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  1. Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

    Directory of Open Access Journals (Sweden)

    Machado DM

    2017-11-01

    Full Text Available Daisy Maria Machado,1 Alexandre Machado de Sant’Anna Carvalho,2 Rachel Riera3 1Disciplina de Infectologia Pediátrica, Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2Universidade Federal do Rio de Janeiro, Rio de Janeiro, 3Disciplina de Medicina Baseada em Evidências, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil Abstract: Adolescents are a critical population that is disproportionately impacted by the HIV epidemic. More than 2 million adolescents between the age group of 10 and 19 years are living with HIV, and millions are at risk of infection. HIV risks are considerably higher among girls, especially in high-prevalence settings such as eastern and southern Africa. In addition to girls, there are other vulnerable adolescent subgroups, such as teenagers, who use intravenous (IV drugs, gay and bisexual boys, transgender youth, male sex workers, and people who fall into more than one of these categories. Pre-exposure prophylaxis (PrEP is a new intervention for people at high risk for acquiring HIV, with an estimated HIV incidence of >3%. Recent data from trials show evidence of the efficacy of PrEP as a powerful HIV prevention tool in high-risk populations, including men who have sex with men, HIV-1-serodiscordant heterosexual couples, and IV drug users. The reported efficacy in those trials of the daily use of oral tenofovir, alone or in combination with emtricitabine, to prevent HIV infection ranged from 44% to 75% and was heavily dependent on adherence. Despite the proven efficacy of PrEP in adult trials, concerns remain about its feasibility in real-life scenarios due to stigma, cost, and limited clinician experience with PrEP delivery. Recent studies are attempting to expand the inquiry into the efficacy of such HIV prophylaxis approaches in adolescent populations, but there are still many gaps in knowledge, and no

  2. Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

    Science.gov (United States)

    Machado, Daisy Maria; de Sant’Anna Carvalho, Alexandre Machado; Riera, Rachel

    2017-01-01

    Adolescents are a critical population that is disproportionately impacted by the HIV epidemic. More than 2 million adolescents between the age group of 10 and 19 years are living with HIV, and millions are at risk of infection. HIV risks are considerably higher among girls, especially in high-prevalence settings such as eastern and southern Africa. In addition to girls, there are other vulnerable adolescent subgroups, such as teenagers, who use intravenous (IV) drugs, gay and bisexual boys, transgender youth, male sex workers, and people who fall into more than one of these categories. Pre-exposure prophylaxis (PrEP) is a new intervention for people at high risk for acquiring HIV, with an estimated HIV incidence of >3%. Recent data from trials show evidence of the efficacy of PrEP as a powerful HIV prevention tool in high-risk populations, including men who have sex with men, HIV-1-serodiscordant heterosexual couples, and IV drug users. The reported efficacy in those trials of the daily use of oral tenofovir, alone or in combination with emtricitabine, to prevent HIV infection ranged from 44% to 75% and was heavily dependent on adherence. Despite the proven efficacy of PrEP in adult trials, concerns remain about its feasibility in real-life scenarios due to stigma, cost, and limited clinician experience with PrEP delivery. Recent studies are attempting to expand the inquiry into the efficacy of such HIV prophylaxis approaches in adolescent populations, but there are still many gaps in knowledge, and no country has yet approved it for use with adolescents. The aim of this review was to identify and summarize the evidence from studies on PrEP for adolescents. We have compiled and reviewed published studies focusing on safety, feasibility, adherence to therapeutics, self-perception, and legal issues related to PrEP in people aged between 10 and 24 years. PMID:29238237

  3. Role of oral pre-exposure prophylaxis (PrEP) in current and future HIV prevention strategies.

    Science.gov (United States)

    Burns, David N; Grossman, Cynthia; Turpin, Jim; Elharrar, Vanessa; Veronese, Fulvia

    2014-12-01

    Treatment as prevention is expected to have a major role in reducing HIV incidence, but other prevention interventions will also be required to bring the epidemic under control, particularly among key populations. One or more forms of pre-exposure prophylaxis (PrEP) will likely play a critical role. Oral PrEP with emtricitabine-tenofovir (Truvada®) is currently available in the US and some other countries, but uptake has been slow. We review the concerns that have contributed to this slow uptake and discuss current and future research in this critical area of HIV prevention research.

  4. Current Best Practices for Preventing Asbestos Exposure Among Brake and Clutch Repair Workers

    Science.gov (United States)

    Covers concerns about asbestos exposure for mechanics, how to tell if asbestos brake or clutch components contain asbestos, work practices to follow, protecting yourself for home mechanics, disposal of waste that contains asbestos.

  5. CURRENT LEVELS OF MEDICAL EXPOSURE IN RUSSIA

    Directory of Open Access Journals (Sweden)

    M. I. Balonov

    2015-01-01

    Full Text Available We considered conditions of patients’ medical radiation exposure in Russian diagnostic radiology and nuclear medicine basing on the data of our own research, of the Unified system of individual dose control and of some relevant literature. We analyzed the data on the number of diagnostic examinations, patients’ individual and collective doses and their distribution by examination types. Time trends of the studied parameters are presented for the period between 1999 and 2013. Current level of Russian patients’ medical exposure is the lowest over the whole observation period and one of the lowest among the developed countries. The annual number of X-ray diagnostic examinations is 1.8 per capita. In 2013 median effective dose of medical exposure per capita in Russia was 0.45 mSv and median dose per procedure was 0.25 mSv. The major contribution to collective dose of medical exposure was from computed tomography and radiography; the largest individual doses were caused by interventional radiology, computed X-Ray and nuclear medicine tomographic examinations. The range of median doses comprises about four orders of magnitude, i.e. from several microSv in dental X-ray examinations up to several tens of milliSv in interventional and multistage tomographic examinations. The median effective dose of adult patients increases by about an order of magnitude with each transition from dental X-ray examinations to conventional radiology and further to computed tomography and interventional radiology examinations. During interventional X-Ray examinations, absorbed skin doses at radiation beam entrance site may reach several Gray, which may lead to deterministic radiation effects in skin and subcutaneous tissues. Due to replacement of low-dose ‘functional’ nuclear medicine examinations with more informative modern scintigraphy and tomography examination, patient doses substantially increased over the last decade. With current trend for re-equipment of

  6. Teen pregnancy prevention: current perspectives.

    Science.gov (United States)

    Lavin, Claudia; Cox, Joanne E

    2012-08-01

    Teen pregnancy has been subject of public concern for many years. In the United States, despite nearly 2 decades of declining teen pregnancy and birth rates, the problem persists, with significant disparities present across racial groups and in state-specific rates. This review examines recent trends, pregnancy prevention initiatives and family planning policies that address the special needs of vulnerable youth. Unintended teen pregnancies impose potentially serious social and health burdens on teen parents and their children, as well as costs to society. Trends in teen pregnancy and birth rates show continued decline, but state and racial disparities have widened. Demographic factors and policy changes have contributed to these disparities. Research supports comprehensive pregnancy prevention initiatives that are multifaceted and promote consistent and correct use of effective methods of contraception for youth at risk of becoming pregnant. There is strong consensus that effective teen pregnancy prevention strategies should be multifaceted, focusing on delay of sexual activity especially in younger teens while promoting consistent and correct use of effective methods of contraception for those youth who are or plan to be sexually active. There is a need for further research to identify effective interventions for vulnerable populations.

  7. Preventing dance injuries: current perspectives

    Directory of Open Access Journals (Sweden)

    Russell JA

    2013-09-01

    Full Text Available Jeffrey A Russell Division of Athletic Training, School of Applied Health Sciences and Wellness, Ohio University, Athens, OH, USA Abstract: Dancers are clearly athletes in the degree to which sophisticated physical capacities are required to perform at a high level. The standard complement of athletic attributes – muscular strength and endurance, anaerobic and aerobic energy utilization, speed, agility, coordination, motor control, and psychological readiness – all are essential to dance performance. In dance, as in any athletic activity, injuries are prevalent. This paper presents the research background of dance injuries, characteristics that distinguish dance and dancers from traditional sports and athletes, and research-based perspectives into how dance injuries can be reduced or prevented, including the factors of physical training, nutrition and rest, flooring, dancing en pointe, and specialized health care access for dancers. The review concludes by offering five essential components for those involved with caring for dancers that, when properly applied, will assist them in decreasing the likelihood of dance-related injury and ensuring that dancers receive optimum attention from the health care profession: (1 screening; (2 physical training; (3 nutrition and rest; (4 specialized dance health care; and (5 becoming acquainted with the nature of dance and dancers. Keywords: dance, injuries, injury prevention, fitness, wellness, health

  8. POST-EXPOSURE IMMUNOLOGICAL PREVENTION AGAINST VARICELLA

    Directory of Open Access Journals (Sweden)

    V.K. Tatochenko

    2010-01-01

    Full Text Available The article focuses on immunological prevention of varicella, particularly efficacy and advisability of vaccinating contact individuals in a pocket (post-exposure vaccination: its role in reducing the epidemiological process and economic burden of the infection, in achieving control over outbreak disease incidence. It features data obtained by foreign researchers and own research results. It demonstrates that vaccination of children and adults immediately after contact with the individual suffering from varicella allows significant reduction in disease incidence. Key words: varicella, vaccination, post-exposure immunological prevention, children. (Pediatric Pharmacology. – 2010; 7(4:30-33

  9. Current perspectives in HIV post-exposure prophylaxis

    Directory of Open Access Journals (Sweden)

    Sultan B

    2014-10-01

    Full Text Available Binta Sultan,1,2 Paul Benn,1 Laura Waters1 1Department of Genitourinary Medicine, Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK; 2Centre for Sexual Health and HIV Research, University College London, London, UK Abstract: The incidence of human immunodeficiency virus (HIV infection continues to rise among core groups and efforts to reduce the numbers of new infections are being redoubled. Post-exposure prophylaxis (PEP is the use of short-term antiretroviral therapy (ART to reduce the risk of acquisition of HIV infection following exposure. Current guidelines recommend a 28-day course of ART within 36–72 hours of exposure to HIV. As long as individuals continue to be exposed to HIV there will be a role for PEP in the foreseeable future. Nonoccupational PEP, the vast majority of which is for sexual exposure (PEPSE, has a significant role to play in HIV prevention efforts. Awareness of PEP and its availability for both clinicians and those who are eligible to receive it are crucial to ensure that PEP is used to its full potential in any HIV prevention strategy. In this review, we provide current evidence for the use of PEPSE, assessment of the risk of HIV transmission, indications for PEP, drug regimens, and management of patients started on PEP. We summarize national and international guidelines for the use of PEPSE. We explore the place of PEP within the wider strategy of reducing HIV incidence rates in the era of treatment as prevention and pre-exposure prophylaxis. We also consider the implications of recent data from interventional and observational studies demonstrating significant reductions in the risk of HIV transmission within a serodiscordant relationship if the HIV-positive partner is taking effective ART upon PEP guidelines. Keywords: post-exposure prophylaxis, pre-exposure prophylaxis, treatment as prevention, human immunodeficiency virus

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

    Science.gov (United States)

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

    2014-04-01

    This paper assesses how many children and youth have had exposure to programs aimed at preventing various kinds of violence perpetration and victimization. Based on a national sample of children 5-17, 65% had ever been exposed to a violence prevention program, 55% in the past year. Most respondents (71%) rated the programs as very or somewhat helpful. Younger children (5-9) who had been exposed to higher quality prevention programs had lower levels of peer victimization and perpetration. But the association did not apply to older youth or youth exposed to lower quality programs. Disclosure to authorities was also more common for children with higher quality program exposure who had experienced peer victimizations or conventional crime victimizations. The findings are consistent with possible benefits from violence prevention education programs. However, they also suggest that too few programs currently include efficacious components. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Exposure Plus Response-Prevention Treatment of Bulimia Nervosa.

    Science.gov (United States)

    Leitenberg, Harold; And Others

    1988-01-01

    Evaluated exposure plus response-prevention treatment of bulimia nervosa among 47 women. Subjects were assigned to either exposure plus response-prevention in one setting, exposure plus response-prevention in multiple settings, cognitive-behavioral therapy, or waiting-list control conditions. Found three treatment groups improved significantly on…

  12. Preventive Vaccination in Russia under Current Conditions

    Directory of Open Access Journals (Sweden)

    S. P. Kaplina

    2018-01-01

    Full Text Available Currently, the vaccination not only does not lose its value, but also becoming more in-demand allowing to prevent mass infection, disability, and mortality due to them, oncological and somatic diseases. The variety of medicinal vaccines is actively developed. The particular importance is given to the vaccination as a key mean to prevent the antibiotic resistance. That is why it is important for every health worker to know the up-to-date approaches to the immunization in whole, and especially for the risk groups, to understand and compare reasonably the risks of the infections and vaccinations, to be able to explain this to their patients and parents. The most important is a common understanding of the importance of the preventive vaccination of the health workers of all specialties and levels. 

  13. Engineered nanomaterials: exposures, hazards, and risk prevention

    Directory of Open Access Journals (Sweden)

    MacPhail Robert C

    2011-03-01

    Full Text Available Abstract Nanotechnology presents the possibility of revolutionizing many aspects of our lives. People in many settings (academic, small and large industrial, and the general public in industrialized nations are either developing or using engineered nanomaterials (ENMs or ENM-containing products. However, our understanding of the occupational, health and safety aspects of ENMs is still in its formative stage. A survey of the literature indicates the available information is incomplete, many of the early findings have not been independently verified, and some may have been over-interpreted. This review describes ENMs briefly, their application, the ENM workforce, the major routes of human exposure, some examples of uptake and adverse effects, what little has been reported on occupational exposure assessment, and approaches to minimize exposure and health hazards. These latter approaches include engineering controls such as fume hoods and personal protective equipment. Results showing the effectiveness - or lack thereof - of some of these controls are also included. This review is presented in the context of the Risk Assessment/Risk Management framework, as a paradigm to systematically work through issues regarding human health hazards of ENMs. Examples are discussed of current knowledge of nanoscale materials for each component of the Risk Assessment/Risk Management framework. Given the notable lack of information, current recommendations to minimize exposure and hazards are largely based on common sense, knowledge by analogy to ultrafine material toxicity, and general health and safety recommendations. This review may serve as an overview for health and safety personnel, management, and ENM workers to establish and maintain a safe work environment. Small start-up companies and research institutions with limited personnel or expertise in nanotechnology health and safety issues may find this review particularly useful.

  14. Food allergy: practical approach on education and accidental exposure prevention.

    Science.gov (United States)

    Pádua, I; Moreira, A; Moreira, P; Barros, R

    2016-09-01

    Food allergies are a growing problem and currently the primary treatment of food allergy is avoidance of culprit foods. However, given the lack of information and education and also the ubiquitous nature of allergens, accidental exposures to food allergens are not uncommon. The fear of potential fatal reactions and the need of a proper avoidance leads in most of the cases to the limitation of leisure and social activities. This review aims to be a practical approach on education and accidental exposure prevention regarding activities like shopping, eating out, and travelling. The recommendations are focused especially on proper reading of food labels and the management of the disease, namely in restaurants and airplanes, concerning cross-contact and communication with other stakeholders. The implementation of effective tools is essential to manage food allergy outside home, avoid serious allergic reactions and minimize the disease's impact on individuals' quality of life.

  15. Molecular Cancer Prevention: Current Status & Future Directions

    Science.gov (United States)

    Maresso, Karen Colbert; Tsai, Kenneth Y.; Brown, Powel H.; Szabo, Eva; Lippman, Scott; Hawk, Ernest

    2016-01-01

    The heterogeneity and complexity of advanced cancers strongly supports the rationale for an enhanced focus on molecular prevention as a priority strategy to reduce the burden of cancer. Molecular prevention encompasses traditional chemopreventive agents as well as vaccinations and therapeutic approaches to cancer-predisposing conditions. Despite challenges to the field, we now have refined insights into cancer etiology and early pathogenesis; successful risk assessment and new risk models; agents with broad preventive efficacy (e.g., aspirin) in common chronic diseases, including cancer; and a successful track record of more than 10 agents approved by the FDA for the treatment of precancerous lesions or cancer risk reduction. The development of molecular preventive agents does not differ significantly from the development of therapies for advanced cancers, yet has unique challenges and special considerations given that it most often involves healthy or asymptomatic individuals. Agents, biomarkers, cohorts, overall design, and endpoints are key determinants of molecular preventive trials, as with therapeutic trials, although distinctions exist for each within the preventive setting. Progress in the development and evolution of molecular preventive agents has been steadier in some organ systems, such as breast and skin, than in others. In order for molecular prevention to be fully realized as an effective strategy, a number of challenges to the field must be addressed. Here we provide a brief overview of the context for and special considerations of molecular prevention along with a discussion of the results of major randomized controlled trials. PMID:26284997

  16. Preventive psychiatry: Current status in contemporary psychiatry

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Chadda

    2017-01-01

    Full Text Available Preventive psychiatry is one of the most ignored subdiscipline of psychiatry, which has got important role to play in the contemporary psychiatry. Mental disorders are very common with lifetime prevalence of about 25%, and tend to be chronic. Due to the stigma associated with mental disorders, lack of awareness, and also lack of adequate mental health resources, nearly 60%–80% of the persons suffering from mental disorders do not access mental health care services. Mental and substance use disorders have been identified as one of the major contributors to the disease-related burden and disability-adjusted life years. In this background, preventive psychiatry has an important role to play in public health sector. Since etiology of most of the mental disorders is not known, it is not possible to follow here the standard model of primary, secondary, and tertiary prevention of public health. A concept of universal, selective, and indicated prevention has been proposed in primary prevention. Preventive approaches in psychiatry focus on evidence-based risk and protective factors, promoting quality of life, reducing stressors, and improving resilience. Such interventions, when planned targeting at specific mental disorders, have a potential to prevent mental disorders. Thus, preventive psychiatry has a crucial role to play in mental health, considering the high prevalence of mental disorders, the associated disability and burden, and a great drain on human resources.

  17. Current Evidence Supporting Obstetric Fistula Prevention Strategies ...

    African Journals Online (AJOL)

    Evidences from the articles were linked to prevention strategies retrieved from grey literature. The strategies were classified using an innovative target-focused method. Gaps in the literature show the need for fistula prevention research to aim at systematically measuring incidence and prevalence of the disease, identify the ...

  18. PRE-EXPOSURE PROPHYLAXIS FOR PREVENTION OF HIV INFECTION

    Directory of Open Access Journals (Sweden)

    Ana Rita Diniz

    2015-04-01

    Full Text Available Objectives: To review existing data on Pre-Exposure Prophylaxis (PrEP for prevention of HIV infection, including the role of medical male circumcision, oral administration of antiretroviral drugs and topical microbicides. Data Sources: PubMed and www.clinicaltrials.gov. Review Methods: Comprehensive review. Results: Medical male circumcision has been shown to prevent 48-60% of new HIV-1 infections. The efficacy rate of antiretroviral drugs given per os to prevent HIV infection varies in direct association with the adherence rate (62.2% in TDF2 study with 84% adherence; 44% in iPrEx study with <50% adherence; 48% in Bangkok study with 67% adherence; 67-75% in Partners PrEP study with 82% adherence; and 6% in FEM-PrEP study with 40% adherence. As for the use of topic microbicides, the CAPRISA 004 study showed 39% reduction in HIV infection using a 1% tenofovir gel. On the other hand, PRO2000 gel showed a modest reduction of 30% which was not statistically significant. Conclusions: The studies suggest that medical male circumcision is highly cost-effective at preventing HIV infection but requires careful communication strategies to be successful. PrEP using antiretroviral drugs is also very effective but it is highly dependent on the adherence rate. As for topical microbicides, 1% tenofovir gel is currently the only promising option.

  19. Primary prevention: exposure reduction, skin exposure and respiratory protection

    NARCIS (Netherlands)

    Heederik, D.|info:eu-repo/dai/nl/072910542; Henneberger, P.K.; Redlich, C.A.

    2012-01-01

    Interventions for the primary prevention of occupational asthma have been reported in the medical literature, understanding the effectiveness of these efforts could help future interventions. The aim of our study was to evaluate the existing knowledge regarding the impact of controlling work

  20. What is the place of pre-exposure prophylaxis in HIV prevention?

    Science.gov (United States)

    De Man, Jeroen; Colebunders, Robert; Florence, Eric; Laga, Marie; Kenyon, Christopher

    2013-01-01

    New tools are needed to bring down ongoing high HIV incidence. This review aims to evaluate the place of one of these new tools (pre-exposure prophylaxis) in a comprehensive prevention strategy. Several trials have demonstrated the safety and the efficacy of pre-exposure prophylaxis in HIV prevention. Two large trials have, however, failed to show such efficacy. This was likely due to poor adherence in these trials. New forms of long-acting pre-exposure prophylaxis currently in trials may deal with these problems of low adherence. Pre-exposure prophylaxis has been demonstrated to be cost-effective within certain settings. The introduction of pre-exposure prophylaxis into prevention programs needs to be carefully thought through. For example, pre-exposure prophylaxis-induced risk compensation, at both an individual and population level, could undermine other aspects of a comprehensive HIV prevention program. In conclusion, pre-exposure prophylaxis could be a useful additional tool for the prevention of HIV in specific high-risk groups. It should be implemented in a way that deals with issues such as ensuring high adherence and ensuring that pre-exposure prophylaxis does not detract from, but complements, other more fundamental elements of HIV prevention programs.

  1. Current exposure method for CCP’s under Basel III

    Directory of Open Access Journals (Sweden)

    Antonie Kotzé

    2013-04-01

    Full Text Available Exposure-at-default is one of the most interesting and most difficult parameters to estimate in counterparty credit risk. Basel I offered only the non-internal Current Exposure Method for estimating this quantity whilst Basel II further introduced the Standardized Method and an Internal Model Method. Under new Basel III rules a central counterparty is defined as being a financial institution. New principles set out by the Basel Committee on Banking Supervision forces Central Counterparties in using the Current Exposure Method when estimating the credit exposures to Clearing Member banks notwithstanding its shortcomings. The Current Exposure Method relies on the Value-at-Risk methodology and its characteristics are discussed in this note. We will particularly investigate exposures to SAFCOM, the South African clearing house and point to a mathematical discrepancy on how netting is effected through the Basel accord.

  2. Current trends in copper theft prevention

    Energy Technology Data Exchange (ETDEWEB)

    Mastrofrancesco, A. [Electrical Safety Authority, ON (Canada)

    2009-07-01

    Copper is used in electrical wiring, water and gas piping, currency, and in household items. An increase in the price and demand for copper has made copper theft a profitable venture for some thieves. Copper consumed in North America is typically supplied by recycling. Scrap dealers may pay near-market prices for pure copper wires. However, copper theft poses a serious threat to the safety of utility workers and the public. Power outages caused by copper theft are now affecting grid reliability. This paper examined technologies and techniques used to prevent copper theft as part of a security strategy for utilities. Attempts to steal copper can leave utility substations unsecured and accessible to children. The theft of neutral grounds will cause the local distribution company (LDC) to malfunction and may cause power surges in homes as well as appliance fires. Utilities are now looking at using a hybrid steel and copper alternative to prevent copper theft. Asset identification techniques are also being used to identify the original owners of the copper and more easily prosecute thieves. Automated monitoring techniques are also being used to increase substation security. Utilities are also partnering with law enforcement agencies and pressuring governments to require scrap dealers to record who they buy from. It was concluded that strategies to prevent copper theft should be considered as part of an overall security strategy for utilities. tabs., figs.

  3. Preventing skin cancer through reduction of indoor tanning: current evidence.

    Science.gov (United States)

    Watson, Meg; Holman, Dawn M; Fox, Kathleen A; Guy, Gery P; Seidenberg, Andrew B; Sampson, Blake P; Sinclair, Craig; Lazovich, DeAnn

    2013-06-01

    Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices. Published by Elsevier Inc.

  4. Technology-based suicide prevention: current applications and future directions.

    Science.gov (United States)

    Luxton, David D; June, Jennifer D; Kinn, Julie T

    2011-01-01

    This review reports on current and emerging technologies for suicide prevention. Technology-based programs discussed include interactive educational and social networking Web sites, e-mail outreach, and programs that use mobile devices and texting. We describe innovative applications such as virtual worlds, gaming, and text analysis that are currently being developed and applied to suicide prevention and outreach programs. We also discuss the benefits and limitations of technology-based applications and discuss future directions for their use.

  5. Pre-Exposure Prophylaxis for HIV Prevention : Safety Concerns

    NARCIS (Netherlands)

    Tetteh, Raymond A; Yankey, Barbara A; Nartey, Edmund T; Lartey, Margaret; Leufkens, Hubert G M; Dodoo, Alexander N O

    Available evidence supports the efficacy of pre-exposure prophylaxis (PrEP) in decreasing the incidence of human immunodeficiency virus (HIV) infection among high-risk individuals, especially when used in combination with other behavioural preventive methods. Safety concerns about PrEP present

  6. Diagnosis, injury and prevention of internal radiation exposure

    International Nuclear Information System (INIS)

    Tatsuzaki, Hideo

    2012-01-01

    Radiation exposure is classified into three categories: external exposure, surface contamination, and internal exposure (also called internal contamination). Internal exposure is an exposure by the ionizing radiation emitted from radioactive materials taken into a human body. Uptake of radioactive materials can go through inhalation, ingestion, or wound contamination. Not like external exposure, alpha ray or beta ray, which has a limited penetration, is also important in internal exposure. Diagnosis of internal exposure is based on measurement and dose assessment in addition to the history taking. Two methods, direct measurement and/or bioassay (indirect measurement), are used for the measurement. These measurements provide information of radioactive materials in the body at the time of the measurement. The exposure dose to the body needs to be calculated in a process of dose assessment, based on the results of these measurements and history of intake, either acute intake or chronic intake. Another method, measurement of environmental samples or food stuff, is also used for dose assessment. For internal exposure, radiation dose to the body is expressed as committed effective dose or committed equivalent dose, which are accumulation of dose over a defined period. Radioactive materials taken into body are transferred among many body components depending on the type of radionuclide or chemicals etc. Some radioactive materials concentrate in a specific organ. Symptoms and signs depend on the distribution of the radioactive materials in the body. Monitoring the concentration in air or foods is conducted in order to control human activities and foods and consequently reduce the amount of intake to human bodies as a preventive measure. Prevention of internal exposure is also conducted by protective gears such as full face masks. Iodine prophylaxis could be used against radioactive iodine intake. Stable iodine, mostly potassium iodide, could be taken into the thyroid and

  7. [Current Guidelines to Prevent Obesity in Childhood and Adolescence].

    Science.gov (United States)

    Blüher, S; Kromeyer-Hauschild, K; Graf, C; Grünewald-Funk, D; Widhalm, K; Korsten-Reck, U; Markert, J; Güssfeld, C; Müller, M J; Moss, A; Wabitsch, M; Wiegand, S

    2016-01-01

    Current guidelines for the prevention of obesity in childhood and adolescence are presented. A literature search was performed in Medline via PubMed, and appropriate studies were analysed. Programs to prevent childhood obesity were to date mainly school-based. Effects were limited to date. Analyses tailored to different age groups show that prevention programs have the best effects in younger children (adolescence, school-based interventions were most effective when adolescents were directly addressed. To date, obesity prevention programs have mainly focused on behavior oriented prevention. Recommendations for condition oriented prevention have been suggested by the German Alliance of Non-communicable Diseases and include one hour of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory quality standards for meals at kindergarten and schools as well as a ban on unhealthy food advertisement addressing children. Behavior oriented prevention programs showed hardly any or only limited effects in the long term. Certain risk groups for the development of obesity are not reached effectively by available programs. Due to the heterogeneity of available studies, universally valid conclusions cannot be drawn. The combination with condition oriented prevention, which has to counteract on an obesogenic environment, is crucial for sustainable success of future obesity prevention programs. © Georg Thieme Verlag KG Stuttgart · New York.

  8. [Disease prevention in the elderly: misconceptions in current models].

    Science.gov (United States)

    Veras, Renato Peixoto

    2012-10-01

    The Brazilian population is aging significantly within a context of gradual improvement in the country's social and economic indicators. Increased longevity leads to increased use of health services, pressuring the public and social welfare health services, generating higher costs, and jeopardizing the system's sustainability. The alternative to avoid overburdening the system is to invest in policies for disease prevention, stabilization of chronic diseases, and maintenance of functional capacity. The current article aims to analyze the difficulties in implementing preventive programs and the reasons for the failure of various programs in health promotion, prevention, and management of chronic diseases in the elderly. There can be no solution to the crisis in financing and restructuring the health sector without implementing a preventive logic. Scientific research has already correctly identified the risk factors for the elderly population, but this is not enough. We must use such knowledge to promote the necessary transition from a healthcare-centered model to a preventive one.

  9. UV dose-effect relationships and current protection exposure standards

    International Nuclear Information System (INIS)

    Singh, M.S.; Campbell, G.W.

    1982-04-01

    In this paper we have attempted to quantify the health effects in man of uv-radiation exposure of wavelengths from 240 nm to 320 nm. Exposure to uv in this region could result in the formation of skin cancer or premature aging in man. The induction of cancer by uv radiation results from changes in genetic material. We have used the DNA action spectrum coupled with the uv skin cancer data available in the literature to derive the dose-effect relationships. The results are compared against the current uv protection standards

  10. Adolescent suicide prevention. Current research and social policy implications.

    Science.gov (United States)

    Garland, A F; Zigler, E

    1993-02-01

    The rate of adolescent suicide has increased dramatically in the past few decades, prompting several interventions to curb the increase. Unfortunately, many of the intervention efforts have not benefited from current research findings because the communication between researchers and those who develop the interventions is inadequate. Of specific concern are the increasingly popular curriculum-based suicide prevention programs, which have not demonstrated effectiveness and may contain potentially deleterious components. This article reviews the current epidemiological research in adolescent suicide and suggests how this knowledge could be used more effectively to reduce the rate of adolescent suicide. Recommendations include support for integrated primary prevention efforts; suicide prevention education for professionals; education and policies on firearm management; education for the media about adolescent suicide; more efficient identification and treatment of at-risk youth, including those exposed to suicidal behavior; crisis intervention; and treatment for suicide attempters.

  11. Preventing excessive radon exposure in U.K. housing

    International Nuclear Information System (INIS)

    Miles, J.C.H.; Cliff, K.D.; Green, B.M.R.; Dixon, D.W.

