Its recreational use appears to have increased over recent years. Because of the lack of accessible data on this substance, it is important that information is made available to health professionals. A literature search was conducted in relevant databases (Medline, Toxbase, PsychInfo, etc.), grey literature (using Google Scholar) and Internet sites to identify key data on phenazepam, including epidemiology such as availability, price, supply sources, confiscations, and health-related problems. Information from these sources indicates the potential for serious adverse health consequences for this drug when taken recreationally and that its use is spreading in the USA and Europe. Although first use was reported in the UK in October 2009, major concerns in the UK arose in summer 2010 when individuals across Britain were admitted to hospital following overdose. Nine UK fatalities were reported in which phenazepam was detected in post mortem toxicology but not implicated in death. The first UK death directly involving phenazepam was notified in July and the second in November 2011. This paper summarises the key information about phenazepam abuse and health problems of which health professionals, especially those in Emergency Departments, should be aware and presents new information in respect of fatalities caused by the drug. Copyright © 2012 John Wiley & Sons, Ltd.

  8. 75 FR 22140 - Office of Clinical and Preventive Services; Division of Oral Health; Dental Preventive and...

    Science.gov (United States)

    2010-04-27

    ... Services; Division of Oral Health; Dental Preventive and Clinical Support Centers Program Announcement Type...' oral health by directly addressing the perceived needs of dental personnel and Area or regional dental... clinic-based and community-based oral health promotion/disease prevention (HP/DP) initiatives. Centers...

  9. Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience.

    Science.gov (United States)

    Afifi, Tracie O; Ford, Derek; Gershoff, Elizabeth T; Merrick, Melissa; Grogan-Kaylor, Andrew; Ports, Katie A; MacMillan, Harriet L; Holden, George W; Taylor, Catherine A; Lee, Shawna J; Peters Bennett, Robbyn

    2017-09-01

    Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1.86), moderate to heavy drinking (AOR)=1.23; 95% CI=1.07 to 1.41), and the use of street drugs (AOR)=1.32; 95% CI=1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Speeding the growth of primary mental health prevention

    OpenAIRE

    Wissow, Lawrence S

    2015-01-01

    While there is a strong case for primary prevention of mental health problems, relatively little mental health scholarship has been devoted to it in the last decade. Efforts to accelerate prevention scholarship could potentially benefit from strengthening pathways for interdisciplinary research; developing new training and working models for mental health professionals; developing a common language for public, policy, and scientific discussion of prevention; learning how to measure the common...

  11. Speeding the growth of primary mental health prevention.

    Science.gov (United States)

    Wissow, Lawrence S

    2015-01-01

    While there is a strong case for primary prevention of mental health problems, relatively little mental health scholarship has been devoted to it in the last decade. Efforts to accelerate prevention scholarship could potentially benefit from strengthening pathways for interdisciplinary research; developing new training and working models for mental health professionals; developing a common language for public, policy, and scientific discussion of prevention; learning how to measure the common outcomes of heterogeneous interventions tailored to diverse communities.

  12. [Suicide Prevention and Mental Health Measures for Japanese University Students].

    Science.gov (United States)

    Ohnishi, Masaru; Koyama, Shihomi; Senoo, Akiko; Kawahara, Hiroko; Shimizu, Yukito

    2016-01-01

    According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation. This guideline refers to the basic philosophy of suicide prevention in Chapter 1, risk factors for suicide in Chapter 2, and systems and activities for suicide prevention in Chapter 3. The Health Service Center, Okayama University plays central roles in mental health and suicide prevention measures on the Medical Campus. The primary prevention includes a mini-lecture on mental health, classes on mental health, and periodic workshops and lectures for freshmen. The secondary prevention includes interviews with students with mental health disorders by a psychiatrist during periodic health check-ups and introducing them to a hospital outside the university. The tertiary prevention includes support for students taking a leave of absence to return to school, periodic consultation with such students with mental disorders, and postvention following a suicide. We believe that for mental health measures on the university campus, it is important to efficiently make use of limited resources, and that these efforts will eventually lead to suicide prevention.

  13. Rebound effect of modern drugs: serious adverse event unknown by health professionals.

    Science.gov (United States)

    Teixeira, Marcus Zulian

    2013-01-01

    Supported in the Hippocratic aphorism primum non nocere, the bioethical principle of non-maleficence pray that the medical act cause the least damage or injury to the health of the patient, leaving it to the doctor to assess the risks of a particular therapy through knowledge of possible adverse events of drugs. Among these, the rebound effect represents a common side effect to numerous classes of modern drugs, may cause serious and fatal disorders in patients. This review aims to clarify the health professionals on clinical and epidemiological aspects of rebound phenomenon. A qualitative, exploratory and bibliographic review was held in the PubMed database using the keywords 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate'. The rebound effect occurs after discontinuation of numerous classes of drugs that act contrary to the disease disorders, exacerbating them at levels above those prior to treatment. Regardless of the disease, the drug and duration of treatment, the phenomenon manifests itself in a small proportion of susceptible individuals. However, it may cause serious and fatal adverse events should be considered a public health problem in view of the enormous consumption of drugs by population. Bringing together a growing and unquestionable body of evidence, the physician needs to have knowledge of the consequences of the rebound effect and how to minimize it, increasing safety in the management of modern drugs. On the other hand, this rebound can be used in a curative way, broadening the spectrum of the modern therapeutics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  14. Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation.

    Science.gov (United States)

    Nepomuceno, Balbino Rivail Ventura; Barreto, Mayana de Sá; Almeida, Naniane Cidreira; Guerreiro, Caroline Ferreira; Xavier-Souza, Eveline; Neto, Mansueto Gomes

    2017-12-28

    The early institution of inspiratory muscle training on hospitalised patients with no established respiratory deficits could prevent in-hospital adverse outcomes that are directly or indirectly associated to the loss of respiratory muscle mass inherent to a prolonged hospital stay. The objective of the clinical trial is to assess the impact of inspiratory muscle training on hospital inpatient complications. This is a double-blind randomised controlled trial. Subjects in the intervention group underwent an inspiratory muscle training loaded with 50% maximum inspiratory pressure twice daily for 4 weeks from study enrolment. Patients were randomly assigned to an inspiratory muscle training group or a sham inspiratory muscle training group. All patients received conventional physiotherapy interventions. Baseline and post-intervention respiratory and peripheral muscle strength, functionality (performance of activities of daily living), length of hospital stay, and death were evaluated. Clinical outcomes were assessed until hospital discharge. This study was approved by the Institutional Hospital Ethics Committee (03/2014). Thirty-one patients assigned to the inspiratory muscle training group and 34 to the sham inspiratory muscle training group were analysed. Patients in the inspiratory muscle training group had a shorter mean length of hospital stay (35.3 ± 2.7 vs. 41.8 ± 3.5 days, p muscle weakness (RR = 0.36; 95% CI 0.19-0.98; p = 0.02) and mortality (RR = 0.23; 95% CI 0.2-0.94; p = 0.04). The risk of adverse events did not differ significantly between groups. Inspiratory muscle training was a protective factor against endotracheal intubation, muscle weakness, and mortality. ClinicalTrials.gov, ID: NCT02459444 . Registered on 19 May 2015.

  15. Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

    Science.gov (United States)

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2014-04-12

    It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

  16. Childhood adversities and post-traumatic stress disorder: evidence for stress sensitisation in the World Mental Health Surveys.

    Science.gov (United States)

    McLaughlin, Katie A; Koenen, Karestan C; Bromet, Evelyn J; Karam, Elie G; Liu, Howard; Petukhova, Maria; Ruscio, Ayelet Meron; Sampson, Nancy A; Stein, Dan J; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Borges, Guilherme; Demyttenaere, Koen; Dinolova, Rumyana V; Ferry, Finola; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Kawakami, Norito; Lee, Sing; Navarro-Mateu, Fernando; Piazza, Marina; Pennell, Beth-Ellen; Posada-Villa, José; Ten Have, Margreet; Viana, Maria Carmen; Kessler, Ronald C

    2017-11-01

    Background Although childhood adversities are known to predict increased risk of post-traumatic stress disorder (PTSD) after traumatic experiences, it is unclear whether this association varies by childhood adversity or traumatic experience types or by age. Aims To examine variation in associations of childhood adversities with PTSD according to childhood adversity types, traumatic experience types and life-course stage. Method Epidemiological data were analysed from the World Mental Health Surveys ( n = 27 017). Results Four childhood adversities (physical and sexual abuse, neglect, parent psychopathology) were associated with similarly increased odds of PTSD following traumatic experiences (odds ratio (OR) = 1.8), whereas the other eight childhood adversities assessed did not predict PTSD. Childhood adversity-PTSD associations did not vary across traumatic experience types, but were stronger in childhood-adolescence and early-middle adulthood than later adulthood. Conclusions Childhood adversities are differentially associated with PTSD, with the strongest associations in childhood-adolescence and early-middle adulthood. Consistency of associations across traumatic experience types suggests that childhood adversities are associated with generalised vulnerability to PTSD following traumatic experiences. © The Royal College of Psychiatrists 2017.

  17. Physical and mental health correlates of adverse childhood experiences among low-income women.

    Science.gov (United States)

    Cambron, Christopher; Gringeri, Christina; Vogel-Ferguson, Mary Beth

    2014-11-01

    The present study used secondary data gathered from a statewide random sample of 1,073 adult women enrolled in Utah's single-parent cash assistance program and logistic regression to examine associations between self-reported physical, emotional, and sexual abuse during childhood and later life physical and mental health indicators. Results demonstrated significant associations between low-income women's self-reports of physical, emotional, or sexual abuse in childhood, and current and lifetime anxiety disorder, domestic violence, current posttraumatic stress disorder, bipolar disorder, physical health or mental health issues, and any mental health diagnosis. These results build on previous research to paint a fuller picture of the associations between childhood abuse and physical and mental health for low-income women in Utah. Consistent with research by the Centers for Disease Control and Prevention, findings suggest the applicability of conceptualizing childhood abuse as a public health issue. Social workers can play an integral role in promoting and implementing broader screening practices, connecting affected individuals with long-term interventions, and applying research findings to the design and provision of services within a public health model.

  18. Adverse childhood experiences, health perception, and the role of shared familial factors in adult twins.

    Science.gov (United States)

    Mostoufi, Sheeva M; Strachan, Eric; Chopko, Laura; Succop, Annemarie; Martinez, Beatrice; Ahumada, Sandra M; Afari, Niloofar

    2013-11-01

    To examine the relationship between adverse childhood experiences (ACE) and health perception in adulthood, and to explore the contribution of shared familial factors to these associations. Data were collected from 180 female twins (90 pairs) from the community-based University of Washington Twin Registry. Participants completed questionnaires including the modified ACE Questionnaire, Traumatic Life Events Questionnaire, McGill Pain Questionnaire-Short Form, and the SF-36. Mixed effects linear regression modeling investigated the effects of ACE on indices of health perception controlling for correlated twin data. Additional models examined the associations while controlling for the experience of physical and/or sexual abuse in childhood; within-twin pair models that inherently adjust for familial factors explored shared familial influences. After controlling for relevant demographic variables, more ACE was associated with worse perceptions of general health (p=.01) and vitality (p=.05) on the SF-36. After controlling for childhood physical and/or sexual abuse, the relationship between ACE and general health remained significant (p=.01) while vitality was no longer significant. None of the associations remained significant after accounting for the influence of familial factors. These results support previous findings on the negative link between ACE and perceived health in adulthood. The detrimental effects of ACE on vitality may be accounted for by the experience of childhood physical and/or sexual abuse. Shared familial factors might play a partial role in the relationship between ACE and health perception. Future research should further investigate the genetic and environmental mechanisms that may explain this relationship. Published by Elsevier Ltd.

  19. Factors Associated with the Reporting of Adverse Drug Reactions by Health Workers in Nnewi Nigeria

    Science.gov (United States)

    Ezeuko, Amaka Y.; Ebenebe, Uzo E.; Nnebue, Chinomnso C; Ugoji, John O.

    2015-01-01

    Background: Under-reporting of adverse drug reactions (ADRs) by the prescribers is a common public health problem. Monitoring of factors that influence ADR reporting will reduce risks associated with drug use; improve patients care, safety and treatment outcome. The aim of this study was to determine the factors associated with the reporting of ADRs by health workers in Nnewi Nigeria. Methods: A cross-sectional study of 372 health workers in different health facilities in Nnewi North Local Government Area of Anambra state, selected using multistage sampling technique was done. Data collection employed pretested, self-administered structured questionnaires. Data were analyzed using Statistical Package for Social Sciences version 17. Tests of statistical significance were carried out using Chi-square tests for proportions. A P < 0.05 was considered significant. Results: Out of the 372 respondents studied, 255 (68.5%) were females, and 117 (31.5%) were males. The modal age range (37.6%) was 31–40 years. Factors related by the respondents to influence ADR reporting include: Unavailability of electronic reporting (83.6%), unavailability of reporting forms (66.4%) and ignorance (58.2%). The difference among medical practitioners who related unavailability of electronic reporting process as obstacle to ADR reporting was not significant (P = 0.18). Conclusions: The study results revealed the factors associated with the reporting of ADRs among health workers in Nnewi Nigeria. It is desirable to initiate electronic reporting process, training programs on ADR reporting and make reporting forms/guidelines available to relevant health workers. PMID:25949775

  20. Causes for the underreporting of adverse drug events by health professionals: a systematic review

    Directory of Open Access Journals (Sweden)

    Fabiana Rossi Varallo

    2014-08-01

    Full Text Available Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29 for physicians (22/29, and pharmacists (10/29. The main causes related to underreporting were ignorance (24/29, insecurity (24/29 and indifference (23/29. Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.

  1. Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military.

    Science.gov (United States)

    Millegan, Jeffrey; Wang, Lawrence; LeardMann, Cynthia A; Miletich, Derek; Street, Amy E

    2016-04-01

    Although absolute counts of U.S. service men who experience sexual trauma are comparable to service women, little is known about the impact of sexual trauma on men. The association of recent sexual trauma (last 3 years) with health and occupational outcomes was investigated using longitudinal data (2004-2013) from the Millennium Cohort Study. Of 37,711 service men, 391 (1.0%) reported recent sexual harassment and 76 (0.2%) sexual assault. In multivariable models, sexual harassment or assault, respectively, was associated with poorer mental health: AOR = 1.60, 95% CI [1.22, 2.12], AOR = 4.39, 95% CI [2.40, 8.05]; posttraumatic stress disorder: AOR = 2.50, 95% CI [1.87, 3.33], AOR = 6.63, 95% CI [3.65, 12.06]; depression: AOR = 2.37, 95% CI [1.69, 3.33], AOR = 5.60, 95% CI [2.83, 11.09]; and multiple physical symptoms: AOR = 2.22, 95% CI [1.69, 2.92]; AOR = 3.57, 95% CI [1.98, 6.42], after adjustment for relevant covariates. Sexual harassment was also associated with poorer physical health: AOR = 1.68, 95% CI [1.27, 2.22]. Men who reported sexual trauma were more likely to have left military service: AOR = 1.60, 95% CI [1.14, 2.24], and be disabled/unemployed postservice: AOR = 1.76, 95% CI [1.02, 3.02]. Results suggest that sexual trauma was significantly associated with adverse health and functionality extending to postmilitary life. Findings support the need for developing better prevention strategies and services to reduce the burden of sexual trauma on service men. Copyright © 2016 International Society for Traumatic Stress Studies.

  2. Associations between health literacy and preventive health behaviors among older adults: findings from the health and retirement study.

    Science.gov (United States)

    Fernandez, Dena M; Larson, Janet L; Zikmund-Fisher, Brian J

    2016-07-19

    While the association between inadequate health literacy and adverse health outcomes has been well documented, less is known about the impact of health literacy on health perceptions, such as perceptions of control over health, and preventive health behaviors. We identified a subsample of participants (N = 707) from the Health and Retirement Study (HRS), a nationally representative sample of older adults, who participated in health literacy testing. Self-reported health literacy was measured with a literacy screening question, and objective health literacy with a summed score of items from the Test of Functional Health Literacy. We compared answers on these items to those related to participation in health behaviors such as cancer screening, exercise, and tobacco use, as well as self-referencing health beliefs. In logistic regression models adjusted for gender, education, race, and age, participants with adequate self-reported health literacy (compared to poorer levels of health literacy) had greater odds of participation in mammography within the last 2 years (Odds ratio [OR] = 2.215, p = 0.01) and participation in moderate exercise two or more times per week (OR = 1.512, p = 0.03). Participants with adequate objective health literacy had reduced odds of participation in monthly breast self-exams (OR = 0.369, p = 0.004) and reduced odds of current tobacco use (OR = 0.456, p = 0.03). In adjusted linear regression analyses, self-reported health literacy made a small but significant contribution to explaining perceived control of health (β 0.151, p = health literacy were positively related to several health promoting behaviors and health-related beliefs and non-use of breast self-exams, a screening behavior of questionable benefit. These relationships varied however, between self-reported and objectively-measured health literacy. Further investigation into the specific mechanisms that lead higher literacy people to pursue

  3. Dual use of Medicare and the Veterans Health Administration: are there adverse health outcomes?

    Directory of Open Access Journals (Sweden)

    Brezinski Paul R

    2006-10-01

    Full Text Available Abstract Background Millions of veterans are eligible to use the Veterans Health Administration (VHA and Medicare because of their military service and age. This article examines whether an indirect measure of dual use based on inpatient services is associated with increased mortality risk. Methods Data on 1,566 self-responding men (weighted N = 1,522 from the Survey of Assets and Health Dynamics among the Oldest Old (AHEAD were linked to Medicare claims and the National Death Index. Dual use was indirectly indicated when the self-reported number of hospital episodes in the 12 months prior to baseline was greater than that observed in the Medicare claims. The independent association of dual use with mortality was estimated using proportional hazards regression. Results 96 (11% of the veterans were classified as dual users. 766 men (50.3% had died by December 31, 2002, including 64.9% of the dual users and 49.3% of all others, for an attributable mortality risk of 15.6% (p Conclusion An indirect measure of veterans' dual use of the VHA and Medicare systems, based on inpatient services, was associated with an increased risk of death. Further examination of dual use, especially in the outpatient setting, is needed, because dual inpatient and dual outpatient use may be different phenomena.

  4. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

    NARCIS (Netherlands)

    Kessler, Ronald C.; McLaughlin, Katie A.; Green, Jennifer Greif; Gruber, Michael J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; de Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Maria Haro, Josep; Hu, Chi-yi; Karam, Elie G.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tsang, Adley; Uestuen, T. Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, David R.

    2010-01-01

    Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV

  5. Health Promotion/Disease Prevention: New Directions for Geriatric Education.

    Science.gov (United States)

    Levkoff, Sue; And Others

    1996-01-01

    Describes 10 modules for primary care practitioners on health promotion/disease prevention for the elderly on these topics: Alzheimer's disease in minorities, dehydration, diabetes, elder abuse, geriatric nutrition, oncology, oral health in long-term care, incontinence, injury prevention, and physical activity. These areas are significant for…

  6. Identifying and managing adverse environmental health effects: 2. Outdoor air pollution

    Science.gov (United States)

    Abelsohn, Alan; Stieb, David; Sanborn, Margaret D.; Weir, Erica

    2002-01-01

    AIR POLLUTION CONTRIBUTES TO PREVENTABLE ILLNESS AND DEATH. Subgroups of patients who appear to be more sensitive to the effects of air pollution include young children, the elderly and people with existing chronic cardiac and respiratory disease such as chronic obstructive pulmonary disease and asthma. It is unclear whether air pollution contributes to the development of asthma, but it does trigger asthma episodes. Physicians are in a position to identify patients at particular risk of health effects from air pollution exposure and to suggest timely and appropriate actions that these patients can take to protect themselves. A simple tool that uses the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) can help physicians take patients' environmental exposure histories to assess those who may be at risk. As public health advocates, physicians contribute to the primary prevention of illness and death related to air pollution in the population. In this article we review the origins of air pollutants, the pathophysiology of health effects, the burden of illness and the clinical implications of smog exposure using the illustrative case of an adolescent patient with asthma. PMID:12000251

  7. Meaningful use of health information technology and declines in in-hospital adverse drug events.

    Science.gov (United States)

    Furukawa, Michael F; Spector, William D; Rhona Limcangco, M; Encinosa, William E

    2017-07-01

    Nationwide initiatives have promoted greater adoption of health information technology as a means to reduce adverse drug events (ADEs). Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. However, evidence that MU capabilities are associated with declines in in-hospital ADEs is lacking. Data came from the 2010-2013 Medicare Patient Safety Monitoring System and the 2008-2013 Healthcare Information and Management Systems Society (HIMSS) Analytics Database. Two-level random intercept logistic regression was used to estimate the association of MU capabilities and occurrence of ADEs, adjusting for patient characteristics, hospital characteristics, and year of observation. Rates of in-hospital ADEs declined by 19% from 2010 to 2013. Adoption of MU capabilities was associated with 11% lower odds of an ADE (95% confidence interval [CI], 0.84-0.96). Interoperability capability was associated with 19% lower odds of an ADE (95% CI, 0.67- 0.98). Adoption of MU capabilities explained 22% of the observed reduction in ADEs, or 67,000 fewer ADEs averted by MU. Concurrent with the rapid uptake of MU and interoperability, occurrence of in-hospital ADEs declined significantly from 2010 to 2013. MU capabilities and interoperability were associated with lower occurrence of ADEs, but the effects did not vary by experience with MU. About one-fifth of the decline in ADEs from 2010 to 2013 was attributable to MU capabilities. Findings support the contention that adoption of MU capabilities and interoperability spurred by the Health Information Technology for Economic and Clinical Health Act contributed in part to the recent decline in ADEs. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the United States.

  8. Disclosing large scale adverse events in the US Veterans Health Administration: lessons from media responses.

    Science.gov (United States)

    Maguire, E M; Bokhour, B G; Asch, S M; Wagner, T H; Gifford, A L; Gallagher, T H; Durfee, J M; Martinello, R A; Elwy, A R

    2016-06-01

    We examined print, broadcast and social media reports about health care systems' disclosures of large scale adverse events to develop future effective messaging. Directed content analysis. We systematically searched four communication databases, YouTube and Really Simple Syndication (RSS) feeds relating to six disclosures of lapses in infection control practices in the Department of Veterans Affairs occurring between 2009 and 2012. We assessed these with a coding frame derived from effective crisis and risk communication models. We identified 148 unique media reports. Some components of effective communication (discussion of cause, reassurance, self-efficacy) were more present than others (apology, lessons learned). Media about 'promoting secrecy' and 'slow response' appeared in reports when time from event discovery to patient notification was over 75 days. Elected officials' quotes (n = 115) were often negative (83%). Hospital officials' comments (n = 165) were predominantly neutral (92%), and focused on information sharing. Health care systems should work to ensure that they develop clear messages focused on what is not well covered by the media, including authentic apologies, remedial actions taken, and shorten the timeframe between event identification and disclosure to patients. Published by Elsevier Ltd.

  9. A tool to determine financial impact of adverse events in health care: healthcare quality calculator.

    Science.gov (United States)

    Yarbrough, Wendell G; Sewell, Andrew; Tickle, Erin; Rhinehardt, Eric; Harkleroad, Rod; Bennett, Marc; Johnson, Deborah; Wen, Li; Pfeiffer, Matthew; Benegas, Manny; Morath, Julie

    2014-12-01

    Hospital leaders lack tools to determine the financial impact of poor patient outcomes and adverse events. To provide health-care leaders with decision support for investments to improve care, we created a tool, the Healthcare Quality Calculator (HQCal), which uses institution-specific financial data to calculate impact of poor patient outcomes or quality improvement on present and future margin. Excel and Web-based versions of the HQCal were based on a cohort study framework and created with modular components including major drivers of cost and reimbursement. The Healthcare Quality Calculator (HQCal) compares payment, cost, and profit/loss for patients with and without poor outcomes or quality issues. Cost and payment information for groups with and without quality issues are used by the HQCal to calculate profit or loss. Importantly, institution-specific payment and cost data are used to calculate financial impact and attributable cost associated with poor patient outcomes, adverse events, or quality issues. Because future cost and reimbursement changes can be forecast, the HQCal incorporates a forward-looking component. The flexibility of the HQCal was demonstrated using surgical site infections after abdominal surgery and postoperative surgical airway complications. The Healthcare Quality Calculator determines financial impact of poor patient outcomes and the benefit of initiatives to improve quality. The calculator can identify quality issues that would provide the largest financial benefit if improved; however, it cannot identify specific interventions. The calculator provides a tool to improve transparency regarding both short- and long-term financial consequences of funding, or failing to fund, initiatives to close gaps in quality or improve patient outcomes.

  10. Women's Health: Prevent the Top Threats

    Science.gov (United States)

    ... activities you enjoy, from brisk walking to ballroom dancing. Limit alcohol. If you choose to drink alcohol, ... lifestyle also might play a role in preventing Alzheimer's disease. Women are more vulnerable than men to ...

  11. Health surveillance under adverse ergonomics conditions--validity of a screening method adapted for the occupational health service.

    Science.gov (United States)

    Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

    2015-01-01

    A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders.

  12. Health surveillance under adverse ergonomics conditions – validity of a screening method adapted for the occupational health service

    Science.gov (United States)

    Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

    2015-01-01

    A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders. PMID:25761380

  13. Men's Health: Prevent the Top Threats

    Science.gov (United States)

    ... can significantly lower your risk of these common killers. Take charge of your health by making better ... other substances, and don't drive while sleepy. Suicide is another leading men's health risk. An important ...

  14. Evidence Report: Risk of Adverse Health Effects Due to Host-Microorganism Interactions

    Science.gov (United States)

    Ott, C. Mark; Oubre, Cherie; Wallace, Sarah; Mehta, Satish; Pierson, Duane

    2016-01-01

    While preventive measures limit the presence of many medically significant microorganisms during spaceflight missions, microbial infection of crewmembers cannot be completely prevented. Spaceflight experiments over the past 50 years have demonstrated a unique microbial response to spaceflight culture, although the mechanisms behind those responses and their operational relevance were unclear. In 2007, the operational importance of these microbial responses was emphasized as the results of an experiment aboard STS-115 demonstrated that the enteric pathogen Salmonella enterica serovar Typhimurium (S. Typhimurium) increased in virulence in a murine model of infection. The experiment was reproduced in 2008 aboard STS-123 confirming this finding. In response to these findings, the Institute of Medicine of the National Academies recommended that NASA investigate this risk and its potential impact on the health of the crew during spaceflight. NASA assigned this risk to the Human Research Program. To better understand this risk, evidence has been collected and reported from both spaceflight analog systems and actual spaceflight including Mir, Space Shuttle, and ISS missions. Although the performance of virulence studies during spaceflight are challenging and often impractical, additional information has been and continues to be collected to better understand the risk to crew health. Still, the uncertainty concerning the extent and severity of these alterations in host-microorganism interactions is very large and requires more investigation as the focus of human spaceflight shifts to longer-duration exploration class missions.

  15. Adverse Childhood Experiences and Mental Health, Chronic Medical Conditions, and Development in Young Children.

    Science.gov (United States)

    Kerker, Bonnie D; Zhang, Jinjin; Nadeem, Erum; Stein, Ruth E K; Hurlburt, Michael S; Heneghan, Amy; Landsverk, John; McCue Horwitz, Sarah

    2015-01-01

    To determine the relationships between adverse childhood experiences (ACEs) and mental health, chronic medical conditions, and social development among young children in the child welfare system. This cross-sectional study used a nationally representative sample of children investigated by child welfare (National Survey of Child and Adolescent Well-Being II) from 2008 to 2009. Our analysis included caregiver interviews and caseworker reports about children aged 18 to 71 months who were not in out-of-home care (n = 912). We examined the associations between ACEs and mental health (measured by the Child Behavior Checklist [CBCL]), reported chronic medical conditions, and social development (measured by the Vineland Socialization Scale) in bivariate and multivariate analyses. Nearly all children (98.1%) were reported to have had an ACE in their lifetime; the average number of ACEs was 3.6. For every additional reported ACE, there was a 32% increased odds of having a problem score on the CBCL (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.14, 1.53) and a 21% increased odds of having a chronic medical condition (OR 1.21, 95% CI 1.05, 1.40). Among children aged 36 to 71 months, for every additional reported ACE, there was a 77% increased odds of a low Vineland Socialization score (OR 1.77, 95% CI 1.12, 2.78). ACEs were associated with poor early childhood mental health and chronic medical conditions, and, among children aged 3 to 5, social development. Efforts are needed to examine whether providing early intervention to families with multiple stressors mitigates the impact of ACEs on children's outcomes. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  16. Adverse health effects of experiencing food insecurity among Greenlandic school children

    Directory of Open Access Journals (Sweden)

    Birgit Niclasen

    2013-08-01

    Full Text Available Background. In vulnerable populations, food security in children has been found to be associated with negative health effects. Still, little is known about whether the negative health effects can be retrieved in children at the population level. Objective. To examine food insecurity reported by Greenlandic school children as a predictor for perceived health, physical symptoms and medicine use. Design. The study is based on the Greenlandic part of the Health Behaviour in School-aged Children survey. The 2010 survey included 2,254 students corresponding to 40% of all Greenlandic school children in Grade 5 through 10. The participation rate in the participating schools was 65%. Food insecurity was measured as going to bed or to school hungry because there was no food at home. Results. Boys, the youngest children (11–12 year-olds, and children from low affluence homes were at increased risk for food insecurity. Poor or fair self-rated health, medicine use last month and physical symptoms during the last 6 months were all more frequent in children reporting food insecurity. Controlling for age, gender and family affluence odds ratio (OR for self-rated health was 1.60 (95% confidence interval (CI 1.23–2.06 (p<0.001, for reporting physical symptoms 1.34 (95% CI 1.06–1.68 (p=0.01 and for medicine use 1.79 (95% CI 1.42–2.26 (p<0.001. Stratification on age groups suggested that children in different age groups experience different health consequences of food insecurity. The oldest children reported food insecurity less often and experienced less negative health effects compared to the younger children. Conclusions. All 3 measures of health were negatively associated to the occurrence of food insecurity in Greenlandic school children aged 11–17. Food security must be seen as a public health issue of concern, and policies should be enforced to prevent food poverty particularly among boys, younger school children and children from low affluence

  17. Recent Sexual Trauma and Adverse Health and Occupational Outcomes Among U.S. Service Women.

    Science.gov (United States)

    Millegan, Jeffrey; Milburn, Emma K; LeardMann, Cynthia A; Street, Amy E; Williams, Diane; Trone, Daniel W; Crum-Cianflone, Nancy F

    2015-08-01

    Sexual trauma is prevalent among military women, but data on potential effects are needed. The association of sexual trauma with health and occupational outcomes was investigated using longitudinal data from the Millennium Cohort Study. Of 13,001 U.S. service women, 1,364 (10.5%) reported recent sexual harassment and 374 (2.9%) recent sexual assault. Women reporting recent sexual harassment or assault were more likely to report poorer mental health: OR = 1.96, 95% CI [1.71, 2.25], and OR = 3.45, 95% CI [2.67, 4.44], respectively. They reported poorer physical health: OR = 1.39, 95% CI [1.20, 1.62], and OR = 1.39, 95% CI [1.04, 1.85], respectively. They reported difficulties in work/activities due to emotional health: OR = 1.80, 95% CI [1.59, 2.04], and OR = 2.70, 95% CI [2.12, 3.44], respectively. They also reported difficulties with physical health: OR = 1.55, 95% CI [1.37, 1.75], and OR = 1.52 95% CI [1.20, 1.91], respectively, after adjustment for demographic, military, health, and prior sexual trauma characteristics. Recent sexual harassment was associated with demotion, OR = 1.47, 95% CI [1.12, 1.93]. Findings demonstrated that sexual trauma represents a potential threat to military operational readiness and draws attention to the importance of prevention strategies and services to reduce the burden of sexual trauma on military victims. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

  18. Childhood nutrition education in health promotion and disease prevention.

    Science.gov (United States)

    Olson, C. M.

    1989-01-01

    In the last 10 to 15 years, nutrition has become a major component of health promotion and chronic disease prevention. Two widely recommended strategies for incorporating nutrition education directed toward children and youth into health promotion and disease prevention efforts are school-based nutrition education and the integration of nutritional care into health care. School-based nutrition education programs targeted toward very specific eating behaviors are showing very promising results in regard to behavior and attitude change of children and adolescents. Substantial changes in health care providers' attitudes and practices and in the funding and financing of health care will be needed if nutrition education delivered in the context of routine health care is to be a major force in health promotion and disease prevention for youth. PMID:2629968

  19. Preventing the Epidemic of Mental Ill Health: An Overview

    OpenAIRE

    Robson , Anthony ,

    2013-01-01

    International audience; Diet, lifestyle and environment do not just affect a person's health, they also determine the health of their children and possibly the health of their grandchildren. Mental ill health is an epidemic worldwide because of the combined effect of the modern diet and a sedentary lifestyle. Primary prevention of mental ill health starts, crucially, with optimal adult nutrition before the inception of pregnancy, includes breastfeeding, and continues throughout the life of th...

  20. Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study.