    1992-01-01

    In the United Kingdom (UK) it has been recognized for some years that some members of the population received excessive radiation exposure in their homes from radon and its decay products. To prevent such exposures, an Action Level of 400 Bq m -3 was adopted in 1987. In January, 1990, the National Radiological Protection Board (NRPB) advised that the Action Level should be reduced to 200 Bq m -3 , and this advice was accepted by the Government. It is estimated that exposures in up to 100,000 UK homes exceed this Action Level; this amounts to about 0.5% of the available housing. The UK authorities have developed a strategy for preventing such exposures: (1) Areas in which it is estimated that >1% of homes exceed the Action Level for radon are being designated as Affected Areas, and a program to map such areas is under way. Households in these areas are advised to have radon measurements made by NRPB under a open-quotes freeclose quotes (Government-funded) scheme. (2) Householders found to have whole-house, whole-year average radon concentrations >200 Bq m -3 are advised to take remedial action and are provided with information on how this can be done. Partial grants toward remedial work are available in cases of financial need. So far, around 3000 such households have been identified. (3) Within Affected Areas, localities are being defined where new homes must incorporate precautions against radon exposure. In addition to this strategy, a joint case-control study of the risks of radon in homes is being undertaken by the Imperial Cancer Research Fund and NRPB, supported by the UK Government and the Commission of the European Communities

  12. Lead exposures in U.S. Children, 2008: implications for prevention.

    Science.gov (United States)

    Levin, Ronnie; Brown, Mary Jean; Kashtock, Michael E; Jacobs, David E; Whelan, Elizabeth A; Rodman, Joanne; Schock, Michael R; Padilla, Alma; Sinks, Thomas

    2008-10-01

    We reviewed the sources of lead in the environments of U.S. children, contributions to children's blood lead levels, source elimination and control efforts, and existing federal authorities. Our context is the U.S. public health goal to eliminate pediatric elevated blood lead levels (EBLs) by 2010. National, state, and local exposure assessments over the past half century have identified risk factors for EBLs among U.S. children, including age, race, income, age and location of housing, parental occupation, and season. Recent national policies have greatly reduced lead exposure among U.S. children, but even very low exposure levels compromise children's later intellectual development and lifetime achievement. No threshold for these effects has been demonstrated. Although lead paint and dust may still account for up to 70% of EBLs in U.S. children, the U.S. Centers for Disease Control and Prevention estimates that >or=30% of current EBLs do not have an immediate lead paint source, and numerous studies indicate that lead exposures result from multiple sources. EBLs and even deaths have been associated with inadequately controlled sources including ethnic remedies and goods, consumer products, and food-related items such as ceramics. Lead in public drinking water and in older urban centers remain exposure sources in many areas. Achieving the 2010 goal requires maintaining current efforts, especially programs addressing lead paint, while developing interventions that prevent exposure before children are poisoned. It also requires active collaboration across all levels of government to identify and control all potential sources of lead exposure, as well as primary prevention.

  13. Can Skin Exposure to Sunlight Prevent Liver Inflammation?

    Directory of Open Access Journals (Sweden)

    Shelley Gorman

    2015-05-01

    Full Text Available Liver inflammation contributes towards the pathology of non-alcoholic fatty liver disease (NAFLD. Here we discuss how skin exposure to sunlight may suppress liver inflammation and the severity of NAFLD. Following exposure to sunlight-derived ultraviolet radiation (UVR, the skin releases anti-inflammatory mediators such as vitamin D and nitric oxide. Animal modeling studies suggest that exposure to UVR can prevent the development of NAFLD. Association studies also support a negative link between circulating 25-hydroxyvitamin D and NAFLD incidence or severity. Clinical trials are in their infancy and are yet to demonstrate a clear beneficial effect of vitamin D supplementation. There are a number of potentially interdependent mechanisms whereby vitamin D could dampen liver inflammation, by inhibiting hepatocyte apoptosis and liver fibrosis, modulating the gut microbiome and through altered production and transport of bile acids. While there has been a focus on vitamin D, other mediators induced by sun exposure, such as nitric oxide may also play important roles in curtailing liver inflammation.

  14. Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention

    OpenAIRE

    Williams, Monnica T.; Mugno, Beth; Franklin, Martin; Faber, Sonya

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The cognitive-behavioral treatment with the most empirical support is currently exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings...

  15. Combining biomedical preventions for HIV: Vaccines with pre-exposure prophylaxis, microbicides or other HIV preventions.

    Science.gov (United States)

    McNicholl, Janet M

    2016-12-01

    Biomedical preventions for HIV, such as vaccines, microbicides or pre-exposure prophylaxis (PrEP) with antiretroviral drugs, can each only partially prevent HIV-1 infection in most human trials. Oral PrEP is now FDA approved for HIV-prevention in high risk groups, but partial adherence reduces efficacy. If combined as biomedical preventions (CBP) an HIV vaccine could provide protection when PrEP adherence is low and PrEP could prevent vaccine breakthroughs. Other types of PrEP or microbicides may also be partially protective. When licensed, first generation HIV vaccines are likely to be partially effective. Individuals at risk for HIV may receive an HIV vaccine combined with other biomedical preventions, in series or in parallel, in clinical trials or as part of standard of care, with the goal of maximally increasing HIV prevention. In human studies, it is challenging to determine which preventions are best combined, how they interact and how effective they are. Animal models can determine CBP efficacy, whether additive or synergistic, the efficacy of different products and combinations, dose, timing and mechanisms. CBP studies in macaques have shown that partially or minimally effective candidate HIV vaccines combined with partially effective oral PrEP, vaginal PrEP or microbicide generally provided greater protection than either prevention alone against SIV or SHIV challenges. Since human CBP trials will be complex, animal models can guide their design, sample size, endpoints, correlates and surrogates of protection. This review focuses on animal studies and human models of CBP and discusses implications for HIV prevention.

  16. Pre-Exposure Prophylaxis for HIV Prevention: Safety Concerns.

    Science.gov (United States)

    Tetteh, Raymond A; Yankey, Barbara A; Nartey, Edmund T; Lartey, Margaret; Leufkens, Hubert G M; Dodoo, Alexander N O

    2017-04-01

    Available evidence supports the efficacy of pre-exposure prophylaxis (PrEP) in decreasing the incidence of human immunodeficiency virus (HIV) infection among high-risk individuals, especially when used in combination with other behavioural preventive methods. Safety concerns about PrEP present challenges in the implementation and use of PrEP. The aim of this review is to discuss safety concerns observed in completed clinical trials on the use of PrEP. We performed a literature search on PrEP in PubMed, global advocacy for HIV prevention (Aids Vaccine Advocacy Coalition) database, clinical trials registry " http://www.clinicaltrials.gov " and scholar.google, using combination search terms 'pre-exposure prophylaxis', 'safety concerns in the use of pre-exposure prophylaxis', 'truvada use as PrEP', 'guidelines for PrEP use', 'HIV pre-exposure prophylaxis' and 'tenofovir' to identify clinical trials and literature on PrEP. We present findings associated with safety issues on the use of PrEP based on a review of 11 clinical trials on PrEP with results on safety and efficacy as at April 2016. We also reviewed findings from routine real-life practice reports. The pharmacological intervention for PrEP was tenofovir disoproxil fumarate/emtricitabine in a combined form as Truvada ® or tenofovir as a single entity. Both products are efficacious for PrEP and seem to have a good safety profile. Regular monitoring is recommended to prevent long-term toxic effects. The main adverse effects observed with PrEP are gastrointestinal related; basically mild to moderate nausea, vomiting and diarrhea. Other adverse drug effects worth monitoring are liver enzymes, renal function and bone mineral density. PrEP as an intervention to reduce HIV transmission appears to have a safe benefit-risk profile in clinical trials. It is recommended for widespread use but adherence monitoring and real-world safety surveillance are critical in the post-marketing phase to ensure that the benefits

  17. Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach.

    Science.gov (United States)

    Seidman, Dominika L; Weber, Shannon; Cohan, Deborah

    2017-03-08

    HIV prevention during pregnancy and lactation is critical for both maternal and child health. Pregnancy provides a critical opportunity for clinicians to elicit women's vulnerabilities to HIV and offer HIV testing, treatment and referral and/or comprehensive HIV prevention options for the current pregnancy, the postpartum period and safer conception options for future pregnancies. In this commentary, we review the safety of oral pre-exposure prophylaxis with tenofovir/emtricitabine in pregnant and lactating women and suggest opportunities to identify pregnant and postpartum women at substantial risk of HIV. We then describe a clinical approach to caring for women who both choose and decline pre-exposure prophylaxis during pregnancy and postpartum, highlighting areas for future research. Evidence suggests that pre-exposure prophylaxis with tenofovir/emtricitabine is safe in pregnancy and lactation. Identifying women vulnerable to HIV and eligible for pre-exposure prophylaxis is challenging in light of the myriad of individual, community, and structural forces impacting HIV acquisition. Validated risk calculators exist for specific populations but have not been used to screen and offer HIV prevention methods. Partner testing and engagement of men living with HIV are additional means of reaching at-risk women. However, women's vulnerabilities to HIV change over time. Combining screening for HIV vulnerability with HIV and/or STI testing at standard intervals during pregnancy is a practical way to prompt providers to incorporate HIV screening and prevention counselling. We suggest using shared decision-making to offer women pre-exposure prophylaxis as one of multiple HIV prevention strategies during pregnancy and postpartum, facilitating open conversations about HIV vulnerabilities, preferences about HIV prevention strategies, and choosing a method that best meets the needs of each woman. Growing evidence suggests that pre-exposure prophylaxis with tenofovir

  18. Drift in ocean currents impacts intergenerational microbial exposure to temperature.

    Science.gov (United States)

    Doblin, Martina A; van Sebille, Erik

    2016-05-17

    Microbes are the foundation of marine ecosystems [Falkowski PG, Fenchel T, Delong EF (2008) Science 320(5879):1034-1039]. Until now, the analytical framework for understanding the implications of ocean warming on microbes has not considered thermal exposure during transport in dynamic seascapes, implying that our current view of change for these critical organisms may be inaccurate. Here we show that upper-ocean microbes experience along-trajectory temperature variability up to 10 °C greater than seasonal fluctuations estimated in a static frame, and that this variability depends strongly on location. These findings demonstrate that drift in ocean currents can increase the thermal exposure of microbes and suggests that microbial populations with broad thermal tolerance will survive transport to distant regions of the ocean and invade new habitats. Our findings also suggest that advection has the capacity to influence microbial community assemblies, such that regions with strong currents and large thermal fluctuations select for communities with greatest plasticity and evolvability, and communities with narrow thermal performance are found where ocean currents are weak or along-trajectory temperature variation is low. Given that fluctuating environments select for individual plasticity in microbial lineages, and that physiological plasticity of ancestors can predict the magnitude of evolutionary responses of subsequent generations to environmental change [Schaum CE, Collins S (2014) Proc Biol Soc 281(1793):20141486], our findings suggest that microbial populations in the sub-Antarctic (∼40°S), North Pacific, and North Atlantic will have the most capacity to adapt to contemporary ocean warming.

  19. [Exposure to addictogenic substances, conditioned response and treatment of the exposure with response prevention].

    Science.gov (United States)

    Khazaal, Y; Frésard, E; Zullino, D

    2007-01-01

    Exposure to drugs or related cues is associated with psycho-physiological reactivity. These responses are conditioned during periods of active consumption. Exposure with response prevention (EPR) is a treatment established for anxiety disorder and aims to reduce anxiety by an extinction of previously conditioned responses. The conditioning recognized in additive processes has led to research into EPR's therapeutic potential for treating addiction. This paper is a review of the main studies on reactivity to cues, and EPR, particularly with respect to addiction to alcohol, opiates, cocaine and tobacco. This review is based on information from the Medline database, dealing with cue reactivity, attentional bias during exposure to cues and exposure treatment for addiction in general and, in particular, for each of the aforementioned substances. Exposure to drug-related cues is clearly associated with psycho-physiological reactivity and with attentional bias. Those phenomena are associated with craving and more difficulty in maintaining abstinence. The subject's attention is thus held by a large number of drug-related environmental stimuli. These observations are linked with conditioning phenomena and suggest the possibility of treatment by EPR conditioning extinction procedures. EPR has been most widely studied for abuse and alcohol addiction. Case reports give favourable outcomes. Results from controlled studies are less clear. Studies on patients addicted to cocaine or heroine are still limited and not conclusive. Different controlled studies on EPR for nicotine addiction have not produced conclusions in favour of this treatment. Generally, the EPR procedures used vary among studies. Studies focussing particularly on the evolution of physiological responses in a laboratory setting after EPR have demonstrated reduced autonomic nervous system activity. These results do not consistently lead to a reduction in consumption behaviour and in craving when the patient is in

  20. Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions

    Science.gov (United States)

    Hong, Jun Sung

    2016-01-01

    Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents’ use of social media, and online communication platforms have exposed adolescents to another mode of bullying—cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided. PMID:28562094

  1. Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions.

    Science.gov (United States)

    Espelage, Dorothy L; Hong, Jun Sung

    2017-06-01

    Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents' use of social media, and online communication platforms have exposed adolescents to another mode of bullying- cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

  2. Cutaneous Scar Prevention and Management; Overview of current therapies

    Directory of Open Access Journals (Sweden)

    Sultan Al-Shaqsi

    2016-02-01

    Full Text Available Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

  3. HIV Prevention among Mexican Migrants at Different Migration Phases: Exposure to Prevention Messages and Association With Testing Behaviors

    Science.gov (United States)

    Martinez-Donate, Ana P.; Rangel, M. Gudelia; Zhang, Xiao; Simon, Norma-Jean; Rhoads, Natalie; Gonzalez-Fagoaga, J. Eduardo; Gonzalez, Ahmed Asadi

    2016-01-01

    Mobile populations are at increased risk for HIV infection. Exposure to HIV prevention messages at all phases of the migration process may help decrease im/migrants’ HIV risk. We investigated levels of exposure to HIV prevention messages, factors associated with message exposure, and the association between exposure to prevention messages and HIV testing behavior among Mexican im/migrants at different phases of the migration process. We conducted a cross-sectional, probability survey of Mexican im/migrants (N=3,149) traveling through the border city of Tijuana, Mexico. The results indicate limited exposure to prevention messages (57%–75%) and suboptimal last 12-month HIV testing rates (14%–25%) across five migration phases. Compared to pre-departure levels (75%), exposure to messages decreases at all post-departure migration phases (57%–63%, pmigration continuum. PMID:26595267

  4. Increasing the efficacy of cue exposure treatment in preventing relapse of addictive behavior.

    Science.gov (United States)

    Havermans, Remco C; Jansen, Anita T M

    2003-07-01

    Theoretically, cue exposure treatment should be able to prevent relapse by extinguishing conditioned drug responding (e.g. cue-elicited craving). According to contemporary learning theory, though, extinction does not eliminate conditioned responding. Analogous cue exposure with response prevention (CERP) as a treatment of addictive behavior might not eliminate the learned relation between drug-related cues and drug use. This does not necessarily mean that cue exposure cannot successfully prevent relapse. Various suggestions for increasing the efficacy of cue exposure treatment are being discussed from a contemporary learning theory perspective. It is suggested that cue exposure treatment incorporating retrieval cues can be a beneficial treatment in preventing relapse of addictive behavior.

  5. Selected important fragrance sensitizers in perfumes--current exposures.

    Science.gov (United States)

    Rastogi, Suresh Chandra; Johansen, Jeanne Duus; Bossi, Rossana

    2007-04-01

    Contact allergy to fragrance ingredients is frequent. Recommendations and regulations of some of the most frequent and potent fragrance allergens have recently been introduced. To investigate current exposures to 4 important fragrance allergens in hydroalcoholic cosmetic products. 25 popular perfume products of Danish as well as international brands were purchased from the Danish retail market. Contents of 4 important fragrance allergens, isoeugenol, hydroxy-iso-hexyl 3-cyclohexene carboxaldehyde (HICC, Lyral), were determined by gas chromatography-mass spectrometry, and atranol and chloro-atranol were determined by liquid chromatography-tandem mass spectrometry. Isoeugenol was found in 56%, HICC in 72%, atranol in 59%, and chloro-atranol in 36% of the 22 eau de toilette/eau de parfum products. The concentrations of isoeugenol were, in all products, below the recommended maximum concentration of 0.02%. HICC reached a maximum of 0.2%, which is 10-fold higher than maximum tolerable concentration considered safe by the EU Scientific Committee. The median concentrations of atranol and chloro-atranol in the investigated products were similar to those found in similar products in 2003. A significant decrease in the frequency of presence of chloro-atranol in the products was observed. There is still a wide-spread exposure to potent fragrance allergens in perfumes.

  6. Nickel exposure from keys: alternatives for protection and prevention.

    Science.gov (United States)

    Hamann, Dathan; Scheman, Andrew J; Jacob, Sharon E

    2013-01-01

    Keys are an important exposure source of metal allergens to consumers and confer a significant problem for nickel-allergic individuals because of repeated daily use. The aims of this study were to investigate the frequency of nickel and cobalt release in keys and to consider the effectiveness of coatings for preventing metallic allergen release from common metal allergen-releasing keys. Keys from a variety of common stores were nickel and cobalt spot tested. Nickel-releasing keys were coated with enamel sprays, subjected to a use test, and retested to assess for metal allergen release. Of 55 tested keys, 80% showed a strong positive result to the nickel spot test. None of the tested keys exhibited cobalt release. No keys initially released nickel after enamel coatings. Key coatings chipped at the portion inserted into a lock after 30 insertions, and keys were found to release nickel. The handle of the key was not found to release nickel after 60 insertions. Nickel release from keys is very common; nickel-allergic consumers should consider purchasing keys that do not release nickel (eg, brass, anodized). Enamel coating may be useful in protecting nickel-sensitive individuals from their keys but cannot consistently prevent nickel-release from portions used frequently.

  7. Inhibition of cardiac sodium currents by toluene exposure

    Science.gov (United States)

    Cruz, Silvia L; Orta-Salazar, Gerardo; Gauthereau, Marcia Y; Millan-Perez Peña, Lourdes; Salinas-Stefanón, Eduardo M

    2003-01-01

    Toluene is an industrial solvent widely used as a drug of abuse, which can produce sudden sniffing death due to cardiac arrhythmias. In this paper, we tested the hypothesis that toluene inhibits cardiac sodium channels in Xenopus laevis oocytes transfected with Nav1.5 cDNA and in isolated rat ventricular myocytes. In oocytes, toluene inhibited sodium currents (INa+) in a concentration-dependent manner, with an IC50 of 274 μM (confidence limits: 141–407μM). The inhibition was complete, voltage-independent, and slowly reversible. Toluene had no effect on: (i) the shape of the I–V curves; (ii) the reversal potential of Na+; and (iii) the steady-state inactivation. The slow recovery time constant from inactivation of INa+ decreased with toluene exposure, while the fast recovery time constant remained unchanged. Block of INa+ by toluene was use- and frequency-dependent. In rat cardiac myocytes, 300 μM toluene inhibited the sodium current (INa+) by 62%; this inhibition was voltage independent. These results suggest that toluene binds to cardiac Na+ channels in the open state and unbinds either when channels move between inactivated states or from an inactivated to a closed state. The use- and frequency-dependent block of INa+ by toluene might be responsible, at least in part, for its arrhythmogenic effect. PMID:14534149

  8. Exploring the Safety Margin in Current Guidelines for Electromagnetic Exposure

    NARCIS (Netherlands)

    F. Adibzadeh (Fatemeh)

    2017-01-01

    markdownabstractExposure to radio-frequency (RF) electromagnetic fields (EMF) is unavoidable in today's modern life. This exposure is growing mainly because of rapid growth in telecommunication systems. Awareness of the possible risks of exposure to EMF has raised public concern. To avoid any

  9. Non-daily pre-exposure prophylaxis for HIV prevention

    Science.gov (United States)

    Anderson, Peter L.; García-Lerma, J. Gerardo; Heneine, Walid

    2015-01-01

    Purpose of review To discuss non-daily pre-exposure prophylaxis (PrEP) modalities that may provide advantages compared with daily PrEP in cost and cumulative toxicity, but may have lower adherence forgiveness. Recent Findings Animal models have informed our understanding of early viral transmission events, which help guide event-driven PrEP dosing strategies. These models indicate early establishment of viral replication in rectal or cervicovaginal tissues, so event-driven PrEP should rapidly deliver high mucosal drug concentrations within hours of the potential exposure event. Macaque models have demonstrated the high biological efficacy for event-driven dosing of oral tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) against both vaginal and rectal virus transmission. In humans, the IPERGAY study demonstrated 86% efficacy for event-driven oral TDF/FTC dosing among men who have sex with men (MSM), while no similar efficacy data are available on women or heterosexual men. The HPTN 067 study showed that certain MSM populations adhere well to non-daily PrEP while other populations of women adhere more poorly to non-daily versus daily regimens. Pharmacokinetic studies following oral TDF/FTC dosing in humans, indicate that TFV-diphosphate (the active form of TFV) accumulates to higher concentrations in rectal versus cervicovaginal tissue but non-adherence in trials complicates the interpretation of differential mucosal drug concentrations. Summary Event-driven dosing for TFV-based PrEP has promise for HIV prevention in MSM. Future research of event-driven PrEP in women and heterosexual men should be guided by a better understanding of the importance of mucosal drug concentrations for PrEP efficacy and its sensitivity to adherence. PMID:26633641

  10. Recent advances in addictive disorders. Prevention. Current research and trends.

    Science.gov (United States)

    Kumpfer, K L; Hopkins, R

    1993-03-01

    The AOD prevention programs of the 1990s should be resiliency-focused and include interventions of sufficient dosage and strength. Although some child behavioral technology exists to tackle successfully changes in resiliency, additional prevention strategies need to be developed and studied. In some way, the prevention field is hampered by the lack of sufficient research in the child and adolescent psychiatry and psychology fields, that includes transactional research in parenting and child rearing for high-risk youth. We simply do not know enough to determine how parents and other adults can best foster resilience in children. Questions that arise include how much to protect children from environmental stressors and how much to push them to confront new life stressors in the form of challenges to develop new skills or talents. There are no simple answers to these questions, but a number of useful guidelines could help parents and teachers to increase resilience in youth. Some of the guidelines currently being stressed include developing in youth an increased sense of responsibility for their own success, helping them to identify their talents, motivating them to dedicate their lives to helping society rather than feeling their only purpose in life is to be consumers, providing realistic appraisals and feedback for youth rather than graciously building up their self-esteem, stressing multicultural competence in an ever-shrinking world, encouraging and valuing education and skills training, increasing cooperative solutions to problems rather than competitive or aggressive solutions, and increasing a sense of responsibility for others and caring for others. Clearly, these are important objectives for creating the type of citizens that can make American strong in the twentieth century.

  11. Integrated fuel cell stack shunt current prevention arrangement

    Energy Technology Data Exchange (ETDEWEB)

    Roche, Robert P. (Cheshire, CT); Nowak, Michael P. (Bolton, CT)

    1992-01-01

    A fuel cell stack includes a plurality of fuel cells juxtaposed with one another in the stack and each including a pair of plate-shaped anode and cathode electrodes that face one another, and a quantity of liquid electrolyte present at least between the electrodes. A separator plate is interposed between each two successive electrodes of adjacent ones of the fuel cells and is unified therewith into an integral separator plate. Each integral separator plate is provided with a circumferentially complete barrier that prevents flow of shunt currents onto and on an outer peripheral surface of the separator plate. This barrier consists of electrolyte-nonwettable barrier members that are accommodated, prior to the formation of the integral separator plate, in corresponding edge recesses situated at the interfaces between the electrodes and the separator plate proper. Each barrier member extends over the entire length of the associated marginal portion and is flush with the outer periphery of the integral separator plate. This barrier also prevents cell-to-cell migration of any electrolyte that may be present at the outer periphery of the integral separator plate while the latter is incorporated in the fuel cell stack.

  12. Exposure information in environmental health research: Current opportunities and future directions for particulate matter, ozone, and toxic air pollutants

    Energy Technology Data Exchange (ETDEWEB)

    McKone, Thomas E.; Ryan, P. Barry; Ozkaynak, Haluk

    2007-02-01

    Understanding and quantifying outdoor and indoor sources of human exposure are essential but often not adequately addressed in health-effects studies for air pollution. Air pollution epidemiology, risk assessment, health tracking and accountability assessments are examples of health-effects studies that require but often lack adequate exposure information. Recent advances in exposure modeling along with better information on time-activity and exposure factors data provide us with unique opportunities to improve the assignment of exposures for both future and ongoing studies linking air pollution to health impacts. In September 2006, scientists from the US Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention (CDC) along with scientists from the academic community and state health departments convened a symposium on air pollution exposure and health in order to identify, evaluate, and improve current approaches for linking air pollution exposures to disease. This manuscript presents the key issues, challenges and recommendations identified by the exposure working group, who used cases studies of particulate matter, ozone, and toxic air pollutant exposure to evaluate health-effects for air pollution. One of the over-arching lessons of this workshop is that obtaining better exposure information for these different health-effects studies requires both goal-setting for what is needed and mapping out the transition pathway from current capabilities to meeting these goals. Meeting our long-term goals requires definition of incremental steps that provide useful information for the interim and move us toward our long-term goals. Another over-arching theme among the three different pollutants and the different health study approaches is the need for integration among alternate exposure assessment approaches. For example, different groups may advocate exposure indicators, biomonitoring, mapping methods (GIS), modeling, environmental media

  13. Role of Nrf2 in preventing oxidative stress induced chloride current alteration in human lung cells.

    Science.gov (United States)

    Canella, Rita; Benedusi, Mascia; Martini, Marta; Cervellati, Franco; Cavicchio, Carlotta; Valacchi, Giuseppe

    2018-08-01

    The lung tissue is one of the main targets of oxidative stress due to external sources and respiratory activity. In our previous work, we have demonstrated in that O 3 exposure alters the Cl - current-voltage relationship, with the appearance of a large outward rectifier component mainly sustained by outward rectifier chloride channels (ORCCs) in human lung epithelial cells (A549 line). In the present study, we have performed patch clamp experiments, in order to identify which one of the O 3 byproducts (4hydroxynonenal (HNE) and/or H 2 O 2 ) was responsible for chloride current change. While 4HNE exposition (up to 25 μM for 30' before electrophysiological analysis) did not reproduce O 3 effect, H 2 O 2 produced by glucose oxidase 10 mU for 24 hr before electrophysiological analysis mimicked O 3 response. This result was confirmed treating the cell with catalase (CAT) before O 3 exposure (1,000 U/ml for 2 hr): CAT was able to rescue Cl - current alteration. Since CAT is regulated by Nrf2 transcription factor, we pre-treated the cells with the Nrf2 activators, resveratrol and tBHQ. Immunochemical and immunocytochemical results showed Nrf2 activation with both substances that lead to prevent OS effect on Cl - current. These data bring new insights into the mechanisms involved in OS-induced lung tissue damage, pointing out the role of H 2 O 2 in chloride current alteration and the ability of Nfr2 activation in preventing this effect. © 2017 Wiley Periodicals, Inc.

  14. Planning for pre-exposure prophylaxis to prevent HIV transmission: challenges and opportunities

    Science.gov (United States)

    2010-01-01

    There are currently several ongoing or planned trials evaluating the efficacy of pre-exposure prophylaxis (PrEP) as a preventative approach to reducing the transmission of HIV. PrEP may prove ineffective, demonstrate partial efficacy, or show high efficacy and have the potential to reduce HIV infection in a significant way. However, in addition to the trial results, it is important that issues related to delivery, implementation and further research are also discussed. As a part of the ongoing discussion, in June 2009, the Bill & Melinda Gates Foundation sponsored a Planning for PrEP conference with stakeholders to review expected trial results, outline responsible educational approaches, and develop potential delivery and implementation strategies. The conference reinforced the need for continued and sustained dialogue to identify where PrEP implementation may fit best within an integrated HIV prevention package. This paper identifies the key action points that emerged from the Planning for PrEP meeting. PMID:20624303

  15. Osteoporosis – a current view of pharmacological prevention and treatment

    Directory of Open Access Journals (Sweden)

    Das S

    2013-05-01

    Full Text Available Subhajit Das, Julie C Crockett Musculoskeletal Research Programme, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK Abstract: Postmenopausal osteoporosis is the most common bone disease, associated with low bone mineral density (BMD and pathological fractures which lead to significant morbidity. It is defined clinically by a BMD of 2.5 standard deviations or more below the young female adult mean (T-score = −2.5. Osteoporosis was a huge global problem both socially and economically – in the UK alone, in 2011 £6 million per day was spent on treatment and social care of the 230,000 osteoporotic fracture patients – and therefore viable preventative and therapeutic approaches are key to managing this problem within the aging population of today. One of the main issues surrounding the potential of osteoporosis management is diagnosing patients at risk before they develop a fracture. We discuss the current and future possibilities for identifying susceptible patients, from fracture risk assessment to shape modeling and in relation to the high heritability of osteoporosis now that a plethora of genes have been associated with low BMD and osteoporotic fracture. This review highlights the current therapeutics in clinical use (including bisphosphonates, anti-RANKL [receptor activator of NF-κB ligand], intermittent low dose parathyroid hormone, and strontium ranelate and some of those in development (anti-sclerostin antibodies and cathepsin K inhibitors. By highlighting the intimate relationship between the activities of bone forming (osteoblasts and bone-resorbing (osteoclasts cells, we include an overview and comparison of the molecular mechanisms exploited in each therapy. Keywords: BMD, fracture, bisphosphonate, strontium, denosumab, teriparatide, raloxifene

  16. 75 FR 80819 - Draft Current Intelligence Bulletin “Occupational Exposure to Carbon Nanotubes and Nanofibers”

    Science.gov (United States)

    2010-12-23

    ... protective equipment; (4) Current exposure measurement methods and challenges in measuring workplace exposures to carbon nanotubes and nanofibers; (5) Areas for future collaborative efforts (e.g., research... business affiliations of the presenter, topic of the presentation, and [[Page 80820

  17. Preventing Agricultural Chemical Exposure: A Safety Program Manual. Participatory Education with Farmworkers in Pesticide Safety.

    Science.gov (United States)

    Wake Forest Univ., Winston-Salem, NC. Dept. of Family and Community Medicine.

    Preventing Agricultural Chemical Exposure among North Carolina Farmworkers (PACE) is a project designed to describe farmworker pesticide exposure and to develop an educational intervention to reduce farmworker pesticide exposure. The PACE project used a community participation framework to ensure that the community played a significant role in…

  18. Biomarkers of nanomaterial exposure and effect: current status

    Science.gov (United States)

    Iavicoli, Ivo; Leso, Veruscka; Manno, Maurizio; Schulte, Paul A.

    2014-03-01

    Recent advances in nanotechnology have induced a widespread production and application of nanomaterials. As a consequence, an increasing number of workers are expected to undergo exposure to these xenobiotics, while the possible hazards to their health remain not being completely understood. In this context, biological monitoring may play a key role not only to identify potential hazards from and to evaluate occupational exposure to nanomaterials, but also to detect their early biological effects to better assess and manage risks of exposure in respect of the health of workers. Therefore, the aim of this review is to provide a critical evaluation of potential biomarkers of nanomaterial exposure and effect investigated in human and animal studies. Concerning exposure biomarkers, internal dose of metallic or metal oxide nanoparticle exposure may be assessed measuring the elemental metallic content in blood or urine or other biological materials, whereas specific molecules may be carefully evaluated in target tissues as possible biomarkers of biologically effective dose. Oxidative stress biomarkers, such as 8-hydroxy-deoxy-guanosine, genotoxicity biomarkers, and inflammatory response indicators may also be useful, although not specific, as biomarkers of nanomaterial early adverse health effects. Finally, potential biomarkers from "omic" technologies appear to be quite innovative and greatly relevant, although mechanistic, ethical, and practical issues should all be resolved before their routine application in occupational settings could be implemented. Although all these findings are interesting, they point out the need for further research to identify and possibly validate sensitive and specific biomarkers of exposure and effect, suitable for future use in occupational biomonitoring programs. A valuable contribution may derive from the studies investigating the biological behavior of nanomaterials and the factors influencing their toxicokinetics and reactivity. In

  19. Current problems of prevention diagnosis and treatment of radiation sickness

    International Nuclear Information System (INIS)

    Gus'kova, A.K.