    Science.gov (United States)

    Lee, Chuan Mei; Mangurian, Christina; Tieu, Lina; Ponath, Claudia; Guzman, David; Kushel, Margot

    2017-02-01

    To examine whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization. History of seven childhood adversities (physical neglect, verbal abuse, physical abuse, sexual abuse, parental death, parental incarceration, and child welfare system placement) was gathered through in-person interviews. Multivariate models examined associations between history of childhood adversities and moderate to severe depressive symptoms, lifetime history of suicide attempt, or lifetime history of psychiatric hospitalization. The study enrolled 350 homeless adults, aged 50 and older, in Oakland, California, using population-based sampling methods. Moderate to severe depressive symptoms were measured on a Center for Epidemiologic Studies-Depression Scale (≥22), self-reported lifetime history of suicide attempt, and self-reported lifetime history of psychiatric hospitalization. Participants with exposure to one childhood adversity had elevated odds of reporting moderate to severe depressive symptoms (adjusted odds ratio [AOR]: 2.0; 95% confidence interval [CI]: 1.1-3.7) and lifetime history of suicide attempt (AOR: 4.6; 95% CI: 1.0-21.6) when compared with those who had none; the odds of these two outcomes increased with exposure to additional childhood adversities. Participants with four or more childhood adversities had higher odds of having a lifetime history of psychiatric hospitalization (AOR: 7.1; 95% CI: 2.8-18.0); no increase with fewer adversities was found. Childhood adversities are associated with poor mental health outcomes among older homeless adults. Clinicians should collect information about childhood adversities among this high-risk population to inform risk assessment and treatment recommendations. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  1. Reporting of Adverse Events in Published and Unpublished Studies of Health Care Interventions: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Su Golder

    2016-09-01

    Full Text Available We performed a systematic review to assess whether we can quantify the underreporting of adverse events (AEs in the published medical literature documenting the results of clinical trials as compared with other nonpublished sources, and whether we can measure the impact this underreporting has on systematic reviews of adverse events.Studies were identified from 15 databases (including MEDLINE and Embase and by handsearching, reference checking, internet searches, and contacting experts. The last database searches were conducted in July 2016. There were 28 methodological evaluations that met the inclusion criteria. Of these, 9 studies compared the proportion of trials reporting adverse events by publication status. The median percentage of published documents with adverse events information was 46% compared to 95% in the corresponding unpublished documents. There was a similar pattern with unmatched studies, for which 43% of published studies contained adverse events information compared to 83% of unpublished studies. A total of 11 studies compared the numbers of adverse events in matched published and unpublished documents. The percentage of adverse events that would have been missed had each analysis relied only on the published versions varied between 43% and 100%, with a median of 64%. Within these 11 studies, 24 comparisons of named adverse events such as death, suicide, or respiratory adverse events were undertaken. In 18 of the 24 comparisons, the number of named adverse events was higher in unpublished than published documents. Additionally, 2 other studies demonstrated that there are substantially more types of adverse events reported in matched unpublished than published documents. There were 20 meta-analyses that reported the odds ratios (ORs and/or risk ratios (RRs for adverse events with and without unpublished data. Inclusion of unpublished data increased the precision of the pooled estimates (narrower 95% confidence intervals in 15

  2. Analysis of health promotion and prevention financing mechanisms in Thailand.

    Science.gov (United States)

    Watabe, Akihito; Wongwatanakul, Weranuch; Thamarangsi, Thaksaphon; Prakongsai, Phusit; Yuasa, Motoyuki

    2017-08-01

    In the transition to the post-2015 agenda, many countries are striving towards universal health coverage (UHC). Achieving this, governments need to shift from curative care to promotion and prevention services. This research analyses Thailand's financing system for health promotion and prevention, and assesses policy options for health financing reforms. The study employed a mixed-methods approach and integrates multiple sources of evidence, including scientific and grey literature, expenditure data, and semi-structured interviews with key stakeholders in Thailand. The analysis was underpinned by the use of a well-known health financing framework. In Thailand, three agencies plus local governments share major funding roles for health promotion and prevention services: the Ministry of Public Health (MOPH), the National Health Security Office, the Thai Health Promotion Foundation and Tambon Health Insurance Funds. The total expenditure on prevention and public health in 2010 was 10.8% of the total health expenditure, greater than many middle-income countries that average 7.0-9.2%. MOPH was the largest contributor at 32.9%, the Universal Coverage scheme was the second at 23.1%, followed by the local governments and ThaiHealth at 22.8 and 7.3%, respectively. Thailand's health financing system for promotion and prevention is strategic and innovative due to the three complementary mechanisms in operation. There are several methodological limitations to determine the adequate level of spending. The health financing reforms in Thailand could usefully inform policymakers on ways to increase spending on promotion and prevention. Further comparative policy research is needed to generate evidence to support efforts towards UHC. © The Author 2016. Published by Oxford University Press.

  3. Women convicted for violent offenses: adverse childhood experiences, low level of education and poor mental health.

    Science.gov (United States)

    Rossegger, Astrid; Wetli, Nicole; Urbaniok, Frank; Elbert, Thomas; Cortoni, Franca; Endrass, Jérôme

    2009-12-22

    In past years, the female offender population has grown, leading to an increased interest in the characteristics of female offenders. The aim of this study was to assess the prevalence of female violent offending in a Swiss offender population and to compare possible socio-demographic and offense-related gender differences. Descriptive and bivariate logistic regression analyses were performed for a representative sample of N = 203 violent offenders convicted in Zurich, Switzerland. 7.9% (N = 16) of the sample were female. Significant gender differences were found: Female offenders were more likely to be married, less educated, to have suffered from adverse childhood experiences and to be in poor mental health. Female violent offending was less heterogeneous than male violent offending, in fact there were only three types of violent offenses females were convicted for in our sample: One third were convicted of murder, one third for arson and only one woman was convicted of a sex offense. The results of our study point toward a gender-specific theory of female offending, as well as toward the importance of developing models for explaining female criminal behavior, which need to be implemented in treatment plans and intervention strategies regarding female offenders.

  4. Women convicted for violent offenses: Adverse childhood experiences, low level of education and poor mental health

    Directory of Open Access Journals (Sweden)

    Cortoni Franca

    2009-12-01

    Full Text Available Abstract Background In past years, the female offender population has grown, leading to an increased interest in the characteristics of female offenders. The aim of this study was to assess the prevalence of female violent offending in a Swiss offender population and to compare possible socio-demographic and offense-related gender differences. Methods Descriptive and bivariate logistic regression analyses were performed for a representative sample of N = 203 violent offenders convicted in Zurich, Switzerland. Results 7.9% (N = 16 of the sample were female. Significant gender differences were found: Female offenders were more likely to be married, less educated, to have suffered from adverse childhood experiences and to be in poor mental health. Female violent offending was less heterogeneous than male violent offending, in fact there were only three types of violent offenses females were convicted for in our sample: One third were convicted of murder, one third for arson and only one woman was convicted of a sex offense. Conclusions The results of our study point toward a gender-specific theory of female offending, as well as toward the importance of developing models for explaining female criminal behavior, which need to be implemented in treatment plans and intervention strategies regarding female offenders.

  5. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  6. Health expenditures spent for prevention, economic performance, and social welfare.

    Science.gov (United States)

    Wang, Fuhmei; Wang, Jung-Der; Huang, Yu-Xiu

    2016-12-01

    Countries with limited resources in economic downturns often reduce government expenditures, of which spending on preventive healthcare with no apparent immediate health impact might be cut down first. This research aims to find the optimum share of preventive health expenditure to gross domestic product (GDP) and investigate the implications of preventive health services on economic performance and the population's wellbeing. We develop the economic growth model to undertake health-economic analyses and parameterize for Taiwan setting. Based on the US experiences over the period from 1975 to 2013, this research further examines the model's predictions on the relationship between preventive health expenditure and economic performance. Theoretical analysis and numerical simulations show that an inverse U-shaped relationship exists between the proportion of GDP spent on prevention and social welfare, as well as between the proportion spent on prevention and economic growth. Empirical analysis shows an under-investment in prevention in Taiwan. The spending of preventive healthcare in Taiwan government was 0.0027 GDP in 2014, while the optimization levels for economic development and social welfare would be 0 · 0119 and 0 · 0203, respectively. There is a statistically significant nonlinear relationship between health expenditure on prevention and the estimated real impact of economic performance from US experiences. The welfare-maximizing proportion of preventive expenditure is usually greater than the proportion maximizing economic growth, indicating a conflict between economic growth and welfare after a marginal share. Our findings indicate that it is worthwhile increasing investment on prevention up until an optimization level for economic development and social welfare. Such levels could also be estimated in other economies.

  7. Preventive Healthcare and Health Promotion for Older Adults.

    Science.gov (United States)

    Rakowski, William; And Others

    1994-01-01

    This issue on preventive health care and health promotion for older adults includes 14 articles on history and definition, development of guidelines, responsibility, implementation of programs for the elderly and how it differs from that for other populations, programs for minorities, access to health care information, and a description of a…

  8. Effect of health education on knowledge and prevention on Hepatitis ...

    African Journals Online (AJOL)

    Effect of health education on knowledge and prevention on Hepatitis infection among secondary school students in Ibadan North Local Government Area of Oyo state. ... Based on these findings, the study recommended that health education/ health campaign should be directed to school students and Specific risk practices ...

  9. Theory in Chronic Disease Prevention and Health Promotion

    Science.gov (United States)

    Hall, Michael; Elise, Eifert

    2016-01-01

    Morbidity and mortality related to chronic diseases are a primary concern of health professionals, including Health Educators. According to the Centers for Disease Control and Prevention, over one half of the adult population in the United States suffer from one or more chronic conditions. Understanding the health risk behaviors that contribute to…

  10. Chemical characterization of sunscreens composition and its related potential adverse health effects.

    Science.gov (United States)

    Jallad, Karim N

    2017-09-01

    Although the sun is very beneficial and essential for life, exposing ourselves too much to sunlight might lead to detrimental health effects such as skin cancer. Eight percent of the total different electromagnetic radiation that regularly irradiates the earth is classified as ultraviolet (UV) radiation. The ozone layer absorbs the most energetic UV rays; consequently, UV-A and UV-B reach the earth surface. UV-A rays heavily contribute to both premature skin aging and skin cancer, while UV-B rays cause sunburn. Hence, the use of sunscreen is strongly encouraged by many healthcare practitioners in order to minimize or possibly eradicate the harmful effects of UV rays on our skin, keeping in mind, that about 90% of all skin cancers are associated with exposure to the sun's harmful radiation. Unfortunately, inaccurate information is currently roaming the media and the Internet regarding the safety, toxicity, and acute side effects of the active ingredients currently used in sunscreens, therefore discouraging people from using sunscreens. In this review article, it is concluded based on the scientific published literature that the sunscreen ingredients are safe and there are no related potential hazardous health risks associated with their use. In addition, at present, sunscreens are very useful in preventing sunburn and probably skin cancer and photoaging and their regular use can have a positive and a significant impact on public health as means or instruments implemented to reduce exposure to UV radiation. © 2016 Wiley Periodicals, Inc.

  11. Adverse health effects in children of women exposed in utero to diethylstilbestrol (DES).

    Science.gov (United States)

    Tournaire, Michel; Epelboin, Sylvie; Devouche, Emmanuel; Viot, Géraldine; Le Bidois, Jérôme; Cabau, Anne; Dunbavand, Annabel; Levadou, Anne

    2016-09-01

    Exposure to diethylstilbestrol (DES) in utero is associated with adverse health effects, including genital anomalies in women and men, and cancers in women. Animal studies showed birth defects and tumors in the offspring of DES exposed mice, revealing transgenerational transmission of DES effects. In humans, birth defects, such as hypospadias were observed in children of prenatally exposed women. The aim of this research was to further assess the health effects in children of prenatally exposed women. In a retrospective cohort study, the reports of women exposed to DES in utero on their 4409 children were compared with those of unexposed women on their 6203 children. Comparisons used odd ratios (OR) between children of exposed and unexposed women and standardized incidence rate (SIR) with the general population. These cohorts were recruited on a voluntary basis to answer questionnaires. There was a global increase of defects in children born to exposed women when compared with those born to unexposed (OR 2.29, 95% CI: 1.80-2.79, P<0.001) and with the general population (SIR 2.39, 95% CI: 2.11-2.68). Increased defects were observed in male genital tract, esophagus, lip or palate, musculoskeletal and circulatory systems. For female genital tract anomalies, there was no significant increase. However, this cohort being relatively young, further follow-up is needed. An increase of cerebral palsy was revealed. The incidence of cancers was not increased, in particular for breast, uterus and ovary. Our results confirmed a transgenerational transmission of defects in male genital tract. With caution due to possible bias associated with this method, our data suggest an increase of defects for esophagus, lip or palate, musculoskeletal and circulatory system in children of exposed women. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  12. Important sources and chemical species of ambient fine particles related to adverse health effects

    Science.gov (United States)

    Heo, J.

    2017-12-01

    contributor to PM2.5, leading to adverse human health effects.

  13. Mental health in retired professional football players: 12-month incidence, adverse life events and support

    NARCIS (Netherlands)

    van Ramele, Serena; Aoki, Haruhito; Kerkhoffs, Gino M. M. J.; Gouttebarge, Vincent

    2017-01-01

    Objectives: The primary aim was to explore the incidence of symptoms of common mental disorders (CMD; distress, sleep disturbance, anxiety/depression, adverse alcohol use) in retired professional football players and to explore the association between adverse life events and the onset of symptoms of

  14. To prevent, react, and rebuild: health research and the prevention of genocide.

    Science.gov (United States)

    Adler, Reva N; Smith, James; Fishman, Paul; Larson, Eric B

    2004-12-01

    To develop an approach to the primary prevention of genocide, based on established public health-based violence prevention methods derived from a variety of high-risk settings. (1) Peer-reviewed literature in the fields of public health, violence/injury prevention, medicine, economics, sociology, psychology, history, and genocide studies, (2) demographic and health data bases made available by governments and international organizations, (3) reports on recent episodes of genocide published by international and nongovernmental organizations, (4) newspaper and journalistic accounts of recent and past genocides, (5) archival testimonies of genocide victims and perpetrators, and (6) court transcripts of international genocide prosecutions. The research was conducted as a medical-historical policy analysis synthesizing data within the following framework: (1) Assessment of current violence and injury prevention models for suitability in the prevention of extreme, population-wide violence, (2) analysis of morbidity and mortality data to quantify the impact of genocide on the health of populations, (3) making an inventory of the known societal risk factors for genocidal violence, (4) identification of the theorized, modifiable attitudinal risk factors for genocidal behavior within a population health model, and (5) assessment of existing projects targeting primary violence and injury prevention in high risk jurisdictions, for future adaptation within a structured, public health approach. Mortality rates due to genocidal violence are far in excess of other public health emergencies including malaria and HIV/AIDS. The immediate and long-range health consequences of genocide include the sequelae of infectious diseases, organ system failure, and psychiatric disorders, conferring an increased burden of disease on affected populations for multiple subsequent generations. The impact of genocide on local health economies is catastrophic, and the opportunity costs of diverting

  15. Application of preventive medicine resources in the health insurance system.

    Science.gov (United States)

    Oliveira, Karla Regina Dias de; Liberal, Márcia Mello Costa de; Zucchi, Paola

    2015-01-01

    To identify the financial resources and investments provided for preventive medicine programs by health insurance companies of all kinds. Data were collected from 30 large health insurance companies, with over 100 thousand individuals recorded, and registered at the Agência Nacional de Saúde Suplementar. It was possible to identify the percentage of participants of the programs in relation to the total number of beneficiaries of the health insurance companies, the prevention and promotion actions held in preventive medicine programs, the inclusion criteria for the programs, as well as the evaluation of human resources and organizational structure of the preventive medicine programs. Most of the respondents (46.7%) invested more than US$ 50,000.00 in preventive medicine program, while 26.7% invested more than US$ 500,000.00. The remaining, about 20%, invested less than US$ 50,000.00, and 3.3% did not report the value applied.

  16. Pressure ulcer prevention: making a difference across a health authority?

    Science.gov (United States)

    Guy, Heidi; Downie, Fiona; McIntyre, Lyn; Peters, Jeremy

    Pressure ulcers (PUs), their cause and prevention have been discussed in the literature for many decades. Their prevention and management has been the core of a tissue viability nurse's daily clinical and strategic workload. The important point to acknowledge is that not all PUs can be prevented but it is believed most of them can and all preventative measures must be implemented and evaluated. Initial efforts focused on establishing a baseline of incidence and prevalence. More recently, the Department of Health has proposed that PUs could be eliminated in 95% of all NHS patients and incentivised the measurement of PUs and other harms by use of the NHS Safety Thermometer through the introduction of a new initiative. A research company was commissioned to explore which communications interventions would be effective in helping health professionals to prevent and treat PUs. A campaign was subsequently set in motion to educate and inform clinical staff on the cause and prevention of PUs.

  17. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions.

    Science.gov (United States)

    Font, Sarah A; Maguire-Jack, Kathryn

    2016-01-01

    Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks-depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions-marriage, divorce and separation, educational attainment, income and insurance status-mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Health promotion and cardiovascular disease prevention in sub-Saharan Africa.

    Science.gov (United States)

    Sampson, Uchechukwu K A; Amuyunzu-Nyamongo, Mary; Mensah, George A

    2013-01-01

    Recent population studies demonstrate an increasing burden of cardiovascular disease (CVD) and related risk factors in sub-Saharan Africa (SSA). The mitigation or reversal of this trend calls for effective health promotion and preventive interventions. In this article, we review the core principles, challenges, and progress in promoting cardiovascular health with special emphasis on interventions to address physical inactivity, poor diet, tobacco use, and adverse cardiometabolic risk factor trends in SSA. We focus on the five essential strategies of the Ottawa Charter for Health Promotion. Successes highlighted include community-based interventions in Ghana, Nigeria, South Africa, and Mauritius and school-based programs in Kenya, Namibia, and Swaziland. We address the major challenge of developing integrated interventions, and showcase partnerships opportunities. We conclude by calling for intersectoral partnerships for effective and sustainable intervention strategies to advance cardiovascular health promotion and close the implementation gap in accordance with the 2009 Nairobi Call to Action on Health Promotion. © 2013.

  19. A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? : An analytical framework

    NARCIS (Netherlands)

    Thurston, George D; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T; Rich, David; Ritz, Beate; Samet, Jonathan M; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert

    The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have

  20. A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? An analytical framework.

    Science.gov (United States)

    Thurston, George D; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T; Rich, David; Ritz, Beate; Samet, Jonathan M; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert

    2017-01-01

    The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution. Copyright ©ERS 2017.

  1. A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? An analytical framework

    Science.gov (United States)

    Thurston, George D.; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D.; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W.; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J.; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T.; Rich, David; Ritz, Beate; Samet, Jonathan M.; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert

    2017-01-01

    The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies. This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution. PMID:28077473

  2. (Un)Healthy in the city : Adverse health effects of traffic-related noise and air pollution

    NARCIS (Netherlands)

    Zijlema, Wilma

    2016-01-01

    We investigated the adverse health effects of urbanity, traffic-related noise and air pollution. We used harmonized data from multiple European cohort studies: LifeLines, HUNT, FINRISK, EPIC-Oxford and KORA. Based on our studies, we concluded that the living environment may be associated with

  3. Toward a Case Definition of Adverse Health Effects in the Environs of Industrial Wind Turbines: Facilitating a Clinical Diagnosis

    Science.gov (United States)

    McMurtry, Robert Y.

    2011-01-01

    Internationally, there are reports of adverse health effects (AHE) in the environs of industrial wind turbines (IWT). There was multidisciplinary confirmation of the key characteristics of the AHE at the first international symposium on AHE/IWT. The symptoms being reported are consistent internationally and are characterized by crossover findings…

  4. Health Workers' Knowledge of Preventing Mother-To-Child ...

    African Journals Online (AJOL)

    child transmission of HIV. This study assessed health workers' knowledge of the national guidelines on preventing mother-to-child transmission of HIV in Benin City, Edo State, Nigeria Methodology: The study design was a descriptive ...

  5. Beyond PM2.5: The role of ultrafine particles on adverse health effects of air pollution.

    Science.gov (United States)

    Chen, Rui; Hu, Bin; Liu, Ying; Xu, Jianxun; Yang, Guosheng; Xu, Diandou; Chen, Chunying

    2016-12-01

    Air pollution constitutes the major threat to human health, whereas their adverse impacts and underlying mechanisms of different particular matters are not clearly defined. Ultrafine particles (UFPs) are high related to the anthropogenic emission sources, i.e. combustion engines and power plants. Their composition, source, typical characters, oxidative effects, potential exposure routes and health risks were thoroughly reviewed. UFPs play a major role in adverse impacts on human health and require further investigations in future toxicological research of air pollution. Unlike PM2.5, UFPs may have much more impacts on human health considering loads of evidences emerging from particulate matters and nanotoxicology research fields. The knowledge of nanotoxicology contributes to the understanding of toxicity mechanisms of airborne UFPs in air pollution. This article is part of a Special Issue entitled Air Pollution, edited by Wenjun Ding, Andrew J. Ghio and Weidong Wu. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Wine Flavonoids in Health and Disease Prevention.

    Science.gov (United States)

    Fernandes, Iva; Pérez-Gregorio, Rosa; Soares, Susana; Mateus, Nuno; de Freitas, Victor

    2017-02-14

    Wine, and particularly red wine, is a beverage with a great chemical complexity that is in continuous evolution. Chemically, wine is a hydroalcoholic solution (~78% water) that comprises a wide variety of chemical components, including aldehydes, esters, ketones, lipids, minerals, organic acids, phenolics, soluble proteins, sugars and vitamins. Flavonoids constitute a major group of polyphenolic compounds which are directly associated with the organoleptic and health-promoting properties of red wine. However, due to the insufficient epidemiological and in vivo evidences on this subject, the presence of a high number of variables such as human age, metabolism, the presence of alcohol, the complex wine chemistry, and the wide array of in vivo biological effects of these compounds suggest that only cautious conclusions may be drawn from studies focusing on the direct effect of wine and any specific health issue. Nevertheless, there are several reports on the health protective properties of wine phenolics for several diseases such as cardiovascular diseases, some cancers, obesity, neurodegenerative diseases, diabetes, allergies and osteoporosis. The different interactions that wine flavonoids may have with key biological targets are crucial for some of these health-promoting effects. The interaction between some wine flavonoids and some specific enzymes are one example. The way wine flavonoids may be absorbed and metabolized could interfere with their bioavailability and therefore in their health-promoting effect. Hence, some reports have focused on flavonoids absorption, metabolism, microbiota effect and overall on flavonoids bioavailability. This review summarizes some of these major issues which are directly related to the potential health-promoting effects of wine flavonoids. Reports related to flavonoids and health highlight some relevant scientific information. However, there is still a gap between the knowledge of wine flavonoids bioavailability and their health

  7. Using the Health Belief Model for Bulimia Prevention.

    Science.gov (United States)

    Grodner, Michele

    1991-01-01

    Discusses application of the Health Belief Model to the prevention of bulimia, describing each model component. The article considers the individual's beliefs about bulimia and bulimic-like behaviors as a means of predicting the likelihood of behavior change to prevent clinically diagnosable bulimia. (SM)

  8. tanzania danida dental health programme progress in prevention

    African Journals Online (AJOL)

    The third sector we need to examine ~ garding progress in prevention is the activities of the dental profeSSionals themselves. As part of the continuing education programme, all dental assistants have attended a workshop' on epidemiology, health education and planning of preventive programmes. They accepted this new.

  9. Impact of health education on home treatment and prevention

    African Journals Online (AJOL)

    Emmanuel Ameh

    Impact of health education on home treatment and prevention of malaria. Chirdan O. O. et al. Page | 115 taken at home and dangers of self treatment. Part 3: Treatment of uncomplicated malaria and prevention of malaria. Posters and chloroquine drug charts were used as teaching aids. Post intervention impact assessment.

  10. Influence of Health Education on Prevention of Drug Abuse ...

    African Journals Online (AJOL)

    The increasing scourge of drug abuse among adolescents is a major challenge facing mankind. As the importance of health education in disease prevention is enormous, drug misuse prevention programme requires introducing innovations, flexibility and reinforcement which will be effective in shortest possible time among ...

  11. Conceptualising the prevention of adverse obstetric outcomes among immigrants using the 'three delays' framework in a high-income context.

    Science.gov (United States)

    Binder, Pauline; Johnsdotter, Sara; Essén, Birgitta

    2012-12-01

    Women from high-mortality settings in sub-Saharan Africa can remain at risk for adverse maternal outcomes even after migrating to low-mortality settings. To conceptualise underlying socio-cultural factors, we assume a 'maternal migration effect' as pre-migration influences on pregnant women's post-migration care-seeking and consistent utilisation of available care. We apply the 'three delays' framework, developed for low-income African contexts, to a high-income western scenario, and aim to identify delay-causing influences on the pathway to optimal facility treatment. We also compare factors influencing the expectations of women and maternal health providers during care encounters. In 2005-2006, we interviewed 54 immigrant African women and 62 maternal providers in greater London, United Kingdom. Participants were recruited by snowball and purposive sampling. We used a hermeneutic, naturalistic study design to create a qualitative proxy for medical anthropology. Data were triangulated to the framework and to the national health system maternity care guidelines. This maintained the original three phases of (1) care-seeking, (2) facility accessibility, and (3) receipt of optimal care, but modified the framework for a migration context. Delays to reciprocal care encounters in Phase 3 result from Phase 1 factors of 'broken trust, which can be mutually held between women and providers. An additional factor is women's 'negative responses to future care', which include rationalisations made during non-emergency situations about future late-booking, low-adherence or refusal of treatment. The greatest potential for delay was found during the care encounter, suggesting that perceived Phase 1 factors have stronger influence on Phase 3 than in the original framework. Phase 2 'language discordance' can lead to a 'reliance on interpreter service', which can cause delays in Phase 3, when 'reciprocal incongruent language ability' is worsened by suboptimal interpreter systems

  12. Effects on preventing mother-to-child transmission of syphilis and associated adverse pregnant outcomes: a longitudinal study from 2001 to 2015 in Shanghai, China.

    Science.gov (United States)

    Li, Yang; Zhu, Liping; Du, Li; Qu, Lingxiao; Jiang, Weili; Xu, Biao

    2017-09-18

    Maternal syphilis is a health threat to both the pregnant women and the children. This study aimed to delineate the longitudinal trend of maternal syphilis and burden of associated adverse pregnant outcomes (APOs) in Shanghai from 2001 to 2015; and to evaluate the effects of preventing mother-to-child transmission (PMTCT) of syphilis in Shanghai with regard to service coverage and APOs averted. PMTCT program of syphilis has been implemented since 2001. Municipal and national PMTCT surveillance data were used in analysis. By using WHO estimation model, the burden of associated APOs and APOs averted were estimated. The differences in access to antenatal care and PMTCT services between resident and non-resident pregnant women were analyzed. The prevalence of seropositivity for maternal syphilis in Shanghai ranged from 0.20% to 0.38% during 2001-2015. The treatment rate varied from 69.8% to 96.8% and remained 83.6% in 2015. Under the PMTCT program, 2163 APOs had been averted during the 15-year period, including 852(39.4%) early fetal loss/stillbirth, 356(16.4%) neonatal death, 190(8.8%) prematurity or low birth weight, and 765(35.4%) clinical evidence of congenital syphilis. Compared with the residents, the non-resident pregnant women had a higher prevalence of syphilis (1.2‰ vs. 2.5‰) and contributed to 81.7% of the syphilis associated APOs in 2015. Screening of maternal syphilis has reached a full coverage both in residents and non-residents. Large numbers of APOs has been averted attributing to the PMTCT program. More attentions should be paid to those vulnerable non-resident pregnant women and tailored interventions including health education, PMTCT promotion and point of care should be given to maximize the effects of PMTCT in Shanghai.

  13. Contributions of Physical Therapists to Primary Preventive Health Care.

    Science.gov (United States)

    Nomura, Takuo

    2016-01-01

    The limitations of what physical therapists can differ from country to country. In Japan, physical therapists are national licensed health care professionals who can help patients improve or restore their mobility. Most Japanese physical therapists provide care for people in health care facilities, medical-welfare transitional facilities, and welfare facilities for the elderly. Currently, physical therapists are unable to sufficiently contribute to primary preventive health care in Japan. However, there are many health problems that physical therapists could help alleviate. For example, low back pain (LBP) more likely than any other condition prevents people from working; thus, making the establishment of effective measures to prevent and reduce LBP vital. An estimated 20,500,000 Japanese individuals have diabetes mellitus (DM) or are at a high risk of developing the disease. DM commonly accompanies stroke and/or heart disease, and is characterized by complications that result from chronic hyperglycemia. Evidence-based physical therapy is effective for the prevention and treatment of LBP and DM. The Japanese Physical Therapy Association established the Japanese Society of Physical Therapy (JSPT) in June 2013. The JSPT has 12 departmental societies and 10 sections. We believe that the JSPT will advance the study of the potential role of physical therapists in primary preventive health care. In the future, it is expected that Japanese physical therapists will contribute to primary preventive health care.

  14. Risk of Adverse Health and Performance Effects of Celestial Dust Exposure

    Science.gov (United States)

    Scully, Robert R.; Meyers, Valerie E.

    2015-01-01

    silica (Permissible Exposure Limit [PEL] 0.05 mg/m3) but more toxic than the nuisance dust titanium dioxide (TiO2 [PEL 5.0 mg/m3]). A PEL for episodic exposure to airborne lunar dust during a six-month stay on the lunar surface was established, in consultation with an independent, extramural panel of expert pulmonary toxicologists, at 0.3 mg/m3. The PEL provided for lunar dust is limited to the conditions and exposure specified therefore additional research remains to be accomplished with lunar dust to further address the issues of activation, address other areas of more unique lunar geology (Glotch et al., 2010; Greenhagen et al., 2010), examine potential toxicological effects of inhaled or ingested dust upon other organ systems, such cardiovascular, nervous systems, and examine effects of acute exposure to massive doses of dust such as may occur during off-nominal situations. Work to support the establishment of PELs for Martian dust and dusts of asteroids remains to be accomplished. The literature that describes health effects of exposure to toxic terrestrial dusts provides substantial basis for concern that prolonged exposure to respirable celestial dust could be detrimental to human health. Celestial bodies where a substantial portion of the dust is in the respirable range or where the dusts have large reactive surface areas or contain transition metals or volatile organics, represent greater risks of adverse effects from exposure to the dust. It is possible that in addition to adverse effects to the respiratory system, inhalation and ingestion of celestial dusts could pose risks to other systems

  15. Adverse trajectories of mental health problems predict subsequent burnout and work-family conflict - a longitudinal study of employed women with children followed over 18 years.

    Science.gov (United States)

    Nilsen, Wendy; Skipstein, Anni; Demerouti, Evangelia

    2016-11-08

    The long-term consequence of experiencing mental health problems may lead to several adverse outcomes. The current study aims to validate previous identified trajectories of mental health problems from 1993 to 2006 in women by examining their implications on subsequent work and family-related outcomes in 2011. Employed women (n = 439) with children were drawn from the Tracking Opportunities and Problems-Study (TOPP), a community-based longitudinal study following Norwegian families across 18 years. Previous identified latent profiles of mental health trajectories (i.e., High; Moderate; Low-rising and Low levels of mental health problems over time) measured at six time points between 1993 and 2006 were examined as predictors of burnout (e.g., exhaustion and disengagement from work) and work-family conflict in 2011 in univariate and multivariate analyses of variance adjusted for potential confounders (age, job demands, and negative emotionality). We found that having consistently High and Moderate symptoms as well as Low-Rising symptoms from 1993 to 2006 predicted higher levels of exhaustion, disengagement from work and work-family conflict in 2011. Findings remained unchanged when adjusting for several potential confounders, but when adjusting for current mental health problems only levels of exhaustion were predicted by the mental health trajectories. The study expands upon previous studies on the field by using a longer time span and by focusing on employed women with children who experience different patterns of mental health trajectories. The long-term effect of these trajectories highlight and validate the importance of early identification and prevention in women experiencing adverse patterns of mental health problems with regards to subsequent work and family-related outcomes.

  16. The economic effect of Planet Health on preventing bulimia nervosa.

    Science.gov (United States)

    Wang, Li Yan; Nichols, Lauren P; Austin, S Bryn

    2011-08-01

    To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors. On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention. Middle schools. A sample of 254 intervention girls aged 10 to 14 years. The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth. Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio. An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years. Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.

  17. A multiparameter investigation into adverse effects of aflatoxin on Oreochromis niloticus health status

    Directory of Open Access Journals (Sweden)

    Magdy E. Mahfouz

    2015-08-01

    Full Text Available Aflatoxin is a common contaminant of foods, particularly in the staple diets of many developing countries. To evaluate adverse effects of aflatoxin B1 (AFB1 toxicity on health status in the Nile tilapia Oreochromis niloticus, fish were fed diet contaminated with either 20 or 100 ppb AFB1 for 6 or 12 weeks. Growth indices, survival rate and hepatosomatic index (HSI were assessed. Blood samples were collected for hematological profiles (e.g. RBCs and WBC count, Hb content. Liver enzyme activity; aspartate aminotransferase (AST, alanine aminotransferase (ALT as well as alkaline phosphatase (ALP, were evaluated and toxin residues in the liver and musculature were detected. Liver histopathological investigations were carried out, whereas antioxidant glutathione peroxidase (GPx and glutathione S-transferase (GST gene expression were determined in this tissue by semi-quantitative RT-PCR. Furthermore, to test the fish immune status, challenge against Aeromonas hydrophila was conducted. Results indicated that 100 ppb AFB1 negatively impacted O. niloticus weight gain, feed efficiency, hematological profiles, HSI as well as liver histopathology, while increase in AST, ALT, ALP liver enzymes activity was evidenced. Further, the expression of liver GPx and GST down-regulated and AFB1 residues were always detected in the liver and only in the musculature in fish fed 100 ppb AFB1 for 12 weeks. The ability of fish to withstand A. hydrophila infection was remarkably lowered. Overall, the results herein demonstrate the toxic effects of AFB1 in O. niloticus. The observed alterations in fish status, especially in the liver coincide well with the expected oxidative stress resulting from the AFB1 toxicity.

  18. Wine Flavonoids in Health and Disease Prevention

    Directory of Open Access Journals (Sweden)

    Iva Fernandes

    2017-02-01

    Full Text Available Wine, and particularly red wine, is a beverage with a great chemical complexity that is in continuous evolution. Chemically, wine is a hydroalcoholic solution (~78% water that comprises a wide variety of chemical components, including aldehydes, esters, ketones, lipids, minerals, organic acids, phenolics, soluble proteins, sugars and vitamins. Flavonoids constitute a major group of polyphenolic compounds which are directly associated with the organoleptic and health-promoting properties of red wine. However, due to the insufficient epidemiological and in vivo evidences on this subject, the presence of a high number of variables such as human age, metabolism, the presence of alcohol, the complex wine chemistry, and the wide array of in vivo biological effects of these compounds suggest that only cautious conclusions may be drawn from studies focusing on the direct effect of wine and any specific health issue. Nevertheless, there are several reports on the health protective properties of wine phenolics for several diseases such as cardiovascular diseases, some cancers, obesity, neurodegenerative diseases, diabetes, allergies and osteoporosis. The different interactions that wine flavonoids may have with key biological targets are crucial for some of these health-promoting effects. The interaction between some wine flavonoids and some specific enzymes are one example. The way wine flavonoids may be absorbed and metabolized could interfere with their bioavailability and therefore in their health-promoting effect. Hence, some reports have focused on flavonoids absorption, metabolism, microbiota effect and overall on flavonoids bioavailability. This review summarizes some of these major issues which are directly related to the potential health-promoting effects of wine flavonoids. Reports related to flavonoids and health highlight some relevant scientific information. However, there is still a gap between the knowledge of wine flavonoids

  19. Suicide Prevention: An Emerging Priority For Health Care.

    Science.gov (United States)

    Hogan, Michael F; Grumet, Julie Goldstein

    2016-06-01

    Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Childhood adversity and adult personality.

    Science.gov (United States)

    Rosenman, Stephen; Rodgers, Bryan

    2006-05-01

    adversity and especially maternal psychological ill-health as a target for preventive intervention for psychological difficulties at all ages.

  1. Health Issues for Gay Men: Prevention First

    Science.gov (United States)

    ... such as condom use every time you have sex. Gay men and men who have sex with men might be at higher risk of ... long-term health. Makadon HJ. Primary care of gay men and men who have sex with men. https://www.uptodate.com/contents/search. ...

  2. Preventing and Treating Child Mental Health Problems

    Science.gov (United States)

    Cuellar, Alison

    2015-01-01

    Children's mental health covers a wide range of disorders. Some, such as ADHD and autism, tend to manifest themselves when children are young, while others, such as depression and addiction, are more likely to appear during the teenage years. Some respond readily to treatment or tend to improve as children grow older, while others, such as autism,…

  3. The influence of childhood adversity on social relations and mental health at mid-life.

    Science.gov (United States)

    Ford, Elizabeth; Clark, Charlotte; Stansfeld, Stephen A

    2011-09-01

    Childhood adversity is predictive of affective and anxiety disorders in adulthood, although there are likely to be several mediating factors. Social relations and social networks are potential mediators, and have also been linked to onset and recovery of affective and anxiety disorders in adulthood. This study explored positive and negative aspects of close relationships, their association with mid-life anxiety and affective disorders, and their mediating role in the relationship between childhood adversity and mid-life disorders. Data from the 1958 British birth cohort were analysed using measures of adversity taken during childhood, measurements of social relations at 45 years, and diagnosis of affective and anxiety disorders at 45 years of age (N=9377). Childhood adversity was associated with smaller social network size and higher negative aspects of close relationships. Smaller social network size and negative aspects of close relationships, but not emotional or practical support, were associated with higher odds of having affective or anxiety disorder. However, social relations did not mediate or moderate the pathway between childhood adversity and mid-life affective and anxiety disorders. Social relations and affective and anxiety disorders were measured cross-sectionally so direction of causation cannot be determined. Negative aspects of close relationships and social network size, rather than emotional or practical support, are associated with affective and anxiety disorders. Childhood adversity is related to later social relationships as well as mid-life affective and anxiety disorders. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. The influence of health disparities on targeting cancer prevention efforts.

    Science.gov (United States)

    Zonderman, Alan B; Ejiogu, Ngozi; Norbeck, Jennifer; Evans, Michele K

    2014-03-01

    Despite the advances in cancer medicine and the resultant 20% decline in cancer death rates for Americans since 1991, there remain distinct cancer health disparities among African Americans, Hispanics, Native Americans, and the those living in poverty. Minorities and the poor continue to bear the disproportionate burden of cancer, especially in terms of stage at diagnosis, incidence, and mortality. Cancer health disparities are persistent reminders that state-of-the-art cancer prevention, diagnosis, and treatment are not equally effective for and accessible to all Americans. The cancer prevention model must take into account the phenotype of accelerated aging associated with health disparities as well as the important interplay of biological and sociocultural factors that lead to disparate health outcomes. The building blocks of this prevention model will include interdisciplinary prevention modalities that encourage partnerships across medical and nonmedical entities, community-based participatory research, development of ethnically and racially diverse research cohorts, and full actualization of the prevention benefits outlined in the 2010 Patient Protection and Affordable Care Act. However, the most essential facet should be a thoughtful integration of cancer prevention and screening into prevention, screening, and disease management activities for hypertension and diabetes mellitus because these chronic medical illnesses have a substantial prevalence in populations at risk for cancer disparities and cause considerable comorbidity and likely complicate effective treatment and contribute to disproportionate cancer death rates. Published by Elsevier Inc.

  5. Healthy Tweets: Use and Importance of Twitter for Health Prevention

    Directory of Open Access Journals (Sweden)

    Lina M. Gomez Vasquez

    2017-12-01

    Full Text Available Social media platforms have changed the way people stayinformed, communicate with others, and share ideas. These interactive social platforms are used for many purposes from being in contact with family and friends to promote products and services. However, little is known about the use and importance of social media for health prevention, especially for communication among Hispanic communities.The purpose of this paper is to analyze how social media platforms, especially Twitter, are used for health prevention and communication in Hispanic communities. In doing so, a quantitative content analysis was performed on 3000 tweets with the hashtag #prevención (prevention. Results indicate that most of the prevention messages shared among organizations and users on Twitter were informational messages and very few users promoted interactive communication and mobilization. Mass media and governmental institutions posted more messages to encourage health prevention, especially about publichealth and healthy cities. This study stresses the many social media platforms’ potentialities and functionalities, especially Twitter, that contribute to health prevention and communication. Findings are useful for organizations and users when planning prevention content or campaigns through these platforms.

  6. Antenatal interventions for preventing the transmission of cytomegalovirus (CMV) from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant.

    LENUS (Irish Health Repository)

    McCarthy, Fergus P

    2012-01-31

    BACKGROUND: Cytomegalovirus (CMV) is a herpesvirus and the most common cause of congenital infection in developed countries. Congenital CMV infection can have devastating consequences to the fetus. The high incidence and the serious morbidity associated with congenital CMV infection emphasise the need for effective interventions to prevent the antenatal transmission of CMV infection. OBJECTIVES: The aim of this review was to assess the benefits and harms of interventions used during pregnancy to prevent mother to fetus transmission of CMV infection. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group\\'s Trials Register (31 December 2010). SELECTION CRITERIA: All randomised controlled trials (RCTs) and quasi RCTs investigating antenatal interventions for preventing the transmission of CMV from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion. MAIN RESULTS: We identified six studies from the search. None of these studies met the pre-defined criteria for inclusion in this review. AUTHORS\\' CONCLUSIONS: To date, no RCTs are available that examine antenatal interventions for preventing the transmission of CMV from the infected mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. Further research is needed to assess the efficacy of interventions aimed at preventing the transmission of CMV from the mother to fetus during pregnancy including a long-term follow-up of exposed infants and a cost effective analysis.

  7. Neutralization of IL-8 prevents the induction of dermatologic adverse events associated with the inhibition of epidermal growth factor receptor

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Houtkamp, Mischa; Schuurhuis, Danita H

    2012-01-01

    Epidermal growth factor receptor (EGFR) inhibitors are widely used in the treatment of cancer. EGFR-targeted treatment is known to be associated with a high incidence of dermatological adverse reactions, including papulopustular rash, which can be dose-limiting and may affect compliance to treatm......Epidermal growth factor receptor (EGFR) inhibitors are widely used in the treatment of cancer. EGFR-targeted treatment is known to be associated with a high incidence of dermatological adverse reactions, including papulopustular rash, which can be dose-limiting and may affect compliance...... repeat dose treatment with HuMab-10F8, a neutralizing human antibody against IL-8, reduced the rash. Inhibition of IL-8 can therefore ameliorate dermatological adverse events induced by treatment with EGFR inhibitors....

  8. E-health interventions for suicide prevention.

    Science.gov (United States)

    Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne

    2014-08-12

    Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.

  9. Planned Repeat Cesarean Section at Term and Adverse Childhood Health Outcomes: A Record-Linkage Study.

    Directory of Open Access Journals (Sweden)

    Mairead Black

    2016-03-01

    Full Text Available Global cesarean section (CS rates range from 1% to 52%, with a previous CS being the commonest indication. Labour following a previous CS carries risk of scar rupture, with potential for offspring hypoxic brain injury, leading to high rates of repeat elective CS. However, the effect of delivery by CS on long-term outcomes in children is unclear. Increasing evidence suggests that in avoiding exposure to maternal bowel flora during labour or vaginal birth, offspring delivered by CS may be adversely affected in terms of energy uptake from the gut and immune development, increasing obesity and asthma risks, respectively. This study aimed to address the evidence gap on long-term childhood outcomes following repeat CS by comparing adverse childhood health outcomes after (1 planned repeat CS and (2 unscheduled repeat CS with those that follow vaginal birth after CS (VBAC.A data-linkage cohort study was performed. All second-born, term, singleton offspring delivered between 1 January 1993 and 31 December 2007 in Scotland, UK, to women with a history of CS (n = 40,145 were followed up until 31 January 2015. Outcomes assessed included obesity at age 5 y, hospitalisation with asthma, learning disability, cerebral palsy, and death. Cox regression and binary logistic regression were used as appropriate to compare outcomes following planned repeat CS (n = 17,919 and unscheduled repeat CS (n = 8,847 with those following VBAC (n = 13,379. Risk of hospitalisation with asthma was greater following both unscheduled repeat CS (3.7% versus 3.3%, adjusted hazard ratio [HR] 1.18, 95% CI 1.05-1.33 and planned repeat CS (3.6% versus 3.3%, adjusted HR 1.24, 95% CI 1.09-1.42 compared with VBAC. Learning disability and death were more common following unscheduled repeat CS compared with VBAC (3.7% versus 2.3%, adjusted odds ratio 1.64, 95% CI 1.17-2.29, and 0.5% versus 0.4%, adjusted HR 1.50, 95% CI 1.00-2.25, respectively. Risk of obesity at age 5 y and risk of cerebral

  10. Health Workers' Knowledge of Preventing Mother-To-Child ...

    African Journals Online (AJOL)

    the monk

    received training on the national guidelines on preventing mother-to-child transmission of HIV. The proportion of health workers with poor, fair, .... collection techniques. The purpose of the training was to ensure uniformity in techniques of data ..... HIV/AIDS Division- Federal. Ministry of Health, 2011:1-3. Available. a t : h t t p ...

  11. Religiosity and the preventive health behaviour of young adults ...

    African Journals Online (AJOL)

    The role of religiosity in preventive health behaviour has received relatively little systematic research attention. Even so, extant literature suggests that religion may play complex and varied roles in enhancing people‗s health. However, the evidence has been both diverse and fragmentary One hundred and sixty unmarried ...

  12. Primary prevention in public health: an analysis of basic assumptions.

    Science.gov (United States)

    Ratcliffe, J; Wallack, L

    1985-01-01

    The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the "lifestyle" theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk-taking, self-destructive behavior. Health protection, on the other hand, is based on the "social-structural" theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and "anti-health promotion" marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk-imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an "upstream" approach that results in far-reaching sociopolitical and economic change.

  13. Migrant's access to preventive health services in five EU countries.

    Science.gov (United States)

    Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia

    2017-08-23

    Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing

  14. Adverse health effects of lead exposure on children and exploration to internal lead indicator

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Q.; Zhao, H.H. [Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030 (China); Chen, J.W.; Gu, K.D.; Zhang, Y.Z.; Zhu, Y.X.; Zhou, Y.K. [Minitry of Environmental Protection Key Lab of Environment, Wuhan 430030 (China); Ye, L.X., E-mail: yelx2004@163.com [Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030 (China)

    2009-11-15

    Our research on adverse effects of lead exposures on physical and neurobehavioral health of children aged 6-12 years in 4 villages, labeled as K, M, L, and X, in rural China, was reported in this article. Lead in blood (PbB), urine (PbU), hairs (PbH), and nails (PbN) were measured by graphite furnace atomic absorption spectrometry. Abbreviated Symptom Questionnaire of Conner's instruments and Revised Raven's Standard Progressive Matrices were applied to evaluate childhood attention deficit/hyperactivity disorders (ADHD) and intelligences. Geometric means (SD) of PbB, PbU, PbH and PbN concentrations were 71.2 {mu}g/L (1.56), 11.7 {mu}g/g (1.75), 12.5 {mu}g/g (2.82), and 25.3 {mu}g/g (2.79), respectively. 54 (17.0%) children had PbB levels of {>=} 100 {mu}g/L. Boys, the 6-10 years old, and living in village K were 2.11, 2.48, and 9.16 times, respectively, more likely to be poisoned by lead than girls, aged 11-12 years, and residing in X. 18 (5.7%) and 37 (11.7%) subjects had ADHD and mental retardations, respectively. Inverse relationships between intelligences and natural log transformed PbU and PbH levels were observed with respective odds ratios (95%CI) of 1.79 (1.00-3.22) and 1.46 (1.06-2.03) or 1.28 (1.04-1.58) and 1.73 (1.18-2.52) by binary or ordinal logistic regression modeling. ADHD prevalence was different by gender and age of subjects. PbU, PbH, and PbN related to PbB positively with respective correlation coefficients of 0.530, 0.477, and 0.181. Receiver operating characteristic (ROC) curves of the three measurements reveled areas under curves (AUCs) being 0.829, 0.758, and 0.687, respectively. In conclusion, children had moderate levels of lead exposures in this rural area. Intelligence declines were associated with internal lead levels among children. ROC analysis suggests PbU an internal lead indicator close to PbB.

  15. Adverse health effects of lead exposure on children and exploration to internal lead indicator

    International Nuclear Information System (INIS)

    Wang, Q.; Zhao, H.H.; Chen, J.W.; Gu, K.D.; Zhang, Y.Z.; Zhu, Y.X.; Zhou, Y.K.; Ye, L.X.

    2009-01-01

    Our research on adverse effects of lead exposures on physical and neurobehavioral health of children aged 6-12 years in 4 villages, labeled as K, M, L, and X, in rural China, was reported in this article. Lead in blood (PbB), urine (PbU), hairs (PbH), and nails (PbN) were measured by graphite furnace atomic absorption spectrometry. Abbreviated Symptom Questionnaire of Conner's instruments and Revised Raven's Standard Progressive Matrices were applied to evaluate childhood attention deficit/hyperactivity disorders (ADHD) and intelligences. Geometric means (SD) of PbB, PbU, PbH and PbN concentrations were 71.2 μg/L (1.56), 11.7 μg/g (1.75), 12.5 μg/g (2.82), and 25.3 μg/g (2.79), respectively. 54 (17.0%) children had PbB levels of ≥ 100 μg/L. Boys, the 6-10 years old, and living in village K were 2.11, 2.48, and 9.16 times, respectively, more likely to be poisoned by lead than girls, aged 11-12 years, and residing in X. 18 (5.7%) and 37 (11.7%) subjects had ADHD and mental retardations, respectively. Inverse relationships between intelligences and natural log transformed PbU and PbH levels were observed with respective odds ratios (95%CI) of 1.79 (1.00-3.22) and 1.46 (1.06-2.03) or 1.28 (1.04-1.58) and 1.73 (1.18-2.52) by binary or ordinal logistic regression modeling. ADHD prevalence was different by gender and age of subjects. PbU, PbH, and PbN related to PbB positively with respective correlation coefficients of 0.530, 0.477, and 0.181. Receiver operating characteristic (ROC) curves of the three measurements reveled areas under curves (AUCs) being 0.829, 0.758, and 0.687, respectively. In conclusion, children had moderate levels of lead exposures in this rural area. Intelligence declines were associated with internal lead levels among children. ROC analysis suggests PbU an internal lead indicator close to PbB.

  16. Population health outcome models in suicide prevention policy.

    Science.gov (United States)

    Lynch, Frances L

    2014-09-01

    Suicide is a leading cause of death in the U.S. and results in immense suffering and significant cost. Effective suicide prevention interventions could reduce this burden, but policy makers need estimates of health outcomes achieved by alternative interventions to focus implementation efforts. To illustrate the utility of health outcome models to help in achieving goals defined by the National Action Alliance for Suicide Prevention's Research Prioritization Task Force. The approach is illustrated specifically with psychotherapeutic interventions to prevent suicide reattempt in emergency department settings. A health outcome model using decision analysis with secondary data was applied to estimate suicide attempts and deaths averted from evidence-based interventions. Under optimal conditions, the model estimated that over 1 year, implementing evidence-based psychotherapeutic interventions in emergency departments could decrease the number of suicide attempts by 18,737, and if offered over 5 years, it could avert 109,306 attempts. Over 1 year, the model estimated 2,498 fewer deaths from suicide, and over 5 years, about 13,928 fewer suicide deaths. Health outcome models could aid in suicide prevention policy by helping focus implementation efforts. Further research developing more sophisticated models of the impact of suicide prevention interventions that include a more complex understanding of suicidal behavior, longer time frames, and inclusion of additional outcomes that capture the full benefits and costs of interventions would be helpful next steps. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

  17. Health risk characterization for exposure to benzene in service stations and petroleum refineries environments using human adverse response data.

    Science.gov (United States)

    Edokpolo, Benjamin; Yu, Qiming Jimmy; Connell, Des

    2015-01-01

    Health risk characterization of exposure to benzene in service stations and petroleum refineries has been carried out in previous studies using guideline values set by various agencies. In this work, health risk was characterized with the exposure data as cumulative probability distribution (CPD) plots but using human epidemiological data. This was achieved by using lowest observable adverse effects levels (LOAEL) data plotted as cumulative probability lowest effects distribution (CPLED). The health risk due to benzene was characterized by using probabilistic methods of hazard quotient (HQ 50/50 and HQ 95/5 ), Monte-Carlo simulation (MCS) and overall risk probability (ORP). CPD relationships of adverse health effects relationships and exposure data were in terms of average daily dose (ADD) and lifetime average daily dose (LADD) for benzene. For service station environments HQ 50/50 and HQ 95/5 were in a range of 0.000071-0.055 and 0.0049-21, respectively. On the other hand, the risk estimated for petroleum refinery environments suggests higher risk with HQ 50/50 and HQ 95/5 values ranging from 0.0012 to 77 and 0.17 to 560, respectively. The results of Monte-Carlo risk probability (MRP) and ORP indicated that workers in petroleum refineries (MRP of 2.9-56% and ORP of 4.6-52% of the affected population) were at a higher risk of adverse health effects from exposure to benzene as compared to exposure to benzene in service station environments (MRP of 0.051 -3.4% and ORP of 0.35-2.7% affected population). The adverse effect risk probabilities estimated by using the Monte-Carlo simulation technique and the ORP method were found to be generally consistent.

  18. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  19. [Vaginal citology. Prevention and good health. Survey].

    Science.gov (United States)

    Ordonez Gomez, M

    1995-06-01

    A 1993 survey of knowledge, attitudes and practices related to sexually transmitted diseases and other conditions included a series of questions for women on vaginal cytology. The survey was based on a subsample of the PROFAMILIA master sample. 15,080 persons were interviewed, including 6949 women 18-69 years old. The section on vaginal cytology began with a description of the procedure before the questions were asked. Among the total sample, 66.2% reported having undergone cervical cytology while 33.8% had not. 4.8% did not request the results. For the 61.4% of the sample that requested the results, 49.4% were normal, 11.1% were abnormal, and 0.9% did not know or were not given their results. Of those with abnormal results, 9.3% returned for another consultation and 1.8% did not. The proportion of women having cervical cytology exceeded 80% for women 30-49 years old. 69.9% of urban and 54.2% of rural women had been tested. 28.9% underwent the most recent test due to a personal decision, 24.7% on medical recommendation, 23.2% because of symptoms, 12.0% to prevent cancer, 3.2% for safety, 2.0% because a year had passed since the last test, 2.0% in response to a campaign, 1.6% because a friend suggested it, and 1.1% because they had never had it done. The symptoms that motivated the test were a discharge for 31.4%, pain for 30.0%, bleeding for 11.8%, itching for 5.5%, postpartum problems for 2.8%, burning for 2.5%, and cyst for 1.9%. Abnormal results were obtained in 40% of the women who had the test because of symptoms. The average number of times in the past 5 years that the test was done was 2.8. 9% of respondents had not had a test in the past 5 years, 26% had 1, 18% had 2, 12% had 3, 7% had 4, 16% had 5, and 11% had 6 or more. 64.4% of women under 25 and 39% over 60 had never had vaginal cytology. Rural women and the less educated were less likely to have had the procedure.

  20. Adapting pressure ulcer prevention for use in home health care.

    Science.gov (United States)

    Bergquist-Beringer, Sandra; Daley, Christine Makosky

    2011-01-01

    Clinical practice guidelines on pressure ulcer (PU)prevention have been written primarily for inpatient settings,but we currently lack data as to how these guidelines have been adapted for use in home health care. The purpose of this study was to delineate interventions and activities used to prevent PU in home health care. Focus group study using text analysis. A focus group was conducted with 9 certified wound care nurses who practiced in home health care at least 50% of the time. Most of the participants had 10 or more years of home health experience and 5 or more years of wound care experience. The single 75-minute focus group was convened by teleconference and audiotaped. A semistructured moderator's guide was used to lead the discussion. Transcribed data were analyzed using standard text analysis. Preliminary results were distributed to focus group participants for review, comment, or clarification, and refined as needed. Certified wound care nurse participants used an array of interventions, including those recommended by clinical practice guidelines, to prevent PU in home health patients.However, specific activities differed from those performed in hospitals and nursing homes. Interventions unique to homehealth care included (1) assessment of patients' economic and insured status to determine implementation options, (2) assessment of caregiving resources and caregivers' ability to manage PU prevention, and (3) collaboration with community resources and health care vendors to obtain needed prevention materials and supplies. Findings provide insight into guideline adaptation in home health care and suggest that PU prevention in the homehealth care setting is more complex than that in hospitals and nursing homes and requires significant skills in communication and collaboration.

  1. Prevention

    Science.gov (United States)

    ... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...

  2. Antiretroviral therapy related adverse effects: Can sub-Saharan Africa cope with the new "test and treat" policy of the World Health Organization?

    Science.gov (United States)

    Nansseu, Jobert Richie N; Bigna, Jean Joel R

    2017-02-15

    Recent studies have shown that early antiretroviral therapy (ART) initiation results in significant HIV transmission reduction. This is the rationale behind the "test and treat" policy of the World Health Organization (WHO). Implementation of this policy will lead to an increased incidence of ART-related adverse effects, especially in sub-Saharan Africa (SSA). Is the region yet ready to cope with such a challenging issue? The introduction and widespread use of ART have drastically changed the natural history of HIV/AIDS, but exposure to ART leads to serious medication-related adverse effects mainly explained by mitochondrial toxicities, and the situation will get worse in the near future. Indeed, ART is associated with an increased risk of developing cardiovascular disease, lipodystrophy, prediabetes and overt diabetes, insulin resistance and hyperlactatemia/lactic acidosis. The prevalence of these disorders is already high in SSA, and the situation will be exacerbated by the implementation of the new WHO recommendations. Most SSA countries are characterized by (extreme) poverty, very weak health systems, inadequate and low quality of health services, inaccessibility to existing health facilities, lack of (qualified) health personnel, lack of adequate equipment, inaccessibility and unaffordability of medicines, and heavy workload in a context of a double burden of disease. Additionally, there is dearth of data on the incidence and predictive factors of ART-related adverse effects in SSA, to anticipate on strategies that should be put in place to prevent the occurrence of these conditions or properly estimate the upcoming burden and prepare an adequate response plan. These are required if we are to anticipate and effectively prevent this upcoming burden. While SSA would be the first region to experience the huge benefits of implementing the "test and treat" policy of the WHO, the region is not yet prepared to manage the consequential increased burden of ART

  3. Prenatal Family Adversity and Maternal Mental Health and Vulnerability to Peer Victimisation at School

    Science.gov (United States)

    Lereya, Suzet Tanya; Wolke, Dieter

    2013-01-01

    Background: Prenatal stress has been shown to predict persistent behavioural abnormalities in offspring. Unknown is whether prenatal stress makes children more vulnerable to peer victimisation. Methods: The current study is based on the Avon Longitudinal Study of Parents and Children, a prospective community-based study. Family adversity, maternal…

  4. Physical Performance Characteristics of Assisted Living Residents and Risk for Adverse Health Outcomes

    Science.gov (United States)

    Giuliani, Carol A.; Gruber-Baldini, Ann L.; Park, Nan S.; Schrodt, Lori A.; Rokoske, Franzi; Sloane, Philip D.; Zimmerman, Sheryl

    2008-01-01

    Purpose: Researchers know little about the physical performance ability of residential care/assisted living (RC/AL) residents and its relationship to adverse outcomes such as fracture, nursing home placement, functional decline, and death. The purposes of this article are to (a) describe the functional characteristics of RC/AL residents, (b)…

  5. How good is the Prevent model for estimating the health benefits of prevention?

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik

    1999-01-01

    Prevent is a public health model for estimating the effect on mortality of changes in exposure to risk factors. When the model is tested by simulating a development that has already taken place, the results may differ considerably from the actual situation. The purpose of this study is to test...... the Prevent model by applying it to a synthetic cohort in which the development is unaffected by concealed factors....

  6. WindVOiCe, a Self-Reporting Survey: Adverse Health Effects, Industrial Wind Turbines, and the Need for Vigilance Monitoring

    Science.gov (United States)

    Krogh, Carmen M. E.; Gillis, Lorrie; Kouwen, Nicholas; Aramini, Jeff

    2011-01-01

    Industrial wind turbines have been operating in many parts of the globe. Anecdotal reports of perceived adverse health effects relating to industrial wind turbines have been published in the media and on the Internet. Based on these reports, indications were that some residents perceived they were experiencing adverse health effects. The purpose…

  7. Designing an Adverse Drug Event Reporting System to Prevent Unintentional Reexposures to Harmful Drugs: Study Protocol for a Multiple Methods Design.

    Science.gov (United States)

    Peddie, David; Small, Serena S; Badke, Katherin; Wickham, Maeve E; Bailey, Chantelle; Chruscicki, Adam; Ackerley, Christine; Balka, Ellen; Hohl, Corinne M

    2016-08-18

    Adverse drug events (ADEs) are unintended and harmful events related to medication use. Up to 30% of serious ADEs recur within six months because culprit drugs are unintentionally represcribed and redispensed. Improving the electronic communication of ADE information between care providers, and across care settings, has the potential to reduce recurrent ADEs. We aim to describe the methods used to design Action ADE, a novel electronic ADE reporting system that can be leveraged to prevent unintentional reexposures to harmful drugs in British Columbia, Canada. To develop the new system, our team will use action research and participatory design, approaches that employ social scientific research methods and practitioner participation to generate insights into work settings and problem resolution. We will develop a systematic search strategy to review existing ADE reporting systems identified in academic and grey literature, and analyze the content of these systems to identify core data fields used to communicate ADE information. We will observe care providers in the emergency departments and on the wards of two urban tertiary hospitals and one urban community hospital, in one rural ambulatory care center, and in three community pharmacies in British Columbia, Canada. We will also conduct participatory workshops with providers to understand their needs and priorities related to communicating ADEs and preventing erroneous represcribing or redispensing of culprit medications. These methods will inform the iterative development of a preliminary paper-based reporting form, which we will then pilot test with providers in a real-world setting. This is an ongoing project with results being published as analyses are completed. The systematic review has been completed; field observations, focus groups, and pilot testing of a preliminary paper-based design are ongoing. Results will inform the development of software that will enable clinically useful user-friendly documentation

  8. Unintended adverse consequences of electronic health record introduction to a mature universal HIV screening program.

    Science.gov (United States)

    Medford-Davis, Laura N; Yang, Katharine; Pasalar, Siavash; Pillow, M Tyson; Miertschin, Nancy P; Peacock, William F; Giordano, Thomas P; Hoxhaj, Shkelzen

    2016-01-01

    Early HIV detection and treatment decreases morbidity and mortality and reduces high-risk behaviors. Many Emergency Departments (EDs) have HIV screening programs as recommended by the Centers for Disease Control and Prevention. Recent federal legislation includes incentives for electronic health record (EHR) adoption. Our objective was to analyze the impact of conversion to EHR on a mature ED-based HIV screening program. A retrospective pre- and post-EHR implementation cohort study was conducted in a large urban, academic ED. Medical records were reviewed for HIV screening rates from August 2008 through October 2013. On 1 November 2010, a comprehensive EHR system was implemented throughout the hospital. Before EHR implementation, labs were requested by providers by paper orders with HIV-1/2 automatically pre-selected on every form. This universal ordering protocol was not duplicated in the new EHR; rather it required a provider to manually enter the order. Using a chi-squared test, we compared HIV testing in the 6 months before and after EHR implementation; 55,054 patients presented before, and 50,576 after EHR implementation. Age, sex, race, acuity of presenting condition, and HIV seropositivity rates were similar pre- and post-EHR, and there were no major patient or provider changes during this period. Average HIV testing rate was 37.7% of all ED patients pre-, and 22.3% post-EHR, a 41% decline (p < 0.0001), leading to 167 missed new diagnoses after EHR. The rate of HIV screening in the ED decreased after EHR implementation, and could have been improved with more thoughtful inclusion of existing human processes in its design.

  9. Energy drink consumption in Europe: A review of the risks, adverse health effects and policy options to respond

    Directory of Open Access Journals (Sweden)

    João Joaquim Breda

    2014-10-01

    Full Text Available With the worldwide consumption of energy drinks increasing in recent years, concerns have been raised both in the scientific community and among the general public about the health effects of these products. Recent studies provide data on consumption patterns in Europe however more research is needed to determine the potential for adverse health effects related to the increasing consumption of energy drinks, particularly among young people. A review of the literature was conducted to identify published articles that examined the health risks, consequences and policies related to energy drink consumption. The health risks associated with energy drink consumption are primarily related to their caffeine content, but more research is needed that evaluates the long term effects of consuming common energy drink ingredients. The evidence indicating adverse health effects due to the consumption of energy drinks with alcohol is growing. The risks of heavy consumption of energy drinks among young people have largely gone unaddressed and are poised to become a significant public health problem in the future.

  10. Energy Drink Consumption in Europe: A Review of the Risks, Adverse Health Effects, and Policy Options to Respond

    Science.gov (United States)

    Breda, João Joaquim; Whiting, Stephen Hugh; Encarnação, Ricardo; Norberg, Stina; Jones, Rebecca; Reinap, Marge; Jewell, Jo

    2014-01-01

    With the worldwide consumption of energy drinks increasing in recent years, concerns have been raised both in the scientific community and among the general public about the health effects of these products. Recent studies provide data on consumption patterns in Europe; however, more research is needed to determine the potential for adverse health effects related to the increasing consumption of energy drinks, particularly among young people. A review of the literature was conducted to identify published articles that examined the health risks, consequences, and policies related to energy drink consumption. The health risks associated with energy drink consumption are primarily related to their caffeine content, but more research is needed that evaluates the long-term effects of consuming common energy drink ingredients. The evidence indicating adverse health effects due to the consumption of energy drinks with alcohol is growing. The risks of heavy consumption of energy drinks among young people have largely gone unaddressed and are poised to become a significant public health problem in the future. PMID:25360435

  11. Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.

    Science.gov (United States)

    Le Pogam, Marie-Annick; Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

    2017-05-11

    Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide. Anticoagulant-related adverse events and the quality of anticoagulation management should thus be routinely assessed to improve patient safety in vulnerable older inpatients. This project aims to develop and validate a set of outcome and process indicators based on linked administrative health data (ie, insurance claims data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients. GPSIs will measure cumulative incidences of thromboembolic and bleeding adverse events based on hospital discharge data linked to insurance claims data. Using linked administrative health data will improve GPSI risk adjustment on patients' conditions that are present at admission and will capture in-hospital and postdischarge adverse events. GQIs will estimate the proportion of index hospital stays resulting in recommended anticoagulation at discharge and up to various time frames based on the same electronic health data. The GPSI and GQI development and validation process will comprise 6 stages: (1) selection and specification of candidate indicators, (2) definition of administrative data

  12. Sources of patients' knowledge of the adverse effects of psychotropic medication and the perceived influence of adverse effects on compliance among service users attending community mental health services.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2009-12-01

    Noncompliance with medication has been a complex issue with patients with severe mental illness during the last few decades, and adverse effects of medication have been identified as a major contributor to noncompliance.