    1986-01-01

    Causes of increasing interest to the problems of prevention, diagnosis and treatment of radiation sickness are presented. On the basis of recent publications some new aspects as quantitative criteria in radiobiology, organization problems of medical aid at radiation incidents estimation of efficiency of preventive medicine and radiation sickness therapy, theoretical development of radiotherapy of different organs et al., are characterized

  20. Drift in ocean currents impacts intergenerational microbial exposure to temperature

    NARCIS (Netherlands)

    Doblin, Martina A.; Van Sebille, Erik

    2016-01-01

    Microbes are the foundation of marine ecosystems [Falkowski PG, Fenchel T, Delong EF (2008) Science 320(5879):1034-1039]. Until now, the analytical framework for understanding the implications of ocean warming on microbes has not considered thermal exposure during transport in dynamic seascapes,

  1. Current issues of preventing tobacco use in secondary school graduates

    Directory of Open Access Journals (Sweden)

    Florova N.B.

    2013-09-01

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

  2. Lost opportunities in HIV prevention: programmes miss places where exposures are highest

    Science.gov (United States)

    Sandøy, Ingvild F; Siziya, Seter; Fylkesnes, Knut

    2008-01-01

    Background Efforts at HIV prevention that focus on high risk places might be more effective and less stigmatizing than those targeting high risk groups. The objective of the present study was to assess risk behaviour patterns, signs of current preventive interventions and apparent gaps in places where the risk of HIV transmission is high and in communities with high HIV prevalence. Methods The PLACE method was used to collect data. Inhabitants of selected communities in Lusaka and Livingstone were interviewed about where people met new sexual partners. Signs of HIV preventive activities in these places were recorded. At selected venues, people were interviewed about their sexual behaviour. Peer educators and staff of NGOs were also interviewed. Results The places identified were mostly bars, restaurants or sherbeens, and fewer than 20% reported any HIV preventive activity such as meetings, pamphlets or posters. In 43% of places in Livingstone and 26% in Lusaka, condoms were never available. There were few active peer educators. Among the 432 persons in Lusaka and 676 in Livingstone who were invited for interview about sexual behaviour, consistent condom use was relatively high in Lusaka (77%) but low in Livingstone (44% of men and 34% of women). Having no condom available was the most common reason for not using one. Condom use in Livingstone was higher among individuals socializing in places where condoms always were available. Conclusion In the places studied we found a high prevalence of behaviours with a high potential for HIV transmission but few signs of HIV preventive interventions. Covering the gaps in prevention in these high exposure places should be given the highest priority. PMID:18218124

  3. Prevention of congenital defects induced by prenatal alcohol exposure (Conference Presentation)

    Science.gov (United States)

    Sheehan, Megan M.; Karunamuni, Ganga; Pedersen, Cameron J.; Gu, Shi; Doughman, Yong Qiu; Jenkins, Michael W.; Watanabe, Michiko; Rollins, Andrew M.

    2017-02-01

    Nearly 2 million women in the United States alone are at risk for an alcohol-exposed pregnancy, including more than 600,000 who binge drink. Even low levels of prenatal alcohol exposure (PAE) can lead to a variety of birth defects, including craniofacial and neurodevelopmental defects, as well as increased risk of miscarriages and stillbirths. Studies have also shown an interaction between drinking while pregnant and an increase in congenital heart defects (CHD), including atrioventricular septal defects and other malformations. We have previously established a quail model of PAE, modeling a single binge drinking episode in the third week of a woman's pregnancy. Using optical coherence tomography (OCT), we quantified intraventricular septum thickness, great vessel diameters, and atrioventricular valve volumes. Early-stage ethanol-exposed embryos had smaller cardiac cushions (valve precursors) and increased retrograde flow, while late-stage embryos presented with gross head/body defects, and exhibited smaller atrio-ventricular (AV) valves, interventricular septum, and aortic vessels. We previously showed that supplementation with the methyl donor betaine reduced gross defects, improved survival rates, and prevented cardiac defects. Here we show that these preventative effects are also observed with folate (another methyl donor) supplementation. Folate also appears to normalize retrograde flow levels which are elevated by ethanol exposure. Finally, preliminary findings have shown that glutathione, a crucial antioxidant, is noticeably effective at improving survival rates and minimizing gross defects in ethanol-exposed embryos. Current investigations will examine the impact of glutathione supplementation on PAE-related CHDs.

  4. Social Justice and HIV Vaccine Research in the Age of Pre-Exposure Prophylaxis and Treatment as Prevention

    Science.gov (United States)

    Bailey, Theodore C.; Sugarman, Jeremy

    2014-01-01

    The advent of pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) as means of HIV prevention raises issues of justice concerning how most fairly and equitably to apportion resources in support of the burgeoning variety of established HIV treatment and prevention measures and further HIV research, including HIV vaccine research. We apply contemporary approaches to social justice to assess the ethical justification for allocating resources in support of HIV vaccine research given competing priorities to support broad implementation of HIV treatment and prevention measures, including TasP and PrEP. We argue that there is prima facie reason to believe that a safe and effective preventive HIV vaccine would offer a distinct set of ethically significant benefits not provided by current HIV treatment or prevention methods. It is thereby possible to justify continued support for HIV vaccine research despite tension with priorities for treatment, prevention, and other research. We then consider a counter-argument to such a justification based on the uncertainty of successfully developing a safe and effective preventive HIV vaccine. Finally, we discuss how HIV vaccine research might now be ethically designed and conducted given the new preventive options of TasP and PrEP, focusing on the ethically appropriate standard of prevention for HIV vaccine trials. PMID:24033297

  5. [Current status of medical accident prevention in our pathology section].

    Science.gov (United States)

    Uehara, Takeshi; Kobayashi, Yukihiro; Honda, Takayuki

    2010-08-01

    Preventive measures against medical accident should be addressed in the pathology section. Medical accidents occur while preparing tissue specimens and making pathological diagnoses. For the preparation of tissue specimens, we have developed a work manual in consultation with past incident reports and update this manual regularly. We can reduce medical accidents by including a check system for each task. For pathological diagnosis, we perform some of the same checks as for tissue specimen preparation and can make more correct diagnoses by conferring with other departments. It is also important to check each other's work to prevent medical accidents.

  6. Environmental exposures, breast development and cancer risk: Through the looking glass of breast cancer prevention.

    Science.gov (United States)

    Forman, Michele R; Winn, Deborah M; Collman, Gwen W; Rizzo, Jeanne; Birnbaum, Linda S

    2015-07-01

    This review summarizes the report entitled: Breast Cancer and the Environment: Prioritizing Prevention, highlights research gaps and the importance of focusing on early life exposures for breast development and breast cancer risk. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Effectiveness of protocols for preventing occupational exposure to blood and body fluids in Dutch hospitals

    NARCIS (Netherlands)

    van Gemert-Pijnen, Julia E.W.C.; Hendrix, M.G.R.; van der Palen, Jacobus Adrianus Maria; Schellens, P.J.

    2006-01-01

    Compliance of different healthcare workers (HCWs) (nurses, physicians, laboratory technicians and cleaners) with protocols to prevent exposure to blood and body fluids (BBF) was studied. Questionnaires were used to assess perception of risks, familiarity with protocols, motivation and actual

  8. Electric current induced prevention of biofilms on stainless steel

    NARCIS (Netherlands)

    Borden, Arnout Johannes van der

    2005-01-01

    As antibiotic therapy usually has little impact on biomaterials-associated infections, since the biofilm mode of growth offers protection, it is the aim of this thesis to investigate the prevention of infection on percutaneous pins and screws as used in the external fixator, with the aid of an

  9. Televised obesity-prevention advertising across US media markets: exposure and content, 2010-2011.

    Science.gov (United States)

    Kornfield, Rachel; Szczypka, Glen; Powell, Lisa M; Emery, Sherry L

    2015-04-01

    To examine levels of exposure and content characteristics for recent televised obesity-prevention campaigns sponsored by state and community health departments, federal agencies, non-profit organizations and television stations in the USA. Nielsen television ratings for obesity-prevention advertising were collected for the top seventy-five US media markets and were used to calculate household exposure levels for 2010 and 2011. Governmental advertisements were coded for content. United States. Average household exposure to obesity-prevention campaigns was 2·6 advertisements per month. Exposure increased by 31 % between 2010 and 2011, largely driven by increases in federal advertisements. In 2011, the federal government accounted for 62 % of obesity-prevention exposure, non-profit organizations for 9 %, community departments for 8 %, state departments for 3 %, and television station-sponsored public-service announcements for 17 %. The greatest percentage increase between 2010 and 2011 was in community advertising, reflecting efforts funded by the Communities Putting Prevention to Work (CPPW) programme. Among thirty-four state and community campaigns, the majority advocated both healthy eating and physical activity (53 %). Campaigns typically had positive or neutral emotional valence (94 %). Obesity or overweight was mentioned in 47 % of campaigns, but only 9 % specifically advocated weight loss. Exposure to televised obesity-prevention advertising increased from 2010 to 2011 and was higher than previously found in 1999-2003, apart from in 2003 during the federal VERB campaign. Nevertheless, exposure remains low relative to advertising for unhealthy foods. New federal campaigns have increased exposure to obesity-prevention advertising nationally, while CPPW grants have increased exposure for targeted areas.

  10. IMPLICATIONS OF THE CURRENT EXPOSURE DRAFT ON AUDIT REPORTING

    Directory of Open Access Journals (Sweden)

    George Silviu CORDOȘ

    2015-04-01

    Full Text Available The regulatory changes come as a response to perceived deficiencies in the postfinancial crisis, and their goal is to improve users' perception of the usefulness and quality of the audit report. The article approaches the subject of these proposals to revise the standards and their implications for the audit report. The article is divided into five parts: the first part the authors present a brief introduction to the subject matter; the second part presents the research methodology; the third part the authors present a review of the literature research; the fourth section presents an analysis of the responses of EU respondents to the Exposure Draft issued by the IAASB in July 2013 and the last part the authors present research findings, limitations and perspectives.

  11. Prevention of OHSS: Current strategies and new insights

    Directory of Open Access Journals (Sweden)

    Cristiano E. Busso

    2010-10-01

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

  12. Stroke Prevention in Atrial Fibrillation: Current Strategies and Recommendations

    Directory of Open Access Journals (Sweden)

    Gerald V. Naccarelli, MD

    2016-02-01

    Full Text Available Stroke is the most common complication of atrial fibrillation (AF. Guidelines recommend anticoagulant treatment in patients with CHA2DS2VASc scores of >2. Registry data suggests that almost half of patients who should be on therapeutic anticoagulation for stroke prevention in AF (SPAF are not. Warfarin and more recently developed agents, the “novel anticoagulants” (NOACs reduce the risk of embolic strokes. In addition, the NOACs also reduce intracranial hemorrhage (ICH by over 50% compared to warfarin. Anticoagulation and bridging strategies involving cardioversion, catheter ablation, and invasive/surgical procedures are reviewed. The development of reversal agents for NOACs and the introduction of left atrial appendage occluding devices will evolve the use of newer strategies for preventing stroke in high risk AF patients.

  13. Timetable for oral prevention in childhood-a current opinion.

    Science.gov (United States)

    Fleming, Paddy

    2015-01-01

    Dental caries in young children remains a public health problem particularly for children whose families are socioeconomically deprived. A child's first dental visit should be at approximately 12 months of age and this should facilitate the provision of anticipatory guidance concerning oral health and dental development to the child's parents/guardians. Compliance with dietary advice is of key importance and motivational interviewing shows promise in relation to parents adopting good oral health practices for their children. Twice daily toothbrushing using toothpaste that contains in the range of 1000- 1500ppmF is a most important preventive measure. It is important to use a minimal amount of toothpaste, insure that it is not swallowed, have parental or adult supervision during toothbrushing and avoid rinsing with water following brushing with toothpaste. The professional application of topical fluoride varnish twice yearly is a proven caries preventative measure. The application of pit and fissure sealants to teeth with deep pits and fissures is recommended.

  14. Prevention of risks in relation with occupational exposure to ionizing radiation

    International Nuclear Information System (INIS)

    2005-01-01

    After remind the base notions in the field of ionizing radiation, this file evaluates the situation on the natural and occupational exposures: modes, sources, and exposure level, risk for health. It presents the principles of prevention allowing in a professional area (out of nuclear industry) to reduce and control these exposures. Some practical cases illustrate the radiation protection approach. references are given: regulatory benchmarks, useful links, books to consult. (N.C.)

  15. [Prevention of hand injuries - current situation in Europe].

    Science.gov (United States)

    Leixnering, M; Quadlbauer, S; Szolarcz, C; Schenk, C; Leixnering, S; Körpert, K

    2013-12-01

    Hand injuries are a frequent occurrence and account for 41% of all occupational injuries. In general such accidents are the result of stress, inattention, tiredness, use of defective or poorly maintained machinery. However, artention must equally be directed at the large number of accidents occurring in leisure time activities since the inability to work due to a leisure time accident is similarly cost-intensive. Throughout Europe attempts have been made in the past 10 years to improve prevention. At the initiative of the Hand Trauma Committee (HTC) of FESSH prevention conferences were stated in 2009. These have in part reduced the number of hand injuries in -Europe. In Austria a special controlling committee was founded by the Austrian Workers' Compensation Board (AUVA) with the specific objective of reducing the number of hand injuries. Similarly the "Circle for Leisure Time Hand Injury Prevention" was created to specifically deal with hand injuries occurring during leisure time activities. Through the cooperation of these 2 committees and implementation of the thus decided measures, a reduction in the number of accidents involving the hand is to be expected with a concomitant reduction in the associated costs. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Radiation cancer, safety standards and current levels of exposure

    International Nuclear Information System (INIS)

    Mole, R.H.

    1976-01-01

    Cancer can be induced by radiation in any tissue where cancer occurs naturally. The observation that antenatal diagnostic radiography causes a small but definite increase in childhood cancer is as good evidence as could be expected in support of the scientific expectation that there would be no threshold of dose for carcinogenesis. A linear relation between radiation dose and frequency of induced cancer is a necessary assumption for a system of radiological protection but is not necessarily a reasonable basis for realistic assessments of cancer risk. Indeed there are radiobiological and epidemiological reasons to the contrary. If the linear hypothesis is accepted then at the present time in the UK the routine practice of medicine is of about 2 orders of magnitude more important in causing cancer than environmental pollution by discharge of radio-activity. The acceptability of radiation safety standards for occupational exposure may be justified by comparison of radiation cancer risks with risks from fatal accidents in the safer industries. The acceptability of the corresponding standards for members of the public seems to require more public discussion of the concept of negligible risk. Emotional reactions to uncontrolled releases of radio-activity are based at least in part on a failure to appreciate the hypothesis of linearity

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

    Directory of Open Access Journals (Sweden)

    Prasanta K. Bhattacharya

    2016-04-01

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

  18. Male circumcision for HIV prevention: current evidence and implementation in sub-Saharan Africa

    Science.gov (United States)

    2011-01-01

    Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low. PMID:22014096

  19. Shift Work and Health: Current Problems and Preventive Actions

    Directory of Open Access Journals (Sweden)

    Giovanni Costa

    2010-12-01

    Full Text Available The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers’ health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

  20. [From Evidence to Health Policy Making: Pre-Exposure Prophylaxis for HIV Prevention].

    Science.gov (United States)

    Ko, Nai-Ying

    2016-12-01

    Pre-exposure prophylaxis (PrEP), in combination with traditional prevention strategies (such as condom use, voluntary HIV counseling and testing, and treatment for sexually transmitted infections), has been shown to effectively prevent HIV infection. As of September 2015, the World Health Organization recommends that people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention. This article introduces how to apply a systematic review using the methodology of Grading of Recommendations Assessment, Development and Evaluation (GRADE) to write clinical guidelines. With support from the Taiwan Centers for Disease Control, the Taiwan AIDS Society published clinical guidelines for oral pre-exposure prophylaxis in Taiwan. Nurses are responsible to apply evidence-based knowledge and to use their professional influence to shape health policies related to HIV prevention.

  1. Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm

    Science.gov (United States)

    Haberer, Jessica E.; Bangsberg, David R.; Baeten, Jared M.; Curran, Kathryn; Koechlin, Florence; Amico, K. Rivet; Anderson, Peter; Mugo, Nelly; Venter, Francois; Goicochea, Pedro; Caceres, Carlos; O’Reilly, Kevin

    2015-01-01

    Clinical trial data have shown that oral pre-exposure prophylaxis (PrEP) is efficacious when taken as prescribed; however, PrEP adherence is complex and must be understood within the context of variable risk for HIV infection and use of other HIV prevention methods. Different levels of adherence may be needed in different populations to achieve HIV prevention, and the optimal methods for achieving the necessary adherence for both individual and public health benefits are unknown. Guidance for PrEP use must consider these questions to determine the success of PrEP-based HIV prevention programs. In this article, we propose a new paradigm for understanding and measuring PrEP adherence, termed prevention-effective adherence, which incorporates dynamic HIV acquisition risk behaviors and the use of HIV alternative prevention strategies. We discuss the need for daily PrEP use only during periods of risk for HIV exposure, describe key issues for measuring and understanding relevant behaviors, review lessons from another health prevention field (i.e., family planning), and provide guidance for prevention-effective PrEP use. Moreover, we challenge emerging calls for sustained, near perfect PrEP adherence regardless of risk exposure and offer a more practical and public health-focused vision for this prevention intervention. PMID:26103095

  2. Lithium prevents long-term neural and behavioral pathology induced by early alcohol exposure.

    Science.gov (United States)

    Sadrian, B; Subbanna, S; Wilson, D A; Basavarajappa, B S; Saito, M

    2012-03-29

    Fetal alcohol exposure can cause developmental defects in offspring known as fetal alcohol spectrum disorder (FASD). FASD symptoms range from obvious facial deformities to changes in neuroanatomy and neurophysiology that disrupt normal brain function and behavior. Ethanol exposure at postnatal day 7 in C57BL/6 mice induces neuronal cell death and long-lasting neurobehavioral dysfunction. Previous work has demonstrated that early ethanol exposure impairs spatial memory task performance into adulthood and perturbs local and interregional brain circuit integrity in the olfacto-hippocampal pathway. Here we pursue these findings to examine whether lithium prevents anatomical, neurophysiological, and behavioral pathologies that result from early ethanol exposure. Lithium has neuroprotective properties that have been shown to prevent ethanol-induced apoptosis. Here we show that mice co-treated with lithium on the same day as ethanol exposure exhibit dramatically reduced acute neurodegeneration in the hippocampus and retain hippocampal-dependent spatial memory as adults. Lithium co-treatment also blocked ethanol-induced disruption in synaptic plasticity in slice recordings of hippocampal CA1 in the adult mouse brain. Moreover, long-lasting dysfunctions caused by ethanol in olfacto-hippocampal networks, including sensory-evoked oscillations and resting state coherence, were prevented in mice co-treated with lithium. Together, these results provide behavioral and physiological evidence that lithium is capable of preventing or reducing immediate and long-term deleterious consequences of early ethanol exposure on brain function. Copyright © 2012 IBRO. Published by Elsevier Ltd. All rights reserved.

  3. New and current preventive treatment options in actinic keratosis.

    Science.gov (United States)

    Arenberger, P; Arenbergerova, M

    2017-09-01

    Actinic keratosis (AK) is a characteristic skin lesion on skin areas of subjects with mainly phototype I and phototype II, or with specific genetic factors and who are exposed to prolonged ultraviolet radiation. AK may be considered a precursor of in situ squamous cell carcinoma (SCC), a type of non-melanoma skin cancer (NMSC). However, it is still not possible to predict which AK lesions will develop into SCC. Early treatment of AK is therefore recommended. Despite the increasing number of patients with AK developing into SCC, to date, there is still no clear suggestion of therapeutic strategy for AK. Current treatment consists of a multitude of topical lesion-directed or field-directed therapies or a combination of both. Recently, orally administered nicotinamide has shown to significantly reduce rates of new NMSC and AK in high-risk patients. This study aims to provide an update on the most relevant information about AK and to provide an insight into current and new treatment options. © 2017 European Academy of Dermatology and Venereology.

  4. Evaluation of Current Operations for the Prevention of Gastroesophageal Reflux

    Science.gov (United States)

    Demeester, Tom R.; Johnson, Lawrence F.; Kent, Alfred H.

    1974-01-01

    A prospective randomized study was done on 45 patients to evaluate the effectiveness of the Hill, Nissen or Belsey anti-reflux procedure. All patients had symptoms of GE reflux unresponsive to medical therapy, a + standard acid reflux test (SART), and esophagitis (38/45) or + Burnstein test (7/45). Esophageal symptomatic, radiographic, manometric and pH (SART and 24-hr monitoring) evaluation was done pre- and 154 days (ave.) postsurgery. All procedures improved the symptoms of pyrosis. The best improvement was seen after the Nissen repair. All procedures increased the distal esophageal sphincter (DES) pressures over preoperative levels. The Nissen and Belsey increased it more than the Hill. Sphincter length and dynamics remained unchanged. The Nissen procedure placed more of the manometric sphincter below the respiratory inversion point in the positive pressure environment of the abdomen. The esophageal length was increased by the Nissen and Hill repairs. This was thought to account for the high incidence of temporary postsurgery dysphagia following the Nissen and Hill repairs and the lower incidence following the Belsey repair. Reflux was most effectively prevented by the Nissen repair, as shown by the SART and the 24-hr esophageal pH monitoring, a sensitive measurement of frequency and duration of reflux. The average length of hospital stay was 20 days for Belsey and 12 days for both Nissen and Hill procedure. Postsurgery complications were more common following the thoracic than the abdominal approach. Ability to vomit postrepair was greatest with the Hill and least with the Belsey and Nissen repair. All procedures temporarily increased amount of flatus. It is concluded that the Nissen repair best controls reflux and its symptoms by providing the greatest increase in DES pressure and placing more of the sphincter in the positive abdominal environment. This is accomplished with the lowest morbidity but at the expense of temporary postoperative dysphagia and a 50

  5. Prevention and control of schistosomiasis: a current perspective

    Directory of Open Access Journals (Sweden)

    Inobaya MT

    2014-10-01

    Full Text Available Marianette T Inobaya,1 Remigio M Olveda,1 Thao NP Chau,3 David U Olveda,2 Allen GP Ross21Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines; 2Griffith Health Institute, School of Medical Sciences, Gold Coast Campus, Griffith University, Southport, Australia; 3Discipline of Public Health, Flinders University, Adelaide, AustraliaAbstract: Schistosomiasis is a neglected tropical disease that ranks second only to malaria in terms of human suffering in the tropics and subtropics. Five species are known to infect man and there are currently over 240 million people infected worldwide. The cornerstone of control to date has been mass drug administration with 40 mg/kg of praziquantel but there are problems with this approach. Human and bovine vaccines are in various stages of development. Integrated control, targeting the life cycle, is the only approach that will lead to sustainability and future elimination.Keywords: schistosomiais, morbidity, treatment and control, mass drug administration

  6. Integrating Antiretroviral Strategies for Human Immunodeficiency Virus Prevention: Post- and Pre-Exposure Prophylaxis and Early Treatment.

    Science.gov (United States)

    Grant, Robert M; Smith, Dawn K

    2015-12-01

    Best practices for integrating human immunodeficiency virus (HIV) testing and antiretroviral interventions for prevention and treatment are suggested based on research evidence and existing normative guidance. The goal is to provide high-impact prevention services during periods of substantial risk. Antiretroviral medications are recommended for postexposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), and treatment of HIV infection. We reviewed research evidence and current normative guidelines to identify best practices for integrating these high-impact prevention strategies. More sensitive HIV tests used for screening enable earlier diagnosis and treatment of HIV infection, more appropriate counseling, and help limit drug resistance. A fully suppressive PEP regimen should be initiated based on exposure history or physical findings when sensitive diagnostic testing is delayed or not available and antibody tests are negative. Transitions from PEP to PrEP are often warranted because HIV exposure events may continue to occur. This algorithmic approach to integrating PEP, PrEP, and early treatment decisions may increase the uptake of these interventions by a greater number and diversity of knowledgeable healthcare providers.

  7. Exercise Prevents Memory Impairment Induced by Arsenic Exposure in Mice: Implication of Hippocampal BDNF and CREB.

    Directory of Open Access Journals (Sweden)

    Bao-Fei Sun

    Full Text Available High concentrations of arsenic, which can be occasionally found in drinking water, have been recognized as a global health problem. Exposure to arsenic can disrupt spatial memory; however, the underlying mechanism remains unclear. In the present study, we tested whether exercise could interfere with the effect of arsenic exposure on the long-term memory (LTM of object recognition in mice. Arsenic (0, 1, 3, and 10 mg/ kg, i.g. was administered daily for 12 weeks. We found that arsenic at dosages of 1, 3, and 10 mg/kg decreased body weight and increased the arsenic content in the brain. The object recognition LTM (tested 24 h after training was disrupted by 3 mg/ kg and 10 mg/ kg, but not 1 mg/ kg arsenic exposure. Swimming exercise also prevented LTM impairment induced by 3 mg/ kg, but not with 10 mg/ kg, of arsenic exposure. The expression of brain-derived neurotrophic factor (BDNF and phosphorylated cAMP-response element binding protein (pCREB in the CA1 and dentate gyrus areas (DG of the dorsal hippocampus were decreased by 3 mg/ kg and 10 mg/ kg, but not by 1 mg/ kg, of arsenic exposure. The decrease in BDNF and pCREB in the CA1 and DG induced by 3 mg/ kg, but not 10 mg/ kg, of arsenic exposure were prevented by swimming exercise. Arsenic exposure did not affect the total CREB expression in the CA1 or DG. Taken together, these results indicated that swimming exercise prevented the impairment of object recognition LTM induced by arsenic exposure, which may be mediated by BDNF and CREB in the dorsal hippocampus.

  8. Prevention of congenital defects induced by prenatal alcohol exposure (Conference Presentation)

    Science.gov (United States)

    Sheehan, Megan M.; Karunamuni, Ganga; Pedersen, Cameron J.; Gu, Shi; Doughman, Yong Qiu; Jenkins, Michael W.; Watanabe, Michiko; Rollins, Andrew M.

    2017-02-01

    Over 500,000 women per year in the United States drink during pregnancy, and 1 in 5 of this population also binge drink. Up to 40% of live-born children with prenatal alcohol exposure (PAE) present with congenital heart defects (CHDs) including life-threatening outflow and valvuloseptal anomalies. Previously we established a PAE model in the avian embryo and used optical coherence tomography (OCT) imaging to assay looping-stage (early) cardiac function/structure and septation-stage (late) cardiac defects. Early-stage ethanol-exposed embryos had smaller cardiac cushions (valve precursors) and increased retrograde flow, while late-stage embryos presented with gross head/body defects, and exhibited smaller atrio-ventricular (AV) valves, interventricular septae, and aortic vessels. However, supplementation with the methyl donor betaine reduced gross defects, prevented cardiac defects such as ventricular septal defects and abnormal AV valves, and normalized cardiac parameters. Immunofluorescent staining for 5-methylcytosine in transverse embryo sections also revealed that DNA methylation levels were reduced by ethanol but normalized by co-administration of betaine. Furthermore, supplementation with folate, another methyl donor, in the PAE model appeared to normalize retrograde flow levels which are typically elevated by ethanol exposure. Studies are underway to correlate retrograde flow numbers for folate with associated cushion volumes. Finally, preliminary findings have revealed that glutathione, a key endogenous antioxidant which also regulates methyl group donation, is particularly effective in improving alcohol-impacted survival and gross defect rates. Current investigations will determine whether glutathione has any positive effect on PAE-related CHDs. Our studies could have significant implications for public health, especially related to prenatal nutrition recommendations.

  9. Habituation of Premonitory Sensations during Exposure and Response Prevention Treatment in Tourette's Syndrome

    Science.gov (United States)

    Verdellen, Cara W. J.; Hoogduin, Cees A. L.; Kato, Bernet S.; Keijsers, Ger P. J.; Cath, Danielle C.; Hoijtink, Herbert B.

    2008-01-01

    Exposure to premonitory sensations and response prevention of tics (ER) has been shown to be a promising new treatment for Tourette's syndrome (TS). The present study tested the hypothesis that habituation to unpleasant premonitory sensations associated with the tic is an underlying mechanism of change in ER. Patients rated the severity of…

  10. Enhancing Exposure and Response Prevention for OCD: A Couple-Based Approach

    Science.gov (United States)

    Abramowitz, Jonathan S.; Baucom, Donald H.; Wheaton, Michael G.; Boeding, Sara; Fabricant, Laura E.; Paprocki, Christine; Fischer, Melanie S.

    2013-01-01

    The effectiveness of individual therapy by exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is well established, yet not all patients respond well, and some show relapse on discontinuation. This article begins by providing an overview of the personal and interpersonal experiences of OCD, focusing on interpersonal…

  11. Behavioural treatment of tics: Habit reversal and exposure with response prevention

    NARCIS (Netherlands)

    Griendt, J.M.T.M. van de; Verdellen, C.W.J.; Dijk, M.K. van; Verbraak, M.J.P.M.

    2013-01-01

    Behaviour therapy has been shown to be an effective strategy in treating tics; both habit reversal (HR) and exposure and response prevention (ER) are recommended as first-line interventions. This review provides an overview of the history, theoretical concepts and evidence at present for HR and ER.

  12. Current exposure of 200 pregnant Danish women to phthalates, parabens and phenols

    DEFF Research Database (Denmark)

    Tefre de Renzy-Martin, Katrine; Frederiksen, Hanne; Christensen, Jeppe Hagstrup

    2014-01-01

    Many phthalates, parabens and phenols are suspected to have endocrine disrupting properties in humans. They are found in consumer products, including food wrapping, cosmetics and building materials. The foetus is vulnerable and exposure to these chemicals is of particular concern for pregnant women...... still raise concern. As current toxicological risk assessments in humans do not take into account simultaneous exposure, the true cumulative risk for the foetus may be underestimated....

  13. Prevention-intervention strategies to reduce exposure to e-waste.

    Science.gov (United States)

    Heacock, Michelle; Trottier, Brittany; Adhikary, Sharad; Asante, Kwadwo Ansong; Basu, Nil; Brune, Marie-Noel; Caravanos, Jack; Carpenter, David; Cazabon, Danielle; Chakraborty, Paromita; Chen, Aimin; Barriga, Fernando Diaz; Ericson, Bret; Fobil, Julius; Haryanto, Budi; Huo, Xia; Joshi, T K; Landrigan, Philip; Lopez, Adeline; Magalini, Frederico; Navasumrit, Panida; Pascale, Antonio; Sambandam, Sankar; Aslia Kamil, Upik Sitti; Sly, Leith; Sly, Peter; Suk, Ann; Suraweera, Inoka; Tamin, Ridwan; Vicario, Elena; Suk, William

    2018-05-11

    As one of the largest waste streams, electronic waste (e-waste) production continues to grow in response to global demand for consumer electronics. This waste is often shipped to developing countries where it is disassembled and recycled. In many cases, e-waste recycling activities are conducted in informal settings with very few controls or protections in place for workers. These activities involve exposure to hazardous substances such as cadmium, lead, and brominated flame retardants and are frequently performed by women and children. Although recycling practices and exposures vary by scale and geographic region, we present case studies of e-waste recycling scenarios and intervention approaches to reduce or prevent exposures to the hazardous substances in e-waste that may be broadly applicable to diverse situations. Drawing on parallels identified in these cases, we discuss the future prevention and intervention strategies that recognize the difficult economic realities of informal e-waste recycling.

  14. Peripubertal exposure to environmental enrichment prevents schizophrenia-like behaviors in the SHR strain animal model.

    Science.gov (United States)

    Santos, Camila Mauricio; Peres, Fernanda Fiel; Diana, Mariana Cepollaro; Justi, Veronica; Suiama, Mayra Akimi; Santana, Marcela Gonçalves; Abílio, Vanessa Costhek

    2016-10-01

    Schizophrenia is a highly disabling mental disorder, in which genetics and environmental factors interact culminating in the disease. The treatment of negative symptoms and cognitive deficits with antipsychotics is currently inefficient and is an important field of research. Environmental enrichment (EE) has been suggested to improve some cognitive deficits in animal models of various psychiatric disorders. In this study, we aimed to evaluate a possible beneficial effect of early and long-term exposure to EE on an animal model of schizophrenia, the SHR strain. Young male Wistar rats (control strain) and SHRs (21 post-natal days) were housed for 6weeks in two different conditions: in large cages (10 animals per cage) containing objects of different textures, forms, colors and materials that were changed 3 times/week (EE condition) or in standard cages (5 animals per cage - Control condition). Behavioral evaluations - social interaction (SI), locomotion, prepulse inhibition of startle (PPI) and spontaneous alternation (SA) - were performed 6weeks after the end of EE. SHRs presented deficits in PPI (a sensorimotor impairment), SI (mimicking the negative symptoms) and SA (a working memory deficit), and also hyperlocomotion (modeling the positive symptoms). EE was able to reduce locomotion and increase PPI in both strains, and to prevent the working memory deficit in SHRs. EE also increased the number of neurons in the CA1 and CA3 of the hippocampus. In conclusion, EE can be a potential nonpharmacological strategy to prevent some behavioral deficits associated with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. HIV Prevention After Discontinuing Pre-Exposure Prophylaxis: Conclusions From a Case Study

    Directory of Open Access Journals (Sweden)

    Kai J. Jonas

    2018-05-01

    Full Text Available Pre-exposure prophylaxis (PrEP with tenofovir disoproxil fumarate in combination with emtricitabine (FTC is a highly effective form of HIV prevention. Endeavors of health-care providers and activists in many countries over the world are directed at making access to PrEP possible, or increasing PrEP use among men-who-have-sex-with-men (MSM. We argue while this effort is necessary, we also need to consider modes of HIV prevention after a period of PrEP use. PrEP uptake is not a one-way street, meaning that individuals may discontinue PrEP use, either voluntarily and involuntarily. Voluntary discontinued PrEP use in conjunction with decreased or no HIV risk exposure is unproblematic, but involuntary discontinuations with continuous high level of HIV risk exposure calls for tailored post-PrEP use HIV prevention. We present a case study of an MSM individual who discontinued PrEP for medical reasons (renal function and seroconverted soon afterward, to illustrate the need for tailored HIV prevention post-PrEP. Furthermore, we provide additional contexts of PrEP discontinuation leading to populations that are in need for post-PrEP types of HIV prevention. Subsequently, we present suggestions for modes of post-PrEP HIV prevention based on knowledge–communication–choice model. Community organization and health-care providers should consider and prepare their HIV prevention consulting protocols for such types of clients and add post-PrEP HIV prevention measures to their consulting offer.

  16. Symptom dimensions in obsessive-compulsive disorder: phenomenology and treatment outcomes with exposure and ritual prevention.

    Science.gov (United States)

    Williams, Monnica T; Mugno, Beth; Franklin, Martin; Faber, Sonya

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. Currently, the cognitive-behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e. symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. Copyright © 2013 S. Karger AG, Basel.

  17. Current densities in a pregnant woman model induced by simultaneous ELF electric and magnetic field exposure

    International Nuclear Information System (INIS)

    Cech, R; Leitgeb, N; Pediaditis, M

    2008-01-01

    The pregnant woman model SILVY was studied to ascertain to what extent the electric current densities induced by 50 Hz homogeneous electric and magnetic fields increase in the case of simultaneous exposure. By vectorial addition of the electric current densities, it could be shown that under worst case conditions the basic restrictions recommended by ICNIRP (International Commission on Non-Ionizing Radiation Protection) guidelines are exceeded within the central nervous system (CNS) of the mother, whereas in sole field exposure they are not. However, within the foetus the induced current densities do not comply with basic restrictions, either from single reference-level electric fields or from simultaneous exposure to electric and magnetic fields. Basic limits were considerably exceeded

  18. Secondhand smoke exposure and serum cotinine levels among current smokers in the USA.

    Science.gov (United States)

    Lindsay, Ryan P; Tsoh, Janice Y; Sung, Hai-Yen; Max, Wendy

    2016-03-01

    Secondhand smoke (SHS) likely provides additional exposure to nicotine and toxins for smokers, but has been understudied. Our objective was to determine whether SHS exposure among smokers yields detectable differences in cotinine levels compared with unexposed smokers at the population level. Using the US National Health and Nutrition Examination Survey (NHANES) for the years 1999-2012, we compared serum cotinine levels of 4547 current adult cigarette smokers stratified by self-reported SHS exposure sources (home and/or work) and smoking intensity. A weighted multivariable linear regression model determined the association between SHS exposure and cotinine levels among smokers. Smokers with SHS exposure at home (43.8%) had higher cotinine levels (β=0.483, p≤0.001) compared with those with no SHS exposure at home after controlling for the number of cigarettes smoked per day and number of days smoked in the previous 5 days, survey year, age, gender and education. Smokers with SHS exposure at work (20.0%) did not have significantly higher cotinine levels after adjustment. The adjusted geometric mean cotinine levels of light smokers (1-9 cigarettes per day) with no SHS exposure, exposure at work only, home only, and both home and work were 52.0, 62.7, 67.2, 74.4 ng/mL, respectively, compared with 219.4, 220.9, 255.2, 250.5 ng/mL among moderate/heavy smokers (≥10 cigarettes per day). Smokers living in residences where others smoke inside the home had significantly higher cotinine levels than smokers reporting no SHS exposure, regardless of individual smoking intensity. Future research should target the role that SHS exposure may have in nicotine dependence, cessation outcomes and other health impacts among smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Aspirin and Zileuton and Biomarker Expression in Nasal Tissue of Current Smokers | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase II trial studies the effects of aspirin and zileuton on genes related to tobacco use in current smokers. Aspirin and zileuton may interfere with genes related to tobacco use and may be useful in preventing lung cancer in current smokers. |

  20. Dietary exposure to cadmium at close to the current provisional tolerable weekly intake does not affect renal function among female Japanese farmers

    International Nuclear Information System (INIS)

    Horiguchi, Hyogo; Oguma, Etsuko; Sasaki, Satoshi; Miyamoto, Kayoko; Ikeda, Yoko; Machida, Munehito; Kayama, Fujio

    2004-01-01

    Dietary cadmium (Cd) exposure and renal tubular function were investigated in 1381 female farmers from five districts in Japan (Japanese Multi-centered Environmental Toxicant Study project; JMETS). Dietary Cd exposure of the five populations was assessed from the individual Cd concentrations of the rice consumed by the study participants and the quantities of rice consumed daily. The populations showed a sequential difference in dietary Cd exposure, ranging from a level as low as that of the general Japanese population to one close to the current provisional tolerable weekly intake (PTWI). The levels of urinary Cd excretion, an indicator of Cd accumulation in the kidneys, increased along the same sequential pattern as dietary Cd exposure. However, no differences were observed among the populations in levels of urinary α 1 -microglobulin and β 2 -microglobulin excretion, which are indicators of renal tubular function. These results indicate that the current PTWI is sufficient to prevent Cd-induced renal dysfunction among the general population

  1. Pre-exposure prophylaxis for HIV-1 prevention does not diminish the pregnancy prevention effectiveness of hormonal contraception.

    Science.gov (United States)

    Murnane, Pamela M; Heffron, Renee; Ronald, Allan; Bukusi, Elizabeth A; Donnell, Deborah; Mugo, Nelly R; Were, Edwin; Mujugira, Andrew; Kiarie, James; Celum, Connie; Baeten, Jared M

    2014-07-31

    For women at risk of HIV-1, effective contraception and effective HIV-1 prevention are global priorities. In a clinical trial of pre-exposure prophylaxis (PrEP) for HIV-1 prevention in HIV-1-serodiscordant couples, we estimated the effectiveness of hormonal contraceptives (oral contraceptive pills, injectable depot medroxyprogesterone acetate, and hormonal implants) for pregnancy prevention relative to no contraception among 1785 HIV-1-uninfected women followed up to 36 months. We compared the effectiveness of each method among women assigned PrEP versus placebo. Contraception was not required for participation, but was offered on-site and was recorded monthly; incident pregnancy was determined by monthly urine testing. For women using no contraception, overall pregnancy incidence was 15.4% per year. Women reporting oral contraceptive use had comparable pregnancy incidence to women using no contraception, and this lack of contraceptive effectiveness was similar for those assigned PrEP and placebo (17.7 and 10.0% incidence per year, respectively; P-value for difference in effect by PrEP use = 0.24). Women reporting injectable contraception had reduced pregnancy incidence compared to those reporting no contraception, which did not differ by arm (PrEP 5.1%, placebo 5.3% per year; P-value for difference = 0.47). Contraceptive effectiveness was highest among women using implants (pregnancy incidence <1% per year in both arms). PrEP had no adverse impact on hormonal contraceptive effectiveness for pregnancy prevention. As seen previously in similar populations, women reporting contraceptive pill use had little protection from pregnancy, possibly due to poor adherence. Injectable or implantable hormonal contraception and PrEP provide effective prevention for pregnancy and HIV-1.

  2. Therapeutic Use of Prebiotics, Probiotics, and Postbiotics to Prevent Necrotizing Enterocolitis: What is the Current Evidence?

    Science.gov (United States)

    Patel, Ravi Mangal; Denning, Patricia Wei

    2013-01-01

    Synopsis Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality and preventative therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants and probiotics are currently the most promising therapy on the horizon for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical use of probiotics in preterm infants. In addition, prebiotics and postbiotics may be potential alternatives or adjunctive therapies to the administration of live microorganisms, although studies demonstrating their clinical efficacy in preventing NEC are lacking. This review summarizes the current evidence regarding the use of probiotics, prebiotics and postbiotics in the preterm infant, including its therapeutic role in preventing NEC. PMID:23415261

  3. Tooth Matrix Analysis for Biomonitoring of Organic Chemical Exposure: Current Status, Challenges, and Opportunities

    Science.gov (United States)

    Andra, Syam S.; Austin, Christine; Arora, Manish

    2015-01-01

    Epidemiological evidence supports associations between prenatal exposure to environmental organic chemicals and childhood health impairments. Unlike the common choice of biological matrices such as urine and blood that can be limited by short half-lives for some chemicals, teeth provide a stable repository for chemicals with half-life in the order of decades. Given the potential of the tooth bio-matrix to study long-term exposures to environmental organic chemicals in human biomonitoring programs, it is important to be aware of possible pitfalls and potential opportunities to improve on the current analytical method for tooth organics analysis. We critically review previous results of studies of this topic. The major drawbacks and challenges in currently practiced concepts and analytical methods in utilizing tooth bio-matrix are (i) no consideration of external (from outer surface) or internal contamination (from micro odontoblast processes), (ii) the misleading assumption that whole ground teeth represent prenatal exposures (latest formed dentine is lipid rich and therefore would absorb and accumulate more organic chemicals), (iii) reverse causality in exposure assessment due to whole ground teeth, and (iv) teeth are a precious bio-matrix and grinding them raises ethical concerns about appropriate use of a very limited resource in exposure biology and epidemiology studies. These can be overcome by addressing the important limitations and possible improvements with the analytical approach associated at each of the following steps (i) tooth sample preparation to retain exposure timing, (ii) organics extraction and pre-concentration to detect ultra-trace levels of analytes, (iii) chromatography separation, (iv) mass spectrometric detection to detect multi-class organics simultaneously, and (v) method validation, especially to exclude chance findings. To highlight the proposed improvements we present findings from a pilot study that utilizes tooth matrix biomarkers to

  4. Are the current Australian sun exposure guidelines effective in maintaining adequate levels of 25-hydroxyvitamin D?

    Science.gov (United States)

    Kimlin, Michael; Sun, Jiandong; Sinclair, Craig; Heward, Sue; Hill, Jane; Dunstone, Kimberley; Brodie, Alison

    2016-01-01

    An adequate vitamin D status, as measured by serum 25-hydroxyvitamin D (25(OH)D) concentration, is important in humans for maintenance of healthy bones and muscle function. Serum 25(OH)D concentration was assessed in participants from Melbourne, Australia (37.81S, 144.96E), who were provided with the current Australian guidelines on sun exposure for 25(OH)D adequacy (25(OH)D ≥50 nmol/L). Participants were interviewed in February (summer, n=104) and August (winter, n=99) of 2013. Serum 25(OH)D concentration was examined as a function of measures of sun exposure and sun protection habits with control of key characteristics such as dietary intake of vitamin D, body mass index (BMI) and skin colour, that may modify this relationship. The mean 25(OH)D concentration in participants who complied with the current sun exposure guidelines was 67.3 nmol/L in summer and 41.9 nmol/L in winter. At the end of the study, 69.3% of participants who complied with the summer sun exposure guidelines were 25(OH)D adequate, while only 27.6% of participants who complied with the winter sun exposure guidelines were 25(OH)D adequate at the end of the study. The results suggest that the current Australian guidelines for sun exposure for 25(OH)D adequacy are effective for most in summer and ineffective for most in winter. This article is part of a Special Issue entitled '17th Vitamin D Workshop'. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Piracetam prevents memory deficit induced by postnatal propofol exposure in mice.

    Science.gov (United States)

    Wang, Yuan-Lin; Li, Feng; Chen, Xin

    2016-05-15

    Postnatal propofol exposure impairs hippocampal synaptic development and memory. However, the effective agent to alleviate the impairments was not verified. In this study, piracetam, a positive allosteric modulator of AMPA receptor was administered following a seven-day propofol regime. Two months after propofol administration, hippocampal long-term potentiation (LTP) and long-term memory decreased, while intraperitoneal injection of piracetam at doses of 100mg/kg and 50mg/kg following last propofol exposure reversed the impairments of memory and LTP. Mechanically, piracetam reversed propofol exposure-induced decrease of BDNF and phosphorylation of mTor. Similar as piracetam, BDNF supplementary also ameliorated propofol-induced abnormalities of synaptic plasticity-related protein expressions, hippocampal LTP and long-term memory. These results suggest that piracetam prevents detrimental effects of propofol, likely via activating BDNF synthesis. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Prevention of risks in relation with occupational exposure to ionizing radiation; Prevention des risques lies a l'exposition professionnelle aux rayonnements ionisants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    After remind the base notions in the field of ionizing radiation, this file evaluates the situation on the natural and occupational exposures: modes, sources, and exposure level, risk for health. It presents the principles of prevention allowing in a professional area (out of nuclear industry) to reduce and control these exposures. Some practical cases illustrate the radiation protection approach. references are given: regulatory benchmarks, useful links, books to consult. (N.C.)

  7. Antiretroviral pre-exposure prophylaxis prevents vaginal transmission of HIV-1 in humanized BLT mice.

    Directory of Open Access Journals (Sweden)

    Paul W Denton

    2008-01-01

    Full Text Available Worldwide, vaginal transmission now accounts for more than half of newly acquired HIV-1 infections. Despite the urgency to develop and implement novel approaches capable of preventing HIV transmission, this process has been hindered by the lack of adequate small animal models for preclinical efficacy and safety testing. Given the importance of this route of transmission, we investigated the susceptibility of humanized mice to intravaginal HIV-1 infection.We show that the female reproductive tract of humanized bone marrow-liver-thymus (BLT mice is reconstituted with human CD4+ T and other relevant human cells, rendering these humanized mice susceptible to intravaginal infection by HIV-1. Effects of HIV-1 infection include CD4+ T cell depletion in gut-associated lymphoid tissue (GALT that closely mimics what is observed in HIV-1-infected humans. We also show that pre-exposure prophylaxis with antiretroviral drugs is a highly effective method for preventing vaginal HIV-1 transmission. Whereas 88% (7/8 of BLT mice inoculated vaginally with HIV-1 became infected, none of the animals (0/5 given pre-exposure prophylaxis of emtricitabine (FTC/tenofovir disoproxil fumarate (TDF showed evidence of infection (Chi square = 7.5, df = 1, p = 0.006.The fact that humanized BLT mice are susceptible to intravaginal infection makes this system an excellent candidate for preclinical evaluation of both microbicides and pre-exposure prophylactic regimens. The utility of humanized mice to study intravaginal HIV-1 transmission is particularly highlighted by the demonstration that pre-exposure prophylaxis can prevent intravaginal HIV-1 transmission in the BLT mouse model.

  8. PREVENTION AND TREATMENT OF VITAMIN D DEFICIENCY: CURRENT LOOK AT THE ISSUE

    Directory of Open Access Journals (Sweden)

    Yu. S. Lashkova

    2015-01-01

    Full Text Available The article presents the current data on the metabolism of vitamin D and its role in the development of bone tissue in children and the further condition thereof. Natural vitamin D sources, as well as the current routine practice of preventing deficiency of this organic substance are unable to fully satisfy a child's demand for this vitamin, which is why recommendations on vitamin D intake ought to be revised. The article details schedules for prescription of vitamin D for preventing and treating the body deficiency thereof based on results of the studies completed in the recent years. The role of the main marker enabling assessing vitamin D concentration in the body — 25(OHD — the reference values whereof are yet to be commonly established has been analyzed. The article lists recommendations on rickets prevention and treatment in children. The article presents data on the possible mechanisms of development of toxic effects in the setting of vitamin D intake.

  9. Current man-made mineral fibers (MMMF) exposures among ontario construction workers.

    Science.gov (United States)

    Verma, Dave K; Sahai, Dru; Kurtz, Lawrence A; Finkelstein, Murray M

    2004-05-01

    Current occupational exposures to man-made mineral fibers (MMMF), including refractory ceramic fibers (RCF), were measured as part of an exposure assessment program for an epidemiological study pertaining to cancer and mortality patterns of Ontario construction workers. The assessments were carried out at commercial and residential sites. A total of 130 MMMF samples (104 personal and 26 area) was collected and included 21 RCF (16 personal and 5 area). The samples were analyzed by the World Health Organization method in which both respirable and nonrespirable airborne fibers are counted. The results show that Ontario construction workers' full-shift exposure to MMMF (excluding RCF) is generally lower than the American Conference of Governmental Industrial Hygienists' (ACGIH) recommended threshold limit value-time-weighted average (TLV-TWA) of 1 fibers/cc and thus should not present any significant hazard. However, approximately 40% of the occupational exposures to RCF are higher than ACGIH's TLV-TWA of 0.2 fibers/cc and present a significant potential hazard. Workers generally wore adequate approved respiratory protection, especially while performing particularly dusty tasks such as blowing, spraying, and cutting, so the actual exposure received by workers was lower than the reported values. Adequate control measures such as ventilation and respiratory protection should always be used when work involves RCF.

  10. [Current situation of human resources of parasitic disease control and prevention organizations in Henan Province].

    Science.gov (United States)

    Ya-Lan, Zhang; Yan-Kun, Zhu; Wei-Qi, Chen; Yan, Deng; Peng, Li

    2018-01-10

    To understand the current status of human resources of parasitic disease control and prevention organizations in Henan Province, so as to provide the reference for promoting the integrative ability of the prevention and control of parasitic diseases in Henan Province. The questionnaires were designed and the method of census was adopted. The information, such as the amounts, majors, education background, technical titles, working years, and turnover in each parasitic disease control and prevention organization was collected by the centers for disease control and prevention (CDCs) at all levels. The data were descriptively analyzed. Totally 179 CDCs were investigated, in which only 19.0% (34/179) had the independent parasitic diseases control institution (department) . There were only 258 full-time staffs working on parasitic disease control and prevention in the whole province, in which only 61.9% (159/258) were health professionals. Those with junior college degree or below in the health professionals accounted for 60.3% (96/159) . Most of them (42.1%) had over 20 years of experience, but 57.9% (92/159) of their technical post titles were at primary level or below. The proportion of the health professionals is low in the parasitic disease control and prevention organizations in Henan Province. The human resource construction for parasitic disease control and prevention at all levels should be strengthened.

  11. Indoor PM2.5 exposure in London's domestic stock: Modelling current and future exposures following energy efficient refurbishment

    Science.gov (United States)

    Shrubsole, C.; Ridley, I.; Biddulph, P.; Milner, J.; Vardoulakis, S.; Ucci, M.; Wilkinson, P.; Chalabi, Z.; Davies, M.

    2012-12-01

    Simulations using CONTAM (a validated multi-zone indoor air quality (IAQ) model) are employed to predict indoor exposure to PM2.5 in London dwellings in both the present day housing stock and the same stock following energy efficient refurbishments to meet greenhouse gas emissions reduction targets for 2050. We modelled interventions that would contribute to the achievement of these targets by reducing the permeability of the dwellings to 3 m3 m-2 h-1 at 50 Pa, combined with the introduction of mechanical ventilation and heat recovery (MVHR) systems. It is assumed that the current mean outdoor PM2.5 concentration of 13 μg m-3 decreased to 9 μg m-3 by 2050 due to emission control policies. Our primary finding was that installation of (assumed perfectly functioning) MVHR systems with permeability reduction are associated with appreciable reductions in PM2.5 exposure in both smoking and non-smoking dwellings. Modelling of the future scenario for non-smoking dwellings show a reduction in annual average indoor exposure to PM2.5 of 18.8 μg m-3 (from 28.4 to 9.6 μg m-3) for a typical household member. Also of interest is that a larger reduction of 42.6 μg m-3 (from 60.5 to 17.9 μg m-3) was shown for members exposed primarily to cooking-related particle emissions in the kitchen (cooks). Reductions in envelope permeability without mechanical ventilation produced increases in indoor PM2.5 concentrations; 5.4 μg m-3 for typical household members and 9.8 μg m-3 for cooks. These estimates of changes in PM2.5 exposure are sensitive to assumptions about occupant behaviour, ventilation system usage and the distributions of input variables (±72% for non-smoking and ±107% in smoking residences). However, if realised, they would result in significant health benefits.

  12. Climate change and occupational allergies: an overview on biological pollution, exposure and prevention.

    Science.gov (United States)

    D'Ovidio, Maria Concetta; Annesi-Maesano, Isabella; D'Amato, Gennaro; Cecchi, Lorenzo

    2016-01-01

    Climate change, air pollution, temperature increase and other environmental variables are modifying air quality, contributing to the increase of prevalence of allergic respiratory diseases. Allergies are complex diseases characterized by multilevel interactions between individual susceptibility, response to immune modulation and environmental exposures to physical, chemical and biological agents. Occupational allergies introduce a further complexity to these relationships by adding occupational exposure to both the indoor and outdoor ones in the living environment. The aim of this paper is to overview climate-related allergy affecting environmental and occupational health, as literature data are scanty in this regard, and to suggest a management model of this risk based on a multidisciplinary approach, taking the case of biological pollution, with details on exposure and prevention. The management of climate-related occupational allergy should take into account preventive health strategies, environmental, public and occupational interventions, as well as to develop, implement, evaluate, and improve guidelines and standards protecting workers health under changing climatic conditions; new tools and strategies based on local conditions will have to be developed. Experimental studies and acquisition of environmental and personal data have to be matched to derive useful information for the scope of occupational health and safety.

  13. Efficacy of long scleral tunnel technique in preventing Ahmed glaucoma valve tube exposure through conjunctiva.

    Science.gov (United States)

    Kugu, Suleyman; Erdogan, Gurkan; Sevim, M Sahin; Ozerturk, Yusuf

    2015-01-01

    To evaluate the efficacy of long scleral tunnel technique used in Ahmed glaucoma valve (AGV) implantation in preventing tube exposure through conjunctiva. Patients of adult age, who were unresponsive to maximum medical treatment and underwent AGV implantation, were divided into two groups and investigated retrospectively. Group 1 consisted of 40 eyes of 38 patients that underwent surgery by long scleral tunnel technique and Group 2 consisted of 38 eyes of 35 patients that underwent implantation by processed pericardium patch graft method. The mean age was 54.8 ± 14.6 years (range 26-68 years) and the mean follow-up duration was 46.7 ± 19.4 months (range 18-76 months) for the patients in Group 1, whereas the mean age was 58.6 ± 16.7 years (range 32-74 years) and mean follow-up period was 43.6 ± 15.7 months (range 20-72 months) for the patients in Group 2 (p > 0.05). In the course of follow-up, tube exposure was detected in one (2.5%) eye in Group 1 and in three (7.9%) eyes in Group 2 (p = 0.042). Long scleral tunnel technique is beneficial in preventing conjunctival tube exposure in AGV implantation surgery.

  14. Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention.

    Science.gov (United States)

    Mugwanya, Kenneth K; Baeten, Jared M

    2016-01-01

    Tenofovir disoproxil fumarate (TDF)-based pre-exposure prophylaxis is a novel HIV prevention strategy for individuals at increased sexual risk for HIV infection. For any biomedical prevention intervention, the bar for tolerating adverse effects in healthy persons is high compared to therapeutic interventions. We provide a concise summary of the clinical safety of TDF-based pre-exposure prophylaxis with focus on TDF-related effects on tolerability, kidney function, bone density, HIV resistance, sexual and reproductive health. The evidence base for this review is derived from a literature search of both randomized and observational studies evaluating efficacy and safety of TDF-based PrEP, TDF alone or in combination with emtricitabine, identified from PUBMED and EMBASE electronic databases, clinicaltrials.gov and major HIV conferences. TDF-based pre-exposure prophylaxis is a potent intervention against HIV acquisition when taken which is generally safe and well tolerated. The risk of the small, non-progressive, and reversible decline in glomerular filtration rate and bone mineral density as well as the potential selection for drug resistance associated with PrEP are outweighed, at the population level and broadly for individuals, by PrEP's substantial reduction in the risk of HIV infection.

  15. Siting criteria based on the prevention of deterministic effects from plutonium inhalation exposures

    International Nuclear Information System (INIS)

    Sorensen, S.A.; Low, J.O.

    1998-01-01

    Siting criteria are established by regulatory authorities to evaluate potential accident scenarios associated with proposed nuclear facilities. The 0.25 Sv (25 rem) siting criteria adopted in the United States has been historically based on the prevention of deterministic effects from acute, whole-body exposures. The Department of Energy has extended the applicability of this criterion to radionuclides that deliver chronic, organ-specific irradiation through the specification of a 0.25 Sv (25 rem) committed effective dose equivalent siting criterion. A methodology is developed to determine siting criteria based on the prevention of deterministic effects from inhalation intakes of radionuclides which deliver chronic, organ-specific irradiation. Revised siting criteria, expressed in terms of committed effective dose equivalent, are proposed for nuclear facilities that handle primarily plutonium compounds. The analysis determined that a siting criterion of 1.2 Sv (120 rem) committed effective dose equivalent for inhalation exposures to weapons-grade plutonium meets the historical goal of preventing deterministic effects during a facility accident scenario. The criterion also meets the Nuclear Regulatory Commission and Department of Energy Nuclear Safety Goals provided that the frequency of the accident is sufficiently low

  16. Preventive Effect of Residential Green Space on Infantile Atopic Dermatitis Associated with Prenatal Air Pollution Exposure.

    Science.gov (United States)

    Lee, Ji-Young; Lamichhane, Dirga Kumar; Lee, Myeongjee; Ye, Shinhee; Kwon, Jung-Hyun; Park, Myung-Sook; Kim, Hwan-Cheol; Leem, Jong-Han; Hong, Yun-Chul; Kim, Yangho; Ha, Mina; Ha, Eunhee

    2018-01-09

    Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether exposure to nitrogen dioxide (NO₂) and particulate matter with an aerodynamic diameter of Health study. Subjects were geocoded to their residential addresses and matched with air pollution data modeled using land-use regression. Information on infantile AD was obtained by using a questionnaire administered to the parents or guardians of the children. The association between infantile AD and exposure to NO₂ and PM 10 was determined using logistic regression models. We assessed the effects of residential green spaces using stratified analyses and by entering product terms into the logistic regression models. The risk of infantile AD significantly increased with an increase in air pollution exposure during the first trimester of pregnancy. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.219 (1.023-1.452) per 10 μg/m³ increase in PM 10 and 1.353 (1.027-1.782) per 10 ppb increase in NO₂. An increase in the green space within 200 m of residence was associated with a decreased risk of AD (OR = 0.996, 95% CI: 0.993-0.999). The stratified analysis of residential green space revealed stronger associations between infantile AD and PM 10 and NO₂ exposure during the first trimester in the areas in the lower tertiles of green space. This study indicated that exposure to TRAP during the first trimester of pregnancy is associated with infantile AD. Less residential green space may intensify the association between TRAP exposure and infantile AD.

  17. Studies of the disruption prevention by ECRH at plasma current rise stage in limiter discharges

    International Nuclear Information System (INIS)

    Alikaev, V.V.; Borshegovskij, A.A.; Chistyakov, V.V.