  13. Knowledge, practice and approaches of health professionals to adverse events following immunization and their reporting in Albania

    Directory of Open Access Journals (Sweden)

    Irsida Mehmeti

    2017-06-01

    Full Text Available In Albania, the reporting of an adverse events following immunization (AEFI is done not only by immunization providers but also from clinicians providing clinical treatment of AEFI in health posts, health centers and private or public hospitals. The AEFI reporting system in Albania has started in 2001 with the establishment of National Regulatory Authority of Vaccines in the Institute of Public Health. The most important problems of passive surveillance systems include underreporting, deficiency and inaccuracy of information. A structured questionnaire containing 68 questions constructed from immunization experts constituted the study tool. The questionnaire addressed health professionals working at child consultant’s facilities and primary health centers in the district of Tirana. There were a total of 102 health professional interviewed. The majority of the respondents working at health centers in the district of Tirana in general, had poor knowledge levels on AEFI surveillance. The lowest score were received in knowledge about the role of different stakeholders involved in AEFI surveillance. The number of years practicing the profession did not influence in the total score of “practice and attitude toward reporting and managing an AEFI”. Although the majority of health care professionals have encountered an AEFI during their practice (72/102, 70,5%, only half of them have never reported an AEFI (37/102, 36,2%. Barriers to reporting included lack of interest, unclear definition of AEFI and lack of awareness of what to report. Nevertheless, the main reason for not reporting was because a respondent thought he or she had not observed an AEFI in the last years (44,1%. Majority of the respondents did not have any training about AEFI (68,6%, 70/102. From this study it is concluded that it is necessary to develop training and educational programs in order to increase awareness of all health professionals involved in child health toward

  14. Health Literacy: Cancer Prevention Strategies for Early Adults.

    Science.gov (United States)

    Simmons, Robert A; Cosgrove, Susan C; Romney, Martha C; Plumb, James D; Brawer, Rickie O; Gonzalez, Evelyn T; Fleisher, Linda G; Moore, Bradley S

    2017-09-01

    Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Basic webliography on health promotion and disease prevention

    Directory of Open Access Journals (Sweden)

    Mario Ferreira Junior

    2009-12-01

    Full Text Available Objectives: To introduce a basic webliography to access highly qualified evidence-based material on health promotion and disease prevention, aiming at the continuing education of health professionals. Methods: By means of Google® browser, applying the descriptors in sequence to progressively refine the search on Internet and key concepts to be learned, all previously defined by the authors themselves, we proceeded a qualitative analyses of the 20 first listed links for each searched issue and the final selection of the most scientifically relevant ones. Results: The 34 selected links are presented in 4 groups: 23 portals, 5 guides and recommendations, 4 scientific journals and 3 blogs that allow free access to health promotion and disease prevention related subjects, such as: concepts; national and international public policies; epidemiology, statistics and health indicators; diseases screening and prophylaxis; counseling for behavior change of health related habits; and interdisciplinary work. Among the selected links 10 (29% are written in English while the others are in Portuguese. Conclusions: The identification of reading materials on health promotion and disease prevention available on Internet, many in Portuguese, allowed us toselect relevant scientifically qualified literature and turn it accessible to health professionals, enabling the acquisition of new knowledge or quick update.

  16. Quinolone antibiotics and suicidal behavior: analysis of the World Health Organization's adverse drug reactions database and discussion of potential mechanisms.

    Science.gov (United States)

    Samyde, Julie; Petit, Pierre; Hillaire-Buys, Dominique; Faillie, Jean-Luc

    2016-07-01

    Several case-reports suggest that the use of quinolones may increase the risk of psychiatric adverse reactions such as suicidal behaviors. The aim of this study is to investigate whether there is a safety signal for quinolone-related suicidal behaviors in a global adverse drug reactions database. All antibiotic-related adverse reactions were extracted from VigiBase, the World Health Organization (WHO) global Individual Case Safety Report (ICSR) database. Disproportionality analyses were performed to investigate the association between reports of suicidal behavior and exposure to quinolones, in comparison with other antibiotics. From December 1970 through January 2015, we identified 992,097 antibiotic-related adverse reactions. Among them, 608 were quinolone-related suicidal behaviors including 97 cases of completed suicides. There was increased reporting of suicidal behavior (adjusted reporting odds ratios [ROR] 2.78, 95 % CI 2.51-3.08) with quinolones as compared to other antibiotics. Candidate mechanisms for quinolone-induced suicidal behaviors include GABAA antagonism, activation of NMDA receptors, decreased serotonin levels, oxidative stress, and altered microRNA expressions. We found a strong safety signal suggesting an increased risk of suicidal behaviors associated with quinolone use. Plausible psychopharmacological mechanisms could underlie this association. Further investigations are urgent to confirm and better understand these findings.

  17. A research framework for pharmacovigilance in health social media: Identification and evaluation of patient adverse drug event reports.

    Science.gov (United States)

    Liu, Xiao; Chen, Hsinchun

    2015-12-01

    Social media offer insights of patients' medical problems such as drug side effects and treatment failures. Patient reports of adverse drug events from social media have great potential to improve current practice of pharmacovigilance. However, extracting patient adverse drug event reports from social media continues to be an important challenge for health informatics research. In this study, we develop a research framework with advanced natural language processing techniques for integrated and high-performance patient reported adverse drug event extraction. The framework consists of medical entity extraction for recognizing patient discussions of drug and events, adverse drug event extraction with shortest dependency path kernel based statistical learning method and semantic filtering with information from medical knowledge bases, and report source classification to tease out noise. To evaluate the proposed framework, a series of experiments were conducted on a test bed encompassing about postings from major diabetes and heart disease forums in the United States. The results reveal that each component of the framework significantly contributes to its overall effectiveness. Our framework significantly outperforms prior work. Published by Elsevier Inc.

  18. Gender inequality, economic growth, and the intergenerational transmission of adverse health consequences at birth.

    Science.gov (United States)

    Qian, Mengcen; Chou, Shin-Yi; Deily, Mary E; Liu, Jin-Tan

    2018-01-31

    We estimate a gender differential in the intergenerational transmission of adverse birth outcomes. We link Taiwan birth certificates from 1978 to 2006 to create a sample of children born in the period 1999-2006 that includes information about their parents and their maternal grandmothers. We use maternal-sibling fixed effects to control for unobserved family-linked factors that may be correlated with birth outcomes across generations, and define adverse birth outcomes as small for gestational age. We find that when a mother is in the 5th percentile of birth weight for her gestational age, then her female children are 49-53% more likely to experience the same adverse birth outcome compared to other female children, while her male children are 27-32% more likely to experience this relative to other male children. We then investigate whether long-run improvements in local socio-economic conditions experienced by the child's family, as measured by intergenerational changes in town-level maternal education, affect the gender differential. We find no evidence that intergenerational improvements in socioeconomic conditions reduce the gender differential. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Health care providers' missed opportunities for preventing femicide.

    Science.gov (United States)

    Sharps, P W; Koziol-McLain, J; Campbell, J; McFarlane, J; Sachs, C; Xu, X

    2001-11-01

    Homicide of women (femicide) by intimate partners is the most serious form of violence against women. The purpose of this analysis of a larger multisite study was to describe health care use in the year prior to murder of women by their intimate partner in order to identify opportunities for intervention to prevent femicide. A sample of femicide cases was identified from police or medical examiner records. Participants (n = 311) were proxy informants (most often female family members) of victims of intimate partner femicide from 11 U.S. cities. Information about prior domestic abuse and use of health care and other helping agencies for victims and perpetrators was obtained during structured telephone interviews. Most victims had been abused by their partners (66%) and had used health care agencies for either injury or physical or mental health problems (41%). Among women who had been pregnant during the relationship, 23% were beaten by partners during pregnancy. Among perpetrators with fair or poor physical health, 53% had contact with physicians and 15% with fair or poor mental health had seen a doctor about their mental health problem. Among perpetrators with substance problems, 5.4% had used alcohol treatment programs and 5.7% had used drug treatment programs. Frequent contacts with helping agencies by victims and perpetrators represent opportunities for the prevention of femicide by health care providers. Copyright 2001 American Health Foundation and Academic Press.

  20. [[How to Prevent Emotional Burnout Syndrome in Health Professionals?].

    Science.gov (United States)

    Elfimova, E V; Elfimov, M A; Berezkin, A S

    2016-01-01

    Working in conditions of physical and psychological overload, occupational hazard makes health workers vulnerable to the development of burnout syndrome. Currently, 67.6% of physicians in Russia suffer from emotional burnout syndrome. This syndrome is characterized by a certain symptoms, which have their predictors. Prevention and treatment of emotional burnout syndrome - a complex problem that can be solved with the participation of heads of medical institutions, full- time psychologists and psychotherapists with the direct involvement of health professionals.

  1. Prevention and early diagnostic of health insult at welding works

    OpenAIRE

    Motejlková, Kateřina

    2010-01-01

    The work is dealing with problems of safety aspects of welding in conjunction with connected preventive provisions. The work seeks to outline complex problem particularly by integration of information from obtainable sources dealing with only alone part of the wide range topic. From technological point of view there are briefly described different welding processes with their summary of health hazards referring to welding. It contains provisions relation impeding health during welding activit...

  2. Adverse childhood experiences and association with health, mental health, and risky behavior in the kingdom of Saudi Arabia.

    Science.gov (United States)

    Almuneef, Maha; Hollinshead, Dana; Saleheen, Hassan; AlMadani, Sereen; Derkash, Bridget; AlBuhairan, Fadia; Al-Eissa, Majid; Fluke, John

    2016-10-01

    The aim of this study is to determine if ACEs impact the health and risk behavior burden among Kingdom of Saudi Arabia (KSA) adults. In 2013, a cross-sectional study was conducted across KSA to identify the retrospective prevalence of ACEs and their association with high risk behaviors and chronic diseases. Surveys from 10,156 adults in all 13 Saudi regions were obtained using an Arabic version of the WHO ACE-IQ (KSA ACE-IQ). Compared to respondents reporting no ACEs, even just one ACE contributed significantly to the odds of experiencing diabetes mellitus (OR=1.3), depression (OR=1.32), or anxiety (OR=1.79) outcomes. Two ACEs were necessary for statistically significant, higher odds to emerge for hypertension (OR=1.46), mental illness (OR=1.93), smoking (OR=1.17), alcohol use (OR=1.75), and drug use (OR=1.45). Respondents who reported four or more ACEs had greater odds of coronary heart disease (OR=1.94), and obesity (OR=2.25). Compared to those reporting no ACEs, respondents reporting four or more ACEs had over four times the odds of Alcohol or Drug Use, Mental Illness, Depression, and/or Anxiety outcomes and more than twice the odds of diabetes, hypertension, obesity, and/or smoking outcomes. Findings from this analysis underscore the potential benefit of providing focused preventative approaches to mitigating ACEs in KSA in relation to both the specific and cumulative burden of health and risky behavior outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Periodontal health status, oral mucosal lesions and adverse oral habits among sea food industry employees of Bhubaneswar, Odisha

    Directory of Open Access Journals (Sweden)

    Gunjan Kumar

    2016-01-01

    Full Text Available Introduction: Industrial employees are often readily available and constitute a well-defined population group although not representing nationwide samples. Aim: To assess the periodontal status, prevalence of oral mucosal lesions, and adverse oral habits among seafood industry employees of Bhubaneswar. Materials and Methods: A cross-sectional descriptive survey was conducted among 21–60 years old 790 seafood industry employees. The questionnaire was designed to record demographic details, routine oral hygiene habits, adverse oral habits, community periodontal index, and prevalence of oral mucosal lesions. One-way analysis of variance and t-test analysis were used. Results: The majority of the subjects (72.6% used toothbrush and toothpaste to clean their teeth. Smoking and pan chewing was recorded among 130 (16.5% and 188 (23.8% subjects, respectively. The prevalence of periodontal disease was 86.1% among the study population. The prevalence of calculus among the age group 39–48 years was statistically significant across the age groups. Females as compared to males had lower attachment loss levels. About 56 (7% subjects had leukoplakia and 7 (0.8% subjects had acute necrotizing gingivitis. Conclusions: The findings of this study provided an insight into the periodontal health status, adverse oral habits, routine oral hygiene practices, and the prevalence of oral mucosal lesions of sea food industry employees, which may be useful in designing and planning oral health promotion programs.

  4. How good is the Prevent model for estimating the health benefits of prevention?

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik

    1999-01-01

    Prevent is a public health model for estimating the effect on mortality of changes in exposure to risk factors. When the model is tested by simulating a development that has already taken place, the results may differ considerably from the actual situation. The purpose of this study is to test...

  5. Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population.

    Science.gov (United States)

    Wade, Roy; Cronholm, Peter F; Fein, Joel A; Forke, Christine M; Davis, Martha B; Harkins-Schwarz, Mary; Pachter, Lee M; Bair-Merritt, Megan H

    2016-02-01

    Adverse Childhood Experiences (ACEs), which include family dysfunction and community-level stressors, negatively impact the health and well being of children throughout the life course. While several studies have examined the impact of these childhood exposures amongst racially and socially diverse populations, the contribution of ACEs in the persistence of socioeconomic disparities in health is poorly understood. To determine the association between ACEs and health outcomes amongst a sample of adults living in Philadelphia and examine the moderating effect of Socioeconomic Status (SES) on this association, we conducted a cross-sectional survey of 1,784 Philadelphia adults, ages 18 and older, using random digit dialing methodology to assess Conventional ACEs (experiences related to family dysfunction), Expanded ACEs (community-level stressors), and health outcomes. Using weighted, multivariable logistic regression analyses along with SES stratified models, we examined the relationship between ACEs and health outcomes as well as the modifying effect of current SES. High Conventional ACE scores were significantly associated with health risk behaviors, physical and mental illness, while elevated Expanded ACE scores were associated only with substance abuse history and sexually transmitted infections. ACEs did have some differential impacts on health outcomes based on SES. Given the robust impact of Conventional ACEs on health, our results support prior research highlighting the primacy of family relationships on a child's life course trajectory and the importance of interventions designed to support families. Our findings related to the modifying effect of SES may provide additional insight into the complex relationship between poverty and childhood adversity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes.

    Science.gov (United States)

    Conway, Sadie H; Pompeii, Lisa A; Gimeno Ruiz de Porras, David; Follis, Jack L; Roberts, Robert E

    2017-07-15

    Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Preventing crime in cooperation with the mental health care profession

    NARCIS (Netherlands)

    Harte, J.M.

    2015-01-01

    Although major mental disorders do not have a central position in many criminological theories, there seems to be an evident relationship between these disorders and criminal behavior. In daily practice police officers and mental health care workers work jointly to prevent nuisance and crime and to

  8. Stomach (Gastric) Cancer Prevention (PDQ®)—Health Professional Version

    Science.gov (United States)

    Risk factors for stomach (gastric) cancer include certain health conditions (e.g., atrophic gastritis, pernicious anemia, H. pylori infection), genetic factors (e.g., Li-Fraumeni syndrome), or environmental factors (e.g., diet, smoking). Review the evidence on these and other risk factors and interventions to prevent stomach cancer in this expert-reviewed summary.

  9. Health Promotion/Disease Prevention Programs for Special Population Groups.

    Science.gov (United States)

    Selker, Leopold; And Others

    1986-01-01

    This article addresses the concept of "special needs" as it applies to health promotion and disease prevention. The three sections of this article deal with three special subgroups of the general population: the elderly, those with disabilities, and those with cultural heritages that are not the same as the majority population's. (Author/CT)

  10. Compliance With Infection Prevention Guidelines By Health Care ...

    African Journals Online (AJOL)

    Objective: To determine the level of health-care workers' compliance with Infection Prevention Guidelines and identify factors that influence compliance at Ronald Ross General Hospital, Mufulira District. Methods: A quantitative study was carried out in 2007. Convenient sampling method was used. Data was obtained using ...

  11. Viewpoint: Prevention is missing: is China's health reform reform for health?

    Science.gov (United States)

    Yang, Le; Zhang, Xiaoli; Tan, Tengfei; Cheng, Jingmin

    2015-02-01

    Ancient China emphasized disease prevention. As a Chinese saying goes, 'it is more important to prevent the disease than to cure it'. Traditional Chinese medicine posits that diseases can be understood, thus, prevented. In today's China, the state of people's health seems worse than in the past. Thus the Chinese government undertook the creation of a new health system. Alas, we believe the results are not very satisfactory. The government seems to have overlooked rational allocation between resources for treatment and prevention. Public investment has been gradually limited to the domain of treatment. We respond to this trend, highlighting the importance of prevention and call for government and policymakers to adjust health policy and work out a solution suitable for improving the health of China's people.

  12. Suicide Prevention Referrals in a Mobile Health Smoking Cessation Intervention.

    Science.gov (United States)

    Christofferson, Dana E; Hamlett-Berry, Kim; Augustson, Erik

    2015-08-01

    Automated mobile health (mHealth) programs deliver effective smoking cessation interventions through text message platforms. Smoking is an independent risk factor for suicide, so the Department of Veterans Affairs incorporated information about the Veterans Crisis Line into its SmokefreeVET smoking cessation text messaging program. Almost 7% of all SmokefreeVET enrollees have accessed this information. Because of the reach and automated nature of this and similar programs, we recommend including a referral to a suicide prevention hotline for all smoking cessation mHealth interventions.

  13. Towards Health in All Policies for Childhood Obesity Prevention

    Directory of Open Access Journals (Sweden)

    Anna-Marie Hendriks

    2013-01-01

    Full Text Available The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

  14. Preventing Criminal Recidivism Through Mental Health and Criminal Justice Collaboration.

    Science.gov (United States)

    Lamberti, J Steven

    2016-11-01

    Criminal justice system involvement is common among persons with serious mental illness in community treatment settings. Various intervention strategies are used to prevent criminal recidivism among justice-involved individuals, including mental health courts, specialty probation, and conditional release programs. Despite differences in these approaches, most involve the use of legal leverage to promote treatment adherence. Evidence supporting the effectiveness of leverage-based interventions at preventing criminal recidivism is mixed, however, with some studies suggesting that involving criminal justice authorities in mental health treatment can increase recidivism rates. The effectiveness of interventions that utilize legal leverage is likely to depend on several factors, including the ability of mental health and criminal justice staff to work together. Collaboration is widely acknowledged as essential in managing justice-involved individuals, yet fundamental differences in goals, values, and methods exist between mental health and criminal justice professionals. This article presents a six-step conceptual framework for optimal mental health-criminal justice collaboration to prevent criminal recidivism among individuals with serious mental illness who are under criminal justice supervision in the community. Combining best practices from each field, the stepwise process includes engagement, assessment, planning and treatment, monitoring, problem solving, and transition. Rationale and opportunities for collaboration at each step are discussed.

  15. The role of health centers in preventive care provision

    Directory of Open Access Journals (Sweden)

    Shemetova G.N.

    2017-12-01

    Full Text Available Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68 and health cards (form025-CZ/y of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.

  16. Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data.

    Science.gov (United States)

    Romero, Roberto; Conde-Agudelo, Agustin; Da Fonseca, Eduardo; O'Brien, John M; Cetingoz, Elcin; Creasy, George W; Hassan, Sonia S; Nicolaides, Kypros H

    2018-02-01

    The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. We searched MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017); Cochrane databases; bibliographies; and conference proceedings for randomized controlled trials comparing vaginal progesterone vs placebo/no treatment in women with a singleton gestation and a midtrimester sonographic cervical length ≤25 mm. This was a systematic review and meta-analysis of individual patient data. The primary outcome was preterm birth preterm birth preterm birth preterm birth preterm birth and improves perinatal outcomes in singleton gestations with a midtrimester sonographic short cervix, without any demonstrable deleterious effects on childhood neurodevelopment. Published by Elsevier Inc.

  17. Human resources needed to affter health prevention and promotion to adults in primary health care.

    Directory of Open Access Journals (Sweden)

    Jacqueline Elizabeth Alcalde-Rabanal

    2013-05-01

    Full Text Available Objective. To estimate human resources (HR needed to deliver prevention and health promotion actions to the population of 20 years and more in units of primary health care (UPHC. Materials and methods. We included 20 UPHC; one urban and one rural for each of the ten selected Mexican states. HR were estimated based on the time to do prevention and health promotion activities, from which a budget was calculated. Measures of central tendency and dispersion were reported, using the ANOVA test and the Wilcoxon test. Results. The number of health professionals estimated in UPHC with spent time is less than the number estimated with required time. Conclusions. The estimated density of health professionals per population needed to offer prevention and health promotion activities for people 20 years and more in UPHC is greater than the current density of health professionals.

  18. Prevention of adverse events of interferon γ gene therapy by gene delivery of interferon γ-heparin-binding domain fusion protein in mice

    Directory of Open Access Journals (Sweden)

    Mitsuru Ando

    2014-01-01

    Full Text Available Sustained gene delivery of interferon (IFN γ can be an effective treatment, but our previous study showed high levels of IFNγ-induced adverse events, including the loss of body weight. These unwanted events could be reduced by target-specific delivery of IFNγ after in vivo gene transfer. To achieve this, we selected the heparin-binding domain (HBD of extracellular superoxide dismutase as a molecule to anchor IFNγ to the cell surface. We designed three IFNγ derivatives, IFNγ-HBD1, IFNγ-HBD2, and IFNγ-HBD3, each of which had 1, 2, or 3 HBDs, respectively. Each plasmid-encoding fusion proteins was delivered to the liver, a model target in this study, by hydrodynamic tail vein injection. The serum concentration of IFNγ-HBD2 and IFNγ-HBD3 after gene delivery was lower than that of IFNγ or IFNγ-HBD1. Gene delivery of IFNγ-HBD2, but not of IFNγ-HBD3, effectively increased the mRNA expression of IFNγ-inducible genes in the liver, suggesting liver-specific distribution of IFNγ-HBD2. Gene delivery of IFNγ-HBD2-suppressed tumor growth in the liver as efficiently as that of IFNγ with much less symptoms of adverse effects. These results indicate that the adverse events of IFNγ gene transfer can be prevented by gene delivery of IFNγ-HBD2, a fusion protein with high cell surface affinity.

  19. Public Health Nurses' Activities for Suicide Prevention in Japan.

    Science.gov (United States)

    Marutani, Miki; Yamamoto-Mitani, Noriko; Kodama, Shimpei

    2016-07-01

    Suicide is a major health issue worldwide, including in Japan. Japanese public health nurses (PHNs) play a distinctive role in suicide prevention, although few studies have delineated this role. The purpose of this study was to develop a conceptual framework that elucidates PHNs' activities for suicide prevention. Semi-structured interviews were conducted in 2012-2013 with 15 PHNs who worked in Tokyo metropolitan regions. Data were analyzed qualitatively using grounded theory, and a conceptual framework with seven categories was developed. Three phases that depict the PHNs' suicide prevention activities emerged. Phase I, Pursuing to understand suicide cases, included two categories: tracing back individual suicide cases and raising consciousness among the general public. Phase II, Spreading a web of care, included three categories: knitting a caring network, weaving regular programs into the web, and continuing to be a member of the web. Phase III, Maintaining motivation and commitment, included two categories: legitimatizing suicide prevention and cultivating continued commitment in the community. The activities of suicide prevention by PHNs included a process of developing a caring network that lead to the enhancement of the caring capacity of the community as a whole. © 2016 Wiley Periodicals, Inc.

  20. University Health Center Providers' Beliefs about Discussing and Recommending Sexual Health Prevention to Women College Students

    Science.gov (United States)

    Jozkowski, Kristen N.; Geshnizjani, Alireza; Middlestadt, Susan E.

    2013-01-01

    Sexual health concerns such as sexually transmitted infections and unintended pregnancy remain substantial health problems faced by young adults, especially college women. University healthcare providers may be instrumental in increasing female patients' involvement in preventative sexual health behaviors, however little research has examined this…

  1. Toward Teen Health. The Ounce of Prevention Fund School-Based Adolescent Health Centers.

    Science.gov (United States)

    Stone, Rebecca

    Sponsored by the Ounce of Prevention Fund, this report presents a comprehensive look at three Toward Teen Health high school-based, adolescent health centers in Chicago, Illinois. Following a brief introduction, the report provides the rationale for opening adolescent health centers and outlines the principles that guide the centers. Next, a…

  2. Obesity Prevention: The Impact of Local Health Departments

    Science.gov (United States)

    Chen, Zhuo (Adam); Roy, Kakoli; Gotway Crawford, Carol A

    2013-01-01

    Objective To examine the association between bodyweight status and provision of population-based prevention services. Data Sources The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2004 and 2005. Study Design Multilevel logistic regressions were used to examine the association between provision of obesity-prevention services and the change in risk of being obese or morbidly obese among BRFSS respondents. The estimation sample was stratified by sex. Low-income samples were also examined. Falsification tests were used to determine whether there is counterevidence. Principal Findings Provision of population-based obesity-prevention services within the jurisdiction of local health departments and specifically those provided by the local health departments are associated with reduced risks of obesity and morbid obesity from 2004 to 2005. The magnitude of the association appears to be stronger among low-income populations and among women. Results of the falsification tests provide additional support of the main findings. Conclusions Population-based obesity-prevention services may be useful in containing the obesity epidemic. PMID:22816510

  3. Does the recent intensification of nationalistic and xenophobic attitudes in Eastern European countries adversely affect public mental health?

    Science.gov (United States)

    Brodziak, Andrzej; Różyk-Myrta, Alicja; Wolińska, Agnieszka

    2016-10-24

    The authors postulate that the recent intensification of the nationalist and xenophobic attitude in Poland and other Eastern European countries is detrimental to public mental health. The xenophobic attitude is accompanied by a higher incidence of anxiety and depression, disputes due to the polarization of opinions, a sense of embarrassment and a sense of contradictions with so-called Christian values, unfavorable demographic predictions and reduced life satisfaction. The authors attempt to describe the sequence of adverse events that led to the intensification of xenophobia and characterize the current state of public mental health in European countries. They formulate and propose possible actions which could counteract the consequences of that transformation. The actions which may be undertaken to counteract the deterioration of public mental health can be based on the recommendations of so-called 'positive psychology' and 'positive psychiatry' as well as the principles of strengthening local social capital.

  4. Celebrity Health Announcements and Online Health Information Seeking: An Analysis of Angelina Jolie's Preventative Health Decision.

    Science.gov (United States)

    Dean, Marleah

    2016-01-01

    On May 14, 2013, Angelina Jolie disclosed she carries BRCA1, which means she has an 87% risk of developing breast cancer during her lifetime. Jolie decided to undergo a preventative bilateral mastectomy (PBM), reducing her risk to 5%. The purpose of this study was to analyze the type of information individuals are exposed to when using the Internet to search health information regarding Jolie's decision. Qualitative content analysis revealed four main themes--information about genetics, information about a PBM, information about health care, and information about Jolie's gender identity. Broadly, the identified websites mention Jolie's high risk for developing cancer due to the genetic mutation BRCA1, describe a PBM occasionally noting reasons why she had this surgery and providing alternatives to the surgery, discuss issues related to health care services, costs, and insurances about Jolie's health decision, and portray Jolie as a sexual icon, a partner to Brad Pitt, a mother of six children, and an inspirational humanitarian. The websites also depict Jolie's health decision in positive, negative, and/or both ways. Discussion centers on how this actress' health decision impacts the public.

  5. Adverse Effects of Carbetocin versus Oxytocin in the Prevention of Postpartum Haemorrhage after Caesarean Section: A Randomized Controlled Trial

    OpenAIRE

    D. Mannaerts; L. Van der Veeken; H. Coppejans; Y. Jacquemyn

    2018-01-01

    Purpose. To compare the incidence of nausea, vomiting, and arterial hypotension between carbetocin and oxytocin to prevent haemorrhage after caesarean section (CS). Methods. A randomized controlled trial in term pregnant women undergoing planned CS. Groups were randomized to carbetocin or oxytocin. Blood pressure (BP), heart rate, presence of nausea/vomitus, and need for vasopressors were evaluated throughout surgery. Preoperative and postoperative haemoglobin and haematocrit levels were comp...

  6. Practitioners' forum: public health and the primary prevention of adolescent violence--the violence prevention project.

    Science.gov (United States)

    Spivak, H; Hausman, A J; Prothrow-Stith, D

    1989-01-01

    The Violence Prevention Project is a community-based outreach and education project directed toward reducing the negative social and medical outcomes of violence among adolescents. Community agency personnel are trained to work with youth on issues of anger and conflict resolution. A mass media campaign advertises the issue to the broader population. Interventions, such as the Violence Prevention Project, can use the public health strategies to increase awareness of the problem and associated risk factors, provide alternative conflict resolution techniques, and generate a new community ethos around violence. This approach holds great promise in an area in which after-the-fact legislative and punitive interventions have not worked.

  7. Oral health information systems--towards measuring progress in oral health promotion and disease prevention

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas

    2005-01-01

    programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers...... systems are being developed within the framework of the WHO STEPwise approach to surveillance of noncommunicable, chronic disease, and data stored in the WHO Global InfoBase may allow advanced health systems research. Sound knowledge about progress made in prevention of oral and chronic disease......This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has...

  8. Local heat stroke prevention plans in Japan: characteristics and elements for public health adaptation to climate change.

    Science.gov (United States)

    Martinez, Gerardo Sanchez; Imai, Chisato; Masumo, Kanako

    2011-12-01

    The adverse health effects from hot weather and heat waves represent significant public health risks in vulnerable areas worldwide. Rising temperatures due to climate change are aggravating these risks in a context of fast urbanization, population growth and societal ageing. However, environmental heat-related health effects are largely preventable through adequate preparedness and responses. Public health adaptation to climate change will often require the implementation of heat wave warning systems and targeted preventive activities at different levels. While several national governments have established such systems at the country level, municipalities do not generally play a major role in the prevention of heat disorders. This paper analyzes selected examples of locally operated heat-health prevention plans in Japan. The analysis of these plans highlights their strengths, but also the need of local institutions for assistance to make the transition towards an effective public health management of high temperatures and heat waves. It can also provide useful elements for municipal governments in vulnerable areas, both in planning their climate change and health adaptation activities or to better protect their communities against current health effects from heat.

  9. Changing experience of adverse medical events in the National Health Service: Comparison of two population surveys in 2001 and 2013.

    Science.gov (United States)

    Gray, Alastair M; Fenn, Paul; Rickman, Neil; Vencappa, Dev

    2017-12-01

    Care quality is important to patients and providers, but is hard to measure. This study aimed to examine changes in the frequency and severity of one quality measure - adverse events associated with medical care - in Great Britain over a 12-year period when available resources initially expanded and were subsequently constrained. Data on perceived adverse events, collected from two representative population surveys in 2001 and 2013, were analysed and compared. The samples consisted of 8202 adults aged 15 and over in 2001 and 19,746 adults aged 15 and over in 2013. The main outcome measures were self-reported illness, injury or impairment caused in the opinion of the respondent by medical treatment or care. Respondents were also asked about the perceived severity of harm in terms of health and work, and any actions taken in response. The proportion of all respondents reporting that over the last three years they had suffered some illness, injury or impairment that in their opinion was caused by their medical treatment or care was 2.5% (497/19746) in 2013, compared with 4.8% (391/8202) in 2001, a reduction of 33% after adjusting for age, gender, income and social class differences between the two surveys. Perceived impact on health and work of these events was similar in both surveys, as was the proportion of injured respondents who pursued a legal claim for financial compensation, at 11% (53/497) in 2013 and 10.5% (41/391) in 2001. We also report multivariate analyses of perceived harm rates and severity, and propensity to seek, and accept, compensation. Our results suggest that the NHS became significantly safer over this period when measured by patient perceived harm from medical care. Our survey method could provide a valuable contribution to the monitoring of trends in health-care related adverse events and the impact of patient safety initiatives. Copyright © 2017. Published by Elsevier Ltd.

  10. A Cross-Cultural Longitudinal Examination of the Effect of Cumulative Adversity on the Mental and Physical Health of Older Adults

    Science.gov (United States)

    Palgi, Yuval; Shrira, Amit

    2015-01-01

    Self-oriented adversity refers to traumatic events that primarily inflict the self, whereas other-oriented adversity refers to events that affect the self by primarily targeting others. The present study aimed to examine whether cultural background moderates the effects of self-oriented and other-oriented adversity on mental and physical health of older adults. Using longitudinal data from the Israeli component of the Survey of Health and Retirement, we focused on 370 Jews and 239 Arabs who reported their exposure to various adversities across the lifespan, and completed questionnaires regarding mental and physical health. Results showed that the effect of self-oriented adversity on health did not differ among Jews and Arabs. However, other-oriented adversity showed a stronger effect on Arabs’ mental and physical health than on Jews’ health. Our findings suggest that the accumulation of adverse events that affect the self by primarily targeting others may have a stronger impact in collectivist cultures than in individualist cultures. PMID:25961862

  11. (Adverse) effects of out-of-pocket-payments in health care.

    NARCIS (Netherlands)

    Reitsma-van Rooijen, M.

    2012-01-01

    Background: Health care expenditures are rising in many countries. This might be caused by the fact that there is no direct relation between health care use and costs, since, for example, these costs have been paid by the insurance. If patients do not fully face the costs, this might lead to

  12. Triumph and adversity: Exploring the complexities of consumer storytelling in mental health nursing education.

    Science.gov (United States)

    Happell, Brenda; Bennetts, Wanda

    2016-12-01

    Consumer participation in the education of health professionals is increasing, particularly in mental health nursing education and storytelling remains the most frequent approach to consumer involvement. The use of story has tended to be accepted as a legitimate educational tool with limited critique or consideration of its potential consequences presented within the academic literature. A qualitative exploratory research study was undertaken with mental health nurse academics (n = 34) and consumer educators and academics (n = 12), to investigate the perceptions and experiences of mental health nurses and consumers regarding the involvement of consumers in mental health nursing education. Data were analysed thematically. Story was a major theme to emerge from consumer participants and received some attention from nurse academics. Consumers and nurses both referred to the power of story to convey the human experience of mental illness diagnosis and service use; and the vulnerability that can result from storytelling. Consumers also described: story as expectation; preparation and support; and the politics of story. All participants supported the value of storytelling in mental health nursing education. Consumers had considered the complexities in far greater detail. The ongoing value of story as an educational technique requires further research. Equally important is considering a broader range of educational roles for mental health consumers. © 2016 Australian College of Mental Health Nurses Inc.

  13. Building associations between markers of environmental stressors and adverse human health impacts using frequent itemset mining

    Science.gov (United States)

    Building associations between markers of exposure and effect using frequent itemset mining The human-health impact of environmental contaminant exposures is unclear. While some exposure-effect relationships are well studied, health effects are unknown for the vast majority of the...

  14. Understanding the organisational context for adverse events in the health services: the role of cultural censorship.

    Science.gov (United States)

    Hart, E; Hazelgrove, J

    2001-12-01

    This paper responds to the current emphasis on organisational learning in the NHS as a means of improving healthcare systems and making hospitals safer places for patients. Conspiracies of silence have been identified as obstacles to organisational learning, covering error and hampering communication. In this paper we question the usefulness of the term and suggest that "cultural censorship", a concept developed by the anthropologist Robin Sherriff, provides a much needed insight into cultures of silence within the NHS. Drawing on a number of illustrations, but in particular the Ritchie inquiry into the disgraced gynaecologist Rodney Ledward, we show how the defining characteristics of cultural censorship can help us to understand how adverse events get pushed underground, only to flourish in the underside of organisational life.

  15. A public health achievement under adversity: the eradication of poliomyelitis from Peru, 1991.

    Science.gov (United States)

    Sobti, Deepak; Cueto, Marcos; He, Yuan

    2014-12-01

    The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America's story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public-private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru's Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements.

  16. Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

    Science.gov (United States)

    ... Act Expands Prevention Coverage for Women’s Health and Well-Being The Affordable Care Act – the health insurance reform ... preventive services are necessary for women’s health and well-being and therefore should be considered in the development ...

  17. Differential roles of childhood adversities and stressful war experiences in the development of mental health symptoms in post-war adolescents in northern Uganda.

    Science.gov (United States)

    Okello, James; De Schryver, Maarten; Musisi, Seggane; Broekaert, Eric; Derluyn, Ilse

    2014-09-09

    Previous studies have shown a relationship between stressful war experiences and mental health symptoms in children and adolescents. To date, no comprehensive studies on the role of childhood adversities have been conducted with war-exposed adolescents living in post-war, low-resource settings in Sub-Saharan Africa. A cross-sectional study of 551 school-going adolescents aged 13-21 years old was undertaken four years post-war in northern Uganda. Participants completed self-administered questionnaires assessing demographics, stressful war experiences, childhood adversities, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Our analyses revealed a main effect of gender on all mental health outcomes except avoidance symptoms, with girls reporting higher scores than boys. Stressful war experiences were associated with all mental health symptoms, after adjusting for potential confounders. Childhood adversity was independently associated with depression symptoms but not PTSD, anxiety, and PTSD cluster symptoms. However, in situations of high childhood adversity, our analyses showed that stressful war experiences were less associated with vulnerability to avoidance symptoms than in situations of low childhood adversity. Both stressful war experiences and childhood adversities are risk factors for mental health symptoms among war-affected adolescents. Adolescents with histories of high childhood adversities may be less likely to develop avoidance symptoms in situations of high stressful war experiences. Further exploration of the differential roles of childhood adversities and stressful war experiences is needed.

  18. Upper-Extremity Function Predicts Adverse Health Outcomes among Older Adults Hospitalized for Ground-Level Falls.

    Science.gov (United States)

    Joseph, Bellal; Toosizadeh, Nima; Orouji Jokar, Tahereh; Heusser, Michelle R; Mohler, Jane; Najafi, Bijan

    2017-01-01

    Despite National Surgical Quality Improvement guidelines to integrate frailty into surgical elder assessments, a quick, accurate, and simple frailty assessment tool suitable for busy clinical settings is still not available. Recently, we have demonstrated that a simple upper-extremity function (UEF) test based on wearable sensors could identify frailty with high agreement with conventional assessments by testing 20-s repetitive elbow flexion and extension. We examined whether UEF parameters are sensitive for predicting adverse health outcomes in bedbound older adults admitted to hospital due to ground-level fall injuries. Frailty was assessed in 101 eligible older adults (age: 79 ± 9 years) admitted to a trauma setting using the UEF test at the time of admission. All participants were followed up for 2 months using phone calls and chart reviews. The measured health outcomes included (1) discharge disposition (favorable: discharge home or rehabilitation; unfavorable: discharge to skilled nursing facility or death), (2) hospital length of stay, (3) 30-day readmission, (4) 60-day readmission, and (5) 30-day prospective falls. Multivariate analyses were used to identify independent predictors of adverse health outcomes based on participants' demographic parameters (i.e., age, gender, and body mass index [BMI]) and UEF index. Based on the UEF frailty status, 53 (52%) of the participants were frail and 48 (48%) were non-frail. Among all adverse health outcomes, age was only a significant predictor of 30-day prospective falls (p = 0.023). On the other hand, the UEF index was a significant predictor of all measured outcomes except hospital length of stay (p < 0.010). Among the UEF parameters, those indicating slowness, weakness, and exhaustion had the highest effect sizes to predict an unfavorable discharge disposition (p < 0.010; effect size = 0.65-0.92). The results of this study suggest that a 20-s UEF test is practical in the trauma setting and could be used as a

  19. Post-marketing surveillance of the safety profile of iodixanol in the outpatient CT setting. A prospective, multicenter, observational study of patient risk factors, adverse reactions and preventive measures in 9953 patients

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Frank Hugo Heinz [Radiology and Nuclear Medicine Center, Ludwigshafen (Germany)

    2014-11-15

    Non-interventional study in outpatient, contrast-enhanced CT: 1. to determine the extent of preventive measures for risk reduction of adverse drug reactions after contrast-enhanced CT examinations. 2. to prospectively determine the incidence and severity of adverse drug reactions occurring after administration of the iso-osmolar contrast medium iodixanol. 3. to determine a possible influence of preventive measures on the incidence/severity of adverse drug reactions. Evaluable documentation was provided for 9953 patients from 66 radiology centers across Germany. Patient characteristics, aspects of iodixanol administration, and adverse events with an at least 'possible' relationship were documented on a standardized case report form (CRF) and were evaluated up to seven days after contrast medium administration. About 55.5% of patients showed one or more risk factors (e.g. impaired renal function 4.4%, diabetes mellitus 8.5%, hypertension 20.6%). One third of the sites did not implement any preventive measures. Patients with a known risk for an allergy-like reaction were more likely to receive pharmacologic preventive treatment (0.5-50.5%). Oral hydration was the main preventive measure in patients with renal risk factors (<8%) followed by intravenous hydration (1%). Adverse drug reactions, mainly hypersensitivity reactions, occurred in 77 patients (0.74%), but were classified as serious in only 3 patients (0.03%). No statistically significant correlation between risk factors, preventive measures, and adverse reactions could be found. The use of preventive measures for CT examinations in this outpatient setting was generally low with risk patients being pre-medicated more often, depending on their history. In the routine outpatient setting, iso-osmolar iodixanol was very well tolerated in almost 10 000 patients undergoing diagnostic CT. The rate of acute and delayed adverse reactions was low. No correlation could be found between risk factors, preventive

  20. mHealth approaches to child obesity prevention: successes, unique challenges, and next directions.

    Science.gov (United States)

    Tate, Eleanor B; Spruijt-Metz, Donna; O'Reilly, Gillian; Jordan-Marsh, Maryalice; Gotsis, Marientina; Pentz, Mary Ann; Dunton, Genevieve F

    2013-12-01

    Childhood obesity continues to be a significant public health issue. mHealth systems offer state-of-the-art approaches to intervention design, delivery, and diffusion of treatment and prevention efforts. Benefits include cost effectiveness, potential for real-time data collection, feedback capability, minimized participant burden, relevance to multiple types of populations, and increased dissemination capability. However, these advantages are coupled with unique challenges. This commentary discusses challenges with using mHealth strategies for child obesity prevention, such as lack of scientific evidence base describing effectiveness of commercially available applications; relatively slower speed of technology development in academic research settings as compared with industry; data security, and patient privacy; potentially adverse consequences of increased sedentary screen time, and decreased focused attention due to technology use. Implications for researchers include development of more nuanced measures of screen time and other technology-related activities, and partnering with industry for developing healthier technologies. Implications for health practitioners include monitoring, assessing, and providing feedback to child obesity program designers about users' data transfer issues, perceived security and privacy, sedentary behavior, focused attention, and maintenance of behavior change. Implications for policy makers include regulation of claims and quality of apps (especially those aimed at children), supporting standardized data encryption and secure open architecture, and resources for research-industry partnerships that improve the look and feel of technology. Partnerships between academia and industry may promote solutions, as discussed in this commentary.

  1. Adverse Childhood Experiences (ACEs) Study

    Science.gov (United States)

    ... Programs Press Room Social Media Publications Injury Center Adverse Childhood Experiences (ACEs) Recommend on Facebook Tweet Share ... in this area has been referred to as Adverse Childhood Experiences (ACEs). ACEs can be prevented. Learn ...

  2. Prevention and Management of Injection-Related Adverse Effects in Facial Aesthetics: Considerations for ATX-101 (Deoxycholic Acid Injection) Treatment.

    Science.gov (United States)

    Fagien, Steven; McChesney, Patricia; Subramanian, Meenakshi; Jones, Derek H

    2016-11-01

    ATX-101 (deoxycholic acid injection; Kythera Biopharmaceuticals, Inc. [an affiliate of Allergan plc, Dublin, Ireland]) was approved in 2015 in the United States (Kybella) and Canada (Belkyra) for submental fat reduction. As expected, injection-site reactions such as pain, swelling, and bruising, which were mostly mild or moderate and transient, were common adverse events (AEs) reported in clinical trials. An exploratory Phase 3b study investigating interventions for management of injection-site AEs associated with ATX-101 treatment was recently completed. Based on its results, literature review, and our clinical experiences, we have put forward considerations for management of AEs associated with ATX-101 treatment in clinical practice. Pretreatment with oral ibuprofen and/or acetaminophen an hour before treatment and preinjection with epinephrine-containing buffered lidocaine 15 minutes before treatment can help with management of pain and bruising. Cold application to the treated area before and immediately after the procedure may help to reduce pain (if local anesthetic preinjection is not performed) and swelling. Discontinuing medications/supplements that result in increased anticoagulant or antiplatelet activity 7 to 10 days before ATX-101 treatment, when possible, can reduce the risk of bruising. In summary, injection-site AEs associated with ATX-101 treatment can be effectively managed with commonly used interventions.

  3. A Review on Dapsone Hypersensitivity Syndrome Among Chinese Patients with an Emphasis on Preventing Adverse Drug Reactions with Genetic Testing.

    Science.gov (United States)

    Wang, Na; Parimi, Leela; Liu, Hong; Zhang, Furen

    2017-05-01

    AbstractDapsone is a bactericidal and bacteriostatic against Mycobacterium leprae , a causative agent of leprosy. Dapsone is also applied in a range of medical fields because of its anti-inflammatory and immunomodulatory effects. Dapsone hypersensitivity syndrome (DHS) is a rare yet serious adverse drug reaction (ADR) caused by dapsone involving multiple organs. We performed a systematic review of published articles describing dapsone-induced hypersensitivity syndrome, including all Chinese articles and the latest literature available in online databases published between October 2009 and October 2015. We determined the prevalence, clinical characteristics, and mortality rate of DHS. Importantly, we also summarized the recent advances in genetic testing allowing prediction of ADRs. In an initial systematic electronic search, we retrieved 191 articles. Subsequently, these articles were further filtered and ultimately 84 articles (60 Chinese case reports, 21 non-Chinese articles, and three epidemiological studies) were selected, which included 877 patients. The prevalence of DHS among Chinese patients was 1.5% with a fatality rate of 9.6%. Early withdrawal of dapsone and appropriate treatment reduced the fatality rate. Most importantly, genetic screening for the HLA-B*13:01 allele among high-risk populations showed a significant utility as a useful genetic marker to DHS. In conclusion, this review discusses the epidemiological and clinical characteristics of DHS among Chinese patients, which may help physicians to understand this syndrome.

  4. Quality assessment of health counseling: performance of health advisors in cardiovascular prevention

    NARCIS (Netherlands)

    Harting, Janneke; van Assema, Patricia; van der Molen, Henk T.; Ambergen, Ton; de Vries, Nanne K.

    2004-01-01

    Quality assessments of interventions are seen as essential in optimizing their implementation, interpreting their effectiveness, and illuminating their underlying processes. In Hartslag Limburg, a cardiovascular prevention project, the quality of a health counseling intervention was assessed as part

  5. Using Watershed Boundaries to Map Adverse Health Outcomes: Examples From Nebraska, USA

    Directory of Open Access Journals (Sweden)

    Brittany Corley

    2018-01-01

    Full Text Available In 2009, a paper was published suggesting that watersheds provide a geospatial platform for establishing linkages between aquatic contaminants, the health of the environment, and human health. This article is a follow-up to that original article. From an environmental perspective, watersheds segregate landscapes into geospatial units that may be relevant to human health outcomes. From an epidemiologic perspective, the watershed concept places anthropogenic health data into a geospatial framework that has environmental relevance. Research discussed in this article includes information gathered from the literature, as well as recent data collected and analyzed by this research group. It is our contention that the use of watersheds to stratify geospatial information may be both environmentally and epidemiologically valuable.

  6. Understanding and Mitigating Adverse Health Effects in Space Using A System Physiology Software, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA's vision for Space Exploration aims for human interplanetary missions that have significant challenges on crew health and safety including fluid shifts, and...

  7. Using Watershed Boundaries to Map Adverse Health Outcomes: Examples From Nebraska, USA.

    Science.gov (United States)

    Corley, Brittany; Bartelt-Hunt, Shannon; Rogan, Eleanor; Coulter, Donald; Sparks, John; Baccaglini, Lorena; Howell, Madeline; Liaquat, Sidra; Commack, Rex; Kolok, Alan S

    2018-01-01

    In 2009, a paper was published suggesting that watersheds provide a geospatial platform for establishing linkages between aquatic contaminants, the health of the environment, and human health. This article is a follow-up to that original article. From an environmental perspective, watersheds segregate landscapes into geospatial units that may be relevant to human health outcomes. From an epidemiologic perspective, the watershed concept places anthropogenic health data into a geospatial framework that has environmental relevance. Research discussed in this article includes information gathered from the literature, as well as recent data collected and analyzed by this research group. It is our contention that the use of watersheds to stratify geospatial information may be both environmentally and epidemiologically valuable.

  8. Adverse effect of high migration stress on mental health during pregnancy: a case report.

    Science.gov (United States)

    Lecompte, Vanessa; Richard-Fortier, Zoé; Rousseau, Cécile

    2017-02-01

    Despite empirical evidence on the numerous consequences associated with high migration stress and mental health problems during pregnancy, a psychosocial stress assessment is rarely done, leaving it largely unaddressed. This case illustration sheds light on the common multiple risk factors related to migration stress that have to be taken into consideration when addressing perinatal mental health, and highlights the importance of obstetric appointments as a unique opportunity to assess psychosocial stress and mobilize interdisciplinary interventions.

  9. Contesting facts about wind farms in Australia and the legitimacy of adverse health effects.

    Science.gov (United States)

    Clark, Shannon; Botterill, Linda Courtenay

    2017-02-01

    The development of wind energy in Australia has been subject to ongoing public debate and has been characterised by concerns over the health impacts of wind turbines. Using discursive psychology, we examine 'wind turbine syndrome' as a contested illness and analyse how people build and undermine divergent arguments about wind-farm health effects. This article explores two facets of the dispute. First, we consider how participants construct 'facts' about the health effects of wind farms. We examine rhetorical resources used to construct wind farms as harmful or benign. Second, we examine the local negotiation of the legitimacy of health complaints. In the research interviews examined, even though interviewees treat those who report experiencing symptoms from wind farms as having primary rights to narrate their own experience, this epistemic primacy does not extend to the ability to 'correctly' identify symptoms' cause. As a result, the legitimacy of health complaints is undermined. Wind turbine syndrome is an example of a contested illness that is politically controversial. We show how stake, interest and legitimacy are particularly relevant for participants' competing descriptions about the 'facts' of wind turbine health effects.

  10. Comparing Dental and Pharmacy Students’ Perceptions on Public Health and Preventive Health Care Course

    Science.gov (United States)

    Mandiracioglu, Aliye; Dogan, Fethi

    2012-01-01

    Objectives: A Public health course has an important role in the undergraduate education of pharmacy and dentistry in terms of emphasizing preventive care. The purpose of this study is to evaluate the views of pharmacy and dentistry students on a public health course and preventive health care. Methods: 173 students enrolled at Ege University, Faculties of Pharmacy and Dentistry completed a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and replied to 18 Likert type question to determine their perceptions on a public health course and preventive health care. The comments of the students were reviewed and categorized into key themes. Results: SWOT analysis and the results of quantitative Likert type questions supported each other. According to the quantitative results, there was no significant difference between the scores of students from both schools in terms of their statements about the public health course and preventive care. Both groups of students mentioned the contribution of the public health course to their professions in the future. They also appreciated the importance of preventive care in the health services. PMID:22347604

  11. [Suspected adverse reactions after vaccination. Results from the German Health Interview and Examination Survey for Children and Adolescents. Part 2: predictors of parental reporting of suspected adverse reactions after vaccinations].

    Science.gov (United States)

    Poethko-Müller, C; Atzpodien, K; Schmitz, R; Schlaud, M

    2011-03-01

    Each method to monitor vaccine safety has strengths and limitations. Therefore, vaccine safety monitoring should rely on different types of data sources. Methods commonly rely on patient-reported adverse reactions. Little is, however, known about factors that may affect the probability with which patients report adverse reactions to vaccines. From 2003-2006, the representative National Health Interview and Examination Survey for Children and Adolescents ("Kinder- und Jugendgesundheitssurvey", KiGGS) retrospectively collected information about vaccines, vaccination dates, and suspected vaccine related adverse reactions from a total of 17,641 participants (vaccinations were more likely reported from parents living in former West Germany compared to former East Germany (OR 1.61; 95% CI 1.08-2.39), parents of children with special health care needs (OR 1.49; 95% CI 1.08-2.04), and from parents reporting reservations against vaccinations (OR 3.29; 95% CI 2.28-4.75). Parental reporting of adverse vaccine reactions appears to be associated with parental perception and assessment of possible adverse vaccine reactions, as well as with the parents' attitude towards immunization in general.

  12. Agricultural sources of contaminants of emerging concern and adverse health effects on freshwater fish

    Science.gov (United States)

    Tillitt, Donald E.; Buxton, Herbert T.

    2011-01-01

    Agricultural contaminants of emerging concern (CECs) are generally thought of as certain classes of chemicals associated with animal feeding and production facilities. Veterinary pharmaceuticals used in animal food production systems represent one of the largest groups of CECs. In our review, we discuss the extensive increase in use of antibiotics in animal feeding operations (AFOs) around the world. AFOs are a major consumer of antibiotics and other veterinary pharmaceuticals and over the past decade there has been growing information on the occurrence, release, and fate of CECs from animal food production operations, including the application of pharmaceutical-containing manure to agricultural fields and releases from waste lagoons. Concentrations of CECs in surface and ground water in proximity to AFOs correspond to their presence in the AFO wastes. In many cases, the environmental concentrations of agriculturally-derived CECs are below toxicity thresholds. Hormones and hormone replacement compounds are a notable exception, where chemical concentrations near AFOs can exceed concentrations known to cause adverse effects on endocrine-related functions in fish. In addition, some agricultural pesticides, once thought to be safe to non-target organisms, have demonstrated endocrine-related effects that may pose threats to fish populations in agricultural regions. That is, we have pesticides with emerging concerns, thus, the concern is emerging and not necessarily the chemical. In this light, one must consider certain agricultural pesticides to be included in the list of CECs. Even though agricultural pesticides are routinely evaluated in regulatory testing schemes which have been used for decades, the potential hazards of some pesticides have only recently been emerging. Emerging concerns of pesticides in fish include interference with hormone signaling pathways; additive (or more than additive) effects from pesticide mixtures; and adverse population-level effects at

  13. Global health diplomacy for obesity prevention: lessons from tobacco control.

    Science.gov (United States)

    Blouin, Chantal; Dubé, Laurette

    2010-07-01

    To date the global health diplomacy agenda has focused primarily on infectious diseases. Policymakers have not dedicated the same level of attention to chronic diseases, despite their rising contribution to the global burden of disease. Negotiation of the Framework convention on tobacco control provides an apt example from global health diplomacy to tackle diet-related chronic diseases. What lessons can be learned from this experience for preventing obesity? This article looks at why a global policy response is necessary, at the actors and interests involved in the negotiations, and at the forum for diplomacy.

  14. Prevention of mental handicaps in children in primary health care.

    Science.gov (United States)

    Shah, P M

    1991-01-01

    Some 5-15% of children aged 3 to 15 years in both developing and developed countries suffer from mental handicaps. There may be as many as 10-30 million severely and about 60-80 million mildly or moderately mentally retarded children in the world. The conditions causing mental handicaps are largely preventable through primary health care measures in developing countries. Birth asphyxia and birth trauma are the leading causes of mental handicaps in developing countries where over 1.2 million newborns die each year from moderate or severe asphyxia and an equal number survive with severe morbidity due to brain damage. The other preventable or manageable conditions are: infections such as tuberculous and pyogenic meningitides and encephalopathies associated with measles and whooping cough; severe malnutrition in infancy; hyperbilirubinaemia in the newborn; iodine deficiency; and iron deficiency anaemia in infancy and early childhood. In addition, recent demographic and socioeconomic changes and an increase in the number of working mothers tend to deprive both infants and young children of stimulation for normal development. To improve this situation, the primary health care approach involving families and communities and instilling the spirit of self-care and self-help is indispensable. Mothers and other family members, traditional birth attendants, community health workers, as well as nurse midwives and physicians should be involved in prevention and intervention activities, for which they should be trained and given knowledge and skills about appropriate technologies such as the risk approach, home-based maternal record, partograph, mobilogram (kick count), home-risk card, icterometer, and mouth-to-mask or bag and mask resuscitation of the newborn. Most of these have been field-tested by WHO and can be used in the home, the health centre or day care centres to detect and prevent the above-mentioned conditions which can cause mental handicap.

  15. Opportunities for Improving Cancer Prevention at Federally Qualified Health Centers

    OpenAIRE

    Allen, Claire L.; Harris, Jeffrey R.; Hannon, Peggy A.; Parrish, Amanda T.; Hammerback, Kristen; Craft, John; Gray, Bruce

    2013-01-01

    As the Affordable Care Act unfolds, federally qualified health centers (FQHCs) will likely experience an influx of newly insured, low-income patients at disparate risk for cancer. Cancer-focused organizations are seeking to collaborate with FQHCs and the Primary Care Associations (PCAs) that serve them, to prevent cancer and reduce disparities. To guide this collaboration, we conducted 21 interviews with representatives from PCAs and FQHCs across four western states. We asked about: FQHC prio...

  16. Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care

    Science.gov (United States)

    2017-08-18

    Interprofessional Relations; Primary Health Care/Organization & Administration; Diabetes Mellitus, Type 2/Prevention & Control; Primary Prevention/Methods; Risk Reduction Behavior; Randomized Controlled Trial; Life Style

  17. Preventative Therapeutics: A Study of Risk and Prevention in Australian Mental Health

    Directory of Open Access Journals (Sweden)

    Andrew McLachlan

    2014-10-01

    Full Text Available his study investigates the preventative therapeutics of two major Australian mental health organisations - beyondblue and The Black Dog Institute. The aim of this study is to examine how the resilience-based programs of both organisations reconfigure clinical and preventative expertise into new forms of ‘anticipatory action' (Anderson 2010. First, this article situates beyondblue and the Black Dog Institute within their historical contexts to consider how issues of risk and protection have become essential to mental health care today. Second, it examines the institutional practices of beyondblue and the Black Dog Institute and the role of clinical and preventative expertise as enacted forms of authority. Finally, this study investigates the intellectual and biokeeping technologies promoted through both organisations“ resilience-based pedagogies. The view taken in this study is that such technologies actively participate in the making of new therapeutic cultures and practices. Moreover, as biomarkers continue to act as indicators of future states of ‘unhealth' (Dumit 2012: 112, biokeeping technologies will continue to act as essential elements in the governmentality of mental health and wellbeing.

  18. Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

    DEFF Research Database (Denmark)

    Stone, Gregg W; Chung, Eugene S; Stancak, Branislav

    2016-01-01

    -diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0......AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset...

  19. Estrategia para la prevención de eventos adversos en el anciano hospitalizado Strategy for the prevention of adverse events in the hospitalized elderly patients

    Directory of Open Access Journals (Sweden)

    M��. Antonia Muñoz Mella

    2009-09-01

    Full Text Available La hospitalización deriva frecuentemente en una declinación irreversible del estado funcional, pudiendo dar como resultado complicaciones no relacionadas con el problema de admisión y producir una cascada de eventos adversos (EA que pueden culminar con la disminución de la calidad de vida. Las causas en los pacientes mayores son múltiples y acumulativas. Nuestro objetivo general fue diseñar un programa específico para la prevención de eventos adversos relacionados con la hospitalización del paciente anciano frágil, determinando para ello los factores de riesgo, tanto intrínsecos como extrínsecos, para establecer estrategias de seguridad que incluyan acciones que minimicen o eliminen los EA según la prioridad de riesgo establecida. Se trata de un estudio prospectivo de los pacientes ingresados en el hospital que cumplen el criterio de edad mayor o igual a 80 años. Las evaluaciones fueron realizadas durante 3 días consecutivos en 3 meses diferentes. La muestra total analizada fue de 133 pacientes, que representa el 20% de los pacientes ingresados en nuestro hospital durante el período de estudio. Como resultado hemos obtenido una valoración de los EA de la población anciana hospitalizada para realizar un plan de prevención de riesgos que desarrolle cuidados específicos para estos pacientes.There are multiple and cumulative causes of functional decline among hospitalized elderly patients Hospitalization itself may frequently cause a state of irreversible functional decline, leading to complications not related to the initial reasons for the hospital admission. Moreover, this lower functional status may carry risks of adverse events, potentially reducing quality of life. Our general goal was to design a specific program to prevent adverse events relating to hospitalized frail elderly patients. We determined intrinsic and extrinsic risk factors within our security strategies, including actions to minimize or even mitigate adverse

  20. Purpose in life and use of preventive health care services.

    Science.gov (United States)

    Kim, Eric S; Strecher, Victor J; Ryff, Carol D

    2014-11-18

    Purpose in life has been linked with better health (mental and physical) and health behaviors, but its link with patterns of health care use are understudied. We hypothesized that people with higher purpose would be more proactive in taking care of their health, as indicated by a higher likelihood of using preventive health care services. We also hypothesized that people with higher purpose would spend fewer nights in the hospital. Participants (n = 7,168) were drawn from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, and tracked for 6 y. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a higher likelihood that people would obtain a cholesterol test [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 1.08-1.29] or colonoscopy (OR = 1.06, 95% CI = 0.99-1.14). Furthermore, females were more likely to receive a mammogram/X-ray (OR = 1.27, 95% CI = 1.16-1.39) or pap smear (OR = 1.16, 95% CI = 1.06-1.28), and males were more likely to receive a prostate examination (OR = 1.31, 95% CI = 1.18-1.45). Each unit increase in purpose was also associated with 17% fewer nights spent in the hospital (rate ratio = 0.83, 95% CI = 0.77-0.89). An increasing number of randomized controlled trials show that purpose in life can be raised. Therefore, with additional research, findings from this study may inform the development of new strategies that increase the use of preventive health care services, offset the burden of rising health care costs, and enhance the quality of life among people moving into the ranks of our aging society.

  1. Purpose in life and use of preventive health care services

    Science.gov (United States)

    Kim, Eric S.; Strecher, Victor J.; Ryff, Carol D.

    2014-01-01

    Purpose in life has been linked with better health (mental and physical) and health behaviors, but its link with patterns of health care use are understudied. We hypothesized that people with higher purpose would be more proactive in taking care of their health, as indicated by a higher likelihood of using preventive health care services. We also hypothesized that people with higher purpose would spend fewer nights in the hospital. Participants (n = 7,168) were drawn from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, and tracked for 6 y. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a higher likelihood that people would obtain a cholesterol test [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 1.08–1.29] or colonoscopy (OR = 1.06, 95% CI = 0.99–1.14). Furthermore, females were more likely to receive a mammogram/X-ray (OR = 1.27, 95% CI = 1.16–1.39) or pap smear (OR = 1.16, 95% CI = 1.06–1.28), and males were more likely to receive a prostate examination (OR = 1.31, 95% CI = 1.18–1.45). Each unit increase in purpose was also associated with 17% fewer nights spent in the hospital (rate ratio = 0.83, 95% CI = 0.77–0.89). An increasing number of randomized controlled trials show that purpose in life can be raised. Therefore, with additional research, findings from this study may inform the development of new strategies that increase the use of preventive health care services, offset the burden of rising health care costs, and enhance the quality of life among people moving into the ranks of our aging society. PMID:25368165

  2. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article.

    Science.gov (United States)

    Yazdkhasti, Mansureh; Pourreza, Abolghasem; Pirak, Arezoo; Abdi, Fatemeh

    2015-01-01

    Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation.

  3. Oral health information systems--towards measuring progress in oral health promotion and disease prevention

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas

    2005-01-01

    This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has...... been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of oral disease which primarily reflect changing risk profiles and the implementation of oral health...... programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers...

  4. [Relation between adverse psychosocial risks, assessed by means of the DECORE Multidimensional Questionnaire, and deficient occupational health].

    Science.gov (United States)

    Martín García, Jesús; Luceño Moreno, Lourdes; Jaén Díaz, Marian; Rubio Valdehita, Susana

    2007-02-01

    This paper describes our search for the possible relationship between workers' health and quality of life and several psychosocial risks: Cognitive demands, Control, Rewards and Organizational support. These psychosocial risks were assessed by means of the DECORE Multidimensional Questionnaire, which provides five scores, one for each factor, plus a global score. Workers' health was assessed with the following variables: job satisfaction, stress perception, fatigue perception, medical leave, occupational accidents, and disease. 614 workers from various business sectors were examined. Results show that workers who feel more fatigued, stressed, and less satisfied perceive their work environment more adversely. Similar results were obtained for workers who went on medical leave, had an occupational accident, or suffered from disease.

  5. Adverse health effects of experiencing food insecurity among Greenlandic school children

    DEFF Research Database (Denmark)

    Niclasen, B.; Petzold, M.; Schnohr, C. W.

    2013-01-01

    Background. In vulnerable populations, food security in children has been found to be associated with negative health effects. Still, little is known about whether the negative health effects can be retrieved in children at the population level. Objective. To examine food insecurity reported...... in Grade 5 through 10. The participation rate in the participating schools was 65%. Food insecurity was measured as going to bed or to school hungry because there was no food at home. Results. Boys, the youngest children (11-12 year-olds), and children from low affluence homes were at increased risk...

  6. Post-marketing surveillance of the safety profile of iodixanol in the outpatient CT setting: a prospective, multicenter, observational study of patient risk factors, adverse reactions and preventive measures in 9953 patients.

    Science.gov (United States)

    Müller, F H H

    2014-11-01

    Non-interventional study in outpatient, contrast-enhanced CT; 1. to determine the extent of preventive measures for risk reduction of adverse drug reactions after contrast-enhanced CT examinations. 2. to prospectively determine the incidence and severity of adverse drug reactions occurring after administration of the iso-osmolar contrast medium iodixanol. 3. to determine a possible influence of preventive measures on the incidence/severity of adverse drug reactions.. Evaluable documentation was provided for 9953 patients from 66 radiology centers across Germany. Patient characteristics, aspects of iodixanol administration, and adverse events with an at least "possible" relationship were documented on a standardized case report form (CRF) and were evaluated up to seven days after contrast medium administration. About 55.5 % of patients showed one or more risk factors (e. g. impaired renal function 4.4 %, diabetes mellitus 8.5 %, hypertension 20.6 %). One third of the sites did not implement any preventive measures. Patients with a known risk for an allergy-like reaction were more likely to receive pharmacologic preventive treatment (0.5 - 50.5 %). Oral hydration was the main preventive measure in patients with renal risk factors (Adverse drug reactions, mainly hypersensitivity reactions, occurred in 77 patients (0.74 %), but were classified as serious in only 3 patients (0.03 %). No statistically significant correlation between risk factors, preventive measures, and adverse reactions could be found. The use of preventive measures for CT examinations in this outpatient setting was generally low with risk patients being pre-medicated more often, depending on their history. In the routine outpatient setting, iso-osmolar iodixanol was very well tolerated in almost 10,000 patients undergoing diagnostic CT. The rate of acute and delayed adverse reactions was low. No correlation could be found between risk factors, preventive measures and the incidence

  7. 75 FR 4655 - National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care...