    1999-01-01

    Studies of disruption prevention by means of ECRH in T-10 at the plasma current rise phase in limiter discharges with circular plasma cross-section were performed. Reliable disruption prevention by ECRH at HF power (P HF ) min level equal to 20% of ohmic heating power P OH was demonstrated. m/n=2/1 mode MHD-activity developed before disruption (with characteristic time ∼120 ms) can be considered as disruption precursor and can be used in a feedback system. (author)

  18. Prevention of Fetal Alcohol Spectrum Disorder: Current Canadian Efforts and Analysis of Gaps

    Directory of Open Access Journals (Sweden)

    Nancy Poole

    2016-01-01

    Full Text Available Effective prevention of risky alcohol use in pregnancy involves much more than providing information about the risk of potential birth defects and developmental disabilities in children. To categorize the breadth of possible initiatives, Canadian experts have identified a four-part framework for fetal alcohol spectrum disorder (FASD prevention: Level 1, public awareness and broad health promotion; Level 2, conversations about alcohol with women of childbearing age and their partners; Level 3, specialized support for pregnant women; and Level 4, postpartum support for new mothers. In order to describe the level of services across Canada, 50 Canadian service providers, civil servants, and researchers working in the area of FASD prevention were involved in an online Delphi survey process to create a snapshot of current FASD prevention efforts, identify gaps, and provide ideas on how to close these gaps to improve FASD prevention. Promising Canadian practices and key areas for future action are described. Overall, Canadian FASD prevention programming reflects evidence-based practices; however, there are many opportunities to improve scope and availability of these initiatives.

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

    Science.gov (United States)

    Bondü, Rebecca; Scheithauer, Herbert

    2009-01-01

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

  20. Caffeine in the milk prevents respiratory disorders caused by in utero caffeine exposure in rats.

    Science.gov (United States)

    Bodineau, Laurence; Saadani-Makki, Fadoua; Jullien, Hugues; Frugière, Alain

    2006-01-25

    Consequences of postnatal caffeine exposure by the milk on ponto-medullary respiratory disturbances observed following an in utero caffeine exposure were analysed. Ponto-medullary-spinal cord preparations from newborn rats exposed to caffeine during gestation but not after the birth display an increase in respiratory frequency and an exaggeration of the hypoxic respiratory depression compared to not treated preparations. These data suggest that tachypneic and apneic episodes encountered in human newborns whose mother consumed caffeine during pregnancy are due in large part to central effect of caffeine at the ponto-medullary level. Both baseline respiratory frequency increase and emphasis of hypoxic respiratory depression are not encountered if rat dams consumed caffeine during nursing. Our hypothesis is that newborn rats exposed to caffeine during gestation but not after the birth would be in withdrawal situation whereas, when caffeine is present in drinking fluid of lactating dams, it goes down the milk and is able to prevent ponto-medullary respiratory disturbances.

  1. Children's Environmental Health in the Digital Era: Understanding Early Screen Exposure as a Preventable Risk Factor for Obesity and Sleep Disorders.

    Science.gov (United States)

    Wolf, Candice; Wolf, Seth; Weiss, Miriam; Nino, Gustavo

    2018-02-23

    The quantity, accessibility and focus on child-targeted programming has exponentially increased since it entered American households in the early 1900s. It may have started with the television (TV), but technology has evolved and now fits in our pockets; as of 2017, 95% of American families own a smartphone. Availability and child-tailored content has subsequently led to a decrease in the age at initial screen exposure. The negative effects that accompany the current culture of early screen exposure are extensive and need to be considered as technology continues to enter the home and inundate social interactions. Increased levels of early screen exposure have been associated with decreased cognitive abilities, decreased growth, addictive behavior, poor school performance, poor sleep patterns, and increased levels of obesity. Research on the adverse effects of early screen exposure is mounting, but further epidemiological studies are still needed to inform prevention and regulation policies.

  2. Children’s Environmental Health in the Digital Era: Understanding Early Screen Exposure as a Preventable Risk Factor for Obesity and Sleep Disorders

    Directory of Open Access Journals (Sweden)

    Candice Wolf

    2018-02-01

    Full Text Available The quantity, accessibility and focus on child-targeted programming has exponentially increased since it entered American households in the early 1900s. It may have started with the television (TV, but technology has evolved and now fits in our pockets; as of 2017, 95% of American families own a smartphone. Availability and child-tailored content has subsequently led to a decrease in the age at initial screen exposure. The negative effects that accompany the current culture of early screen exposure are extensive and need to be considered as technology continues to enter the home and inundate social interactions. Increased levels of early screen exposure have been associated with decreased cognitive abilities, decreased growth, addictive behavior, poor school performance, poor sleep patterns, and increased levels of obesity. Research on the adverse effects of early screen exposure is mounting, but further epidemiological studies are still needed to inform prevention and regulation policies.

  3. Current practices for maintaining occupational exposures ALARA at low-level waste disposal sites

    International Nuclear Information System (INIS)

    Hadlock, D.E.; Herrington, W.N.; Hooker, C.D.; Murphy, D.W.; Gilchrist, R.L.

    1983-12-01

    The United States Nuclear Regulatory Commission contracted with Pacific Northwest Laboratory (PNL) to provide technical assistance in establishing operational guidelines, with respect to radiation control programs and methods of minimizing occupational radiation exposure, at Low-Level Waste (LLW) disposal sites. The PNL, through site visits, evaluated operations at LLW disposal sites to determine the adequacy of current practices in maintaining occupational exposures as low as is reasonably achievable (ALARA). The data sought included the specifics of: ALARA programs, training programs, external exposure control, internal exposure control, respiratory protection, surveillance, radioactive waste management, facilities and equipment, and external dose analysis. The results of the study indicated the following: The Radiation Protection and ALARA programs at the three commercial LLW disposal sites were observed to be adequate in scope and content compared to similar programs at other types of nuclear facilities. However, it should be noted that there were many areas that could be improved upon to help ensure the health and safety of occupationally exposed individuals

  4. Current practices for maintaining occupational exposures ALARA at low-level waste disposal sites

    Energy Technology Data Exchange (ETDEWEB)

    Hadlock, D.E.; Herrington, W.N.; Hooker, C.D.; Murphy, D.W.; Gilchrist, R.L.

    1983-12-01

    The United States Nuclear Regulatory Commission contracted with Pacific Northwest Laboratory (PNL) to provide technical assistance in establishing operational guidelines, with respect to radiation control programs and methods of minimizing occupational radiation exposure, at Low-Level Waste (LLW) disposal sites. The PNL, through site visits, evaluated operations at LLW disposal sites to determine the adequacy of current practices in maintaining occupational exposures as low as is reasonably achievable (ALARA). The data sought included the specifics of: ALARA programs, training programs, external exposure control, internal exposure control, respiratory protection, surveillance, radioactive waste management, facilities and equipment, and external dose analysis. The results of the study indicated the following: The Radiation Protection and ALARA programs at the three commercial LLW disposal sites were observed to be adequate in scope and content compared to similar programs at other types of nuclear facilities. However, it should be noted that there were many areas that could be improved upon to help ensure the health and safety of occupationally exposed individuals.

  5. Mathematical modeling of HIV prevention measures including pre-exposure prophylaxis on HIV incidence in South Korea.

    Science.gov (United States)

    Kim, Sun Bean; Yoon, Myoungho; Ku, Nam Su; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Kim, Changsoo; Kwon, Hee-Dae; Lee, Jeehyun; Smith, Davey M; Choi, Jun Yong

    2014-01-01

    Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM.

  6. The ICRP 86: prevention of accidental exposure among patients receiving a radiotherapy

    International Nuclear Information System (INIS)

    2005-01-01

    The international commission radiological protection (ICRP) has been created in 1928 at the demand of radiologist physicians. It publishes the recommendations concerning the whole of situations at which man confronts when he is submitted to ionizing radiations from natural or artificial origin. this publication is devoted to give a guidance contribution in the prevention of accidental exposures implying patients suffering a treatment by external radiotherapy or by brachytherapy. It does not treat directly the therapies using unsealed sources. It speaks to professional readership implied in radiotherapy procedures, to hospital managers, public Health Authorities and regulation organisms. The chosen approach is the description of exemplary severe accidents, the examination of causes of these events and contributory factors, the summary of their disastrous consequences and the proposition of recommendations for their prevention. The measures proposed include institutional dispositions, personnel training, quality assurance programmes, follow up adequacy, clear definition of liability and celerity of events report. (N.C.)

  7. Noise exposure and hearing loss prevention programmes after 20 years of regulations in the United States.

    Science.gov (United States)

    Daniell, W E; Swan, S S; McDaniel, M M; Camp, J E; Cohen, M A; Stebbins, J G

    2006-05-01

    To evaluate noise exposures and hearing loss prevention efforts in industries with relatively high rates of workers' compensation claims for hearing loss. Washington State workers' compensation records were used to identify up to 10 companies in each of eight industries. Each company (n = 76) was evaluated by a management interview, employee personal noise dosimetry (n = 983), and employee interviews (n = 1557). Full-shift average exposures were > or =85 dBA for 50% of monitored employees, using Occupational Safety and Health Administration (OSHA) parameters with a 5 dB exchange rate (L(ave)), but 74% were > or =85 dBA using a 3 dB exchange rate (L(eq)). Only 14% had L(ave) > or =90 dBA, but 42% had L(eq) > or =90 dBA. Most companies conducted noise measurements, but most kept no records, and consideration of noise controls was low in all industries. Hearing loss prevention programmes were commonly incomplete. Management interview scores (higher score = more complete programme) showed significant associations with percentage of employees having L(ave) > or =85 dBA and presence of a union (multiple linear regression; R2 = 0.24). Overall, 62% of interviewed employees reported always using hearing protection when exposed. Protector use showed significant associations with percentage of employees specifically required to use protection, management score, and average employee time spent > or =95 dBA (R2 = 0.65). The findings raise serious concerns about the adequacy of prevention, regulation, and enforcement strategies in the United States. The percentage of workers with excessive exposure was 1.5-3 times higher using a 3 dB exchange rate instead of the OSHA specified 5 dB exchange rate. Most companies gave limited or no attention to noise controls and relied primarily on hearing protection to prevent hearing loss; yet 38% of employees did not use protectors routinely. Protector use was highest when hearing loss prevention programmes were most complete, indicating that

  8. Economic benefits of methylmercury exposure control in Europe: Monetary value of neurotoxicity prevention

    Science.gov (United States)

    2013-01-01

    Background Due to global mercury pollution and the adverse health effects of prenatal exposure to methylmercury (MeHg), an assessment of the economic benefits of prevented developmental neurotoxicity is necessary for any cost-benefit analysis. Methods Distributions of hair-Hg concentrations among women of reproductive age were obtained from the DEMOCOPHES project (1,875 subjects in 17 countries) and literature data (6,820 subjects from 8 countries). The exposures were assumed to comply with log-normal distributions. Neurotoxicity effects were estimated from a linear dose-response function with a slope of 0.465 Intelligence Quotient (IQ) point reduction per μg/g increase in the maternal hair-Hg concentration during pregnancy, assuming no deficits below a hair-Hg limit of 0.58 μg/g thought to be safe. A logarithmic IQ response was used in sensitivity analyses. The estimated IQ benefit cost was based on lifetime income, adjusted for purchasing power parity. Results The hair-mercury concentrations were the highest in Southern Europe and lowest in Eastern Europe. The results suggest that, within the EU, more than 1.8 million children are born every year with MeHg exposures above the limit of 0.58 μg/g, and about 200,000 births exceed a higher limit of 2.5 μg/g proposed by the World Health Organization (WHO). The total annual benefits of exposure prevention within the EU were estimated at more than 600,000 IQ points per year, corresponding to a total economic benefit between €8,000 million and €9,000 million per year. About four-fold higher values were obtained when using the logarithmic response function, while adjustment for productivity resulted in slightly lower total benefits. These calculations do not include the less tangible advantages of protecting brain development against neurotoxicity or any other adverse effects. Conclusions These estimates document that efforts to combat mercury pollution and to reduce MeHg exposures will have very substantial

  9. Candidiasis: a fungal infection--current challenges and progress in prevention and treatment.

    Science.gov (United States)

    Hani, Umme; Shivakumar, Hosakote G; Vaghela, Rudra; Osmani, Riyaz Ali M; Shrivastava, Atul

    2015-01-01

    Despite therapeutic advances candidiasis remains a common fungal infection most frequently caused by C. albicans and may occur as vulvovaginal candidiasis or thrush, a mucocutaneous candidiasis. Candidiasis frequently occurs in newborns, in immune-deficient people like AIDS patients, and in people being treated with broad spectrum antibiotics. It is mainly due to C. albicans while other species such as C. tropicalis, C. glabrata, C. parapsilosis and C. krusei are increasingly isolated. OTC antifungal dosage forms such as creams and gels can be used for effective treatment of local candidiasis. Whereas, for preventing spread of the disease to deeper vital organs, candidiasis antifungal chemotherapy is preferred. Use of probiotics and development of novel vaccines is an advanced approach for the prevention of candidiasis. Present review summarizes the diagnosis, current status and challenges in the treatment and prevention of candidiasis with prime focus on host defense against candidiasis, advancements in diagnosis, probiotics role and recent progress in the development of vaccines against candidiasis.

  10. Construction of natural radiation exposure study network - overview and current status

    International Nuclear Information System (INIS)

    Tokonami, Shinji

    2010-01-01

    A new project entitled 'Construction of natural radiation exposure study network' was adopted in the Program of Promotion of International Joint Research under the Special Coordination Funds for Promoting Science and Technology operated by the Ministry of Education, Culture, Sports, Science and Technology of Japan. Eight institutions were involved in this project and the project will continue until March, 2012. The aims of the project are to assess the dose for natural radiation exposures using state-of- the-art measurement techniques in four Asian countries (China, India, Korea and Thailand) and their outcomes will be distributed worldwide. Throughout the project, conventional measurement techniques will be improved and be optimized. More scientific data and results will be obtained as well. In particular, the following advanced technologies for inhalation exposures will be introduced: (1) Discriminative measurements of radon ( 222 Rn) and thoron ( 220 Rn) gases, (2) Evaluation of thoron decay products concentration, (3) Simple but effective particle size distribution measurements. In China, we are conducting a case-control study of radon and lung cancer in Gansu, China. This Gansu area was investigated in the past for the case-control study. New data are being accumulated. In India, we focused on Orissa in order to carry out radiation measurements in this project. In parallel, Kerala is currently involved as the comparative study area. In Korea, we are now measuring radon and thoron in radon/thoron prone areas. These results will give us new information for further understanding of exposure due to radon and thoron. In Thailand, we are carrying out comprehensively radiation measurements in NORM industries. Not only these surveys but also quality assurance of radon measurements are being addressed in Japan. We have managed an international intercomparison exercise of passive radon detectors at NIRS. This study presents an overview of the project and current status

  11. Child obesity prevention in primary health care: investigating practice nurse roles, attitudes and current practices.

    Science.gov (United States)

    Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark

    2013-04-01

    Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review.

    Science.gov (United States)

    Saraiya, Mona; Glanz, Karen; Briss, Peter A; Nichols, Phyllis; White, Cornelia; Das, Debjani; Smith, S Jay; Tannor, Bernice; Hutchinson, Angela B; Wilson, Katherine M; Gandhi, Nisha; Lee, Nancy C; Rimer, Barbara; Coates, Ralph C; Kerner, Jon F; Hiatt, Robert A; Buffler, Patricia; Rochester, Phyllis

    2004-12-01

    The relationship between skin cancer and ultraviolet radiation is well established. Behaviors such as seeking shade, avoiding sun exposure during peak hours of radiation, wearing protective clothing, or some combination of these behaviors can provide protection. Sunscreen use alone is not considered an adequate protection against ultraviolet radiation. This report presents the results of systematic reviews of effectiveness, applicability, other harms or benefits, economic evaluations, and barriers to use of selected interventions to prevent skin cancer by reducing exposure to ultraviolet radiation. The Task Force on Community Preventive Services found that education and policy approaches to increasing sun-protective behaviors were effective when implemented in primary schools and in recreational or tourism settings, but found insufficient evidence to determine effectiveness when implemented in other settings, such as child care centers, secondary schools and colleges, and occupational settings. They also found insufficient evidence to determine the effectiveness of interventions oriented to healthcare settings and providers, media campaigns alone, interventions oriented to parents or caregivers of children, and community-wide multicomponent interventions. The report also provides suggestions for areas for future research.

  13. Economic benefits of methylmercury exposure control in Europe: Monetary value of neurotoxicity prevention

    DEFF Research Database (Denmark)

    Bellanger, Martine; Pichery, Céline; Aerts, Dominique

    2013-01-01

    BACKGROUND: Due to global mercury pollution and the adverse health effects of prenatal exposure to methylmercury (MeHg), an assessment of the economic benefits of prevented developmental neurotoxicity is necessary for any cost-benefit analysis. METHODS: Distributions of hair-Hg concentrations among...... with a slope of 0.465 Intelligence Quotient (IQ) point reduction per μg/g increase in the maternal hair-Hg concentration during pregnancy, assuming no deficits below a hair-Hg limit of 0.58 μg/g thought to be safe. A logarithmic IQ response was used in sensitivity analyses. The estimated IQ benefit cost.......58 μg/g, and about 200,000 births exceed a higher limit of 2.5 μg/g proposed by the World Health Organization (WHO). The total annual benefits of exposure prevention within the EU were estimated at more than 600,000 IQ points per year, corresponding to a total economic benefit between €8,000 million...

  14. [An increase in allergic diseases in childhood--current hypotheses and possible prevention].

    Science.gov (United States)

    Kurz, Herbert; Riedler, Jose

    2003-01-01

    During the last few decades there has ben a significant rise in the prevalence of allergic diseases such as asthma, hay fever and atopic dermatitis. Epidemiological studies strongly suggest that this increase is real and not due to changes in diagnostic labelling. It has become increasingly clear that a complex interplay between genetic and environmental factors account for this phenomenon. Genetically predisposed individuals are at an increased susceptibility to develop asthma or other allergic diseases when exposed to certain environmental or lifestyle factors. Particularly passive smoking has been shown to increase the risk for asthma in many studies and for atopy at least in some studies. This association is less clear for the exposure to sulfur dioxide, particulate matter, diesel exhaust and ozone. Lifestyle factors like socioeconomic status, sib-ship size, early childhood infections, dietary habits, growing up in antroposophic families or on a farm are more and more realised to be of great relevance for the development of allergic conditions. At the moment, there is a lot of uncertainty about which recommendations should be given for primary prevention. Recent studies have challenged the old paradigma that avoidance of early allergen contact could prevent the development of allergic disease. However, there is consensus that avoidance of smoking during pregnancy and avoidance of passive smoking during childhood should be recommended for primary prevention of asthma.

  15. Pre-exposure prophylaxis and antiretroviral resistance: HIV prevention at a cost?

    Science.gov (United States)

    Hurt, Christopher B; Eron, Joseph J; Cohen, Myron S

    2011-12-01

    Pre-exposure prophylaxis (PrEP), the use of antiretrovirals (ARVs) by human immunodeficiency virus (HIV)-uninfected individuals to prevent acquisition of the virus during high-risk sexual encounters, enjoyed its first 2 major successes with the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 and the Pre-Exposure Prophylaxis Initiative (iPrEx). These successes were buoyed by additional positive results from the TDF2 and Partners PrEP trials. Although no seroconverters in either arm of CAPRISA developed resistance to tenofovir, 2 participants in iPrEx with undetected, seronegative acute HIV infection were randomized to receive daily oral tenofovir-emtricitabine and resistance to emtricitabine was later discovered in both men. A similar case in the TDF2 study resulted in resistance to both ARVs. These cases prompted us to examine existing literature on the nature of resistance mutations elicited by ARVs used for PrEP. Here, we discuss the impact of signature mutations selected by PrEP, how rapidly these emerge with daily ARV exposure, and the individual-level and public health consequences of ARV resistance.

  16. Violet Light Exposure Can Be a Preventive Strategy Against Myopia Progression

    Directory of Open Access Journals (Sweden)

    Hidemasa Torii

    2017-02-01

    Full Text Available Prevalence of myopia is increasing worldwide. Outdoor activity is one of the most important environmental factors for myopia control. Here we show that violet light (VL, 360–400 nm wavelength suppresses myopia progression. First, we confirmed that VL suppressed the axial length (AL elongation in the chick myopia model. Expression microarray analyses revealed that myopia suppressive gene EGR1 was upregulated by VL exposure. VL exposure induced significantly higher upregulation of EGR1 in chick chorioretinal tissues than blue light under the same conditions. Next, we conducted clinical research retrospectively to compare the AL elongation among myopic children who wore eyeglasses (VL blocked and two types of contact lenses (partially VL blocked and VL transmitting. The data showed the VL transmitting contact lenses suppressed myopia progression most. These results suggest that VL is one of the important outdoor environmental factors for myopia control. Since VL is apt to be excluded from our modern society due to the excessive UV protection, VL exposure can be a preventive strategy against myopia progression.

  17. MRSA colonization and infection among persons with occupational livestock exposure in Europe: Prevalence, preventive options and evidence.

    Science.gov (United States)

    Goerge, Tobias; Lorenz, Marthe Barbara; van Alen, Sarah; Hübner, Nils-Olaf; Becker, Karsten; Köck, Robin

    2017-02-01

    Colonization with livestock-associated Methicillin-resistant Staphylococcusaureus (LA-MRSA) among persons occupationally exposed to pigs, cattle or poultry is very frequent. In Europe, LA-MRSA mostly belong to the clonal lineage CC398. Since colonized persons have an increased risk of developing MRSA infections, defining the burden of work-related infection caused by LA-MRSA CC398 is of interest to exposed personnel, insurance companies and infection control staff. This review summarizes data on the types of occupation-related infections caused by LA-MRSA CC398, the incidence of such infections as well as potential preventive strategies. We identified twelve case reports on infections among livestock-exposed persons. Overall, there is a lack of data describing the incidence of occupation-related infections due to MRSA CC398. Currently, no specific guidance towards the prevention of LA-MRSA CC398 colonization of persons with routine exposure exists. In vitro, MRSA CC398 strains are susceptible (>95%) to mupirocin. Single reports have described effective decolonization of persons carrying LA-MRSA CC398, but long-term success rates are low in case of continuous livestock contact. Overall, the occupational health risk due to LA-MRSA CC398 is not well understood. Currently, prevention of human LA-MRSA CC398 infection is mostly based on the recommendation to perform screening and decolonization therapies prior to elective medical interventions in order to avoid nosocomial infections, but there is no conclusive evidence to perform specific measures aiming to forestall community-acquired infections. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Current Evidence for Developmental, Structural, and Functional Brain Defects following Prenatal Radiation Exposure

    Directory of Open Access Journals (Sweden)

    Tine Verreet

    2016-01-01

    Full Text Available Ionizing radiation is omnipresent. We are continuously exposed to natural (e.g., radon and cosmic and man-made radiation sources, including those from industry but especially from the medical sector. The increasing use of medical radiation modalities, in particular those employing low-dose radiation such as CT scans, raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques. One of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother, of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors. In the following years, animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits. However, the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established. This review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered.

  19. Longitudinal study of Thai people media exposure, knowledge, and behavior on dengue fever prevention and control.

    Science.gov (United States)

    Boonchutima, Smith; Kachentawa, Kirati; Limpavithayakul, Manasanun; Prachansri, Anan

    Dengue hemorrhagic fever is transmitted through a bite by a dengue -infected Aedes aegypti mosquito. It was first reported in the mid -20th century in Thailand, and since then its epidemiology has been of great concern and has spread all across the country. The alarming incidence of dengue posed a serious threat to human health in all major cities of Thailand. This study was aimed at identifying the level of awareness of dengue fever in Thai population knowledge for prevention and control, and most importantly contribution of media in educating masses for dengue control measures. It is longitudinal in nature and was conducted in 25 provinces of Thailand during 2013-2015. Approximately 7772 respondents participated in this study, with the selection of provinces based on considerations like population, prevalence and demography. A pre-tested structured questionnaire was used to collect information relevant to study participants' demographic profile, pre-existing knowledge about dengue fever and its reinforcement through media, and population attitudes toward prevention and control. Over the period of three years, a positive trend was revealed relevant to the contribution of media in educating and reminding the Thai population of dengue, without any uniformity or powerful campaigns. Based on the results drawn from this study, we conclude that despite the measures undertaken to prevent dengue fever, there is insufficient media exposure. An interdisciplinary approach involving the community participation, media, and government is needed to overcome dengue threat in Thailand. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Diagnosis, monitoring and prevention of exposure-related non-communicable diseases in the living and working environment: DiMoPEx-project is designed to determine the impacts of environmental exposure on human health.

    Science.gov (United States)

    Budnik, Lygia Therese; Adam, Balazs; Albin, Maria; Banelli, Barbara; Baur, Xaver; Belpoggi, Fiorella; Bolognesi, Claudia; Broberg, Karin; Gustavsson, Per; Göen, Thomas; Fischer, Axel; Jarosinska, Dorota; Manservisi, Fabiana; O'Kennedy, Richard; Øvrevik, Johan; Paunovic, Elizabet; Ritz, Beate; Scheepers, Paul T J; Schlünssen, Vivi; Schwarzenbach, Heidi; Schwarze, Per E; Sheils, Orla; Sigsgaard, Torben; Van Damme, Karel; Casteleyn, Ludwine

    2018-01-01

    The WHO has ranked environmental hazardous exposures in the living and working environment among the top risk factors for chronic disease mortality. Worldwide, about 40 million people die each year from noncommunicable diseases (NCDs) including cancer, diabetes, and chronic cardiovascular, neurological and lung diseases. The exposure to ambient pollution in the living and working environment is exacerbated by individual susceptibilities and lifestyle-driven factors to produce complex and complicated NCD etiologies. Research addressing the links between environmental exposure and disease prevalence is key for prevention of the pandemic increase in NCD morbidity and mortality. However, the long latency, the chronic course of some diseases and the necessity to address cumulative exposures over very long periods does mean that it is often difficult to identify causal environmental exposures. EU-funded COST Action DiMoPEx is developing new concepts for a better understanding of health-environment (including gene-environment) interactions in the etiology of NCDs. The overarching idea is to teach and train scientists and physicians to learn how to include efficient and valid exposure assessments in their research and in their clinical practice in current and future cooperative projects. DiMoPEx partners have identified some of the emerging research needs, which include the lack of evidence-based exposure data and the need for human-equivalent animal models mirroring human lifespan and low-dose cumulative exposures. Utilizing an interdisciplinary approach incorporating seven working groups, DiMoPEx will focus on aspects of air pollution with particulate matter including dust and fibers and on exposure to low doses of solvents and sensitizing agents. Biomarkers of early exposure and their associated effects as indicators of disease-derived information will be tested and standardized within individual projects. Risks arising from some NCDs, like pneumoconioses, cancers and

  1. Polarised press reporting about HIV prevention: Social representations of pre-exposure prophylaxis in the UK press.

    Science.gov (United States)

    Jaspal, Rusi; Nerlich, Brigitte

    2017-09-01

    Pre-exposure prophylaxis is a novel biomedical HIV prevention option for individuals at high risk of HIV acquisition. Although pre-exposure prophylaxis has yielded encouraging results in various clinical trials, opponents argue that pre-exposure prophylaxis poses a number of risks to human health and to sexually transmitted infection prevention efforts. Using qualitative thematic analysis and social representation theory, this article explores coverage of pre-exposure prophylaxis in the UK print media between 2008 and 2015 in order to chart the emerging social representations of this novel HIV prevention strategy. The analysis revealed two competing social representations of pre-exposure prophylaxis: (1) as a positive development in the 'battle' against HIV (the hope representation) and (2) as a medical, social and psychological setback in this battle, particularly for gay/bisexual men (the risk representation). These social representations map onto the themes of pre-exposure prophylaxis as a superlatively positive development; pre-exposure prophylaxis as a weapon in the battle against HIV/AIDS; and risk, uncertainty and fear in relation to pre-exposure prophylaxis. The hope representation focuses on taking (individual and collective) responsibility, while the risk representation focuses on attributing (individual and collective) blame. The implications for policy and practice are discussed.

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

    Science.gov (United States)

    Sedighi, Iraj; Karimi, Abdollah; Amanati, Ali

    2016-01-01

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

  3. [Current situation of suicide in Japan, and what pharmacists contribute to suicide prevention].

    Science.gov (United States)

    Matsumoto, Toshihiko

    2013-01-01

      In Japan, a national countermeasure has been forwarded since the enactment of the Basic Act on Suicide Countermeasures in 2006 and the Comprehensive Suicide Prevention Initiative in 2007. The distinctive policy of the Japanese countermeasure is expressed as the word, "comprehensive," which means that suicide prevention may not only be carried out only by mental health measures but also by comprehensive measures including chance of administrative practices. This policy is proper, although mental health measures appear to be too simple inclining to psychiatric treatments for the classic type of "depression" by a pharmacotherapy. The authors have insisted that mental health measures including psychiatric treatments are also required to be more comprehensive. This paper describes that benzodiazepine (BZ)-abuse problems including overdosing by suicidal intents have got worse recently as psychiatric clinics have increased and most of BZ abusers obtain the abused drugs form psychiatrists. This current situation indicates that pharmacists need to monitor psychiatrists' prescribing behavior and qualities of psychiatric treatment is required to be refined, suggesting pharmacists may be one of the "Gate Keeper," as supporting resources for suicide prevention. Additionally, this paper explained that basic attitudes and responses acquired by pharmacists as a supporter for suicide prevention.