    Science.gov (United States)

    2010-01-28

    ... Reporting negative actions or findings taken by peer review organizations or private accreditation entities... entity (both as defined in Sec. 60.3), respectively. With respect to reporting by private accreditation... practitioners and health care entities, the proposed rule limited reporting of peer review organization actions...

  8. Adverse social, nutrition and health conditions in rural districts of the ...

    African Journals Online (AJOL)

    2010-08-25

    Aug 25, 2010 ... Abstract. Objective: This study determined the socio-demographic, nutritional and health status of children and their caregivers in two rural districts ... Wood was the main energy source used to cook food in all three districts (> 75%). .... HST facilitators did the quality control by checking the completed.

  9. Legislated changes to federal pension income in Canada will adversely affect low income seniors' health.

    Science.gov (United States)

    Emery, J C Herbert; Fleisch, Valerie C; McIntyre, Lynn

    2013-12-01

    This study uses a population health intervention modeling approach to project the impact of recent legislated increases in age eligibility for Canadian federally-funded pension benefits on low income seniors' health, using food insecurity as a health indicator. Food insecurity prevalence and income source were assessed for unattached low income (pension plans constituted the main source of income for the majority (79.4%) of low income seniors aged 65-69 years, in contrast to low income seniors aged 60-64 years who reported their main income from employment, employment insurance, Workers' Compensation, or welfare. The increase in income provided by federal pension benefits for low income Canadians 65 and over coincided with a pronounced (50%) decrease in food insecurity prevalence (11.6% for seniors ≥65 years versus 22.8% for seniors pension seniors' benefits in Canada from 65 to 67 years will negatively impact low income seniors' health, relegating those who are food insecure to continued hardship. © 2013.

  10. Residential exposure to mould and dampness is associated with adverse respiratory health

    NARCIS (Netherlands)

    Hagmolen of ten Have, W.; van den Berg, N. J.; van der Palen, J.; van Aalderen, W. M. C.; Bindels, P. J. E.

    2007-01-01

    BACKGROUND: Indoor exposure to mould and dampness is frequently associated with asthma symptoms with and without lung function changes. However, the mechanisms contributing to this threat to respiratory health are only partly understood. OBJECTIVE: To investigate the contribution of recent exposure

  11. Adverse effects of Busulfan on the cornea | Idu | Journal of Health ...

    African Journals Online (AJOL)

    Journal of Health and Visual Sciences. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 3 (2002) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT ...

  12. Integrating Health Promotion Into Physical Therapy Practice to Improve Brain Health and Prevent Alzheimer Disease.

    Science.gov (United States)

    McGough, Ellen; Kirk-Sanchez, Neva; Liu-Ambrose, Teresa

    2017-07-01

    Alzheimer disease is the most common cause of dementia, and brain pathology appears years before symptoms are evident. Primary prevention through health promotion can incorporate lifestyle improvement across the lifespan. Risk factor assessment and identifying markers of disease might also trigger preventive measures needed for high-risk individuals and groups. Many potential risk factors are modifiable through exercise, and may be responsive to early intervention strategies to reduce the downward slope toward disability. Through the use of common clinical tests to identify cognitive and noncognitive functional markers of disease, detection and intervention can occur at earlier stages, including preclinical stages of disease. Physical activity and exercise interventions to address modifiable risk factors and impairments can play a pivotal role in the prevention and delay of functional decline, ultimately reducing the incidence of dementia. This article discusses prevention, prediction, plasticity, and participation in the context of preserving brain health and preventing Alzheimer disease and related dementias in aging adults. Rehabilitation professionals have opportunities to slow disease progression through research, practice, and education initiatives. From a clinical perspective, interventions that target brain health through lifestyle changes and exercise interventions show promise for preventing stroke and associated neurovascular diseases in addition to dementia. Physical therapists are well positioned to integrate primary health promotion into practice for the prevention of dementia and other neurological conditions in older adults.

  13. Improving patient safety and quality: what are the challenges and gaps in introducing an integrated electronic adverse incident and recording system within health care industry?

    Science.gov (United States)

    Walsh, Kerry; Antony, Jiju

    2007-01-01

    The purpose of this paper is to present the challenges and gaps in using an electronic adverse incident recording and reporting system from a commercial supplier to an acute health care setting. The paper used action diary, documentation and triangulation to obtain an understanding of the challenges and gaps. The paper provides health care with further understanding of the complexity, challenges and gaps of using an electronic adverse incident recording system to improve patient safety. This paper explains the important views of clinicians and managers in relation to improving patient safety by using an electronic adverse incident management system.

  14. Health promotion, preventive and curative aspects of diseases in astrology.

    Science.gov (United States)

    Sharma, Bhuvnesh Kumar; Subhakta, P K J P; Narayana, A

    2007-01-01

    The whole universe is intermingling into a unit in the period of globalization. Different cultures, life-styles and sciences are co-operating with each other in this situation. World Health Organization is working towards collaborating all prevalent medical sciences for attainment of good health and family welfare for each and every individual by 2020. Astrology is a part of Indian heritage. Astrology means the art of predicting or determining the influence of the planets and stars on human affairs. The origin of this word is from Greek word astron, star + logos (discourse). The account of deeds of good and bad during the present life and previous lives, their consequences of health or ill health during this life i.e. what, when and how the things takes place will be clearly known through Astrology. Highly advanced knowledge related to Astrology on medicine is preserved in Indian scriptures and the knowledge was transmitted from generation to generation. It is also a good source for health promotion, preventive, curative and other medical aspects. Brief direction related to astrological medical aspects is also available in Ayurvedic literature (Carakasamhită, Suśrutasamhhită, Aşţăngasangraha, Aşţăngahŗdaya, Sărngadharasamhită , Băvaprakăśa etc.) Some Ayurvedic practitioners, scholars and scientists realize the need of astrological knowledge related to medicine in the present time. In ancient times physician, astrologer and purŏhita (Hindu priest) simultaneously looked after the health and family welfare of individual, families and country. Astrologer guides medication and suitable time for the better cure of ailments. Even the medicinal herbs were collected and treated at appropriate time for their efficacy. Astrology and Ayurvĕda are inseparable sciences of life. Hence, in this article, a concise astrological evaluation related to health promotion, preventive and curative aspects of Astrology is being presented.

  15. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda

    Directory of Open Access Journals (Sweden)

    Turyakira Eleanor

    2011-10-01

    Full Text Available Abstract Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%, malpresentation or malposition (36.4% and hydrocephalus (0.3%. The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86, with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78, having delivered once before (AOR 1.57, 95% CI: 1.30-1.91 and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45. The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08 and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22. Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by

  16. Story Immersion in a Health Videogame for Childhood Obesity Prevention

    Science.gov (United States)

    Thompson, Debbe; Baranowski, Janice; Buday, Richard; Baranowski, Tom

    2012-01-01

    Abstract Objective Stories can serve as powerful tools for health interventions. Story immersion refers to the experience of being absorbed in a story. This is among the first studies to analyze story immersion's role in health videogames among children by addressing two main questions: Will children be more immersed when the main characters are similar to them? Do increased levels of immersion relate to more positive health outcomes? Subjects and Methods Eighty-seven 10–12-year-old African-American, Caucasian, and Hispanic children from Houston, TX, played a health videogame, “Escape from Diab” (Archimage, Houston, TX), featuring a protagonist with both African-American and Hispanic phenotypic features. Children's demographic information, immersion, and health outcomes (i.e., preference, motivation, and self-efficacy) were recorded and then correlated and analyzed. Results African-American and Hispanic participants reported higher immersion scores than Caucasian participants (P=0.01). Story immersion correlated positively (P valuesvideogame characters and players enhanced immersion and several health outcomes. Effectively embedding characters with similar phenotypic features to the target population in interactive health videogame narratives may be important when motivating children to adopt obesity prevention behaviors. PMID:24066276

  17. Adverse Effects of Carbetocin versus Oxytocin in the Prevention of Postpartum Haemorrhage after Caesarean Section: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    D. Mannaerts

    2018-01-01

    Full Text Available Purpose. To compare the incidence of nausea, vomiting, and arterial hypotension between carbetocin and oxytocin to prevent haemorrhage after caesarean section (CS. Methods. A randomized controlled trial in term pregnant women undergoing planned CS. Groups were randomized to carbetocin or oxytocin. Blood pressure (BP, heart rate, presence of nausea/vomitus, and need for vasopressors were evaluated throughout surgery. Preoperative and postoperative haemoglobin and haematocrit levels were compared. Results. Fifty-eight women were randomized (carbetocin n=32; oxytocin n=26. Both medications had hypotensive effect, difference in BP for carbetocin versus oxytocin: systolic (14.4 ± 2.4 mmHg versus 8.5 ± 1.8 mmHg; diastolic (7.8 ± 1.6 mmHg versus 8.9 ± 3.0 mmHg without significant difference between the drugs (p=0.1 and p=0.7. Both groups had similar needs for vasopressors. The presence of nausea was not rare, but the difference was not statistically significant (p=0.4. Average blood loss was slightly lower in the carbetocin group but not statistically significant (p=0.8. Conclusion. In planned CS, a possible clinical significant lower incidence of nausea after carbetocin was noted but this was not statistically significant. There were no differences regarding BP, heart rate, the need for vasopressor, and blood loss. The study was registered in the International Journal of Clinical Trials (ISRCTN 95504420, 2/2017.

  18. National pathways for suicide prevention and health services research.

    Science.gov (United States)

    Ahmedani, Brian K; Vannoy, Steven

    2014-09-01

    In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

  19. Identifying and managing adverse environmental health effects: 6. Carbon monoxide poisoning

    Science.gov (United States)

    Abelsohn, Alan; Sanborn, Margaret D.; Jessiman, Barry J.; Weir, Erica

    2002-01-01

    CARBON MONOXIDE POISONING IS AN ENIGMATIC ILLNESS. The symptoms are often nonspecific or masked by an exacerbation of an underlying illness, such as congestive heart failure, that has been triggered by carbon monoxide inhalation. The effects can range from mild, annoying symptoms relieved by removal of the source to severe morbidity with profound central nervous system dysfunction, acute complications and delayed sequelae. Estimates suggest that about one-third of nonfatal cases of carbon monoxide poisoning go undetected and undiagnosed. We present a case of residential carbon monoxide poisoning to illustrate these points and to demonstrate the usefulness of a simple tool based on the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) that physicians can use to obtain an environmental exposure history. We outline the clinical management of carbon monoxide poisoning and provide strategies and resources to prevent exposure. PMID:12126326

  20. The Relationship between Working Conditions and Adverse Health Symptoms of Employee in Solar Greenhouse.

    Science.gov (United States)

    Zhang, Min; Wang, Xiu Feng; Cui, Xiu Min; Wang, Jian; Yu, Shi Xin

    2015-02-01

    To determine the correlation between the working environment and the health status of employees in solar greenhouse, 1171 employees were surveyed. The results show the 'Greenhouse diseases' are affected by many factors. Among general uncomforts, the morbidity of the bone and joint damage is the highest and closely related to labor time and age. Planting summer squash and wax gourd more easily cause skin pruritus. Asthma-related cough, eye disease, and skin pruritus are significantly correlated with the cultivation of wax gourd. The application of inorganic fertilizer and fertigation dramatically induce the bone and joint damage. The smell of covering film greatly influence skin pruritus. Personal protection is badly scanty and normative occupational health and safety need to be completed. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  1. Identifying and managing adverse environmental health effects: 5. Persistent organic pollutants

    Science.gov (United States)

    Abelsohn, Alan; Gibson, Brian L.; Sanborn, Margaret D.; Weir, Erica

    2002-01-01

    CONCERN AND AWARENESS IS GROWING about the health effects of exposures to environmental contaminants, including those found in food. Most primary care physicians lack knowledge and training in the clinical recognition and management of the health effects of environmental exposures. We have found that the use of a simple history-taking tool — the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) — can help physicians identify patients at risk of such health effects. We present an illustrative case of a mother who is concerned about eating fish and wild game because her 7-year-old son has been found to have learning difficulties and she is planning another pregnancy. Potential exposures to persistent organic pollutants (POPs) and mercury are considered. The neurodevelopmental effects of POPs on the fetus are reviewed. We provide advice to limit a patient's exposure to these contaminants and discuss the relevance of these exposures to the learning difficulties of the 7-year-old child and to the planning of future pregnancies. PMID:12074124

  2. SUPPLEMENTATION WITH VITAMINS C AND E DURING PREGNANCY FOR THE PREVENTION OF PREECLAMPSIA AND OTHER ADVERSE MATERNAL AND PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND METAANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustín; ROMERO, Roberto; KUSANOVIC, Juan Pedro; HASSAN, Sonia

    2011-01-01

    OBJECTIVE To determine whether supplementation with vitamins C and E during pregnancy reduces the risk of preeclampsia and other adverse maternal and perinatal outcomes. STUDY DESIGN Systematic review and metaanalysis of randomized controlled trials. RESULTS Nine trials involving a total of 19,810 women were included. Overall, there were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (9.6% versus 9.6%; relative risk 1.00, 95% confidence interval 0.92–1.09). Similar results were obtained when subgroup analyses were restricted to women at high risk or low/moderate risk for preeclampsia. Women supplemented with vitamins C and E were at increased risk of developing gestational hypertension and premature rupture of membranes, and a decreased risk of abruptio placentae. There were no significant differences between the vitamin and placebo groups in the risk of other adverse maternal or fetal/perinatal outcomes. CONCLUSION Supplementation with vitamins C and E during pregnancy does not prevent preeclampsia. PMID:21529757

  3. The design of the SAFE or SORRY? study : A cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events

    NARCIS (Netherlands)

    Betsie van Gaal; Theo van Achterberg; Marlies Hulscher; George F Borm; Joke Mintjes; Raymond TCM Koopmans; Lisette Schoonhoven

    2009-01-01

    Patients in hospitals and nursing homes are at risk of the development of, often preventable, adverse events (AEs), which threaten patient safety. Guidelines for prevention of many types of AEs are available, however, compliance with these guidelines appears to be lacking. Besides general barriers

  4. The design of the SAFE or SORRY? study: a cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events.

    NARCIS (Netherlands)

    Gaal, H.G.I. van; Schoonhoven, L.; Hulscher, M.E.J.L.; Mintjes, J.A.; Borm, G.F.; Koopmans, R.T.C.M.; Achterberg, T. van

    2009-01-01

    BACKGROUND: Patients in hospitals and nursing homes are at risk of the development of, often preventable, adverse events (AEs), which threaten patient safety. Guidelines for prevention of many types of AEs are available, however, compliance with these guidelines appears to be lacking. Besides

  5. Effects of Vascular and Nonvascular Adverse Events and of Extended-Release Niacin With Laropiprant on Health and Healthcare Costs.

    Science.gov (United States)

    Kent, Seamus; Haynes, Richard; Hopewell, Jemma C; Parish, Sarah; Gray, Alastair; Landray, Martin J; Collins, Rory; Armitage, Jane; Mihaylova, Borislava

    2016-07-01

    Extended-release niacin with laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events in Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE), but its net effects on health and healthcare costs are unknown. 25 673 participants aged 50 to 80 years with previous cardiovascular disease were randomized to 2 g of extended-release niacin with 40 mg of laropiprant daily versus matching placebo, in addition to effective statin-based low-density lipoprotein cholesterol-lowering treatment. The net effects of niacin-laropiprant on quality-adjusted life years and hospital care costs (2012 UK £; converted into US $ using purchasing power parity index) during 4 years in HPS2-THRIVE were evaluated using estimates of the impact of serious adverse events on health-related quality of life and hospital care costs. During the study, participants assigned niacin-laropiprant experienced marginally but not statistically significantly lower survival (0.012 fewer years [standard error (SE) 0.007]), fewer quality-adjusted life years (0.023 [SE 0.007] fewer using UK EQ-5D scores; 0.020 [SE 0.006] fewer using US EQ-5D scores) and accrued greater hospital costs (UK £101 [SE £37]; US $145 [SE $53]). Stroke, heart failure, musculoskeletal events, gastrointestinal events, and infections were associated with significant decreases in health-related quality of life in both the year of the event and in subsequent years. All serious vascular and nonvascular events were associated with substantial increases in hospital care costs. In HPS2-THRIVE, the addition of extended-release niacin-laropiprant to statin-based therapy reduced quality of life-adjusted survival and increased hospital costs. URL: http://clinicaltrials.gov. Unique identifier: NCT00461630. © 2016 American Heart Association, Inc.

  6. Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia

    Directory of Open Access Journals (Sweden)

    Kristina Adachi

    2016-01-01

    Full Text Available Screening and treatment of sexually transmitted infections (STIs in pregnancy represents an overlooked opportunity to improve the health outcomes of women and infants worldwide. Although Chlamydia trachomatis is the most common treatable bacterial STI, few countries have routine pregnancy screening and treatment programs. We reviewed the current literature surrounding Chlamydia trachomatis in pregnancy, particularly focusing on countries in sub-Saharan Africa and Asia. We discuss possible chlamydial adverse pregnancy and infant health outcomes (miscarriage, stillbirth, ectopic pregnancy, preterm birth, neonatal conjunctivitis, neonatal pneumonia, and other potential effects including HIV perinatal transmission and review studies of chlamydial screening and treatment in pregnancy, while simultaneously highlighting research from resource-limited countries in sub-Saharan Africa and Asia.

  7. Prospective associations of psychosocial adversity in childhood with risk factors for cardiovascular disease in adulthood: the MRC National Survey of Health and Development.

    Science.gov (United States)

    Anderson, Emma L; Caleyachetty, Rishi; Stafford, Mai; Kuh, Diana; Hardy, Rebecca; Lawlor, Debbie A; Fraser, Abigail; Howe, Laura D

    2017-09-07

    Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. We aimed to assess associations of various forms of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. Participants were from the MRC National Survey of Health and Development. Childhood psychosocial risk factors were reported prospectively by parents from 1950-1957, and retrospectively by participants at mean age 43 years in 1989. CVD risk factors were assessed at mean age 60-64 years in 2006-2011. Associations of a summary score of total psychosocial adversity and CVD risk in adulthood were assessed. There was no consistent evidence that cumulative psychosocial adversity, nor any specific form of psychosocial adversity in childhood, was associated with CVD risk factors in late adulthood. There was some evidence that parental death in the first 15 years was associated with higher SBP (Beta: 0.23, 95% confidence interval: 0.06 to 0.40, P=0.01) and DBP (Beta: 0.15, 95% confidence interval: -0.01 to 0.32, P=0.07). We found no evidence that exposure to greater psychosocial adversity, or specific forms of psychosocial adversity during childhood is associated with adult CVD risk factors. Further large population studies are needed to clarify whether parental death is associated with higher systolic and diastolic blood pressure.

  8. Do flexicurity policies protect workers from the adverse health consequences of temporary employment? A cross-national comparative analysis

    Directory of Open Access Journals (Sweden)

    Faraz Vahid Shahidi

    2016-12-01

    Full Text Available Flexicurity policies comprise a relatively novel approach to the regulation of work and welfare that aims to combine labour market flexibility with social security. Advocates of this approach argue that, by striking the right balance between flexibility and security, flexicurity policies allow firms to take advantage of loose contractual arrangements in an increasingly competitive economic environment while simultaneously protecting workers from the adverse health and social consequences of flexible forms of employment. In this study, we use multilevel Poisson regression models to test the theoretical claim of the flexicurity approach using data for 23 countries across three waves of the European Social Survey. We construct an institutional typology of labour market regulation and social security to evaluate whether inequalities in self-reported health and limiting longstanding illness between temporary workers and their permanent counterparts are smaller in countries that most closely approximate the ideal type described by advocates of the flexicurity approach. Our results indicate that, while the association between temporary employment and health varies across countries, institutional configurations of labour market regulation and social security do not provide a meaningful explanation for this cross-national variation. Contrary to the expectations of the flexicurity hypothesis, our data do not indicate that employment-related inequalities are smaller in countries that approximate the flexicurity approach. We discuss potential explanations for these findings and conclude that there remains a relative lack of evidence in support of the theoretical claims of the flexicurity approach. Keywords: Health inequalities, Cross-national, Temporary, Employment, Flexicurity, Multilevel

  9. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health.

    Science.gov (United States)

    Garner, Andrew S; Shonkoff, Jack P

    2012-01-01

    Advances in a wide range of biological, behavioral, and social sciences are expanding our understanding of how early environmental influences (the ecology) and genetic predispositions (the biologic program) affect learning capacities, adaptive behaviors, lifelong physical and mental health, and adult productivity. A supporting technical report from the American Academy of Pediatrics (AAP) presents an integrated ecobiodevelopmental framework to assist in translating these dramatic advances in developmental science into improved health across the life span. Pediatricians are now armed with new information about the adverse effects of toxic stress on brain development, as well as a deeper understanding of the early life origins of many adult diseases. As trusted authorities in child health and development, pediatric providers must now complement the early identification of developmental concerns with a greater focus on those interventions and community investments that reduce external threats to healthy brain growth. To this end, AAP endorses a developing leadership role for the entire pediatric community-one that mobilizes the scientific expertise of both basic and clinical researchers, the family-centered care of the pediatric medical home, and the public influence of AAP and its state chapters-to catalyze fundamental change in early childhood policy and services. AAP is committed to leveraging science to inform the development of innovative strategies to reduce the precipitants of toxic stress in young children and to mitigate their negative effects on the course of development and health across the life span.

  10. Adverse child health impacts resulting from food adulterations in the Greater China Region.

    Science.gov (United States)

    Li, Wai Chin; Chow, Chin Fung

    2017-09-01

    Food adulteration has a long history in human society, and it still occurs in modern times. Because children are relatively vulnerable to food adulterants, studying the health impacts of food adulteration on children is important. This article provides an overview of the child health impacts of food adulterants in two recent food adulteration incidents in the Greater China Region: (1) a plasticizer incident in Taiwan and (2) a 2,4,6-triamino-1,3,5-triazine (melamine)-tainted milk incident in China. The involved food adulterants, di-(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DiNP) and melamine, are harmful to the hippocampus, kidneys, reproductive organs and immune system of children, and they also increase the risk of cancer. To detect food adulteration and to avoid further harm caused by food adulteration, simple screening methods have been developed, and they have recently emerged as a new focus area for research. This article also summarizes the simple screening methods used to analyse the aforementioned food adulterants and reports how governments reacted to the recent food incidents. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  11. Diabetes mellitus and hypertension have comparable adverse effects on health-related quality of life

    Directory of Open Access Journals (Sweden)

    Metelko Željko

    2010-01-01

    Full Text Available Abstract Background We aimed to assess health-related quality of life (HRQoL among people with diabetes or hypertension, estimate the effect of cardiovascular comorbidities on HRQoL as well as compare HRQoL in these groups with that of healthy individuals. Methods A total of 9,070 respondents aged 18 years and over were assessed for HRQoL. Data were obtained from the Croatian Adult Health Survey. Respondents were divided into five groups according to their medical history: participants with hypertension (RR, hypertension and cardiovascular comorbidities (RR+, diabetes mellitus (DM, diabetes and cardiovascular comorbidities (DM+ and participants free of these conditions (healthy individuals, HI. HRQoL was assessed on 8 dimensions of the SF-36 questionnaire. Results Participants with diabetes and those with hypertension reported comparably limited (p > 0.05 HRQoL in all dimensions of SF-36, compared with healthy individuals (p 0.05 than participants without such comorbidities (p Conclusion Diabetes and hypertension seem to comparably impair HRQoL. Cardiovascular comorbidities further reduce HRQoL in participants with both chronic conditions. Future research of interventions aimed at improving these participants' HRQoL is needed.

  12. Postoperative Adverse Events Inconsistently Improved by the World Health Organization Surgical Safety Checklist: A Systematic Literature Review of 25 Studies.

    Science.gov (United States)

    de Jager, Elzerie; McKenna, Chloe; Bartlett, Lynne; Gunnarsson, Ronny; Ho, Yik-Hong

    2016-08-01

    The World Health Organization Surgical Safety Checklist (SSC) has been widely implemented in an effort to decrease surgical adverse events. This systematic literature review examined the effects of the SSC on postoperative outcomes. The review included 25 studies: two randomised controlled trials, 13 prospective and ten retrospective cohort trials. A meta-analysis was not conducted as combining observational studies of heterogeneous quality may be highly biased. The quality of the studies was largely suboptimal; only four studies had a concurrent control group, many studies were underpowered to examine specific postoperative outcomes and teamwork-training initiatives were often combined with the implementation of the checklist, confounding the results. The effects of the checklist were largely inconsistent. Postoperative complications were examined in 20 studies; complication rates significantly decreased in ten and increased in one. Eighteen studies examined postoperative mortality. Rates significantly decreased in four and increased in one. Postoperative mortality rates were not significantly decreased in any studies in developed nations, whereas they were significantly decreased in 75 % of studies conducted in developing nations. The checklist may be associated with a decrease in surgical adverse events and this effect seems to be greater in developing nations. With the observed incongruence between specific postoperative outcomes and the overall poor study designs, it is possible that many of the positive changes associated with the use of the checklist were due to temporal changes, confounding factors and publication bias.

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

    Science.gov (United States)

    Ierodiakonou, C S

    1988-03-01

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

  14. Information Technology: The Preventive Health Care Application and an Associated Upgrade

    National Research Council Canada - National Science Library

    2002-01-01

    The Preventive Health Care Application was a tool designed to enable clinicians to deliver and track appropriate and timely preventive services provided to all enrolled military health system members...

  15. Through a public health lens. Preventing violence against women: an update from the US Centers for Disease Control and Prevention.

    Science.gov (United States)

    Graffunder, Corinne M; Noonan, Rita K; Cox, Pamela; Wheaton, Jocelyn

    2004-01-01

    Over the past two decades, the Centers for Disease Control and Prevention (CDC) has been a key contributor to the growing public health effort to prevent violence. Although CDC and its partners are proud of their many successes, much work remains to be done. Violence continues to be a leading cause of death worldwide for people aged 15-44. Moreover, although many forms of violence garner national concern and resources, much more violence occurs in private domains and receives less attention. These hidden health hazards silently drain our nation's human, economic, and health resources. In this paper, we highlight the current efforts of the Division of Violence Prevention (DVP), housed within CDC's National Center for Injury Prevention and Control (NCIPC), to use a public health approach to the prevention of one key hidden health hazard: violence against women (VAW). Building from a recently developed strategic plan and a research agenda, we explain how four core public health principles--emphasizing primary prevention, advancing the science of prevention, translating science into effective programs, and building on the efforts of others--drive current programmatic activities in VAW prevention. Several current programs and projects are described. Finally, we conclude with recommendations for future prevention work by deepening our vision of leadership, expanding our partnerships, pursuing comprehensive approaches, and using evidence-based strategies.

  16. The mental health of prisoners: a review of prevalence, adverse outcomes and interventions

    Science.gov (United States)

    Fazel, Seena; Hayes, Adrian J; Bartellas, Katrina; Clerici, Massimo; Trestman, Robert

    2016-01-01

    There are more than 10 million prisoners worldwide, and the prevalence of all investigated mental disorders is higher than general population comparisons. Although the extent to which prison increases the incidence of mental disorders is uncertain, there is considerable evidence of low rates of identification and treatment of psychiatric disorders. Prisoners are also at increased risk of all-cause mortality, suicide, self-harm, violence, and victimization, and research has outlined some modifiable risk factors. High quality treatment trials for psychiatric disorders in prisoners have been limited. Despite this, it has been shown in trials that opiate substitution treatments reduce substance misuse relapse and possibly reoffending. The mental health needs of women and older adults in prison are distinct, and national policies should be developed to meet these. Clinical, research, and policy recommendations to improve prison mental healthcare are presented. National attempts to meet these recommendations should be annually surveyed. PMID:27426440

  17. Chronic arsenic exposure and its adverse health effects in Taiwan: A paradigm for management of a global environmental problem

    Directory of Open Access Journals (Sweden)

    Cheng-Che Lan

    2011-09-01

    Full Text Available It was estimated that, nearly 100 million people are at risk for drinking arsenic (As-contaminated drinking water. Although the WHO guideline recommends that levels of As in drinking water should not exceed 10 μm/L, it was estimated that more than 30 million people drink As-containing water at levels more than 50 μm/L in Bangladesh and India alone. Therefore, the adverse health effects resulting from chronic As exposure pose a global threat. In Taiwan, studies focusing on the health effects resulting from chronic As exposure through contaminated drinking water have been ongoing for more than 50 years. During the past half century, it was recognized that the impact of high As exposure on human health is much more complicated than originally anticipated. Chronic As exposure resulted in infamous blackfoot disease, which is unique to As endemic areas in Taiwan, and various diseases including cancers and non-cancers. Although the potential-biological outcomes have been well-documented, the pathomechanisms leading from As exposure to occurrence and development of the diseases remain largely unclear. One of the major obstacles that hindered further understanding regarding the adverse health effect resulting from chronic As exposure is documentation of cumulative As exposure from the distant past, which remains difficult as the present technologies mostly document relatively recent As exposure. Furthermore, the susceptibility to As exposure appears to differ between different ethnic groups and individuals and is modified by lifestyle factors including smoking habits and nutrition status. No consensus data has yet been reached even after comparing the study results obtained from different parts of the world focusing on associations between human As toxicity and genetic polymorphisms in terms of cellular detoxification enzymes, tumor suppressor proteins, and DNA repair pathway. With the availability of the new powerful “OMIC” technologies, it may

  18. Chronic arsenic exposure and its adverse health effects in Taiwan: a paradigm for management of a global environmental problem.

    Science.gov (United States)

    Lan, Cheng-Che; Yu, Hsin-Su; Ko, Ying-Chin

    2011-09-01

    It was estimated that, nearly 100 million people are at risk for drinking arsenic (As)-contaminated drinking water. Although the WHO guideline recommends that levels of As in drinking water should not exceed 10 μm/L, it was estimated that more than 30 million people drink As-containing water at levels more than 50 μm/L in Bangladesh and India alone. Therefore, the adverse health effects resulting from chronic As exposure pose a global threat. In Taiwan, studies focusing on the health effects resulting from chronic As exposure through contaminated drinking water have been ongoing for more than 50 years. During the past half century, it was recognized that the impact of high As exposure on human health is much more complicated than originally anticipated. Chronic As exposure resulted in infamous blackfoot disease, which is unique to As endemic areas in Taiwan, and various diseases including cancers and non-cancers. Although the potential-biological outcomes have been well-documented, the pathomechanisms leading from As exposure to occurrence and development of the diseases remain largely unclear. One of the major obstacles that hindered further understanding regarding the adverse health effect resulting from chronic As exposure is documentation of cumulative As exposure from the distant past, which remains difficult as the present technologies mostly document relatively recent As exposure. Furthermore, the susceptibility to As exposure appears to differ between different ethnic groups and individuals and is modified by lifestyle factors including smoking habits and nutrition status. No consensus data has yet been reached even after comparing the study results obtained from different parts of the world focusing on associations between human As toxicity and genetic polymorphisms in terms of cellular detoxification enzymes, tumor suppressor proteins, and DNA repair pathway. With the availability of the new powerful "OMIC" technologies, it may now be possible to gain

  19. Mental Health Among Help-Seeking Urban Women: The Relationships Between Adverse Childhood Experiences, Sexual Abuse, and Suicidality.

    Science.gov (United States)

    Hamdullahpur, Kevin; Jacobs, Kahá Wi J; Gill, Kathryn J

    2018-03-01

    Adverse childhood experiences (ACEs) and adult mental health were explored in a sample of urban Aboriginal ( n = 83) and non-Aboriginal ( n = 89) women. Childhood sexual abuse (CSA) was associated with negative home environments, teenage pregnancy, lifetime suicide attempts, and treatment seeking. Aboriginal women with CSA witnessed higher levels of physical/sexual abuse of family members. The severity of current psychological distress was associated with a history of childhood neglect. The results indicate that CSA rarely occurs in isolation, and that multiple ACEs are strongly associated with suicide attempts and treatment seeking in adulthood. Future studies should focus on the role of CSA in suicidality, as well as familial, community, and cultural protective factors.

  20. Gender-based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia.

    Science.gov (United States)

    Almuneef, Maha; ElChoueiry, Nathalie; Saleheen, Hassan N; Al-Eissa, Majid

    2017-05-30

    Adverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Studies on gender differences from developing countries are scarce. In this paper, we will examine gender variations in the types of reported ACEs and gender-specific relationships between cumulative ACEs and physical and mental health, and Risky Health Behaviors (RHB) in adulthood in the Kingdom of Saudi Arabia (KSA). A cross sectional national study was conducted in all of the 13 regions in KSA in 2013 using the ACE- International Questionnaire (ACE-IQ). We used multivariate logistic regression to examine the relationship between 4 + ACEs and physical, mental health and RHBs for both men and women separately after adjusting for age, education, marital status and current employment. The total number of participants was 10,156 and women comprised 48% of the sample. The majority of respondents (80%) reported at least one ACE. Women had higher percentages of women who experienced 4+ ACEs were associated with the highest likelihood of depression (OR = 7.0; 95% CI: 5.2-9.4), anxiety (OR = 6.4; 95% CI: 5.0-8.2) and other mental illnesses (OR = 7.4; 95% CI: 5.2-10.6). As for chronic diseases, abused men and women in childhood showed similarly a twofold increased risk of developing diabetes, hypertension, coronary heart disease and obesity when compared to non-abused participants. Findings highlight the need to consider gender specific differences in the development of preventive strategies to address ACEs in KSA.

  1. 75 FR 38099 - Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

    Science.gov (United States)

    2010-07-01

    ... and management, integrative health care practices, and health promotion. Membership and Designation... HUMAN SERVICES Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and... March 23, 2010. The Advisory Group on Prevention, Health Promotion, and Integrative and Public Health...

  2. Do flexicurity policies protect workers from the adverse health consequences of temporary employment? A cross-national comparative analysis.

    Science.gov (United States)

    Shahidi, Faraz Vahid; De Moortel, Deborah; Muntaner, Carles; Davis, Owen; Siddiqi, Arjumand

    2016-12-01

    Flexicurity policies comprise a relatively novel approach to the regulation of work and welfare that aims to combine labour market flexibility with social security. Advocates of this approach argue that, by striking the right balance between flexibility and security, flexicurity policies allow firms to take advantage of loose contractual arrangements in an increasingly competitive economic environment while simultaneously protecting workers from the adverse health and social consequences of flexible forms of employment. In this study, we use multilevel Poisson regression models to test the theoretical claim of the flexicurity approach using data for 23 countries across three waves of the European Social Survey. We construct an institutional typology of labour market regulation and social security to evaluate whether inequalities in self-reported health and limiting longstanding illness between temporary workers and their permanent counterparts are smaller in countries that most closely approximate the ideal type described by advocates of the flexicurity approach. Our results indicate that, while the association between temporary employment and health varies across countries, institutional configurations of labour market regulation and social security do not provide a meaningful explanation for this cross-national variation. Contrary to the expectations of the flexicurity hypothesis, our data do not indicate that employment-related inequalities are smaller in countries that approximate the flexicurity approach. We discuss potential explanations for these findings and conclude that there remains a relative lack of evidence in support of the theoretical claims of the flexicurity approach.

  3. Adverse health effects among adults exposed to home dampness and molds.

    Science.gov (United States)

    Dales, R E; Burnett, R; Zwanenburg, H

    1991-03-01

    To investigate the association between home dampness and mold and health, questionnaires were administered through the primary school system to parents of school-aged children in six regions of Canada. The present report focuses on the symptoms of the 14,799 adults at least 21 yr of age. The overall response rate was 83%, and missing values for individual variables ranged from 3 to 8%. The presence of home dampness and/or molds (that is, damp spots, visible mold or mildew, water damage, and flooding) was reported by 38% of respondents. The prevalence of lower respiratory symptoms (any cough, phlegm, wheeze, or wheeze with dyspnea) was increased among those reporting dampness or mold compared with those not reporting dampness or mold as follows: 38 versus 27% among current smokers, 21 versus 14% among exsmokers, and 19 versus 11% among nonsmokers (all p values less than 0.001). This association persisted after adjusting for several sociodemographic variables (including age, sex, and region) and several other exposure variables (including active and passive cigarette smoke, natural gas heating, and wood stoves). The odds ratio between symptoms and dampness was 1.62 (95% confidence interval, 1.48 to 1.78) in the final model chosen. This association persisted despite stratification by the presence of allergies or asthma. Exposure to home dampness and mold may be a risk factor for respiratory disease in the Canadian population.

  4. Adverse impact of industrial animal agriculture on the health and welfare of farmed animals.

    Science.gov (United States)

    D'Silva, Joyce

    2006-03-01

    Industrial animal agriculture is grounded in the concept of maximizing productivity and profit. Selective breeding for maximum productivity in one characteristic of the animal (e.g. milk yield in cows, or breast meat in broiler chickens) has resulted in genotypes and phenotypes that may predispose the animals to poor health and welfare. The conditions in which these individuals are kept may also frustrate many inherited behaviors that they are strongly motivated to perform. In order to curb the resulting harmful aberrant behaviors, such as feather-pecking in chickens, we sometimes resort to mutilating the animals. In many places chickens are routinely de-beaked by means of a hot metal guillotine. Compassion in World Farming (an international organization that promotes the humane treatment of farm animals) believes that it is unethical to treat sentient beings in such ways. We have a duty to respect farm animals' sentience by providing them with housing conditions that take their needs and wants into account, and by reverting to the use of dual-purpose, slower-growing breeds that have the potential for good welfare. Alternatives to current farming practices are available, and we owe it to the animals, and to our consciences, to pursue them.

  5. Preventive dental health care experiences of preschool-age children with special health care needs.

    Science.gov (United States)

    Huebner, Colleen E; Chi, Donald L; Masterson, Erin; Milgrom, Peter

    2015-01-01

    This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Study methods included 90 parent interviews and dental examinations of their preschool-age children. Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37% experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.

  6. Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey.

    Directory of Open Access Journals (Sweden)

    Aline Richard

    Full Text Available Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age.Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity. Wald tests were used to test for interactions.Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30-1.54, high cholesterol levels (OR 1.31, 95% CI 1.18-1.45, diabetes (OR 1.40, 95% CI 1.16-1.67, moderate and high psychological distress (OR 3.74, 95% CI 3.37-4.16, depression (OR 2.78, 95% CI 2.22-3.48 and impaired self-perceived health (OR 1.94, 95% CI 1.74-2.16. Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05-1.23. Age, but not sex, moderated loneliness' association with several variables.Loneliness is associated with poorer physical and mental health and unhealthy lifestyle, modified by age, but not by sex. Our findings

  7. Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey.

    Science.gov (United States)

    Richard, Aline; Rohrmann, Sabine; Vandeleur, Caroline L; Schmid, Margareta; Barth, Jürgen; Eichholzer, Monika

    2017-01-01

    Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age. Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS) were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity). Wald tests were used to test for interactions. Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30-1.54), high cholesterol levels (OR 1.31, 95% CI 1.18-1.45), diabetes (OR 1.40, 95% CI 1.16-1.67), moderate and high psychological distress (OR 3.74, 95% CI 3.37-4.16), depression (OR 2.78, 95% CI 2.22-3.48) and impaired self-perceived health (OR 1.94, 95% CI 1.74-2.16). Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05-1.23). Age, but not sex, moderated loneliness' association with several variables. Loneliness is associated with poorer physical and mental health and unhealthy lifestyle, modified by age, but not by sex. Our findings illustrate the

  8. Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey

    Science.gov (United States)

    Rohrmann, Sabine; Vandeleur, Caroline L.; Schmid, Margareta; Barth, Jürgen; Eichholzer, Monika

    2017-01-01

    Introduction Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age. Methods Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS) were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity). Wald tests were used to test for interactions. Results Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30–1.54), high cholesterol levels (OR 1.31, 95% CI 1.18–1.45), diabetes (OR 1.40, 95% CI 1.16–1.67), moderate and high psychological distress (OR 3.74, 95% CI 3.37–4.16), depression (OR 2.78, 95% CI 2.22–3.48) and impaired self-perceived health (OR 1.94, 95% CI 1.74–2.16). Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05–1.23). Age, but not sex, moderated loneliness’ association with several variables. Conclusion Loneliness is associated with poorer physical and mental health and unhealthy lifestyle

  9. Planned Cesarean Delivery at Term and Adverse Outcomes in Childhood Health

    Science.gov (United States)

    Black, Mairead; Bhattacharya, Siladitya; Philip, Sam; Norman, Jane E.; McLernon, David J.

    2016-01-01

    Importance Planned cesarean delivery comprises a significant proportion of births globally, with combined rates of planned and unscheduled cesarean delivery in a number of regions approaching 50%. Observational studies have shown that offspring born by cesarean delivery are at increased risk of ill health in childhood, but these studies have been unable to adjust for some key confounding variables. Additionally, risk of death beyond the neonatal period has not yet been reported for offspring born by planned cesarean delivery. Objective To investigate the relationship between planned cesarean delivery and offspring health problems or death in childhood. Design, Setting, and Participants Population-based data-linkage study of 321 287 term singleton first-born offspring born in Scotland, United Kingdom, between 1993 and 2007, with follow-up until February 2015. Exposures Offspring born by planned cesarean delivery in a first pregnancy were compared with offspring born by unscheduled cesarean delivery and with offspring delivered vaginally. Main Outcomes and Measures The primary outcome was asthma requiring hospital admission; secondary outcomes were salbutamol inhaler prescription at age 5 years, obesity at age 5 years, inflammatory bowel disease, type 1 diabetes, cancer, and death. Results Compared with offspring born by unscheduled cesarean delivery (n = 56 015 [17.4%]), those born by planned cesarean delivery (12 355 [3.8%]) were at no significantly different risk of asthma requiring hospital admission, salbutamol inhaler prescription at age 5 years, obesity at age 5 years, inflammatory bowel disease, cancer, or death but were at increased risk of type 1 diabetes (0.66% vs 0.44%; difference, 0.22% [95% CI, 0.13%-0.31%]; adjusted hazard ratio [HR], 1.35 [95% CI, 1.05-1.75]). In comparison with children born vaginally (n = 252 917 [78.7%]), offspring born by planned cesarean delivery were at increased risk of asthma requiring hospital admission (3.73% vs 3

  10. Psychological health of operators in NPPs and accident prevention

    International Nuclear Information System (INIS)

    Zhou Huayun

    2004-01-01

    Mental and physical health of operators of nuclear power plants (NPPs) is directly related to normal and safe operation of NPPs. The cognitive process, volitional character, attention, emotion, feeling and personality are important factors that affect operators' safe behavior. Alcohol, medical drugs and operators' biological rhythm are can also make great effects on their psychological health. By means of job-fitness psychological test, better candidates for operators could be primarily selected from point of psychological view. Psychological follow-up of post skill training, simulator training and practical work of operators can make NPPs prevent from operational accidents due to human errors to the greatest extent. It is helpful for NPPs to find and solve some psychological problems by means of psychological counseling, regulation or psychotherapy. (author)

  11. Jazzin' Healthy: Interdisciplinary Health Outreach Events Focused on Disease Prevention and Health Promotion.

    Science.gov (United States)

    Isaacs, Diana; Riley, Angela C; Prasad-Reddy, Lalita; Castner, Rebecca; Fields, Heather; Harper-Brown, Deborah; Hussein, Sabah; Johnson, Charisse L; Mangum, Traiana; Srivastava, Sneha

    2017-04-01

    Health-related disparities are a significant public health concern. In conjunction with a university concert series, healthcare professionals and students provided education, clinical services, and preventive care using an interdisciplinary approach to a primarily African American cohort. The objective was to assess cardiovascular risk factors and readiness to change health-related behaviors. Six outreach events were conducted over 3 years by an interdisciplinary team including pharmacy, medicine, nursing, nutrition, occupational therapy, public health, optometry, and health information technology. Clinical services, such as health screenings for glucose, blood pressure, cholesterol, and body fat along with counseling on the results and smoking cessation behavioral counseling, were provided. Education initiatives addressed bone health, heart disease, HIV risk, nutrition, and access to physician care. Preventative care included vaccinations and eye exams. There were 285 participants that were predominantly African American (95.8 %), female (71.5 %), and age within 55-64 years (45.1 %). Hypertension (50.8 %) and obesity (65.1 %) were the most common cardiovascular risk factors. Of those advised to make health behavior changes, 76.4 % reported they planned to make changes within 1 month. These interdisciplinary outreach events provided health information and access to care in a novel setting and led to a high rate of planned health behavior changes.

  12. Evaluating the implementation of a national disclosure policy for large-scale adverse events in an integrated health care system: identification of gaps and successes

    OpenAIRE

    Maguire, Elizabeth M.; Bokhour, Barbara G.; Wagner, Todd H.; Asch, Steven M.; Gifford, Allen L.; Gallagher, Thomas H.; Durfee, Janet M.; Martinello, Richard A.; Elwy, A. Rani

    2016-01-01

    Background Many healthcare organizations have developed disclosure policies for large-scale adverse events, including the Veterans Health Administration (VA). This study evaluated VA?s national large-scale disclosure policy and identifies gaps and successes in its implementation. Methods Semi-structured qualitative interviews were conducted with leaders, hospital employees, and patients at nine sites to elicit their perceptions of recent large-scale adverse events notifications and the nation...

  13. Magnesium in Disease Prevention and Overall Health12

    Science.gov (United States)

    Volpe, Stella Lucia

    2013-01-01

    Magnesium is the fourth most abundant mineral and the second most abundant intracellular divalent cation and has been recognized as a cofactor for >300 metabolic reactions in the body. Some of the processes in which magnesium is a cofactor include, but are not limited to, protein synthesis, cellular energy production and storage, reproduction, DNA and RNA synthesis, and stabilizing mitochondrial membranes. Magnesium also plays a critical role in nerve transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor tone, blood pressure, and glucose and insulin metabolism. Because of magnesium’s many functions within the body, it plays a major role in disease prevention and overall health. Low levels of magnesium have been associated with a number of chronic diseases including migraine headaches, Alzheimer’s disease, cerebrovascular accident (stroke), hypertension, cardiovascular disease, and type 2 diabetes mellitus. Good food sources of magnesium include unrefined (whole) grains, spinach, nuts, legumes, and white potatoes (tubers). This review presents recent research in the areas of magnesium and chronic disease, with the goal of emphasizing magnesium’s role in disease prevention and overall health. PMID:23674807

  14. Preventive health screenings and health consultations in primary care increase life expectancy without increasing costs

    DEFF Research Database (Denmark)

    Rasmussen, Susanne R; Thomsen, Janus Laust; Kilsmark, Janni

    2007-01-01

    AIMS: The intention was to investigate whether preventive health checks and health discussions are cost effective. METHODS: In a randomized trial the authors compared two intervention groups (A and B) and one control group. In 1991 2,000 30- to 49-year-old persons were invited and those who...... were given fixed appointments for health consultations. The follow-up period was six years. Analysis was carried out on the "intention to treat" principle. Outcome parameters were life years gained, and direct and total health costs (including productivity costs), discounted by 3% annually. Costs were...

  15. Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention

    Directory of Open Access Journals (Sweden)

    Samar Al-Hajj

    2017-09-01

    Full Text Available Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology—group analytics (GA. GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders’ observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results: The GA methodology triggered the emergence of ‘common ground’ among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders’ verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusions: Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ‘common ground’ among diverse stakeholders about health data and their implications.

  16. Birth Defects in India: Magnitude, Public Health Impact and Prevention

    Directory of Open Access Journals (Sweden)

    Anita Kar

    2014-07-01

    Full Text Available Birth defects refer to a group of diverse congenital conditions, which are responsible for stillbirths, neonatal deaths, chronic medical conditions and disability. Due to their low prevalence and high mortality, birth defects are not considered to be a significant health problem in India. Various data however identify that India may harbour a significant burden of birth defects, and that these conditions may be responsible for a considerable proportion of neonatal deaths in India. Although it is widely assumed that survival of patients with birth defects is low, data suggests that in 2002, there were nearly six million Indians living with impairments arising at birth. These data urge the need for implementation of a national birth defects programme in India, with a strong component of prevention. The need for significant research investments to understand the epidemiology and public health impact of birth defects in India is identified. Translation research, transcending the disciplines of medicine, public health and genetics is required to develop a low cost birth defects service as a component of the existing maternal and child health programme.

  17. [Guidelines for the preventive health care of hairdressing apprentices].

    Science.gov (United States)

    Golińska-Zach, Aleksandra; Wiszniewska, Marta; Walusiak-Skorupa, Jolanta

    2017-07-26

    Hairdressing is one of the most developing branch of the service industry in Poland. Providing representatives of this occupational group with preventive health care services it should be remembered that they are at risk of skin and respiratory diseases, which occur due to a quite frequent exposure to harmful agents in the work environment of hairdressers and hairdressing apprentices. Interestingly, a much lower number of researches concentrate on respiratory symptoms than on skin disorders in hairdressers. The authors of this article have carried out the first Polish follow-up study focused not only on skin disorders but also on respiratory tract symptoms in hairdressing apprentices. The results of the study have been reported in other publications while this paper presents a literature review based on EBSCO and PubMed databases, Elsevier and contained articles (on the subject discussed in this paper). On the basis of information obtained from the authors' own research evidence and from the literature review, the guidelines for the preventive health care of hairdressing apprentices were developed. It was confirmed that neither determination of allergen-specific immunoglobulin E (IgE) nor performance of skin prick tests (SPTs) and patch tests for hairdressing factors are necessary. They should be performed as a part of preventive medical examination only in those apprentice candidates and trainees in this profession who report work-related symptoms and it is suspected that they result from exposure to particular factor in the work environment. Med Pr 2017;68(5):677-687. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  18. Guidelines for the preventive health care of hairdressing apprentices

    Directory of Open Access Journals (Sweden)

    Aleksandra Golińska-Zach

    2017-10-01

    Full Text Available Hairdressing is one of the most developing branch of the service industry in Poland. Providing representatives of this occupational group with preventive health care services it should be remembered that they are at risk of skin and respiratory diseases, which occur due to a quite frequent exposure to harmful agents in the work environment of hairdressers and hairdressing apprentices. Interestingly, a much lower number of researches concentrate on respiratory symptoms than on skin disorders in hairdressers. The authors of this article have carried out the first Polish follow-up study focused not only on skin disorders but also on respiratory tract symptoms in hairdressing apprentices. The results of the study have been reported in other publications while this paper presents a literature review based on EBSCO and PubMed databases, Elsevier and contained articles (on the subject discussed in this paper. On the basis of information obtained from the authors’ own research evidence and from the literature review, the guidelines for the preventive health care of hairdressing apprentices were developed. It was confirmed that neither determination of allergen-specific immunoglobulin E (IgE nor performance of skin prick tests (SPTs and patch tests for hairdressing factors are necessary. They should be performed as a part of preventive medical examination only in those apprentice candidates and trainees in this profession who report work-related symptoms and it is suspected that they result from exposure to particular factor in the work environment. Med Pr 2017;68(5:677–687

  19. Disclosure of Adverse Events in Pediatrics.

    Science.gov (United States)

    2016-12-01

    Despite increasing attention to issues of patient safety, preventable adverse events (AEs) continue to occur, causing direct and consequential injuries to patients, families, and health care providers. Pediatricians generally agree that there is an ethical obligation to inform patients and families about preventable AEs and medical errors. Nonetheless, barriers, such as fear of liability, interfere with disclosure regarding preventable AEs. Changes to the legal system, improved communications skills, and carefully developed disclosure policies and programs can improve the quality and frequency of appropriate AE disclosure communications. Copyright © 2016 by the American Academy of Pediatrics.

  20. Adverse Weather Evokes Nostalgia.

    Science.gov (United States)

    van Tilburg, Wijnand A P; Sedikides, Constantine; Wildschut, Tim

    2018-03-01

    Four studies examined the link between adverse weather and the palliative role of nostalgia. We proposed and tested that (a) adverse weather evokes nostalgia (Hypothesis 1); (b) adverse weather causes distress, which predicts elevated nostalgia (Hypothesis 2); (c) preventing nostalgia exacerbates weather-induced distress (Hypothesis 3); and (d) weather-evoked nostalgia confers psychological benefits (Hypothesis 4). In Study 1, participants listened to recordings of wind, thunder, rain, and neutral sounds. Adverse weather evoked nostalgia. In Study 2, participants kept a 10-day diary recording weather conditions, distress, and nostalgia. We also obtained meteorological data. Adverse weather perceptions were positively correlated with distress, which predicted higher nostalgia. Also, adverse natural weather was associated with corresponding weather perceptions, which predicted elevated nostalgia. (Results were mixed for rain.) In Study 3, preventing nostalgia (via cognitive load) increased weather-evoked distress. In Study 4, weather-evoked nostalgia was positively associated with psychological benefits. The findings pioneer the relevance of nostalgia as source of comfort in adverse weather.

  1. [Electrosmog, cellular phones, sunbeds etc. -- adverse health effects from radiation? Health aspects of non-ionizing radiation].

    Science.gov (United States)

    Bernhardt, J H

    2005-01-01

    This review supplies a survey of the three physical influences, i. e. UV radiation, high-frequency electromagnetic fields of radio telephone systems and other wireless radio applications as well as low-frequency fields of electric power supply. The exposure to UV radiation must be considered to be by far the highest health risk. The annual rate of about 2000 deaths from skin cancer in Germany, mainly caused by extensive exposure to solar UV radiation, demands protective measures. Teaching reasonable behaviour is the supreme issue. Recommended protective measures in the order of their effectiveness are protection by adaptation of behaviour, by clothes, sun hats and sunglasses as well as by sun creams. Children are the most important target group. With regard to UV tanning appliances it is recommended not to use artificial UV radiation for cosmetic purposes because of the related health risks. For the assessment of health impairments caused by exposure to electromagnetic fields, direct field reactions due to induced electric body currents, reactions on the surface of the body or heating effects should be separated from indirect field reactions (e. g. electric shocks and burns) due to contact currents or interference with electronic body aids and implants. Risk assessment has led to recommendations of threshold values which-in agreement with international research results-exclude all impairments of health caused by direct field reactions scientifically proven to date. Contrary to public concerns, which are mostly related to base transmitters of radio telephone systems, exposure due to handheld radio telephones (cellular phones) should rather be considered from the viewpoint of precautionary health protection, since it is more likely that their use can lead to high exposure of the user. Due to the protective measures provided so far and observance of the threshold values based on scientific results, exposures do not lead to health impairments-not even in children

  2. INTERDISCIPLINARY MODULE IN PREVENTION AND HEALTH PROMOTION IN POPULATION HEALTH FOR OCCUPATIONAL THERAPY AND PHYSIOTHERAPY STUDENTS

    DEFF Research Database (Denmark)

    Brandt, Jørgen

    PURPOSE: The purpose is to provide physiotherapy and occupational therapy students at the University College Cvu vita in Holstebro, Denmark, the opportunity to develop competences for interdisciplinary working situations concerning promotion of population health. RELEVANCE: The Danish Ministry......-operation, and we find that especially the area of population health represents multi factorial cases suited for training of strategies for interdisciplinary problem solving. DESCRIPTION: The course unit is an obligatory, interdisciplinary, 10 week, full time project-based module in prevention, health promotion......-operate towards appropriate solutions. The groups suggest and present preventive and health promotion solutions and strategies especially designed for this particular situation. The groups are supervised by an interdisciplinary team of occupational therapy and physiotherapy lecturers. In addition...

  3. Differences between Drug-Induced and Contrast Media-Induced Adverse Reactions Based on Spontaneously Reported Adverse Drug Reactions.

    Science.gov (United States)

    Ryu, JiHyeon; Lee, HeeYoung; Suh, JinUk; Yang, MyungSuk; Kang, WonKu; Kim, EunYoung

    2015-01-01

    We analyzed differences between spontaneously reported drug-induced (not including contrast media) and contrast media-induced adverse reactions. Adverse drug reactions reported by an in-hospital pharmacovigilance center (St. Mary's teaching hospital, Daejeon, Korea) from 2010-2012 were classified as drug-induced or contrast media-induced. Clinical patterns, frequency, causality, severity, Schumock and Thornton's preventability, and type A/B reactions were recorded. The trends among causality tools measuring drug and contrast-induced adverse reactions were analyzed. Of 1,335 reports, 636 drug-induced and contrast media-induced adverse reactions were identified. The prevalence of spontaneously reported adverse drug reaction-related admissions revealed a suspected adverse drug reaction-reporting rate of 20.9/100,000 (inpatient, 0.021%) and 3.9/100,000 (outpatients, 0.004%). The most common adverse drug reaction-associated drug classes included nervous system agents and anti-infectives. Dermatological and gastrointestinal adverse drug reactions were most frequently and similarly reported between drug and contrast media-induced adverse reactions. Compared to contrast media-induced adverse reactions, drug-induced adverse reactions were milder, more likely to be preventable (9.8% vs. 1.1%, p contrast media-induced adverse reactions (56.6%, p = 0.066). Causality patterns differed between the two adverse reaction classes. The World Health Organization-Uppsala Monitoring Centre causality evaluation and Naranjo algorithm results significantly differed from those of the Korean algorithm version II (p contrast media-induced adverse reactions. The World Health Organization-Uppsala Monitoring Centre and Naranjo algorithm causality evaluation afforded similar results.

  4. ADEPt, a semantically-enriched pipeline for extracting adverse drug events from free-text electronic health records.

    Directory of Open Access Journals (Sweden)

    Ehtesham Iqbal

    Full Text Available Adverse drug events (ADEs are unintended responses to medical treatment. They can greatly affect a patient's quality of life and present a substantial burden on healthcare. Although Electronic health records (EHRs document a wealth of information relating to ADEs, they are frequently stored in the unstructured or semi-structured free-text narrative requiring Natural Language Processing (NLP techniques to mine the relevant information. Here we present a rule-based ADE detection and classification pipeline built and tested on a large Psychiatric corpus comprising 264k patients using the de-identified EHRs of four UK-based psychiatric hospitals. The pipeline uses characteristics specific to Psychiatric EHRs to guide the annotation process, and distinguishes: a the temporal value associated with the ADE mention (whether it is historical or present, b the categorical value of the ADE (whether it is assertive, hypothetical, retrospective or a general discussion and c the implicit contextual value where the status of the ADE is deduced from surrounding indicators, rather than explicitly stated. We manually created the rulebase in collaboration with clinicians and pharmacists by studying ADE mentions in various types of clinical notes. We evaluated the open-source Adverse Drug Event annotation Pipeline (ADEPt using 19 ADEs specific to antipsychotics and antidepressants medication. The ADEs chosen vary in severity, regularity and persistence. The average F-measure and accuracy achieved by our tool across all tested ADEs were 0.83 and 0.83 respectively. In addition to annotation power, the ADEPT pipeline presents an improvement to the state of the art context-discerning algorithm, ConText.

  5. Health behaviours of young mothers: Implications for health promotion and cancer prevention

    OpenAIRE

    Hackshaw-mcgeagh, Lucy; Jamie, Kimberly; Beynon, Rhona; O’neill, Roisin

    2017-01-01

    Objective: Evidence suggests that younger mothers engage in poorer health behaviours, resulting in increased cancer risk. We aimed to better understand the health behaviours of younger mothers and the factors that influence their lifestyle choices, in order to improve cancer prevention within this population. Methods: A multiple focus group, photo-elicitation-aided approach was used, in which young mothers (n = 27; aged 16–24 years) were provided with cameras and asked to capture ‘a week in y...

  6. Examining resilience of quality of life in the face of health-related and psychosocial adversity at older ages: what is "right" about the way we age?

    Science.gov (United States)

    Hildon, Zoe; Montgomery, Scott M; Blane, David; Wiggins, Richard D; Netuveli, Gopalakrishnan

    2010-02-01

    This article examines resilience at older ages, focusing on the relationships between quality of life (qol) and adversity. Our objectives are to identify (a) the basis of adversity, (b) the characteristics of resilient individuals, and (c) the attributes that attenuate the full impact of adversity. Resilience is defined as flourishing despite adversity. Analysis is carried out in a subsample of the Boyd Orr cohort (aged between 68 and 82 years) using questionnaire data. Adversity was identified as circumstances that produce a significant average decrease in qol (CASP-19 scores). Participants were classified into resilient and vulnerable groups based on high or low qol (CASP-19 scores dichotomized at the median) in the face of significant adversity. Shared characteristics that define these outcomes are reported. Attributes that attenuate the negative impact of adversity were analyzed using stratified logistic regression. Adversity was typified by functional limitation; life getting worse in the domains of health, stress, and general living circumstances; and experiencing a negative life event. The resilient tended to report fewer multiple adversities. Indicators of protective attributes, which also characterized resilient outcomes relative to qol, included good quality relationships (5.105, confidence interval [CI] 95% 1.323-19.699), integration in the community (10.800, 95% CI 1.227-95.014), developmental coping (3.397, 95% CI 1.079-10.690), and adaptive coping styles (3.211, 95% CI 1.041-9.910). Overall results indicate that policies that offer access to protection and help minimize adversity exposure where possible will promote resilience.

  7. Effectiveness of Mindfulness-Based Relapse Prevention in opioid Dependence Treatment &Mental Health

    Directory of Open Access Journals (Sweden)

    2008-11-01

    Findings: therapy compliance, retention in treatment, decrease in somatic symptoms, anxiety, social dysfunction and increase in health was significantly in both combination of psychological intervention method than the Naltroxan group. Mindfulness-based on relapse prevention was more effective than CBT relapse prevention in decreasing of, social dysfunction, relapse prevention, increase of therapy compliance, and health. Results: Mindfulness based relapse prevention was superior to CBT and Naltroxan and considerably increased effectiveness of opioid relapse prevention therapy.

  8. Correlates of Adverse Outcomes in Abdominally Obese Individuals: Findings from the Five-Year Followup of the Population-Based Study of Health in Pomerania

    Directory of Open Access Journals (Sweden)

    Nele Friedrich

    2013-01-01

    Full Text Available Background. Abdominal obesity is a major risk factor of cardiovascular disease (CVD, type 2 diabetes (T2DM, and premature death. However, it has not been resolved which factors predispose for the development of these adverse obesity-related outcomes in otherwise healthy individuals with abdominal obesity. Methods. We studied 1,506 abdominal obese individuals (waist-to-height ratio (WHtR ≥ 0.5 free of CVD or T2DM from the population-based Study of Health in Pomerania and assessed the incidence of CVD or T2DM after a five-year followup. Logistic regression models were adjusted for major cardiovascular risk factors and liver, kidney diseases, and sociodemographic status. Results. During follow-up time, we observed 114 and 136 new T2DM and CVD cases, respectively. Regression models identified age, waist circumference, serum glucose, and liver disease as predictors of T2DM. Regarding CVD, only age, unemployment, and a divorced or widowed marital status were significantly associated with incident CVD. In this subgroup of obese individuals blood pressure, serum glucose, or lipids did not influence incidence of T2DM or CVD. Conclusion. We identified various factors associated with an increased risk of incident T2DM and CVD among abdominally obese individuals. These findings may improve the detection of high-risk individuals and help to advance prevention strategies in abdominal obesity.

  9. 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

  10. OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion

    NARCIS (Netherlands)

    Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

    2006-01-01

    PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health

  11. Punica granatum (Pomegranate activity in health promotion and cancer prevention

    Directory of Open Access Journals (Sweden)

    Shahindokht Bassiri-Jahromi

    2018-01-01

    Full Text Available Cancer has become one of the most fatal diseases in most countries. In spite of the medical care developing, cancer still remains a significant problem. The majority of the cancers are resistant to treatment. Thus, the research for novel, more efficient and less side effect treatment methods continues. Pomegranate contains strong antioxidant activity, with potential health interests. Research concern in pomegranate is increasing because of their anticancer potential due to possess rich in polyphenols. We highlight the pomegranate potential health benefits and mechanism of cancer progression inhibition. Pomegranate has indicated antiproliferative, anti-metastatic and anti-invasive effects on different cancer cell line in vitro, in vivo and clinical trial. The aim of this review is to evaluate functional properties and the medical benifits of pomegranate against various cancer diseases. In addition, pomegranate properties in in vitro and in vivo experimental human and animal clinical trials and its future use are explored. The available data suggest that Punica granatum (pomegranate might be used in the control and potential therapeutic for some disease conditions and benefits human health status. This review summarizes in vitro, in vivo and clinical trial studies highlighting the pomegranate role in prevent and treatment of breast, prostate, lung, colon, skin and hepatocellular cell cancers.

  12. Punica granatum (Pomegranate) activity in health promotion and cancer prevention

    Science.gov (United States)

    2018-01-01

    Cancer has become one of the most fatal diseases in most countries. In spite of the medical care developing, cancer still remains a significant problem. The majority of the cancers are resistant to treatment. Thus, the research for novel, more efficient and less side effect treatment methods continues. Pomegranate contains strong antioxidant activity, with potential health interests. Research concern in pomegranate is increasing because of their anticancer potential due to possess rich in polyphenols. We highlight the pomegranate potential health benefits and mechanism of cancer progression inhibition. Pomegranate has indicated antiproliferative, anti-metastatic and anti-invasive effects on different cancer cell line in vitro, in vivo and clinical trial. The aim of this review is to evaluate functional properties and the medical benifits of pomegranate against various cancer diseases. In addition, pomegranate properties in in vitro and in vivo experimental human and animal clinical trials and its future use are explored. The available data suggest that Punica granatum (pomegranate) might be used in the control and potential therapeutic for some disease conditions and benefits human health status. This review summarizes in vitro, in vivo and clinical trial studies highlighting the pomegranate role in prevent and treatment of breast, prostate, lung, colon, skin and hepatocellular cell cancers. PMID:29441150

  13. Food Components in Health Promotion and Disease Prevention.

    Science.gov (United States)

    Langhans, Wolfgang

    2018-03-14

    The current obesity epidemic with its deleterious effects on public health and the increase in the prevalence of non-communicable diseases in our aging society have dramatically increased public awareness of nutrition-related health issues. On one hand, food components, such as fat, sugar, flavors, and spices, are major determinants of the hedonic value of food, and the constant and almost ubiquitous availability of good-tasting food in our affluent societies promotes overeating and weight gain. On the other hand, several food components, including flavoring compounds and the active ingredients of many plants, such as spices and herbs (e.g., polyphenols and capsaicinoids) or thylakoids, supposedly can decrease food intake and affect gastrointestinal function and metabolism. These substances may act as antioxidants, may stimulate the release of incretins and, hence, insulin, and may improve insulin sensitivity or decrease plasma levels of lipids. Such beneficial effects are often difficult to demonstrate in epidemiological studies because they may occur only at supraphysiological doses and/or when the purified compounds are administered, but they can be present under certain circumstances. This review discusses the putative mechanisms of the health-promoting and disease-preventing effects of some food components and their potential physiological relevance, primarily with respect to counteracting obesity and type 2 diabetes.