  4. Measurement of obesity prevention in childcare settings: A systematic review of current instruments.

    Science.gov (United States)

    Stanhope, Kaitlyn K; Kay, Christi; Stevenson, Beth; Gazmararian, Julie A

    The incidence of childhood obesity is highest among children entering kindergarten. Overweight and obesity in early childhood track through adulthood. Programs increasingly target children in early life for obesity prevention. However, the published literature lacks a review on tools available for measuring behaviour and environmental level change in child care. The objective is to describe measurement tools currently in use in evaluating obesity-prevention in preschool-aged children. Literature searches were conducted in PubMed using the keywords "early childhood obesity," "early childhood measurement," "early childhood nutrition" and "early childhood physical activity." Inclusion criteria included a discussion of: (1) obesity prevention, risk assessment or treatment in children ages 1-5 years; and (2) measurement of nutrition or physical activity. One hundred thirty-four publications were selected for analysis. Data on measurement tools, population and outcomes were abstracted into tables. Tables are divided by individual and environmental level measures and further divided into physical activity, diet and physical health outcomes. Recommendations are made for weighing advantages and disadvantages of tools. Despite rising numbers of interventions targeting obesity-prevention and treatment in preschool-aged children, there is no consensus for which tools represent a gold standard or threshold of accuracy. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  5. Prevention of Backover Fatalities in Highway Work Zones: A Synthesis of Current Practices and Recommendations

    Directory of Open Access Journals (Sweden)

    Wei Fan

    2014-12-01

    Full Text Available The purpose of this paper is to synthesize current practices and procedures on the prevention of backing fatalities in highway work zones. First, general work zone safety hazards are reviewed, particularly blind areas are identified. Second, engineering controls currently in use are examined and explained to help understand what steps can be taken to prevent future backing fatalities. Third, administrative controls (including signalers, drivers, and workers-on-foot training are also discussed. Fourth, existing technology controls are reviewed for use in aiding equipment operators in identifying when pedestrian personnel are in dangerous areas around their equipment (i.e., back-up camera, radar. Fifth, recommendations are made based on the comprehensive review of the backover fatality prevention techniques in construction work zones and the conducted testing results of several commercially available systems. Recommendations on engineering and technology controls are discussed, with detailed information such as improving internal traffic control plans, and integrating technology with traffic control plans. Information and drawings are provided to illustrate how to design work zones, and the internal traffic flow diagrams are created using the integrated technology available, and site specific characteristics. The drawings represent examples of using different types of technology, in different scenarios using the proper legend, as well as using the proper general and technology notes to help explain the traffic control plan, ensuring that full comprehension is made. Recommendations on administrative controls are also given such as how to conduct safety meetings, electing safety officers, how to set regulations and guidelines for workers, and how to handle training. Training should be used as a backover fatality prevention method for pedestrian workers, flaggers, spotters, and equipment operators. Finally, a summary and discussion of future research

  6. Effects of Violence Prevention Behavior on Exposure to Workplace Violence and Threats: A Follow-Up Study.

    Science.gov (United States)

    Gadegaard, Charlotte Ann; Andersen, Lars Peter; Hogh, Annie

    2018-04-01

    This longitudinal study investigates the relationship between prevention behaviors, that is, enacted violence prevention policies, and exposure to workplace violence and threats across four different high risk work sectors: psychiatry, special schools, eldercare, and the prison and probation services. Logistic regression analysis of a 1-year follow-up sample of 3.016 employees from these four sectors shows that prevention behaviors are significantly and negatively associated with self-reported exposure to workplace violence and threats-in the prison and probation services, eldercare, and in psychiatry, while no significant associations are found for special schools. The results therefore show clear sector differences with regard to the preventive effect of violence prevention behaviors. Furthermore, this multisector comparison suggests that prevention behaviors are more effective in relation to a moderate frequency of violence and threats, and that only top management prevention behavior can prevent very frequent incidents (odds ratio [ OR] = 0.58). This study contributes to the literature by use of a longitudinal design and acceptable response rates, while also simultaneously investigating several high risk sectors. The results imply that when managing workplace violence in high risk areas of human service work, there should be emphasis on the use of violence prevention behaviors from top management, supervisor, and among coworkers. However, type of sector and the frequency of workplace violence should be analyzed to evaluate the potential impact of prevention behaviors.

  7. Behavioural treatment of tics: habit reversal and exposure with response prevention.

    Science.gov (United States)

    van de Griendt, J M T M; Verdellen, C W J; van Dijk, M K; Verbraak, M J P M

    2013-07-01

    Behaviour therapy has been shown to be an effective strategy in treating tics; both habit reversal (HR) and exposure and response prevention (ER) are recommended as first-line interventions. This review provides an overview of the history, theoretical concepts and evidence at present for HR and ER. In addition, treatment manuals for HR and ER are described. Despite the evidence and availability of treatment manuals, many patients do not receive a first-line psychological intervention for tics. Barriers to the acceptance and dissemination of behaviour therapy are discussed as are ways to overcome these barriers, such as the use of E-health and E-learning. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study.

    Science.gov (United States)

    Verdellen, Cara W J; Keijsers, Ger P J; Cath, Danielle C; Hoogduin, Cees A L

    2004-05-01

    The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.

  9. Current smoking and secondhand smoke exposure and depression among Korean adolescents: analysis of a national cross-sectional survey.

    Science.gov (United States)

    Lee, Kyung-Jae

    2014-02-06

    To examine the association between cigarette smoke exposure and depression among Korean adolescents using the seventh Korea Youth Risk Behavior Web-based Survey (KYRBWS). Cross-sectional study. A nationally representative sample of middle and high school students across South Korea. 75 643 eligible participants across the country. Current smoking, secondhand smoke exposure and depression. Data were analysed from a nationally representative survey of 75 643 participants (37 873 men and 37 770 women). Data were gathered on extensive information including current smoking, secondhand smoke exposure and depression in adolescence. Multiple logistic regression analysis was used to estimate the association between current smoking, secondhand smoke exposure and depression in Korean adolescents. Among those who had never smoked, secondhand smoke exposure was positively associated with depression in male and female adolescents in a dose-response relation (OR 1.27, OR 1.52 in males; OR 1.25, OR 1.72 in females). Similar associations were observed among currently smoking men and women in a dose-response manner (OR 1.29, OR 1.55 in males; OR 1.22, OR 1.41 in females). These significant trends were consistently observed even after adjustments. We suggested that current smoking and secondhand smoke exposure were positively associated with depression in male and female adolescents. Efforts to encourage no smoking and no secondhand smoke exposure will be established for adolescents.

  10. Current knowledge of environmental exposure in children during the sensitive developmental periods

    Directory of Open Access Journals (Sweden)

    Norma Helena Perlroth

    2017-01-01

    Full Text Available Objective: This study aims to identify the scientific evidence on the risks and effects of exposure to environmental contaminants in children during sensitive developmental periods. Data source: The search was performed in the Bireme database, using the terms: children's health, environmental exposure, health vulnerability, toxicity pathways and developmental disabilities in the LILACS, MEDLINE and SciELO systems. Data synthesis: Children differ from adults in their unique physiological and behavioral characteristics and the potential exposure to risks caused by several threats in the environment. Exposure to toxic agents is analyzed through toxicokinetic processes in the several systems and organs during the sensitive phases of child development. The caused effects are reflected in the increased prevalence of congenital malformations, diarrhea, asthma, cancer, endocrine and neurological disorders, among others, with negative impacts throughout adult life. Conclusion: To identify the causes and understand the mechanisms involved in the genesis of these diseases is a challenge for science, as there is still a lack of knowledge on children's susceptibility to many environmental contaminants. Prevention policies and more research on child environmental health, improving the recording and surveillance of environmental risks to children's health, should be an ongoing priority in the public health field. Resumo: Objetivo: O presente estudo busca identificar as evidências científicas sobre os riscos e efeitos da exposição de contaminantes ambientais no organismo infantil durante os períodos sensíveis de seu desenvolvimento. Fonte de dados: As pesquisas foram realizadas pelo banco de dados da Bireme, com os termos children's health, environmental exposure, health vulnerability, toxicity pathways and developmental disabilities nos sistemas LILACS, MEDLINE e SciELO. Síntese de dados: A criança difere do adulto por suas características singulares

  11. [Current situation and reflection on the prevention and treatment of burns in the elderly].

    Science.gov (United States)

    Zhang, J P; Huang, Y S

    2017-09-20

    With ageing of the population, it is estimated that the percentage of old people aged above 65 years old will be approached to 30% in China by 2035. This presents a considerable challenge to geriatric burn treatment, as elderly burn patients have more serious injuries, longer hospital lengths of stay, and higher rates of complications and mortality. In this article, we analyze the current status of burns in the elderly in China and the factors contributing to the outcome of the elderly, and put forward therapeutic strategies so as to improve the level of prevention and treatment of burns in the elderly.

  12. Experimental study of prevention effect of andrographolide against radiation exposure in rats

    International Nuclear Information System (INIS)

    Bai Huiyun; Mu Xiang; Li Li; Ding Kuke; Yang Lijian; Li Jie; Dong Xiaoli

    2011-01-01

    Objective: To explore the effects of andrographolide (AP), extracted from the traditional Chinese herb Andrographlis paniculata (AP), on injury induced by radiation exposure. Methods: Sixty male rats were randomly divided into 4 equal groups and irradiated with 60 Co γ-rays at the doses of 1, 2, and 4 Gy, respectively: low dose AP group(intragastrically administered with AP at the dose of 100 ms/kg daily for 10 d before irradiation), and high dose AP group (intragastrically administered with AP at the dose of 200 ms/kg daily for 10 d before irradiation), model group (administered with the same volume of normal saline instead of AP for 10 d before irradiation), and control group(irradiated only at 3 different doses). One day after irradiation all rats were killed with their livers being fixed to make paraffin section. The morphological feature was observed under light microscope after HE staining, and the cell apoptosis was detected by TUNEL technology. Results: Compared to the control and model groups, the pathological changes of liver were significantly gentler in the AP treatment groups. The apoptosis rates of the liver cells of all the AP sub-groups were significantly lower than those of the control and model subgroup (t=2.19-4.80, P<0.05). Conclusions: AP might have prevention effect against radiation exposure. (authors)

  13. Exposure of native bees foraging in an agricultural landscape to current-use pesticides

    Science.gov (United States)

    Hladik, Michelle; Vandever, Mark W.; Smalling, Kelly L.

    2016-01-01

    The awareness of insects as pollinators and indicators of environmental quality has grown in recent years, partially in response to declines in honey bee (Apis mellifera) populations. While most pesticide research has focused on honey bees, there has been less work on native bee populations. To determine the exposure of native bees to pesticides, bees were collected from an existing research area in northeastern Colorado from two land cover types: grasslands (2013-2014) and wheat fields (2014). Traps were deployed bi-monthly during the summer at each land cover type and all bees, regardless of species, were composited as whole samples and analyzed for 136 current-use pesticides and degradates. This reconnaissance approach provides a sampling of all species and represents overall pesticide exposure (internal and external). Nineteen pesticides and degradates were detected in 54 composite samples collected. Compounds detected in >10% of the samples included the insecticides thiamethoxam (46%), bifenthrin (28%), clothianidin (24%), chlorpyrifos (17%), and imidacloprid (13%), the fungicides azoxystrobin (17%), and pyraclostrobin (11%), and the herbicide atrazine (19%). Concentrations ranged from 1.1 to 312 ng/g for individual pesticides. Pesticides were detected in samples collected from both grasslands and wheat fields; the location of the sample and the surrounding land cover at the 1000 m buffer influenced the pesticides detected but because of a small number of temporally comparable samples, correlations between pesticide concentration and land cover were not significant. The results show native bees collected in both grasslands and wheat fields are exposed to multiple pesticides, these results can direct future research on routes/timing of pesticide exposure and the design of future conservation efforts for pollinators.

  14. Exposure of native bees foraging in an agricultural landscape to current-use pesticides.

    Science.gov (United States)

    Hladik, Michelle L; Vandever, Mark; Smalling, Kelly L

    2016-01-15

    The awareness of insects as pollinators and indicators of environmental quality has grown in recent years, partially in response to declines in honey bee (Apis mellifera) populations. While most pesticide research has focused on honey bees, there has been less work on native bee populations. To determine the exposure of native bees to pesticides, bees were collected from an existing research area in northeastern Colorado in both grasslands (2013-2014) and wheat fields (2014). Traps were deployed bi-monthly during the summer at each land cover type and all bees, regardless of species, were composited as whole samples and analyzed for 136 current-use pesticides and degradates. This reconnaissance approach provides a sampling of all species and represents overall pesticide exposure (internal and external). Nineteen pesticides and degradates were detected in 54 composite samples collected. Compounds detected in >2% of the samples included: insecticides thiamethoxam (46%), bifenthrin (28%), clothianidin (24%), chlorpyrifos (17%), imidacloprid (13%), fipronil desulfinyl (7%; degradate); fungicides azoxystrobin (17%), pyraclostrobin (11%), fluxapyroxad (9%), and propiconazole (9%); herbicides atrazine (19%) and metolachlor (9%). Concentrations ranged from 1 to 310 ng/g for individual pesticides. Pesticides were detected in samples collected from both grasslands and wheat fields; the location of the sample and the surrounding land cover at the 1000 m radius influenced the pesticides detected but because of a small number of temporally comparable samples, correlations between pesticide concentration and land cover were not significant. The results show native bees collected in an agricultural landscape are exposed to multiple pesticides, these results can direct future research on routes/timing of pesticide exposure and the design of future conservation efforts for pollinators. Published by Elsevier B.V.

  15. Current status and perspectives of Clonorchis sinensis and clonorchiasis: epidemiology, pathogenesis, omics, prevention and control.

    Science.gov (United States)

    Tang, Ze-Li; Huang, Yan; Yu, Xin-Bing

    2016-07-06

    Clonorchiasis, caused by Clonorchis sinensis (C. sinensis), is an important food-borne parasitic disease and one of the most common zoonoses. Currently, it is estimated that more than 200 million people are at risk of C. sinensis infection, and over 15 million are infected worldwide. C. sinensis infection is closely related to cholangiocarcinoma (CCA), fibrosis and other human hepatobiliary diseases; thus, clonorchiasis is a serious public health problem in endemic areas. This article reviews the current knowledge regarding the epidemiology, disease burden and treatment of clonorchiasis as well as summarizes the techniques for detecting C. sinensis infection in humans and intermediate hosts and vaccine development against clonorchiasis. Newer data regarding the pathogenesis of clonorchiasis and the genome, transcriptome and secretome of C. sinensis are collected, thus providing perspectives for future studies. These advances in research will aid the development of innovative strategies for the prevention and control of clonorchiasis.

  16. [Current prevention and treatment strategies for osteoporosis. Fracture-oriented, effective, low side effects and inexpensive].

    Science.gov (United States)

    Bartl, R; Bartl, C

    2015-12-01

    Osteoporosis is still an underdiagnosed and insufficiently therapied widespread disease in Germany. Of the estimated 7 million osteoporosis patients only 1.5 million receive a guideline conform diagnosis and even less receive appropriate treatment. Some 90 % of patients are provided with analgesics but only 10 % receive an effective therapy, although efficacious, well-tested and affordable medications are available. In addition, approximately one half of the patients terminate treatment after only 1 year although according to the results of recent studies the duration of therapy should be at least 3-5 years. In view of the increasing average life expectancy, a consistent management for prevention of fractures associated with osteoporosis is always most important for society, even if only for reasons of costs. Achievement of this target depends on four circumstances: clarification of the origin of osteoporosis and fractures (bone consciousness), prophylaxis of bone loss and fractures (primary prevention), consistent guideline conform diagnostics and therapy (secondary and tertiary prevention) and cooperation of all disciplines in medicine (bone is everybody's business). This article describes the current state of diagnostics (bone density measurement with dual X-ray absorptiometry, FRAX®), prophylaxis of fractures (screening program) and therapy (use of economic and effective medications with low side effects). Novel medications are already undergoing clinical testing and a "healing" of bone reduction with restoration of the normal bone structure is to be expected.

  17. Dietary exposures and allergy prevention in high-risk infants: A joint statement with the Canadian Society of Allergy and Clinical Immunology.

    Science.gov (United States)

    Chan, Edmond S; Cummings, Carl

    2013-12-01

    Allergic conditions in children are a prevalent health concern in Canada. The burden of disease and the societal costs of proper diagnosis and management are considerable, making the primary prevention of allergic conditions a desirable health care objective. This position statement reviews current evidence on dietary exposures and allergy prevention in infants at high risk for developing allergic conditions. It revisits previous dietary recommendations for pregnancy, breastfeeding and formula feeding, and provides an approach for introducing solid foods to high-risk infants. While there is no evidence that delaying the introduction of any specific food beyond six months of age helps to prevent allergy, the protective effect of early introduction of potentially allergenic foods (at four to six months of age) remains under investigation. Recent research appears to suggest that regularly ingesting a new, potentially allergenic food may be as important as when that food is first introduced.

  18. Prevention of the current-quench phase of a major disruption in a tokamak reactor

    International Nuclear Information System (INIS)

    Miller, J.B.

    1987-01-01

    The 2-D Tokamak Simulation Code written by the Princeton Plasma Physics Laboratory was joined to a 3-D eddy-current code, which models periodic torus sectors. The combined system was found to be an efficient and accurate method for modeling the plasma/eddy current interaction during a major disruption. For modeling large highly compartmentalized structures, artificially increasing the self-inductance and limiting the mutual inductance of current elements were necessary to enhance numerical stability. Even with these modifications, a slowly growing instability made the results unreliable after 58 ms. This model was used to demonstrate prevention of the current quench phase of a major disruption in INTOR. The average plasma temperature was reduced to 150 eV over 3 ms. The (outboard) breeding blanket structure was constructed of CuBeNi and was electrically connected between torus sectors. Disruption recovery coils were provided inboard of the inboard shield (linking the toroidal field coils). It was necessary to supply to these coils a total of 500 MW for 0.6 s and to reheat the plasma to full beta in 6 s. The calculation shows a method of recovery from the most severe disruption probable. Determining the severity of the disruption from which recovery would be cost effective is beyond the scope of this study

  19. Contribution of job-exposure matrices for exposure assessment in occupational safety and health monitoring systems: application from the French national occupational disease surveillance and prevention network.

    Science.gov (United States)

    Florentin, Arnaud; Zmirou-Navier, Denis; Paris, Christophe

    2017-08-01

    To detect new hazards ("signals"), occupational health monitoring systems mostly rest on the description of exposures in the jobs held and on reports by medical doctors; these are subject to declarative bias. Our study aims to assess whether job-exposure matrices (JEMs) could be useful tools for signal detection by improving exposure reporting. Using the French national occupational disease surveillance and prevention network (RNV3P) data from 2001 to 2011, we explored the associations between disease and exposure prevalence for 3 well-known pathology/exposure couples and for one debatable couple. We compared the associations measured when using physicians' reports or applying the JEMs, respectively, for these selected diseases and across non-selected RNV3P population or for cases with musculoskeletal disorders, used as two reference groups; the ratio of exposure prevalences according to the two sources of information were computed for each disease category. Our population contained 58,188 subjects referred with pathologies related to work. Mean age at diagnosis was 45.8 years (95% CI 45.7; 45.9), and 57.2% were men. For experts, exposure ratios increase with knowledge on exposure causality. As expected, JEMs retrieved more exposed cases than experts (exposure ratios between 12 and 194), except for the couple silica/silicosis, but not for the MSD control group (ratio between 0.2 and 0.8). JEMs enhanced the number of exposures possibly linked with some conditions, compared to experts' assessment, relative to the whole database or to a reference group; they are less likely to suffer from declarative bias than reports by occupational health professionals.

  20. Transitioning to HIV Pre-Exposure Prophylaxis (PrEP) from Non-Occupational Post-Exposure Prophylaxis (nPEP) in a Comprehensive HIV Prevention Clinic: A Prospective Cohort Study.

    Science.gov (United States)

    Siemieniuk, Reed A C; Sivachandran, Nirojini; Murphy, Pauline; Sharp, Andrea; Walach, Christine; Placido, Tania; Bogoch, Isaac I

    2015-08-01

    The uptake of pre-exposure prophylaxis (PrEP) for HIV prevention remains low. We hypothesized that a high proportion of patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP) would be candidates for PrEP based on current CDC guidelines. Outcomes from a comprehensive HIV Prevention Clinic are described. We evaluated all patients who attended the HIV Prevention Clinic for nPEP between January 1, 2013 and September 30, 2014. Each patient was evaluated for PrEP candidacy based on current CDC-guidelines and subjectively based on physician opinion. Patients were then evaluated for initiation of PrEP if they met guideline suggestions. Demographic, social, and behavioral factors were then analyzed with logistic regression for associations with PrEP candidacy and initiation. 99 individuals who attended the nPEP clinic were evaluated for PrEP. The average age was 32 years (range, 18-62), 83 (84%) were male, of whom 46 (55%) men who had have sex with men (MSM). 31 (31%) met CDC guidelines for PrEP initiation, which had very good agreement with physician recommendation (kappa=0.88, 0.78-0.98). Factors associated with PrEP candidacy included sexual exposure to HIV, prior nPEP use, and lack of drug insurance (p<0.05 for all comparisons). Combining nPEP and PrEP services in a dedicated clinic can lead to identification of PrEP candidates and may facilitate PrEP uptake. Strategies to ensure equitable access of PrEP should be explored such that those without drug coverage may also benefit from this effective HIV prevention modality.

  1. 78 FR 64425 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-10-29

    ..., 507, and 579 [Docket No. FDA-2011-N-0922] Current Good Manufacturing Practice and Hazard Analysis and... requirements for current good manufacturing practice and hazard analysis and risk-based preventive controls for..., packing, or holding of animal food in two ways. First, it would create new current good manufacturing...

  2. Individual Differences in Preventive Jealousy Determine Men's Jealousy after Subliminal Exposure to Rivals Wearing High- or Low-Status Clothes.

    Science.gov (United States)

    Massar, Karlijn; Buunk, Abraham Bram P

    2016-02-01

    This study investigated sex differences in jealousy after subliminal exposure to rivals wearing high-status or low-status clothes. It was expected that individual differences in preventive jealousy would moderate the relationship between a rival's characteristics and jealousy. Participants (Men: n = 54, M age = 21.6 yr., SD = 3.5; women: n = 71, M age = 20.7 yr., SD = 1.9) completed a parafoveal subliminal priming paradigm as well as questionnaires about jealousy and preventive jealousy. As predicted, women were not affected by their rival's status, but women high in preventive jealousy reported more jealousy than women low in preventive jealousy. However, whereas men low in preventive jealousy reported equal amounts of jealousy after exposure to a high-status and a low-status rival, surprisingly, and contrary to the expectations, men high in preventive jealousy reported most jealousy after exposure to a low-status rival. To explain these unexpected results, threats to self-esteem were discussed.

  3. Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP therapy for HIV prevention

    Directory of Open Access Journals (Sweden)

    Clauson KA

    2009-03-01

    Full Text Available With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies. They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an “evening before pill”. The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy

  4. Policies to restrict secondhand smoke exposure: American College of Preventive Medicine Position Statement.

    Science.gov (United States)

    Jacobs, Michelle; Alonso, Alina M; Sherin, Kevin M; Koh, Yumi; Dhamija, Asha; Lowe, Andrea L

    2013-09-01

    Secondhand smoke (SHS) exposure poses serious health risks for all nonsmokers, especially children and pregnant women. SHS is estimated to contribute to heart attacks in nonsmokers and nearly 53,800 deaths in the U.S. annually. A literature review of English-language articles was performed using PubMed, organizational websites, and pertinent review articles. Over the past 25 years, smokefree policies have protected nearly half the U.S. population from the adverse health effects of SHS. Smokefree policies have been shown to improve health outcomes with no consequences to local businesses. As of April 2013, a total of 24 states and 561 municipalities and territories, including the District of Columbia, New York City, Puerto Rico, and the U.S. Virgin Islands, have established laws that require nonhospitality workplaces, restaurants, and bars to be 100% smokefree. Four other states-Florida, Indiana, Louisiana, and Nevada-have smokefree laws that cover restaurants but provide an exemption for stand-alone bars. At least 14 states have no smokefree laws. This paper describes the benefits of policies that reduce SHS and concludes with recommendations for future directions. The American College of Preventive Medicine (ACPM) recommends expanded clean indoor air policies for workplaces, stand-alone bars, restaurants, and multi-use family housing such as apartment buildings. ACPM recommends clean air policies for all university campuses, secondary school campuses, primary schools, child care centers, and city landmarks to further shift social norms and protect the health of children, adolescents, and adults. ACPM recommends closing existing gaps in clean indoor air policies. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Biomonitoring of the mycotoxin Zearalenone: current state-of-the art and application to human exposure assessment.

    Science.gov (United States)

    Mally, Angela; Solfrizzo, Michele; Degen, Gisela H

    2016-06-01

    Zearalenone (ZEN), a mycotoxin with high estrogenic activity in vitro and in vivo, is a widespread food contaminant that is commonly detected in maize, wheat, barley, sorghum, rye and other grains. Human exposure estimates based on analytical data on ZEN occurrence in various food categories and food consumption data suggest that human exposure to ZEN and modified forms of ZEN may be close to or even exceed the tolerable daily intake (TDI) derived by the European Food Safety Authority (EFSA) for some consumer groups. Considering the inherent uncertainties in estimating dietary intake of ZEN that may lead to an under- or overestimation of ZEN exposure and consequently human risk and current lack of data on vulnerable consumer groups, there is a clear need for more comprehensive and reliable exposure data to refine ZEN risk assessment. Human biomonitoring (HBM) is increasingly being recognized as an efficient and cost-effective way of assessing human exposure to food contaminants, including mycotoxins. Based on animal and (limited) human data on the toxicokinetics of ZEN, it appears that excretion of ZEN and its major metabolites may present suitable biomarkers of ZEN exposure. In view of the limitations of available dietary exposure data on ZEN and its modified forms, the purpose of this review is to provide an overview of recent studies utilizing HBM to monitor and assess human exposure to ZEN. Considerations are given to animal and human toxicokinetic data relevant to HBM, analytical methods, and available HBM data on urinary biomarkers of ZEN exposure in different cohorts.

  6. Prevention of and response to inadvertent exposure of embryo/fetus to ionizing radiation, due to medical exposure of the mother. The Greek regulatory authority initiatives.

    Science.gov (United States)

    Economides, Sotirios; Boziari, Argiro; Vogiatzi, Stavroula; Hourdakis, Konstantinos J; Kamenopoulou, Vassiliki; Dimitriou, Panagiotis

    2014-03-01

    Embryo/fetus (E/F) irradiation as a result of medical exposure of the mother should be avoided, unless there are strong clinical indications. Medical practitioners are assigned the primary task and obligation of ensuring overall patient protection and safety in the prescription of and during the delivery of medical exposure. In cases of unintended exposure of embryo/fetus (E/F), the risk analysis and communication is conducted by or under the supervision of medical physicists at local level. National competent authorities can contribute to the prevention, risk analysis and communication of inadvertent E/F exposure to ionizing radiation by recording, analyzing and disseminating the relevant information. Since 2001, Greek Atomic Energy Commission has established a committee with the mandate to provide advice, to keep records, to analyze and disseminate the experience gained in cases of unintended E/F exposure. During the period 2001-2011, the committee was consulted by 269 pregnant women undergone medical exposures. The conclusions from the relevant data analysis, as well as the experience gained are herein presented and discussed. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Current strategies and future directions for the prevention of transfusion-transmitted cytomegalovirus

    Directory of Open Access Journals (Sweden)

    Harmon CM

    2017-04-01

    Full Text Available Charles M Harmon, Laura L Cooling Department of Pathology, University of Michigan, Ann Arbor, MI, USA Abstract: Cytomegalovirus (CMV is a pervasive DNA virus that infects a significant portion of individuals worldwide, and may be transmitted through the transfusion of blood products. Although CMV infection is of little consequence in immunocompetent individuals, patients with an impaired immune system are at risk of significant morbidity and mortality. Unlike other blood-borne infectious agents, it is impractical to defer all CMV-positive individuals from blood donation as this would exclude a substantial number of otherwise eligible donors. Other methods such as transfusion of CMV-seronegative and leukoreduced blood products must be employed to prevent the transmission of CMV to at-risk patients. In this study, the widespread use of current strategies for the prevention of transfusion-transmitted CMV (TT-CMV infection and the evidence to support these methods in various at-risk groups were reviewed. In addition, emerging pathogen inactivation technologies that have the potential to eliminate TT-CMV were also discussed. Keywords: blood transfusion, cytomegalovirus, leukoreduction, pathogen inactivation, hematopoietic stem cell transplantation, very low birth weight infants

  8. A reading of the crisis of prevention activities: current paradoxes and future challenges

    Directory of Open Access Journals (Sweden)

    Rodolfo Andrade de Gouveia Vilela

    2017-12-01

    Full Text Available Introduction: The activity of occupational health and safety professionals is in a paradoxical situation considering, among other aspects, the productivity context, which gives low priority to safety and health, the limitation imposed by the hegemonic conceptual references in the field, the limitation of these professionals’ power to act and the highly conflicting and complex character of the occupational world. Objective: In essay form, the article, in dialog with the literature of the field, proposes to reflect on the impasses and challenges of the prevention field. Method: The reflections are based on the experience of the authors both in the practical area as also in research, teaching and extension activities in the field of health surveillance and workers’ safety. Results: Even though this field of activity has been recognized as a specialized and legal area for more than 40 years in the country, the magnitude of the data concerning occupational and industrial accidents reveals the limitations and difficulties that these professionals face, and justifies the importance of the analysis of current practices in order to understand the contradictions that lie at the root of the difficulties to achieve prevention. Conclusion: Citizens could pressure corporations to improve their safety practices and concepts. State can also be pressured to create new safety policies.

  9. Current approaches to prevent NSAID-induced gastropathy – COX selectivity and beyond

    Science.gov (United States)

    Becker, Jan C; Domschke, Wolfram; Pohle, Thorsten

    2004-01-01

    Gastrointestinal (GI) toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs) is still an important medical and socio-economic problem – despite recent pharmaceutical advances. To prevent NSAID-induced gastropathy, three strategies are followed in clinical routine: (i) coprescription of a gastroprotective drug, (ii) use of selective COX-2 inhibitors, and (iii) eradication of Helicobacter pylori. Proton pump inhibitors are the comedication of choice as they effectively reduce gastrointestinal adverse events of NSAIDs and are safe even in long-term use. Co-medication with vitamin C has only been little studied in the prevention of NSAID-induced gastropathy. Apart from scavenging free radicals it is able to induce haeme-oxgenase 1 in gastric cells, a protective enzyme with antioxidant and vasodilative properties. Final results of the celecoxib outcome study (CLASS study) attenuated the initial enthusiasm about the GI safety of selective COX-2 inhibitors, especially in patients concomitantly taking aspirin for cardiovascular prophylaxis. Helicobacter pylori increases the risk for ulcers particularly in NSAID-naive patients and therefore eradication is recommended prior to long-term NSAID therapy at least in patients at high risk. New classes of COX-inhibitors are currently evaluated in clinical studies with very promising results: NSAIDs combined with a nitric oxide releasing moiety (NO-NSAID) and dual inhibitors of COX and 5-LOX. These drugs offer extended anti-inflammatory potency while sparing gastric mucosa. PMID:15563357

  10. Substance use by Egyptian youth: current patterns and potential avenues for prevention.

    Science.gov (United States)

    Loffredo, Christopher A; Boulos, Dina N K; Saleh, Doa'a A; Jillson, Irene A; Garas, Magdy; Loza, Nasser; Samuel, Philip; Shaker, Yousri Edward; Ostrowski, Mar-Jan; Amr, Sania

    2015-04-01

    Substance abuse in Egypt is a serious public health threat. Recent studies have demonstrated increases in the prevalence of the use of tobacco, illegal drugs, and over-the-counter drugs, particularly among youth. We conducted focus groups with a total of 40 male and female youth participants, ages 12-14 and 15-18, recruited from two different areas (Cairo and Alexandria) in 2012. We investigated their knowledge and perceptions regarding current substance use, its sources, and promoting and protecting factors, broadly addressing the use of tobacco products, illicit and prescription drugs, inhaled substances such as glue and solvents, and alcohol. Our findings suggest that: (1) youth in Egypt had access to and were actively using substances encountered in similar research worldwide, including tobacco, alcohol, illicit drugs, glue sniffing, and pharmaceutical agents; (2) smoking cigarettes and using hashish were the most common practices, and Tramadol was the most commonly used pharmaceutical drug; (3) peer pressure from friends stood out as the most common reason to start and continue using substances, followed by adverse life events and having a parent or family member who used substances; (4) strict parenting, religiosity, and having non-user friends were among the factors perceived by youth to prevent substance use or help them quit using substances; (5) most youths were aware of the adverse health effects of substance use. These findings will inform the design of quantitative surveys aimed at estimating the prevalence of specific behaviors related to substance use among youth and potential avenues for prevention.