  14. Punica granatum (Pomegranate) activity in health promotion and cancer prevention.

    Science.gov (United States)

    Bassiri-Jahromi, Shahindokht

    2018-01-30

    Cancer has become one of the most fatal diseases in most countries. In spite of the medical care developing, cancer still remains a significant problem. The majority of the cancers are resistant to treatment. Thus, the research for novel, more efficient and less side effect treatment methods continues. Pomegranate contains strong antioxidant activity, with potential health interests. Research concern in pomegranate is increasing because of their anticancer potential due to possess rich in polyphenols. We highlight the pomegranate potential health benefits and mechanism of cancer progression inhibition. Pomegranate has indicated antiproliferative, anti-metastatic and anti-invasive effects on different cancer cell line in vitro , in vivo and clinical trial. The aim of this review is to evaluate functional properties and the medical benifits of pomegranate against various cancer diseases. In addition, pomegranate properties in in vitro and in vivo experimental human and animal clinical trials and its future use are explored. The available data suggest that Punica granatum (pomegranate) might be used in the control and potential therapeutic for some disease conditions and benefits human health status. This review summarizes in vitro , in vivo and clinical trial studies highlighting the pomegranate role in prevent and treatment of breast, prostate, lung, colon, skin and hepatocellular cell cancers.

  15. A cooperative reduction model for regional air pollution control in China that considers adverse health effects and pollutant reduction costs.

    Science.gov (United States)

    Xie, Yujing; Zhao, Laijun; Xue, Jian; Hu, Qingmi; Xu, Xiang; Wang, Hongbo

    2016-12-15

    How to effectively control severe regional air pollution has become a focus of global concern recently. The non-cooperative reduction model (NCRM) is still the main air pollution control pattern in China, but it is both ineffective and costly, because each province must independently fight air pollution. Thus, we proposed a cooperative reduction model (CRM), with the goal of maximizing the reduction in adverse health effects (AHEs) at the lowest cost by encouraging neighboring areas to jointly control air pollution. CRM has two parts: a model of optimal pollutant removal rates using two optimization objectives (maximizing the reduction in AHEs and minimizing pollutant reduction cost) while meeting the regional pollution control targets set by the central government, and a model that allocates the cooperation benefits (i.e., health improvement and cost reduction) among the participants according to their contributions using the Shapley value method. We applied CRM to the case of sulfur dioxide (SO 2 ) reduction in Yangtze River Delta region. Based on data from 2003 to 2013, and using mortality due to respiratory and cardiovascular diseases as the health endpoints, CRM saves 437 more lives than NCRM, amounting to 12.1% of the reduction under NCRM. CRM also reduced costs by US $65.8×10 6 compared with NCRM, which is 5.2% of the total cost of NCRM. Thus, CRM performs significantly better than NCRM. Each province obtains significant benefits from cooperation, which can motivate them to actively cooperate in the long term. A sensitivity analysis was performed to quantify the effects of parameter values on the cooperation benefits. Results shown that the CRM is not sensitive to the changes in each province's pollutant carrying capacity and the minimum pollutant removal capacity, but sensitive to the maximum pollutant reduction capacity. Moreover, higher cooperation benefits will be generated when a province's maximum pollutant reduction capacity increases. Copyright

  16. Burden and Prevention of Adverse Cardiac Events in Patients with Concomitant Chronic Heart Failure and Coronary Artery Disease: A Literature Review.

    Science.gov (United States)

    Lavoie, Louis; Khoury, Hanane; Welner, Sharon; Briere, Jean-Baptiste

    2016-06-01

    Chronic heart failure (HF) or coronary artery disease (CAD) confers risk for thromboembolism and secondary adverse cardiac events (ACEs) (e.g., mortality, myocardial infarction, and stroke). When HF and CAD occur concomitantly, ACE risk is reported to be elevated. We investigated ACEs, their epidemiology, and the resulting burden among patients with concomitant HF and CAD through a structured review of recent literature. Antithrombotic treatment for ACE prevention was assessed. Pertinent databases (PubMed, other) were searched for relevant articles published from January 2004 to March 2015. Data collected included ACE incidence, healthcare resource use, costs, change in quality of life attributed to ACEs, and treatment practice for prevention of ACEs in patients with concomitant HF and CAD. Mortality rates for patients with both HF and CAD ranged from 4.9-12.3% at 30 days to 13.7-86% for periods between 9.9 months and 10 years. Incidence of ACEs among HF patients with CAD is, respectively, at least 82% and 15% higher than for patients without HF or without CAD, except for stroke investigated in two studies. All-cause and HF-related hospitalization is the main driver of the economic burden in patients with HF, the majority of whom had CAD origin. Despite high prevalence of ischemic complications, there is limited evidence to support the use of warfarin-type antithrombotics among HF patients. This study confirms that patients with concomitant HF and CAD are at elevated risk for ACEs and suggests the need for effective new antithrombotic treatments to further decrease ischemic complication rates in this population. © 2016 John Wiley & Sons Ltd.

  17. Standard-based comprehensive detection of adverse drug reaction signals from nursing statements and laboratory results in electronic health records.

    Science.gov (United States)

    Lee, Suehyun; Choi, Jiyeob; Kim, Hun-Sung; Kim, Grace Juyun; Lee, Kye Hwa; Park, Chan Hee; Han, Jongsoo; Yoon, Dukyong; Park, Man Young; Park, Rae Woong; Kang, Hye-Ryun; Kim, Ju Han

    2017-07-01

    We propose 2 Medical Dictionary for Regulatory Activities-enabled pharmacovigilance algorithms, MetaLAB and MetaNurse, powered by a per-year meta-analysis technique and improved subject sampling strategy. This study developed 2 novel algorithms, MetaLAB for laboratory abnormalities and MetaNurse for standard nursing statements, as significantly improved versions of our previous electronic health record (EHR)-based pharmacovigilance method, called CLEAR. Adverse drug reaction (ADR) signals from 117 laboratory abnormalities and 1357 standard nursing statements for all precautionary drugs ( n   = 101) were comprehensively detected and validated against SIDER (Side Effect Resource) by MetaLAB and MetaNurse against 11 817 and 76 457 drug-ADR pairs, respectively. We demonstrate that MetaLAB (area under the curve, AUC = 0.61 ± 0.18) outperformed CLEAR (AUC = 0.55 ± 0.06) when we applied the same 470 drug-event pairs as the gold standard, as in our previous research. Receiver operating characteristic curves for 101 precautionary terms in the Medical Dictionary for Regulatory Activities Preferred Terms were obtained for MetaLAB and MetaNurse (0.69 ± 0.11; 0.62 ± 0.07), which complemented each other in terms of ADR signal coverage. Novel ADR signals discovered by MetaLAB and MetaNurse were successfully validated against spontaneous reports in the US Food and Drug Administration Adverse Event Reporting System database. The present study demonstrates the symbiosis of laboratory test results and nursing statements for ADR signal detection in terms of their system organ class coverage and performance profiles. Systematic discovery and evaluation of the wide spectrum of ADR signals using standard-based observational electronic health record data across many institutions will affect drug development and use, as well as postmarketing surveillance and regulation. © The Author 2017. Published by Oxford University Press on behalf of the American

  18. Knowledge engineering for adverse drug event prevention: on the design and development of a uniform, contextualized and sustainable knowledge-based framework.

    Science.gov (United States)

    Koutkias, Vassilis; Kilintzis, Vassilis; Stalidis, George; Lazou, Katerina; Niès, Julie; Durand-Texte, Ludovic; McNair, Peter; Beuscart, Régis; Maglaveras, Nicos

    2012-06-01

    The primary aim of this work was the development of a uniform, contextualized and sustainable knowledge-based framework to support adverse drug event (ADE) prevention via Clinical Decision Support Systems (CDSSs). In this regard, the employed methodology involved first the systematic analysis and formalization of the knowledge sources elaborated in the scope of this work, through which an application-specific knowledge model has been defined. The entire framework architecture has been then specified and implemented by adopting Computer Interpretable Guidelines (CIGs) as the knowledge engineering formalism for its construction. The framework integrates diverse and dynamic knowledge sources in the form of rule-based ADE signals, all under a uniform Knowledge Base (KB) structure, according to the defined knowledge model. Equally important, it employs the means to contextualize the encapsulated knowledge, in order to provide appropriate support considering the specific local environment (hospital, medical department, language, etc.), as well as the mechanisms for knowledge querying, inference, sharing, and management. In this paper, we present thoroughly the establishment of the proposed knowledge framework by presenting the employed methodology and the results obtained as regards implementation, performance and validation aspects that highlight its applicability and virtue in medication safety. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Public health implications: translation into diabetes prevention initiatives--four-level public health concept.

    Science.gov (United States)

    Schwarz, Peter E H

    2011-03-01

    Many countries are struggling to meet the health care needs of a rapidly growing number of individuals with common chronic illnesses, especially diabetes mellitus. Incorporating the evidence from prevention trials into clinical practice represents one of the major challenges for public health, and the medical community is still learning how this can best be achieved at a population level. A 4-level public health initiative has been initiated that provides guidance for establishing milestones and strategies for such a program. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Implications of the 2015 World Health Organization isoniazid preventive therapy recommendations on tuberculosis prevention efforts in Namibia.

    Science.gov (United States)

    Oloo, Stella Anne

    2016-07-01

    The World Health Organization recently released guidelines recommending 36-month use of isoniazid preventive therapy in adults and adolescents living with HIV in resource-limited settings. Namibia continues to grapple with one of the highest incidences of tuberculosis (TB) worldwide. Implementation of these guidelines requires considerations of TB epidemiology, health infrastructure, programmatic priorities and patient adherence. This article explores the challenges Namibia currently faces in its fight against TB and the implications of the new guidelines on Namibian TB prevention efforts.

  1. Improving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Moineddin Rahim

    2006-07-01

    Full Text Available Abstract Background To determine the effectiveness of a single checklist reminder form to improve the delivery of preventive health services at adult health check-ups in a family practice setting. Methods A prospective cluster randomized controlled trial was conducted at four urban family practice clinics among 38 primary care physicians affiliated with the University of Toronto. Preventive Care Checklist Forms© were created to be used by family physicians at adult health check-ups over a five-month period. The sex-specific forms incorporate evidence-based recommendations on preventive health services and documentation space for routine procedures such as physical examination. The forms were used in two intervention clinics and two control clinics. Rates and relative risks (RR of the performance of 13 preventive health maneuvers at baseline and post-intervention and the percentage of up-to-date preventive health services delivered per patient were compared between the two groups. Results Randomly-selected charts were reviewed at baseline (n = 509 and post-intervention (n = 608. Baseline rates for provision of preventive health services ranged from 3% (fecal occult blood testing to 93% (blood pressure measurement, similar to other settings. The percentage of up-to-date preventive health services delivered per patient at the end of the intervention was 48.9% in the control group and 71.7% in the intervention group. This is an overall 22.8% absolute increase (p = 0.0001, and 46.6% relative increase in the delivery of preventive health services per patient in the intervention group compared to controls. Eight of thirteen preventive health services showed a statistically significant change (p Conclusion This simple, low cost, clinically relevant intervention improves the delivery of preventive health services by prompting physicians of evidence-based recommendations in a checklist format that incorporates existing practice patterns. Periodic updates

  2. Decolonization in Prevention of Health Care-Associated Infections

    Science.gov (United States)

    Schweizer, Marin L.

    2016-01-01

    SUMMARY Colonization with health care-associated pathogens such as Staphylococcus aureus, enterococci, Gram-negative organisms, and Clostridium difficile is associated with increased risk of infection. Decolonization is an evidence-based intervention that can be used to prevent health care-associated infections (HAIs). This review evaluates agents used for nasal topical decolonization, topical (e.g., skin) decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination. Although the majority of studies performed to date have focused on S. aureus decolonization, there is increasing interest in how to apply decolonization strategies to reduce infections due to Gram-negative organisms, especially those that are multidrug resistant. Nasal topical decolonization agents reviewed include mupirocin, bacitracin, retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, photodynamic therapy, omiganan pentahydrochloride, and lysostaphin. Mupirocin is still the gold standard agent for S. aureus nasal decolonization, but there is concern about mupirocin resistance, and alternative agents are needed. Of the other nasal decolonization agents, large clinical trials are still needed to evaluate the effectiveness of retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, omiganan pentahydrochloride, and lysostaphin. Given inferior outcomes and increased risk of allergic dermatitis, the use of bacitracin-containing compounds cannot be recommended as a decolonization strategy. Topical decolonization agents reviewed included chlorhexidine gluconate (CHG), hexachlorophane, povidone-iodine, triclosan, and sodium hypochlorite. Of these, CHG is the skin decolonization agent that has the strongest evidence base, and sodium hypochlorite can also be recommended. CHG is associated with prevention of infections due to Gram-positive and Gram-negative organisms as well as Candida. Conversely, triclosan use is discouraged, and

  3. Future Directions in Childhood Adversity and Youth Psychopathology.

    Science.gov (United States)

    McLaughlin, Katie A

    2016-01-01

    Despite long-standing interest in the influence of adverse early experiences on mental health, systematic scientific inquiry into childhood adversity and developmental outcomes has emerged only recently. Existing research has amply demonstrated that exposure to childhood adversity is associated with elevated risk for multiple forms of youth psychopathology. In contrast, knowledge of developmental mechanisms linking childhood adversity to the onset of psychopathology-and whether those mechanisms are general or specific to particular kinds of adversity-remains cursory. Greater understanding of these pathways and identification of protective factors that buffer children from developmental disruptions following exposure to adversity is essential to guide the development of interventions to prevent the onset of psychopathology following adverse childhood experiences. This article provides recommendations for future research in this area. In particular, use of a consistent definition of childhood adversity, integration of studies of typical development with those focused on childhood adversity, and identification of distinct dimensions of environmental experience that differentially influence development are required to uncover mechanisms that explain how childhood adversity is associated with numerous psychopathology outcomes (i.e., multifinality) and identify moderators that shape divergent trajectories following adverse childhood experiences. A transdiagnostic model that highlights disruptions in emotional processing and poor executive functioning as key mechanisms linking childhood adversity with multiple forms of psychopathology is presented as a starting point in this endeavour. Distinguishing between general and specific mechanisms linking childhood adversity with psychopathology is needed to generate empirically informed interventions to prevent the long-term consequences of adverse early environments on children's development.

  4. Endocrine-disrupting activity of hydraulic fracturing chemicals and adverse health outcomes after prenatal exposure in male mice

    Science.gov (United States)

    Kassotis, Christopher D.; Klemp, Kara C.; Vu, Danh C.; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L.; Pinatti, Lisa; Zoeller, R. Thomas; Drobnis, Erma Z.; Balise, Victoria D.; Isiguzo, Chiamaka J.; Williams, Michelle A.; Tillitt, Donald E.; Nagel, Susan C.

    2015-01-01

    Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals.

  5. Adverse impact of international NGOs during and after the Bam earthquake: health system's consumers' points of view.

    Science.gov (United States)

    Seyedin, Seyed Hesam; Aflatoonian, Mohammad Reza; Ryan, James

    2009-01-01

    On December 26, 2003, an earthquake occurred in the city of Bam in Iran which completely destroyed the city. National and international responses to the calamity were quick and considerable and nongovernmental organizations (NGOs) from all over the world conducted extensive emergency assistance, fulfilling a crucial role during the emergency. The present study discusses some difficulties and problems which originated from the activities of international NGOs during their response to the Bam earthquake. A qualitative study using semistructured interview technique was conducted with nineteen public health and therapeutic affairs managers who were directly responsible for response and recovery in Bam. Analysis of the data was carried out by the framework analysis technique and supported by qualitative research software, the Atlas.ti. The study found that although international NGOs did their best to help people in the region, they also had some adverse impacts on the community in the disaster affected areas. The problems originated from lack of knowledge of cultural issues, inefficient timing for the delivery of funds and services, uneven goods delivery, and poor communication with local people and authorities. The study's findings could have implications for the international aid organizations including the United Nations (UN). Some activities such as roles and responsibilities of the NGOs; networking; and coordination and education of the NGOs could serve as the cornerstone for improvement of their efforts during disasters.

  6. Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study.

    Science.gov (United States)

    Nabi, Hermann; Kivimäki, Mika; Batty, G David; Shipley, Martin J; Britton, Annie; Brunner, Eric J; Vahtera, Jussi; Lemogne, Cédric; Elbaz, Alexis; Singh-Manoux, Archana

    2013-09-01

    Response to stress can vary greatly between individuals. However, it remains unknown whether perceived impact of stress on health is associated with adverse health outcomes. We examined whether individuals who report that stress adversely affects their health are at increased risk of coronary heart disease (CHD) compared with those who report that stress has no adverse health impact. Analyses are based on 7268 men and women (mean age: 49.5 years, interquartile range: 11 years) from the British Whitehall II cohort study. Over 18 years of follow-up, there were 352 coronary deaths or first non-fatal myocardial infarction (MI) events. After adjustment for sociodemographic characteristics, participants who reported at baseline that stress has affected their health 'a lot or extremely' had a 2.12 times higher (95% CI 1.52-2.98) risk of coronary death or incident non-fatal MI when compared with those who reported no effect of stress on their health. This association was attenuated but remained statistically significant after adjustment for biological, behavioural, and other psychological risk factors including perceived stress levels, and measures of social support; fully adjusted hazard ratio: 1.49 (95% CI 1.01-2.22). In this prospective cohort study, the perception that stress affects health, different from perceived stress levels, was associated with an increased risk of coronary heart disease. Randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health.

  7. The Relationship of Health Literacy with Health status, Preventive Behaviors and Health services Utilization in Baluchistan, Iran

    Directory of Open Access Journals (Sweden)

    Hossien Izadirad

    2015-12-01

    Full Text Available Background and Objectives: Health Literacy has been defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. People with inadequate health literacy have poorer health status. Thus, the aim of this study was to determine the status of health literacy and its relationship with general health status, use of health services and preventive behaviors. Materials and Methods: This descriptive-analytical study was conducted on 400 individuals aged 18to 65 years in Balochestan, Iran. Multi-stage cluster sampling was used. Data were collected using Health Literacy for Iranian Adults (HELIA questionnaires. Data analyses were conducted using Kruskal-Wallis and Mann-Whitney, using SPSS (version 18. Results: The mean age of the studied population was 9.29± 28.7years. Only %32 of adults were found to have adequate health literacy. Inadequate health literacy was more common in older people, ones with fewer years of schooling or lower household income, and females. The health literacy level was associated with outpatient visits, screening, and health status. Individuals with higher levels of health literacy had performed screening more than others. conclusions: Due to the low health literacy level in the target population, educational interventions are needed to develop health literacy skills in the community.

  8. Mobile phone base stations and adverse health effects: phase 1 of a population-based, cross-sectional study in Germany.

    Science.gov (United States)

    Blettner, M; Schlehofer, B; Breckenkamp, J; Kowall, B; Schmiedel, S; Reis, U; Potthoff, P; Schüz, J; Berg-Beckhoff, G

    2009-02-01

    The aim of this first phase of a cross-sectional study from Germany was to investigate whether proximity of residence to mobile phone base stations as well as risk perception is associated with health complaints. The researchers conducted a population-based, multi-phase, cross-sectional study within the context of a large panel survey regularly carried out by a private research institute in Germany. In the initial phase, reported on in this paper, 30,047 persons from a total of 51,444 who took part in the nationwide survey also answered questions on how mobile phone base stations affected their health. A list of 38 health complaints was used. A multiple linear regression model was used to identify predictors of health complaints including proximity of residence to mobile phone base stations and risk perception. Of the 30,047 participants (response rate 58.6%), 18.7% of participants were concerned about adverse health effects of mobile phone base stations, while an additional 10.3% attributed their personal adverse health effects to the exposure from them. Participants who were concerned about or attributed adverse health effects to mobile phone base stations and those living in the vicinity of a mobile phone base station (500 m) reported slightly more health complaints than others. A substantial proportion of the German population is concerned about adverse health effects caused by exposure from mobile phone base stations. The observed slightly higher prevalence of health complaints near base stations can not however be fully explained by attributions or concerns.

  9. Serious fall injury history and adverse health outcomes after initiating hemodialysis among older U.S. adults.

    Science.gov (United States)

    Bowling, C Barrett; Hall, Rasheeda; Khakharia, Anjali; Franch, Harold A; Plantinga, Laura C

    2018-01-16

    Although older adults with pre-dialysis chronic kidney disease (CKD) are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. We examined the association between a serious fall injury in the year prior to starting hemodialysis and adverse health outcomes in the year following dialysis initiation using a retrospective cohort study of U.S. Medicare beneficiaries ≥ 67 years old who initiated dialysis in 2010-2012. Serious fall injuries were defined using diagnostic codes for falls plus an injury (fracture, joint dislocation, or head injury). Health outcomes, defined as time-to-event variables within the first year of dialysis, included four outcomes: a subsequent serious fall injury, hospital admission, post-acute skilled nursing facility (SNF) utilization, and mortality. Among this cohort of 81,653 initiating hemodialysis, 2,958 (3.6%) patients had a serious fall injury in the year prior to hemodialysis initiation. In the first year of dialysis, 7.6% had a subsequent serious fall injury, 67.6% a hospitalization, 30.7% a SNF claim and 26.1% died. Those with vs. without a serious fall injury in the year prior to hemodialysis initiation were at higher risk (hazard ratio, 95% confidence interval) for a subsequent serious fall injury (2.65, 2.41-2.91), hospitalization (1.11, 1.06-1.16), SNF claim (1.40, 1.30-1.50), and death (1.14, 1.06-1.22). For older adults initiating dialysis, a history of a serious fall injury may provide prognostic information to support decision-making and establish expectations for life after dialysis initiation. Published by Oxford University Press on behalf of The Gerontological Society of America 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  10. Adverse and Hypersensitivity Reactions to Prescription Nonsteroidal Anti-Inflammatory Agents in a Large Health Care System.

    Science.gov (United States)

    Blumenthal, Kimberly G; Lai, Kenneth H; Huang, Mingshu; Wallace, Zachary S; Wickner, Paige G; Zhou, Li

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used medications in the United States. NSAID use can be limited by adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs). We aimed to use electronic health record data to determine the incidence and predictors of HSRs to prescription NSAIDs. We performed a retrospective cohort study of all adult outpatients in a large health care system prescribed diclofenac, indomethacin, nabumetone, or piroxicam between January 1, 2004, and September 30, 2012. The primary outcome was an ADR or HSR attributed to the prescribed NSAID within 1 year of prescription, determined from a longitudinal allergy database. We used natural language processing to classify known ADRs as either HSRs or side effects. Multivariable logistic regression models were used to identify independent risk factors for NSAID HSRs. Of 62,719 patients prescribed NSAIDs, 1,035 (1.7%) had an ADR, of which 189 (18.3%) were HSRs. Multivariable regression analysis identified that patients with prior drug HSR history (odds ratio [OR] 1.8 [95% CI 1.3, 2.5]), female sex (OR 1.8 [95% CI 1.3, 2.4]), autoimmune disease (OR 1.7 [95% CI 1.1, 2.7]), and those prescribed the maximum standing NSAID dose (OR 1.5 [95% CI 1.1, 2.0]) had increased odds of NSAID HSR. NSAID therapeutic use can be limited by ADRs; about 1 in 5 NSAID ADRs is an HSR. Both patient and drug factors contribute to HSR risk and are important to guide patient counseling. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. [Health prevention for children and adolescents in competitive sports].

    Science.gov (United States)

    Rosenhagen, A; Pommerening, S; Vogt, L; Banzer, W

    2009-12-01

    The promotion of sport talents in Germany is federally standardised. Apart from the training and management support, annual sports-medical investigations with standardised procedures are mandatory for athletes' health and safety. For the first time, this study evaluates the prevalence ratio of medical findings in Hessian top athletes. The data of all athletes presenting in one of the 27 licenced examination centres in Hesse during the period of investigation were evaluated for age, sex and sports discipline as well as medical findings and a trinomial classification of the sports-related health status. The completeness of this collection in the relevant period from November 2006 to October 2007 was assured by cross-checking the application charts of all related sports associations. Data of 1620 (m: 904, 14.8 +/- 2.5 years; w: 716, 14.3 +/- 2.6 years) of all 1713 athletes presenting during the evaluation period were used for analysis. Medical findings (e. g., resulting in follow-up evaluation or further consultations) were seen in 83.5 % of all athletes. A small group (3.6 %) was temporarily, and one single athlete was completely exempted from sports participation. These results underline (additionally to the preventive capability of sports-medical investigations) the need for an annual medical consultation of juvenile athletes. Further investigations should be extended to other districts and classes and might evaluate the direct and indirect costs of diseases.

  12. The role of mental health in primary prevention of sexual and gender-based violence.

    Science.gov (United States)

    Gevers, Aník; Dartnall, Elizabeth

    2014-01-01

    In this short communication, we assert that mental health has a crucial role in the primary prevention of sexual and gender-based violence (SGBV). However, we found that most research and practice to date has focused on the role of mental health post-violence, and SGBV primary prevention is relying on public health models that do not explicitly include mental health. Yet, key concepts, processes, and competencies in the mental health field appear essential to successful SGBV primary prevention. For example, empathy, self-esteem, compassion, emotional regulation and resilience, stress management, relationship building, and challenging problematic social norms are crucial. Furthermore, competencies such as rapport building, group processing, emotional nurturing, modelling, and the prevention of vicarious trauma among staff are important for the successful implementation of SGBV primary prevention programmes. SGBV primary prevention work would benefit from increased collaboration with mental health professionals and integration of key mental health concepts, processes, and skills in SGBV research.

  13. The role of mental health in primary prevention of sexual and gender-based violence

    Directory of Open Access Journals (Sweden)

    Aník Gevers

    2014-09-01

    Full Text Available In this short communication, we assert that mental health has a crucial role in the primary prevention of sexual and gender-based violence (SGBV. However, we found that most research and practice to date has focused on the role of mental health post-violence, and SGBV primary prevention is relying on public health models that do not explicitly include mental health. Yet, key concepts, processes, and competencies in the mental health field appear essential to successful SGBV primary prevention. For example, empathy, self-esteem, compassion, emotional regulation and resilience, stress management, relationship building, and challenging problematic social norms are crucial. Furthermore, competencies such as rapport building, group processing, emotional nurturing, modelling, and the prevention of vicarious trauma among staff are important for the successful implementation of SGBV primary prevention programmes. SGBV primary prevention work would benefit from increased collaboration with mental health professionals and integration of key mental health concepts, processes, and skills in SGBV research.

  14. Business oriented EU human cell and tissue product legislation will adversely impact Member States' health care systems.

    Science.gov (United States)

    Pirnay, Jean-Paul; Vanderkelen, Alain; De Vos, Daniel; Draye, Jean-Pierre; Rose, Thomas; Ceulemans, Carl; Ectors, Nadine; Huys, Isabelle; Jennes, Serge; Verbeken, Gilbert

    2013-12-01

    The transplantation of conventional human cell and tissue grafts, such as heart valve replacements and skin for severely burnt patients, has saved many lives over the last decades. The late eighties saw the emergence of tissue engineering with the focus on the development of biological substitutes that restore or improve tissue function. In the nineties, at the height of the tissue engineering hype, industry incited policymakers to create a European regulatory environment, which would facilitate the emergence of a strong single market for tissue engineered products and their starting materials (human cells and tissues). In this paper we analyze the elaboration process of this new European Union (EU) human cell and tissue product regulatory regime-i.e. the EU Cell and Tissue Directives (EUCTDs) and the Advanced Therapy Medicinal Product (ATMP) Regulation and evaluate its impact on Member States' health care systems. We demonstrate that the successful lobbying on key areas of regulatory and policy processes by industry, in congruence with Europe's risk aversion and urge to promote growth and jobs, led to excessively business oriented legislation. Expensive industry oriented requirements were introduced and contentious social and ethical issues were excluded. We found indications that this new EU safety and health legislation will adversely impact Member States' health care systems; since 30 December 2012 (the end of the ATMP transitional period) there is a clear threat to the sustainability of some lifesaving and established ATMPs that were provided by public health institutions and small and medium-sized enterprises under the frame of the EUCTDs. In the light of the current economic crisis it is not clear how social security systems will cope with the inflation of costs associated with this new regulatory regime and how priorities will be set with regard to reimbursement decisions. We argue that the ATMP Regulation should urgently be revised to focus on delivering

  15. Dental Health Behavior in the Prevention of Pulmonary TB at Health Centre in Several Provinces

    Directory of Open Access Journals (Sweden)

    Indirawati Tjahja Notohartojo

    2016-02-01

    Full Text Available Background: Pulmonary TB is an infectious disease of the respiratory tract caused by bacteria. Dental health professionals such as dentists and dental nurses are in charge of health personnel to prevent, treat, cure, teeth the mouth, so as not to arise or aggravate toothache. In doing their job as dental health workers is expected to use gloves or masks, and always wash their hands to avoid the transmission of pulmonary TB disease. Methods: A cross sectional study was conducted involving 78 dental health professionals in 50 primary health centers that were chosen in six districts in three provinces of Banten, South Kalimantan and Gorontalo. Data were obtained by interviews and processed using SPSSResults: More than 90% dental health workers in work wore masks gloves and washed their hands after work. There was a signifi cant relationship between exercise with dental health professionals with a p value of 0.007, which means a signifi cant. Conclusion: In performing their duties, dental health workers have already used personal protective equipment such asmasks, gloves, and washed their hands and did enough exercise. Recommendation: need to increase knowledge about pulmonary TB in dental health professionals.

  16. Impact of interpersonal adversity in childhood on adult mental health: how much is mediated by social support and socio-economic status in Japan?

    Science.gov (United States)

    Oshio, T; Umeda, M; Kawakami, N

    2013-08-01

    To examine the extent to which social support and socio-economic status (SES) in adulthood mediate the impact of interpersonal adversity in childhood on adult mental health using large-scale population data in Japan. Cross-sectional survey. Data were derived from the Japanese Study of Stratification, Health, Income and Neighbourhood, which was conducted from October 2010 to February 2011 in four municipalities in and around the Tokyo metropolitan area. Survey participants were community residents aged 25-50 years who were selected at random from voter registration lists. The total sample size was 3292. The self-reported experience of parental maltreatment (physical abuse and/or neglect) and bullying in school and their impacts on adult mental health (in terms of K6 = 5+, K6 = 13+ and suicide ideation) were examined using multivariate logistic models. Interpersonal adversity in childhood has a negative impact on adult mental health even after controlling for childhood SES. For example, the odds ratio for K6 = 5+, responding to parental maltreatment, was 2.64 (95% confidence interval 2.04-3.41). Perceived social support and adult SES mediated the impact of interpersonal adversity in childhood, but a substantial proportion of the impact was unexplained by their mediating effects; social support and adult SES only mediated 11-24% and 6-12%, respectively. It was also found that social support and adult SES (except educational attainment) did not moderate the negative impact of interpersonal adversity in childhood. This analysis highlighted that the impact of interpersonal adversity in childhood is relatively independent of social support and SES in adulthood. This result has clear policy implications; more focus should be placed on policies that aim to reduce incidents of childhood maltreatment and bullying per se, both of which have a long-lasting direct impact on mental health. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All

  17. Delinquency and Recidivism: A Multicohort, Matched-Control Study of the Role of Early Adverse Experiences, Mental Health Problems, and Disabilities

    Science.gov (United States)

    Barrett, David E.; Katsiyannis, Antonis; Zhang, Dalun; Zhang, Dake

    2014-01-01

    The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile…

  18. Speak Up: Help Prevent Errors in Your Care: Behavioral Health Care

    Science.gov (United States)

    ... TM Help Prevent Errors in Your Care Behavioral Health Care To prevent health care errors, patients are urged to... SpeakUP TM Service ... individuals should be involved in their own behavioral health care. These efforts to increase consumer awareness and involvement ...

  19. Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

    Science.gov (United States)

    Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

    2012-01-01

    Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

  20. Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan.

    Science.gov (United States)

    Yen, Suh-May; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen

    2014-06-12

    This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services. Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services.

  1. "Macho men" and preventive health care: implications for older men in different social classes.

    Science.gov (United States)

    Springer, Kristen W; Mouzon, Dawne M

    2011-06-01

    The gender paradox in mortality--where men die earlier than women despite having more socioeconomic resources--may be partly explained by men's lower levels of preventive health care. Stereotypical notions of masculinity reduce preventive health care; however, the relationship between masculinity, socioeconomic status (SES), and preventive health care is unknown. Using the Wisconsin Longitudinal Study, the authors conduct a population-based assessment of masculinity beliefs and preventive health care, including whether these relationships vary by SES. The results show that men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventive care. Furthermore, in contrast to the well-established SES gradient in health, men with strong masculinity beliefs do not benefit from higher education and their probability of obtaining preventive health care decreases as their occupational status, wealth, and/or income increases. Masculinity may be a partial explanation for the paradox of men's lower life expectancy, despite their higher SES.