  11. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel.

    Science.gov (United States)

    Mischke, Christina; Verbeek, Jos H; Saarto, Annika; Lavoie, Marie-Claude; Pahwa, Manisha; Ijaz, Sharea

    2014-03-07

    Healthcare workers are at risk of acquiring viral diseases such as hepatitis B, hepatitis C and HIV through exposure to contaminated blood and body fluids at work. Most often infection occurs when a healthcare worker inadvertently punctures the skin of their hand with a sharp implement that has been used in the treatment of an infected patient, thus bringing the patient's blood into contact with their own. Such occurrences are commonly known as percutaneous exposure incidents. To determine the benefits and harms of extra gloves for preventing percutaneous exposure incidents among healthcare workers versus no intervention or alternative interventions. We searched CENTRAL, MEDLINE, EMBASE, NHSEED, Science Citation Index Expanded, CINAHL, NIOSHTIC, CISDOC, PsycINFO and LILACS until 26 June 2013. Randomised controlled trials (RCTs) with healthcare workers as the majority of participants, extra gloves or special types of gloves as the intervention, and exposure to blood or bodily fluids as the outcome. Two authors independently assessed study eligibility and risk of bias, and extracted data. We performed meta-analyses for seven different comparisons. We found 34 RCTs that included 6890 person-operations as participating units and reported on 46 intervention-control group comparisons. We grouped interventions as follows: increased layers of standard gloves, gloves manufactured with special protective materials or thicker gloves, and gloves with puncture indicator systems. Indicator gloves show a coloured spot when they are perforated. Participants were surgeons in all studies and they used at least one pair of standard gloves as the control intervention. Twenty-seven studies also included other surgical staff (e.g. nurses). All but one study used perforations in gloves as an indication of exposure. The median control group rate was 18.5 perforations per 100 person-operations. Seven studies reported blood stains on the skin and two studies reported self reported

  12. Knowledge, Attitudes and Preventive Efforts of Malaysian Medical Students Regarding Exposure to Environmental Tobacco and Cigarette Smoking.

    Science.gov (United States)

    Frisch, Ann Stirling; Kurtz, Margot; Shamsuddin, Khadijah

    1999-01-01

    Study examines changes in knowledge, attitudes, and preventive efforts of Malaysian students concerning cigarette smoking and environmental exposure to tobacco smoke from their first pre-clinical year in medical school until their final clinical year. Although there were significant improvements in knowledge about smoking and environmental…

  13. Preliminary Predictors of within-Session Adherence to Exposure and Response Prevention in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Morgan, Jessica; Caporino, Nicole E.; De Nadai, Alessandro S.; Truax, Tatyana; Lewin, Adam B.; Jung, Leah; Park, Jennifer M.; Khan, Yasmeen Ali; Murphy, Tanya K.; Storch, Eric A.

    2013-01-01

    Background: Cognitive-behavioral therapy with exposure and response prevention (ERP) is an effective treatment for pediatric OCD; however, up to 30 % of children are treatment non-responders and as many as 40% are partial responders. Although poor treatment adherence has been linked to attenuated response in adults with OCD, little research has…

  14. [Current status of hearing loss and related influencing factors in workers with noise exposure in refining and chemical industry].

    Science.gov (United States)

    Wu, S S; Yu, J N; He, C H; Mu, H X; Wang, C; Zhang, Y; Zhang, C Y; Yu, S F; Li, X L

    2016-12-20

    Objective: To investigate the current status of hearing loss and related influencing factors in workers with noise exposure in refining and chemical industry. Methods: From August 2015 to March 2016, the investigation method of collecting the data of past occupational health examinations and measuring noise in working environment was used to enroll 8 672 male workers. Results: Of all workers, 11.6% were diagnosed with hearing loss. There were significant differences in the distribution of hearing impairment among workers exposed to noise at different ages, device types and types of work (χ(2)=17.80, 77.80 and 30.53, all P hearing loss in workers with noise exposure in refining and chemical industry. Conclusion: The level of noise exposure and working years with noise exposure are main influencing factors for hearing loss in workers with noise exposure in refining and chemical industry.

  15. What Primary Care Providers Need to Know about Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: Narrative Review

    Science.gov (United States)

    Krakower, Douglas; Mayer, Kenneth H.

    2013-01-01

    As HIV prevalence climbs globally, including more than 50,000 new infections per year in the United States, we need effective HIV prevention strategies. The use of antiretrovirals for pre-exposure prophylaxis (known as “PrEP”) among high-risk HIV-uninfected persons is emerging as one such strategy. Randomized controlled trials have demonstrated that once daily oral PrEP decreased HIV incidence among at-risk MSM and African heterosexuals, including HIV serodiscordant couples. An additional randomized control trial of a pericoital topical application of antiretroviral microbicide gel reduced HIV incidence among at-risk heterosexual South African women. Two other studies in African women did not demonstrate the efficacy of oral or topical PrEP, raising concerns about adherence patterns and efficacy in this population. The FDA Antiretroviral Advisory Panel reviewed these studies and additional data in May 2012 and recommended the approval of oral tenofovir-emtricitabine for PrEP in high-risk populations. Patients may seek PrEP from their primary care providers and those on PrEP require monitoring. Thus, primary care providers should become familiar with PrEP. This review outlines the current state of knowledge about PrEP as it pertains to primary care including identification of individuals likely to benefit from PrEP, counseling to maximize adherence and minimize potential increases in risky behavior, and monitoring for potential drug toxicities, HIV acquisition, and antiretroviral drug resistance. Issues related to cost and insurance coverage are also discussed. Recent data suggest that PrEP, in conjunction with other prevention strategies, holds promise in helping to curtail the HIV epidemic. PMID:22821365

  16. Prevention of lung cancer by remediation of residential exposure to radon daughters

    International Nuclear Information System (INIS)

    Mahaffey, J.A.; Cross, F.T.; Johnson, J.R.; Baechler, M.C.

    1991-01-01

    The United States Bonneville Power Administration (BPA), as part of an energy conservation programme in the states of Washington, Oregon, Idaho, Wyoming, and Montana, has collected over 36,000 residential radon concentration measurements. Data were collected between 1983 and 1989 with ambient α etched track dosemeters. Based on the linear risk coefficient from the BEIR IV report for lifetime lung cancer in smokers and non-smokers, numbers of lung cancer cases attributable to radon exposure were predicted. Numbers of baseline lung cancer cases and numbers of these that were preventable by remediation were also estimated. Remediation to 10 pCi.1 -1 , to 4 pCi.1 -1 , and to outdoor levels were considered. With vital statistics data, results were extrapolated to populations in the states represented by the BPA data. Costs of remediation were estimated. Results were evaluated in terms of cost per cancer saved and per cent reduction in fatal lung cancer cases from the baseline estimate. (author)

  17. The importance of preventive dental visits from a young age: systematic review and current perspectives

    Directory of Open Access Journals (Sweden)

    Bhaskar V

    2014-03-01

    -seeking pattern were frequently articulated themes in the reviewed studies. Conclusion: The currently available evidence base supporting the effectiveness of EPDVs and the year 1 first dental visit recommendation is weak, and more research is warranted. The benefits of EPDVs before the age of 3 years are evident among children at high risk or with existing dental disease. However, EPDVs may be associated with reduced restorative dental care visits and related expenditures during the first years of life. Keywords: prevention, children, dental visits, anticipatory guidance, dental home, caries

  18. Association between current asthma and secondhand smoke exposure in vehicles among adults living in four US states.

    Science.gov (United States)

    Nguyen, Kimberly H; King, Brian A; Dube, Shanta R

    2015-07-01

    Many states have implemented laws prohibiting tobacco smoking in indoor public places. However, private settings remain a major source of secondhand smoke (SHS) exposure for many people. We assessed the association between current asthma and SHS exposure in vehicles among adult never-smokers in Indiana, Kentucky, Louisiana and Mississippi. Data came from the 2011 Behavioral Risk Factor Surveillance System, a state-based telephone survey of US adults aged ≥18 years. Analyses were restricted to states (n=4) that administered an optional SHS module. Prevalence of self-reported asthma and past 7-day SHS exposure in vehicles was calculated by demographics, voluntary smoke-free vehicle rules and SHS exposure in homes, public places and workplaces. Logistic regression was used to assess the adjusted association between asthma and SHS exposure in vehicles. Among 17 863 never-smoking adults, 7.4% reported having current asthma, whereas 12.3% reported past 7-day SHS exposure in vehicles. Among adults with asthma, SHS exposure in vehicles was lower among those with voluntary smoke-free rules compared with those without voluntary smoke-free rules (9.5% vs 56.7%, psmoke-free rules in vehicles, especially among adults with asthma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Shy Cian Khor

    2014-01-01

    Full Text Available Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies.

  20. 78 FR 24691 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-04-26

    ... comments should be identified with the title ``Current Good Manufacturing Practice and Hazard Analysis and..., 114, 117, 120, 123, 129, 179, and 211 [Docket No. FDA-2011-N-0920] RIN 0910-AG36 Current Good Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of...

  1. A review of current strategy for rabies prevention and control in the developing world

    Directory of Open Access Journals (Sweden)

    Suneela Garg

    2017-03-01

    Full Text Available The control of Rabies, a zoonotic viral disease is a major public challenge in several developing countries. Current approaches for rabies control are overwhelmingly directed towards provision of effective post exposure prophylaxis (PEP to animal bite victims. The enormous costs involved in rabies prophylaxis is an important factor precluding its universal application in all animal bite victims especially in those residing in resource constrained settings. The intradermal route of administration has been shown to be cost effective except in peripheral regions with fewer animal bite cases. Nevertheless, rabies control program with their expected emphasis on human rabies prophylaxis have neglected canine vaccination. The feasibility of canine rabies vaccination depends primarily upon allocation of resources through political commitment and effective public private partnerships. However, in large parts of the world including India formal dog ownership constitutes a small minority of the overall canine population while state funded canine vaccination drives often fail to impress policy makers who struggle to maintain budgets for adequate coverage of rabies PEP for animal bite victims. The key to rabies control may therefore rest upon a one health approach with development of newer vaccine technology which is cost effective for vaccination in both, man and animal.

  2. Prevention of Asbestos-Related Disease in Countries Currently Using Asbestos

    Directory of Open Access Journals (Sweden)

    Daniela Marsili

    2016-05-01

    Full Text Available More than 40 years of evaluation have consistently confirmed the carcinogenicity of asbestos in all of its forms. This notwithstanding, according to recent figures, the annual world production of asbestos is approximatively 2,000,000 tons. Currently, about 90% of world asbestos comes from four countries: Russia, China, Brazil and Kazakhstan; and the wide use of asbestos worldwide represents a global threat. The purpose of this paper is to present a review of the asbestos health impact and to discuss the role of epidemiological investigations in countries where asbestos is still used. In these contexts, new, “local” studies can stimulate awareness of the size of the problem by public opinion and other stakeholders and provide important information on the circumstances of exposure, as well as local asbestos-related health impacts. This paper suggests an agenda for an international cooperation framework dedicated to foster a public health response to asbestos, including: new epidemiological studies for assessing the health impact of asbestos in specific contexts; socio-cultural and economic analyses for contributing to identifying stakeholders and to address both the local and global implications of asbestos diffusion; public awareness on the health and socio-economic impact of asbestos use and banning.

  3. Current status of programmes to measure and reduce radon exposure in Irish workplaces

    International Nuclear Information System (INIS)

    Colgan, P A; Madden, J S; Synnott, H; Fennell, S; Pollard, D; Fenton, D

    2004-01-01

    National legislation, which implements European Council Directive 96/29/EURATOM in Ireland, sets a reference level of 400 Bq m -3 averaged over any 3 month period for radon exposure in the workplace and also empowers the Radiological Protection Institute of Ireland to direct employers to have radon measurements carried out. This legislation came into effect in May 2000. Radon measurements have already been completed in show caves and other underground workplaces. Between 1998 and 2001, over 33 800 individual radon measurements were carried out in all ground floor offices and classrooms in 3444 schools nationwide as part of a programme undertaken jointly with the Department of Education and Science. Where the average indoor radon concentration in one or more rooms exceeded 200 Bq m -3 , remedial measures were implemented. For concentrations up to 400 Bq m -3 this involved increased ventilation while for higher concentrations an active sump was normally installed. The results of the survey, as well as the effectiveness of the different remedial strategies, are discussed. In the case of other above ground workplaces, different approaches have been adopted. As a first step, workplaces in two known high radon areas were directed to have radon measurements carried out. This programme had limited success because of problems in obtaining accurate workplace databases and a general lack of awareness on the part of employers of the issues involved. From a sample of 2610 employers directed to measure radon, only 408 actually completed measurements and 37 workplaces were identified as having average 3 month average radon concentrations above 400 Bq m -3 . A total of 1356 employers ignored all correspondence, some of which was sent by registered post and signed for on receipt. Current initiatives are focused on the provision of information and include newspaper advertising as well as publications aimed specifically at both employer and employee representative groups. The ability

  4. Sexual behaviour of heterosexual men and women receiving antiretroviral pre-exposure prophylaxis for HIV prevention: a longitudinal analysis.

    Science.gov (United States)

    Mugwanya, Kenneth K; Donnell, Deborah; Celum, Connie; Thomas, Katherine K; Ndase, Patrick; Mugo, Nelly; Katabira, Elly; Ngure, Kenneth; Baeten, Jared M

    2013-12-01

    Scarce data are available to assess sexual behaviour of individuals using antiretroviral pre-exposure prophylaxis for HIV prevention. Increased sexual risk taking by individuals using effective HIV prevention strategies, like pre-exposure prophylaxis, could offset the benefits of HIV prevention. We studied whether the use of pre-exposure prophylaxis in HIV-uninfected men and women in HIV-serodiscordant couples was associated with increased sexual risk behaviour. We undertook a longitudinal analysis of data from the Partners PrEP Study, a double-blind, randomised, placebo-controlled trial of daily oral pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-serodiscordant couples (n=3163, ≥18 years of age). Efficacy for HIV prevention was publicly reported in July 2011, and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex-unprotected by a condom-during the 12 months after compared with the 12 months before July 2011, to assess whether knowledge of pre-exposure prophylaxis efficacy for HIV prevention caused increased sexual risk behaviour. We analysed 56 132 person-months from 3024 HIV-uninfected individuals (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months before unmasking versus 53 after unmasking; we recorded no immediate change (p=0·66) or change over time (p=0·25) after July, 2011. We identified a significant increase in unprotected sex with outside partners after July, 2011, but the effect was small (average of 6·8 unprotected sex acts per year vs 6·2 acts in a predicted counterfactual scenario had patients remained masked, p=0·04). Compared with before July, 2011, we noted no significant increase in incident sexually transmitted infections or pregnancy after July, 2011. Pre-exposure prophylaxis, provided as part of a comprehensive prevention package, might not result in substantial changes in risk

  5. Reduced radiation exposure to the mammary glands in thoracic computed tomography using organ-based tube-current modulation

    International Nuclear Information System (INIS)

    Munechika, Jiro; Ohgiya, Yoshimitsu; Gokan, Takehiko; Hashimoto, Toshi; Iwai, Tsugunori

    2013-01-01

    Organ-based tube-current modulation has been used to reduce radiation exposure to specific organs. However, there are no reports yet published on reducing radiation exposure in clinical cases. In this study, we assessed the reduction in radiation exposure to the mammary glands during thoracic computed tomography (CT) using X-CARE. In a phantom experiment, the use of X-CARE reduced radiation exposure at the midline of the precordial region by a maximum of 45.1%. In our corresponding clinical study, CT was performed using X-CARE in 15 patients, and without X-CARE in another 15. Compared to the non-X-CARE group, radiation exposure was reduced in the X-CARE group at the midline of the precordial region by 22.3% (P 0.05). X-CARE thus reduced radiation exposure at the midline of the precordial region and allowed us to obtain consistent CT values without increasing noise. However, this study revealed increases in radiation exposure at the lateral sides of the breasts. It is conceivable that patients' breasts were laterally displaced by gravity under the standard thoracic imaging conditions. Further studies that consider factors such as body size and adjustment of imaging conditions may be needed in the future. (author)

  6. Human taeniasis: current insights into prevention and management strategies in endemic countries

    Science.gov (United States)

    Okello, Anna L; Thomas, Lian Francesca

    2017-01-01

    Human taeniasis is a zoonotic condition resulting from infection with the adult stages of Taenia saginata (“beef tapeworm”), Taenia solium (“pork tapeworm”) or Taenia asiatica (“Asian tapeworm”). Although these parasites have a worldwide distribution, the overwhelming burden is felt by communities in low- and middle-income countries. This is particularly true for T. solium, whereby infection of the central nervous system with the larval stage of the parasite (neurocysticercosis) is a major cause of acquired epilepsy in low-resource settings. With a focus on endemic countries, this review provides an insight into the prevention and management of human taeniasis, concluding with some recent case studies describing their implementation. Discussion of the opportunities and challenges regarding current fecal and serological diagnostic assays for detecting Taenia spp. highlights the importance of accurate and accessible diagnostic options for the field situation. The lack of long-term impact on the parasites’ lifecycle from human anthelmintic treatment, coupled with the propensity for adverse reactions, highlights the importance of a “two-pronged” approach that considers the relevant animal hosts, particularly in the case of T. solium. Aside from the therapeutic options, this review reiterates the importance of adequate assessment and consideration of the associated behavioral and policy aspects around sanitation, hygiene and meat inspection that have been shown to support parasite control, and potential elimination, in endemic regions. PMID:28615981

  7. Protobacco Media Exposure and Youth Susceptibility to Smoking Cigarettes, Cigarette Experimentation, and Current Tobacco Use among US Youth.

    Directory of Open Access Journals (Sweden)

    Erika B Fulmer

    Full Text Available Youth are exposed to many types of protobacco influences, including smoking in movies, which has been shown to cause initiation. This study investigates associations between different channels of protobacco media and susceptibility to smoking cigarettes, cigarette experimentation, and current tobacco use among US middle and high school students.By using data from the 2012 National Youth Tobacco Survey, structural equation modeling was performed in 2013. The analyses examined exposure to tobacco use in different channels of protobacco media on smoking susceptibility, experimentation, and current tobacco use, accounting for perceived peer tobacco use.In 2012, 27.9% of respondents were never-smokers who reported being susceptible to trying cigarette smoking. Cigarette experimentation increased from 6.3% in 6th grade to 37.1% in 12th grade. Likewise, current tobacco use increased from 5.2% in 6th grade to 33.2% in 12th grade. Structural equation modeling supported a model in which current tobacco use is associated with exposure to static advertising through perception of peer use, and by exposure to tobacco use depicted on TV and in movies, both directly and through perception of peer use. Exposure to static advertising appears to directly increase smoking susceptibility but indirectly (through increased perceptions of peer use to increase cigarette experimentation. Models that explicitly incorporate peer use as a mediator can better discern the direct and indirect effects of exposure to static advertising on youth tobacco use initiation.These findings underscore the importance of reducing youth exposure to smoking in TV, movies, and static advertising.

  8. Occupational Health Update: Focus on Preventing the Acquisition of Infections with Pre-exposure Prophylaxis and Postexposure Prophylaxis.

    Science.gov (United States)

    Weber, David J; Rutala, William A

    2016-09-01

    Health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, Clostridium difficile). An effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and isolation of potentially infectious patients, and hand hygiene; (2) assuring immunity to vaccine-preventable diseases; and, (3) immediate availability of a medical evaluation after a nonprotected exposure to an infectious disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Assessing exposure and health consequences of chemicals in drinking water: current state of knowledge and research needs.

    Science.gov (United States)

    Villanueva, Cristina M; Kogevinas, Manolis; Cordier, Sylvaine; Templeton, Michael R; Vermeulen, Roel; Nuckols, John R; Nieuwenhuijsen, Mark J; Levallois, Patrick

    2014-03-01

    exposure and health consequences of chemicals in drinking water: current state of knowledge and research needs. Environ Health Perspect 122:213–221; http://dx.doi.org/10.1289/ehp.1206229

  10. Modifying exposure to smoking depicted in movies: a novel approach to preventing adolescent smoking.

    Science.gov (United States)

    Sargent, James D; Dalton, Madeline A; Heatherton, Todd; Beach, Mike

    2003-07-01

    Most behavioral approaches to adolescent smoking address the behavior directly. We explore an indirect approach: modifying exposure to portrayals of smoking in movies. To describe adolescents' exposure to smoking in movies and to examine factors that could modify such exposure. Occurrences of smoking were counted in each of 601 popular movies. Four thousand nine hundred ten northern New England junior high school students were asked to report which movies they had seen from a randomly generated subsample of 50 films, and responses were used to estimate exposure to the entire sample. Analysis The outcome variable was exposure to movie smoking, defined as the number of smoking occurrences seen. Risk factors for exposure included access to movies (movie channels, videotape use, and movie theater); parenting (R [restricted]-rated movie restrictions, television restrictions, parenting style); and characteristics of the child (age, sex, school performance, sensation-seeking propensity, rebelliousness, and self-esteem). We used multiple regression to assess the association between risk factors and exposure to movie smoking. Subjects had seen an average of 30% of the movie sample (interquartile range, 20%-44%), from which they were exposed to 1160 (interquartile range, 640-1970) occurrences of smoking. In a multivariate model, exposure to movie smoking increased (all P values Parent restriction on viewing R-rated movies resulted in a 50% reduction in exposure to movie smoking. There was no association between parenting style and exposure to movie smoking. Much of the protective effect of parent R-rated movie restriction on adolescent smoking was mediated through lower exposure to movie smoking. Adolescents see thousands of smoking depictions in movies, and this influences their attitudes and behavior. Exposure to movie smoking is reduced when parents limit movie access. Teaching parents to monitor and enforce movie access guidelines could reduce adolescent smoking in an

  11. The relationship of temperature rise to specific absorption rate and current in the human leg for exposure to electromagnetic radiation in the high frequency band

    International Nuclear Information System (INIS)

    Wainwright, P R

    2003-01-01

    Of the biological effects of human exposure to radiofrequency and microwave radiation, the best-established are those due to elevation of tissue temperature. To prevent harmful levels of heating, restrictions have been proposed on the specific absorption rate (SAR). However, the relationship between SAR and temperature rise is not an invariant, since not only the heat capacity but also the efficiency of heat dissipation varies between different tissues and exposure scenarios. For small enough SAR, the relationship is linear and may be characterized by a 'heating factor'. Under whole-body irradiation the SAR may be particularly high in the ankles due to the concentration of current flowing through a relatively small cross-sectional area. In a previous paper, the author has presented calculations of the SAR distribution in a human leg in the high frequency (HF) band. In this paper, the heating factor for this situation is derived using a finite element approximation of the Pennes bio-heat equation. The sensitivity of the results to different blood perfusion rates is investigated, and a simple local thermoregulatory model is applied. Both time-dependent and steady-state solutions are considered. Results confirm the appropriateness of the ICNIRP reference level of 100 mA on current through the leg, but suggest that at higher currents significant thermoregulatory adjustments to muscle blood flow will occur

  12. The prevalence of chromium allergy in Denmark is currently increasing as a result of leather exposure

    DEFF Research Database (Denmark)

    Thyssen, J P; Jensen, P; Carlsen, B C

    2009-01-01

    BACKGROUND: Chromium allergy has traditionally been caused by occupational skin contact with cement. In 1983, Danish legislation made the addition of ferrous sulphate compulsory in cement to reduce the water-soluble chromium content to not more than 2 ppm. An effect from this intervention has pre...... leather exposure increased significantly from 24.1% during 1989-1994 to 45.5% during 1995-2007 (P leather exposure....

  13. Obsessive Compulsive Personality Disorder as a Predictor of Exposure and Ritual Prevention Outcome for Obsessive Compulsive Disorder

    OpenAIRE

    Pinto, Anthony; Liebowitz, Michael R.; Foa, Edna B.; Simpson, H. Blair

    2011-01-01

    Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 ses...

  14. Current status of programmes to measure and reduce radon exposure in Irish workplaces

    Energy Technology Data Exchange (ETDEWEB)

    Colgan, P A; Madden, J S; Synnott, H; Fennell, S; Pollard, D; Fenton, D [Radiological Protection Institute of Ireland, 3 Clonskeagh Square, Dublin 14(Ireland)

    2004-06-01

    National legislation, which implements European Council Directive 96/29/EURATOM in Ireland, sets a reference level of 400 Bq m{sup -3} averaged over any 3 month period for radon exposure in the workplace and also empowers the Radiological Protection Institute of Ireland to direct employers to have radon measurements carried out. This legislation came into effect in May 2000. Radon measurements have already been completed in show caves and other underground workplaces. Between 1998 and 2001, over 33 800 individual radon measurements were carried out in all ground floor offices and classrooms in 3444 schools nationwide as part of a programme undertaken jointly with the Department of Education and Science. Where the average indoor radon concentration in one or more rooms exceeded 200 Bq m{sup -3}, remedial measures were implemented. For concentrations up to 400 Bq m{sup -3} this involved increased ventilation while for higher concentrations an active sump was normally installed. The results of the survey, as well as the effectiveness of the different remedial strategies, are discussed. In the case of other above ground workplaces, different approaches have been adopted. As a first step, workplaces in two known high radon areas were directed to have radon measurements carried out. This programme had limited success because of problems in obtaining accurate workplace databases and a general lack of awareness on the part of employers of the issues involved. From a sample of 2610 employers directed to measure radon, only 408 actually completed measurements and 37 workplaces were identified as having average 3 month average radon concentrations above 400 Bq m{sup -3}. A total of 1356 employers ignored all correspondence, some of which was sent by registered post and signed for on receipt. Current initiatives are focused on the provision of information and include newspaper advertising as well as publications aimed specifically at both employer and employee representative

  15. Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults.

    Science.gov (United States)

    Costello, Joseph T; Baker, Philip R A; Minett, Geoffrey M; Bieuzen, Francois; Stewart, Ian B; Bleakley, Chris

    2015-09-18

    Recovery strategies are often used with the intention of preventing or minimising muscle soreness after exercise. Whole-body cryotherapy, which involves a single or repeated exposure(s) to extremely cold dry air (below -100 °C) in a specialised chamber or cabin for two to four minutes per exposure, is currently being advocated as an effective intervention to reduce muscle soreness after exercise. To assess the effects (benefits and harms) of whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, the British Nursing Index and the Physiotherapy Evidence Database. We also searched the reference lists of articles, trial registers and conference proceedings, handsearched journals and contacted experts.The searches were run in August 2015. We aimed to include randomised and quasi-randomised trials that compared the use of whole-body cryotherapy (WBC) versus a passive or control intervention (rest, no treatment or placebo treatment) or active interventions including cold or contrast water immersion, active recovery and infrared therapy for preventing or treating muscle soreness after exercise in adults. We also aimed to include randomised trials that compared different durations or dosages of WBC. Our prespecified primary outcomes were muscle soreness, subjective recovery (e.g. tiredness, well-being) and adverse effects. Two review authors independently screened search results, selected studies, assessed risk of bias and extracted and cross-checked data. Where appropriate, we pooled results of comparable trials. The random-effects model was used for pooling where there was substantial heterogeneity. We assessed the quality of the evidence using GRADE. Four laboratory-based randomised controlled trials were included. These reported results for 64

  16. Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

    Science.gov (United States)

    Slone, Michelle; Shoshani, Anat

    2010-01-01

    The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

  17. 78 FR 47320 - Preventing Skin Cancer Through Reduction of UV Exposure

    Science.gov (United States)

    2013-08-05

    ... radiation and a history of sunburn (indicating both intensity of UV exposure and skin sensitivity to... experiencing one or more sunburns in the past 12 months, and sunburn is even more common among younger adults... sun protection is low, while excessive sun exposure, indoor tanning, and sunburn are common. HHS/CDC...

  18. Pre-Exposure Prophylaxis and Antiretroviral Resistance: HIV Prevention at a Cost?

    OpenAIRE

    Hurt, Christopher B.; Eron, Joseph J.; Cohen, Myron S.

    2011-01-01

    Prompted by 3 cases of resistance noted in the Pre-Exposure Prophylaxis Initiative and TDF2 trials, we examined literature on mutations elicited by antiretrovirals used for pre-exposure prophylaxis. We discuss signature mutations, how rapidly these emerge, and individual-level and public health consequences of antiretroviral resistance.

  19. Human taeniasis: current insights into prevention and management strategies in endemic countries

    Directory of Open Access Journals (Sweden)

    Okello A

    2017-06-01

    Full Text Available Anna L Okello,1 Lian Francesca Thomas2 1Division of Infection and Pathway Medicine, Edinburgh Medical School, Biomedical Sciences College of Medicine and Veterinary Medicine, University of Edinburgh, Scotland; 2Independent Consultant, Lusaka, Zambia Abstract: Human taeniasis is a zoonotic condition resulting from infection with the adult stages of Taenia saginata (“beef tapeworm”, Taenia solium (“pork tapeworm” or Taenia asiatica (“Asian tapeworm”. Although these parasites have a worldwide distribution, the overwhelming burden is felt by communities in low- and middle-income countries. This is particularly true for T. solium, whereby infection of the central nervous system with the larval stage of the parasite (neurocysticercosis is a major cause of acquired epilepsy in low-resource settings. With a focus on endemic countries, this review provides an insight into the prevention and management of human taeniasis, concluding with some recent case studies describing their implementation. Discussion of the opportunities and challenges regarding current fecal and serological diagnostic assays for detecting Taenia spp. highlights the importance of accurate and accessible diagnostic options for the field situation. The lack of long-term impact on the parasites’ lifecycle from human anthelmintic treatment, coupled with the propensity for adverse reactions, highlights the importance of a “two-pronged” approach that considers the relevant animal hosts, particularly in the case of T. solium. Aside from the therapeutic options, this review reiterates the importance of adequate assessment and consideration of the associated behavioral and policy aspects around sanitation, hygiene and meat inspection that have been shown to support parasite control, and potential elimination, in endemic regions. Keywords: Taenia solium, Taenia saginata, cysticercosis, zoonotic disease, neglected tropical diseases

  20. Silica Exposures in Artisanal Small-Scale Gold Mining in Tanzania and Implications for Tuberculosis Prevention.

    Science.gov (United States)

    Gottesfeld, Perry; Andrew, Damian; Dalhoff, Jeffrey

    2015-01-01

    Gold miners exposed to crystalline silica are at risk of silicosis, lung cancer, and experience higher incidence rates of pulmonary tuberculosis (TB). Although the hazards associated with mercury exposure in artisanal small-scale gold mining (ASGM) have been well documented, no published data was available on crystalline silica exposures in this population. Air sampling was conducted in the breathing zone of workers in five villages in Tanzania with battery-operated sampling pumps and bulk samples were collected to measure the type and concentration of crystalline silica in the ore. Samples were analyzed at an accredited laboratory with X-ray diffraction. Airborne crystalline silica exposures exceeded recommended limits for all tasks monitored with an average exposure of 16.85 mg/m(3) for underground drilling that was 337 fold greater than the recommended exposure limit (REL) published by the U.S. National Institute for Occupational Safety and Health (NIOSH) and 0.19 mg/m(3) for aboveground operations or 4-fold greater than the REL. The exposures measured raise concern for possible acute and chronic silicosis and are known to significantly contribute to TB incidence rates in mining communities. The use of wet methods could greatly reduce exposures and the risk of TB and silicosis in ASGM. Ongoing efforts to address mercury and other hazards in ASGM should incorporate crystalline silica dust controls.

  1. Effects of current inhalation exposure methods on cardiopulmonary function of immature dogs

    International Nuclear Information System (INIS)

    Mauderly, J.A.; Muggenburg, B.A.; Lay, J.C.

    1976-01-01

    Approximately 9% of 84 3-mo-old dogs exposed to inhalation of radioactive aerosols have experienced respiratory failure during exposure. A study was conducted to evaluate effects of exposure on cardiopulmonary function of immature dogs. Results indicate that the combination of nose breathing and breathing into the aerosol delivery cone quadrupled breathing effort of 3-mo-old dogs. Excitement exacerbated a failure to maintain adequate alveolar ventilation and resulted in CO 2 retention and acidosis. General anesthesia and use of an endotracheal tube alleviated problems due to nasal airflow resistance and behaviorally-related increases in ventilatory requirement

  2. Systemic administration of antiretrovirals prior to exposure prevents rectal and intravenous HIV-1 transmission in humanized BLT mice.

    Directory of Open Access Journals (Sweden)

    Paul W Denton

    2010-01-01

    Full Text Available Successful antiretroviral pre-exposure prophylaxis (PrEP for mucosal and intravenous HIV-1 transmission could reduce new infections among targeted high-risk populations including discordant couples, injection drug users, high-risk women and men who have sex with men. Targeted antiretroviral PrEP could be particularly effective at slowing the spread of HIV-1 if a single antiretroviral combination were found to be broadly protective across multiple routes of transmission. Therefore, we designed our in vivo preclinical study to systematically investigate whether rectal and intravenous HIV-1 transmission can be blocked by antiretrovirals administered systemically prior to HIV-1 exposure. We performed these studies using a highly relevant in vivo model of mucosal HIV-1 transmission, humanized Bone marrow/Liver/Thymus mice (BLT. BLT mice are susceptible to HIV-1 infection via three major physiological routes of viral transmission: vaginal, rectal and intravenous. Our results show that BLT mice given systemic antiretroviral PrEP are efficiently protected from HIV-1 infection regardless of the route of exposure. Specifically, systemic antiretroviral PrEP with emtricitabine and tenofovir disoproxil fumarate prevented both rectal (Chi square = 8.6, df = 1, p = 0.003 and intravenous (Chi square = 13, df = 1, p = 0.0003 HIV-1 transmission. Our results indicate that antiretroviral PrEP has the potential to be broadly effective at preventing new rectal or intravenous HIV transmissions in targeted high risk individuals. These in vivo preclinical findings provide strong experimental evidence supporting the potential clinical implementation of antiretroviral based pre-exposure prophylactic measures to prevent the spread of HIV/AIDS.

  3. [Current dietary exposure to mercury during pregnancy and childhood, and public health recommendations].

    Science.gov (United States)

    Llop, Sabrina; Ibarlucea, Jesús; Sunyer, Jordi; Ballester, Ferran

    2013-01-01

    Exposure to high levels of mercury during vulnerable periods (such as pregnancy and childhood) may have serious consequences for cognitive development, as observed after acute poisoning episodes in Japan and Irak. The main source of mercury exposure in the general population is consumption of certain types of fish. There is growing concern about the possible neurotoxic effects of mercury, especially in younger children in populations where fish intake is moderate to high. The scientific evidence to date is inconclusive. In Spain, the Childhood and Environment (Infancia y Medio Ambiente [INMA]) project has provided information on levels of prenatal exposure to mercury among 1800 newborns from Valencia, Sabadell, Asturias and Guipúzcoa. In general, levels were high, being above the World Health Organization's recommended dose in 24% of children and above the recommended levels of the U.S. Environmental Protection Agency in 64%. However, the results did not indicate a significant association between prenatal mercury exposure and delayed cognitive development during the second year of life. Various agencies have developed recommendations on fish consumption for pregnant women and children, due to the presence of mercury. These recommendations should be strengthened, since there is general consensus among all regional and national public administrations that fish is an essential source of nutrients for development in the early stages of life. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  4. Glazed clay pottery and lead exposure in Mexico: Current experimental evidence.

    Science.gov (United States)

    Diaz-Ruiz, Araceli; Tristán-López, Luis Antonio; Medrano-Gómez, Karen Itzel; Torres-Domínguez, Juan Alejandro; Ríos, Camilo; Montes, Sergio

    2017-11-01

    Lead exposure remains a significant environmental problem; lead is neurotoxic, especially in developing humans. In Mexico, lead in human blood is still a concern. Historically, much of the lead exposure is attributed to the use of handcrafted clay pottery for cooking, storing and serving food. However, experimental cause-and-effect demonstration is lacking. The present study explores this issue with a prospective experimental approach. We used handcrafted clay containers to prepare and store lemonade, which was supplied as drinking water to pregnant rats throughout the gestational period. We found that clay pots, jars, and mugs leached on average 200 µg/l lead, and exposure to the lemonade resulted in 2.5 µg/dl of lead in the pregnant rats' blood. Neonates also showed increased lead content in the hippocampus and cerebellum. Caspase-3 activity was found to be statistically increased in the hippocampus in prenatally exposed neonates, suggesting increased apoptosis in that brain region. Glazed ceramics are still an important source of lead exposure in Mexico, and our results confirm that pregnancy is a vulnerable period for brain development.

  5. Routine Immunization of Adults in Canada: Review of the Epidemiology of Vaccine-Preventable Diseases and Current Recommendations for Primary Prevention

    Directory of Open Access Journals (Sweden)

    Michael D Parkins

    2009-01-01

    Full Text Available Vaccination is one of the greatest achievements in public health of the 20th century. However, the success of vaccine uptake and adherence to immunization guidelines seen in pediatric populations has not been observed among adult Canadians. As a result of the disparity in susceptibility to vaccine-preventable disease, there has been an increasing shift of vaccine-preventable childhood diseases into adult populations. Accordingly, morbidity and mortality due to vaccine-preventable illnesses now occur disproportionately in adults. All Canadians, irrespective of age, should have immunity to measles, mumps, rubella, tetanus, diphtheria, pertussis and varicella. All adult Canadians with significant medical comorbidities or those older than 65 years of age should receive the pneumococcal polysaccharide vaccine and yearly trivalent inactivate influenza vaccines. The present review summarizes the burden of illness of these vaccine-preventable diseases in the Canadian adult population and reviews the current immunization recommendations. Vaccination of all Canadians to these common agents remains a vital tool to decrease individual morbidity and mortality and reduce the overall burden of preventable disease in Canada.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  7. Early Intervention and Maltreated Children: A Current Look at the Child Abuse Prevention and Treatment Act and Part C

    Science.gov (United States)

    Moxley, Kathleen M.; Squires, Jane; Lindstrom, Lauren

    2012-01-01

    Current literature regarding the prevalence of child abuse and neglect, resulting developmental impacts on children, and early intervention services for children and families involved in the child welfare system is summarized. While early intervention eligibility referrals are mandated for this population under the Child Abuse Prevention and…

  8. Advertising exposure and use of e-cigarettes among female current and former tobacco users of childbearing age.

    Science.gov (United States)

    Ashford, Kristin; Rayens, Emily; Wiggins, Amanda T; Rayens, Mary Kay; Fallin, Amanda; Sayre, Molly Malany

    2017-09-01

    The study examined the relationship between exposure to e-cigarette advertising and e-cigarette use by pregnancy status, including use of flavored e-cigarette products, among women of childbearing age. A cross-sectional, correlational design was used. Female current or former tobacco users in Central and Eastern Kentucky, 18-45 years old (N = 194, 52% pregnant). Demographics, pregnancy status, cigarette and e-cigarette use, and exposure to e-cigarette advertising. Younger age, white non-Hispanic race, and greater exposure to e-cigarette advertising were associated with a higher likelihood of ever using e-cigarettes (p advertisements or information about e-cigarettes on social media, compared to those who used unflavored e-cigarettes only (p = .016). There is a link between advertising exposure and ever use of e-cigarettes. Pregnancy status is not significantly associated with ever use. Use of flavored e-cigarettes is associated with younger age. E-cigarette users with greater exposure to advertising on social media were more likely to use flavored products. © 2017 Wiley Periodicals, Inc.

  9. Second-hand smoke exposure in homes and in cars among Canadian youth: current prevalence, beliefs about exposure, and changes between 2004 and 2006.

    Science.gov (United States)

    Leatherdale, Scott T; Ahmed, Rashid

    2009-08-01

    youth do not think smoking should be allowed around kids in those locations. Considering the health and social consequences associated with SHS exposure, it may be a timely opportunity to move forward with programs and policies designed to prevent individuals from smoking around youth in these locations.

  10. Neuropeptide Y stimulation as primary target for preventive measures of maladaptative cardiovascular reactions in occupational chronic stress exposure.

    Science.gov (United States)

    Ciumaşu-Rîmbu, Mălina; Popa, Livia; Vulpoi, Carmen

    2012-01-01

    Chronic stress may produce a decrease in central NPY expression and subjects exposed to it may prove hypersensitivity to a novel stressor with dysfunctions in the NPY system and cardiovascular maladaptation to stress, even hypertension. Upregulation of NPY expression may contribute to successful behavioral adaptation to stress by reducing cardiovascular tone and suppressing anxious behaviors. Adaptogens, a new class of metabolic regulators stimulate NPY expression and release. The aim of this study is to increase tolerance and adaptation to stress of hypersensitive to novel stressor, occupational chronic stress exposed subjects with cardiovascular maladaptation to mild new stressor using adaptogens as part of prevention protocol. 40 military personnel with known cardiostressor reactional mode and occupational chronic stress exposure were exposed to mild novel stressor: occupational medicine routine evaluation and clinically assessed for maladaptative cardiovascular response prior and before application of 30 day prevention protocol. Employees were randomly split in two groups, one receiving standard prevention protocol (lifestyle counseling) plus adaptogens in multiple dose administration, twice daily and the other receiving only standard prevention protocol. We found significant statistic differences in all cardiovascular parameters in adaptogen group and only in diastolic blood pressure in control group. Adaptogens could be an important factor in successful prevention protocols of chronic occupational stress dysfunctions involving NPY systems.

  11. Prenatal zinc prevents communication impairments and BDNF disturbance in a rat model of autism induced by prenatal lipopolysaccharide exposure.

    Science.gov (United States)

    Kirsten, Thiago B; Queiroz-Hazarbassanov, Nicolle; Bernardi, Maria M; Felicio, Luciano F

    2015-06-01

    Aims: Previous investigations by our group have shown that prenatal exposure to lipopolysaccharide (LPS),which mimics infections by Gram-negative bacteria, induced autistic-like behavior. No effective treatment yet exists for autism. Therefore, we used our rat model to test a possible treatment for autism.We selected zinc as the prenatal treatment to prevent or ease the impairments induced by LPS because LPS induces hypozincaemia.Materials and methods:We evaluated the effects of LPS and zinc on female reproductive performance. Communication,which is impaired in autism,was tested in pups by ultrasonic vocalizations. Plasma levels of brain-derived neurotrophic factor (BDNF) were determined because it has been considered an autism important biomarker.Key findings: Prenatal LPS exposure reduced offspring number and treatment with zinc prevented this reduction.Moreover, pups that were prenatally exposed to LPS spent longer periods without calling their mothers, and posttreatment with zinc prevented this impairment induced by LPS to the same levels as controls. Prenatal LPS also increased BDNF levels in adult offspring, and posttreatment with zinc reduced the elevation of BDNF to the same levels as controls.Significance: BDNF hyperactivity was also found in several studies of autistic patients. Together with our previous studies, our model of prenatal LPS induced autistic-like behavioral, brain, and immune disturbances. This suggests that it is a valid rat model of autism. Prenatal zinc prevented reproductive, communication, and BDNF impairments.The present study revealed a potential beneficial effect of prenatal zinc administration for the prevention of autism with regard to the BDNF pathway.

  12. Technical guidelines for maintaining occupational exposures as low as practicable. Phase I. Summary of current practices

    International Nuclear Information System (INIS)

    Gilchrist, R.L.; Selby, J.M.; Wedlick, H.L.

    1978-08-01

    Reducing radiation exposures to as low as practicable is a principle that was first introduced in 1949. However, the recent controversy over the low-level effects of radiation has led the Department of Energy (DOE) to review its programs. One such review was conducted by the Pacific Northwest Laboratory to survey the implementation of the ALAP principle in the DOE laboratories. This report contains the results of that survey, performed in 18 major DOE installations. The DOE contractors were asked questions concerning the following eight major areas: management, operational health physics, design, dosimetry, instrumentation, training, risk/cost-benefit, and impact of the ALAP philosophy. The survey revealed several potential areas of concern, which are described in this report. These areas will be addressed in the forthcoming manual, A Guide to Reducing Radiation Exposures As Low As Practicable

  13. Current understanding of the toxicological risk posed to the fetus following maternal exposure to nanoparticles.

    Science.gov (United States)

    Zhang, Yanli; Wu, Junrong; Feng, Xiaoli; Wang, Ruolan; Chen, Aijie; Shao, Longquan

    2017-12-01

    With the broad use of nanotechnology, the number and variety of nanoparticles that humans can be exposed to has further increased. Consequently, there is growing concern about the potential effect of maternal exposure to various nanoparticles during pregnancy on a fetus. However, the nature of this risk is not fully known. Areas covered: In this review, materno-fetal transfer of nanoparticles through the placenta is described. Both prenatal and postnatal adverse effects, such as fetal resorption, malformation and injury to various organs in mice exposed to nanoparticles are reviewed. The potential mechanisms of toxicity are also discussed. Expert opinion: The toxicology and safe application of recently developed nanoparticles has attracted much attention in the past few years. Although many studies have demonstrated the toxicology of nanoparticles in various species, only a small number of studies have examined the effect on a fetus after maternal exposure to nanoparticles. This is particularly important, because the developing fetus is especially vulnerable to the toxic effects of nanoparticles during fetal development due to the unique physical stage of the fetus. Nanoparticles may directly or indirectly impair fetal development and growth after maternal exposure to nanoparticles.

  14. Neuraminidase inhibitors in the treatment and post exposure prevention of influenza

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2006-01-01

    and spread of the virus begin. Objective: The effectiveness of NI during treatment and post exposure prophylaxis (PEP of an influenza infection are analyzed from a medical and an economical perspective. The effectiveness of NI in seasonal prophylaxis is not investigated in this report. Safety aspects of the drugs are also discussed. Methods: The relevant literature was identified by a systematic, structured bibliographic data base review. In addition, a manual search of relevant journals was conducted. The structured electronic data base analysis was supported by DIMDI and comprised the bibliographic data bases MEDLINE, HealthStar, Current Contents/Clinical Medicine, EMBASE, DA-RA, Cochrane Library, CancerLit, as well as Dissertation Abstracts for the period between 1999 and September 2004. Pre-defined key words were linked by AND/OR operators. A manual search of the Cochrane register was conducted for the time period before September 1999. Relevant medical journals were also hand-searched from January to November 2004. Quantitative reviews, randomized, double-blind clinical trials (RCT, and cost-benefit-analyses were considered as relevant if they fulfilled predefined inclusion criteria. Results: As compared to placebo, NI shortened the median duration of symptoms by approximately one day in meta-analyses, when the drug was taken within 48 hours after the onset of symptoms. The symptom reduction for other subgroups (such as patients who are at-risk for complicated influenza courses was even greater. For children under twelve, however, this was not the case. However, the incidence of severe influenza courses which led to hospitalization or death was low in the controlled studies. Pooled analyses nevertheless showed a tendency of a possible benefit of NI with respect to the hospitalization rate. Regarding PEP in homes with one infected household member, the reviewed studies showed a prophylactic effect of inhaled Zanamivir and Oseltamivir if a person started

  15. The prevention of radiological accidents (how to avoid or minimize potential exposures)

    International Nuclear Information System (INIS)

    Touzet, Rodolfo E.

    2006-01-01

    A detailed analysis of 7 major accidents occurred in radiotherapy services in different countries is performed. Then a generic analysis of the causes is realized and finally the methodology used to prevent them effectively is described [es

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

    Science.gov (United States)

    Wherrett, Diane K

    2014-08-01

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

  17. Late-life suicide prevention strategies: current status and future directions.

    Science.gov (United States)

    Van Orden, Kim; Deming, Charlene

    2017-09-08

    Late life suicide prevention differs from suicide prevention for other age groups: first, the number of older adults worldwide is on the rise; second, late-life suicide receives much less attention in all societal spheres, from the media, to federal funding agencies, to healthcare initiatives. Recent findings indicate an association between internalized ageist stereotypes and reduced will to live. Recent research also addresses the role of cognitive control as a contributor to risk and as an intervention target (e.g., through psychotherapies such as problem solving therapy) as well as firearm safety as a promising, though a politicized and challenging strategy to implement. Another strategy that may prove feasible is an approach on upstream prevention strategies in healthcare. One strategy we believe holds great promise is the promotion of high quality geriatric medicine. Geriatricians are trained to work with patients to prioritize the promotion of physical and cognitive functioning (rather than solely absence of disease) and to focus on well-being as a goal. Thus, geriatricians routinely target numerous late-life suicide risk factors-physical illness, functioning, pain, and (dis)satisfaction with life. However, efficacious strategies will not prevent suicide deaths if they are not implemented-addressing ageism as a universal prevention strategy is essential. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Preventive effect of curcumin and its highly bioavailable preparation on hearing loss induced by single or repeated exposure to noise: A comparative and mechanistic study

    Directory of Open Access Journals (Sweden)

    Taro Yamaguchi

    2017-08-01

    Full Text Available We sought to determine the preventive effects of curcumin and its highly bioavailable preparation on noise-induced hearing loss in a novel murine model of permanent hearing loss developed by repeated exposure to noise. Upon exposure to noise (8-kHz octave band noise, 90 dB sound pressure level, 1 h, hearing ability was impaired in a temporary and reversible manner. During repeated noise exposure (1-h exposure per day, 5 days, there was a progressive increase in the auditory threshold shift at 12 and 20 kHz. The threshold shift persisted for at least 6 days after noise exposure. Oral administration of curcumin for 3 days before and each day during noise exposure significantly alleviated the hearing loss induced by repeated noise exposure. Curcumin abolished intranuclear translocation of nuclear factor-κB-p65 and generation of 4-hydroxynonenal-adducted proteins found in the cochlea after noise exposure. Theracurmin®, a highly absorbable and bioavailable preparation of curcumin, had strong preventive effects on hearing loss induced by repeated noise exposure. Together, these data suggest that curcumin exerts a preventive effect on noise-induced hearing loss and is therefore a good therapeutic candidate for preventing sensorineural hearing loss.

  19. Preventive effect of curcumin and its highly bioavailable preparation on hearing loss induced by single or repeated exposure to noise: A comparative and mechanistic study.

    Science.gov (United States)

    Yamaguchi, Taro; Yoneyama, Masanori; Onaka, Yusuke; Imaizumi, Atsushi; Ogita, Kiyokazu

    2017-08-01

    We sought to determine the preventive effects of curcumin and its highly bioavailable preparation on noise-induced hearing loss in a novel murine model of permanent hearing loss developed by repeated exposure to noise. Upon exposure to noise (8-kHz octave band noise, 90 dB sound pressure level, 1 h), hearing ability was impaired in a temporary and reversible manner. During repeated noise exposure (1-h exposure per day, 5 days), there was a progressive increase in the auditory threshold shift at 12 and 20 kHz. The threshold shift persisted for at least 6 days after noise exposure. Oral administration of curcumin for 3 days before and each day during noise exposure significantly alleviated the hearing loss induced by repeated noise exposure. Curcumin abolished intranuclear translocation of nuclear factor-κB-p65 and generation of 4-hydroxynonenal-adducted proteins found in the cochlea after noise exposure. Theracurmin ® , a highly absorbable and bioavailable preparation of curcumin, had strong preventive effects on hearing loss induced by repeated noise exposure. Together, these data suggest that curcumin exerts a preventive effect on noise-induced hearing loss and is therefore a good therapeutic candidate for preventing sensorineural hearing loss. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  20. Attributable causes of cancer in Japan in 2005--systematic assessment to estimate current burden of cancer attributable to known preventable risk factors in Japan.

    Science.gov (United States)

    Inoue, M; Sawada, N; Matsuda, T; Iwasaki, M; Sasazuki, S; Shimazu, T; Shibuya, K; Tsugane, S

    2012-05-01

    To contribute to evidence-based policy decision making for national cancer control, we conducted a systematic assessment to estimate the current burden of cancer attributable to known preventable risk factors in Japan in 2005. We first estimated the population attributable fractions (PAFs) of each cancer attributable to known risk factors from relative risks derived primarily from Japanese pooled analyses and large-scale cohort studies and the prevalence of exposure in the period around 1990. Using nationwide vital statistics records and incidence estimates, we then estimated the attributable cancer incidence and mortality in 2005. In 2005, ≈ 55% of cancer among men was attributable to preventable risk factors in Japan. The corresponding figure was lower among women, but preventable risk factors still accounted for nearly 30% of cancer. In men, tobacco smoking had the highest PAF (30% for incidence and 35% for mortality, respectively) followed by infectious agents (23% and 23%). In women, in contrast, infectious agents had the highest PAF (18% and 19% for incidence and mortality, respectively) followed by tobacco smoking (6% and 8%). In Japan, tobacco smoking and infections are major causes of cancer. Further control of these factors will contribute to substantial reductions in cancer incidence and mortality in Japan.

  1. Occupational Hepatitis B Exposure: A Peek into Indian Dental Students’ Knowledge, Opinion, and Preventive Practices

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2015-01-01

    Full Text Available Objective. To determine the level of knowledge, opinions, and preventive practices followed by dental students against Hepatitis B. The study also explored if any correlation existed between knowledge, opinion, and preventive practices score. Materials and Methods. A cross-sectional study was conducted in a dental teaching institution. The subjects comprised 216 dental students. The study was conducted using a pretested, self-administered questionnaire. The questionnaire was prepared to assess knowledge, opinion, and preventive practices against Hepatitis B. Kruskal-Wallis and Kendall Tau test were performed. Results. The study found that only 44.4% of the students were vaccinated with Hepatitis B vaccine. 59.3% of the students reported washing their hands after contact with patient’s body fluids. 63.9% used personal protective measures like facemask, aprons, head cap, eye shields, and so forth, while treating patients. Median knowledge, opinion, and practice scores were found to be 5.00, 3.00, and 3.00, respectively. Significant correlation was obtained between knowledge and preventive practices score (r=0.385, p value <0.0001. Conclusion. Effective measures need to be taken to improve preventive practices of the students to prevent them from risk of Hepatitis transmission. Mandatory vaccination against Hepatitis B needs to be implemented.

  2. Reducing tobacco smoking and smoke exposure to prevent preterm birth and its complications.

    Science.gov (United States)

    Wagijo, Mary-Ann; Sheikh, Aziz; Duijts, Liesbeth; Been, Jasper V

    2017-03-01

    Tobacco smoking and smoke exposure during pregnancy are associated with a range of adverse health outcomes, including preterm birth. Also, children born preterm have a higher risk of complications including bronchopulmonary dysplasia and asthma when their mothers smoked during pregnancy. Smoking cessation in early pregnancy can help reduce the adverse impact on offspring health. Counselling interventions are effective in promoting smoking cessation and reducing the incidence of preterm birth. Peer support and incentive-based approaches are likely to be of additional benefit, whereas the effectiveness of pharmacological interventions, including nicotine replacement therapy, has not definitely been established. Smoke-free legislation can help reduce smoke exposure as well as maternal smoking rates at a population level, and is associated with a reduction in preterm birth. Helping future mothers to stop smoking and protect their children from second hand smoke exposure must be a key priority for health care workers and policy makers alike. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Approach to the current state of work harassment prevention in Colombia

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Dávila Londoño

    2015-12-01

    Full Text Available Mobbing or harassment is now recognized as a phenomenon of high impact on individuals, organizations and society. In Latin America, and specifically in Colombia, has been identified little development of thematic; this is a weakness against the possibilities to know, identify and intervene on this reality, growing in organizations. The objective of this paper is to present the results of theoretical analysis and review of prevention of mobbing in Colombia. The paper is divided into four parts. In the first, the main theoretical elements of the discussion about mobbing are synthesized. In the second, reviewed the legislation on mobbing in Colombia, and that the state has responsibilities for the identification, assessment, prevention and intervention of psychosocial risk factors at work. In a third part, presents and analyzes some measures and procedures existing prevention and intervention. Finally conclusions of the review are presented.

  4. Gene–Environment Interactions in Preventive Medicine: Current Status and Expectations for the Future

    Directory of Open Access Journals (Sweden)

    Hiroto Narimatsu

    2017-01-01

    Full Text Available The progression of many common disorders involves a complex interplay of multiple factors, including numerous different genes and environmental factors. Gene–environmental cohort studies focus on the identification of risk factors that cannot be discovered by conventional epidemiological methodologies. Such epidemiological methodologies preclude precise predictions, because the exact risk factors can be revealed only after detailed analyses of the interactions among multiple factors, that is, between genes and environmental factors. To date, these cohort studies have reported some promising results. However, the findings do not yet have sufficient clinical significance for the development of precise, personalized preventive medicine. Especially, some promising preliminary studies have been conducted in terms of the prevention of obesity. Large-scale validation studies of those preliminary studies, using a prospective cohort design and long follow-ups, will produce useful and practical evidence for the development of preventive medicine in the future.

  5. Exercise Prevents Memory Impairment Induced by Arsenic Exposure in Mice: Implication of Hippocampal BDNF and CREB

    OpenAIRE

    Sun, Bao-Fei; Wang, Qing-Qing; Yu, Zi-Jiang; Yu, Yan; Xiao, Chao-Lun; Kang, Chao-Sheng; Ge, Guo; Linghu, Yan; Zhu, Jun-De; Li, Yu-Mei; Li, Qiang-Ming; Luo, Shi-Peng; Yang, Dang; Li, Lin; Zhang, Wen-Yan

    2015-01-01

    High concentrations of arsenic, which can be occasionally found in drinking water, have been recognized as a global health problem. Exposure to arsenic can disrupt spatial memory; however, the underlying mechanism remains unclear. In the present study, we tested whether exercise could interfere with the effect of arsenic exposure on the long-term memory (LTM) of object recognition in mice. Arsenic (0, 1, 3, and 10 mg/ kg, i.g.) was administered daily for 12 weeks. We found that arsenic at dos...

  6. Educating women for HIV prevention: does exposure to mass media make them more knowledgeable?

    Science.gov (United States)

    Jesmin, Syeda S; Chaudhuri, Sanjukta; Abdullah, Shahnaz

    2013-01-01

    Mass media is an important vehicle for health promotion in developing countries. In Bangladesh multiple media campaigns are being carried out to educate people about HIV/AIDS. We examined the extent of HIV/AIDS knowledge and the association of exposure to mass media among women in Bangladesh. The Bangladesh Demographic and Health Survey (BDHS) provides data for this article. We found that media exposure (combined index of television, radio, and newspaper) was a highly significant predictor of women's knowledge about HIV and AIDS. Other significant predictors of HIV knowledge include women's education, age, employment, and urban residence.

  7. Current strategies for preventing renal dysfunction in patients with heart failure: a heart failure stage approach

    Science.gov (United States)

    Issa, Victor Sarli; Andrade, Lúcia; Bocchi, Edimar Alcides

    2013-01-01

    Renal dysfunction is common during episodes of acute decompensated heart failure, and historical data indicate that the mean creatinine level at admission has risen in recent decades. Different mechanisms underlying this change over time have been proposed, such as demographic changes, hemodynamic and neurohumoral derangements and medical interventions. In this setting, various strategies have been proposed for the prevention of renal dysfunction with heterogeneous results. In the present article, we review and discuss the main aspects of renal dysfunction prevention according to the different stages of heart failure. PMID:23644863

  8. PrEP Whores and HIV Prevention: The Queer Communication of HIV Pre-Exposure Prophylaxis (PrEP).

    Science.gov (United States)

    Spieldenner, Andrew

    2016-12-01

    HIV pre-exposure prophylaxis (PrEP) has been introduced as another biomedical tool in HIV prevention. Whereas other such tools-including post-exposure prophylaxis (PEP) and interruption of perinatal transmission-have been embraced by those impacted by HIV, PrEP has been met with more conflict, especially within the gay community and HIV organizations. The "PrEP whore" has come to designate the social value and personal practices of those taking PrEP. This study examines the "PrEP whore" discourse by using queer theory and quare theory. Within these theoretical vantage points, the study explicates four discursive areas: slut shaming, dirty/clean binaries, mourning the loss of condoms, and reclaiming the inner whore. The study illuminates possible discursive strategies that lie outside of the domains of public health and within the individual and community.

  9. Current knowledge of environmental exposure in children during the sensitive developmental periods

    Directory of Open Access Journals (Sweden)

    Norma Helena Perlroth

    2017-01-01

    Conclusion: To identify the causes and understand the mechanisms involved in the genesis of these diseases is a challenge for science, as there is still a lack of knowledge on children's susceptibility to many environmental contaminants. Prevention policies and more research on child environmental health, improving the recording and surveillance of environmental risks to children's health, should be an ongoing priority in the public health field.

  10. Dietary exposures and allergy prevention in high-risk infants: a joint position statement of the Canadian Society of Allergy and Clinical Immunology and the Canadian Paediatric Society.

    Science.gov (United States)

    Chan, Edmond S; Cummings, Carl; Atkinson, Adelle; Chad, Zave; Francoeur, Marie-Josée; Kirste, Linda; Mack, Douglas; Primeau, Marie-Noël; Vander Leek, Timothy K; Watson, Wade Ta

    2014-01-01

    Allergic conditions in children are a prevalent health concern in Canada. The burden of disease and the societal costs of proper diagnosis and management are considerable, making the primary prevention of allergic conditions a desirable health care objective. This position statement reviews current evidence on dietary exposures and allergy prevention in infants at high risk of developing allergic conditions. It revisits previous dietary recommendations for pregnancy, breastfeeding and formula-feeding, and provides an approach for introducing solid foods to high-risk infants. While there is no evidence that delaying the introduction of any specific food beyond six months of age helps to prevent allergy, the protective effect of early introduction of potentially allergenic foods (at four to six months) remains under investigation. Recent research appears to suggest that regularly ingesting a new, potentially allergenic food may be as important as when that food is first introduced. This article has already been published (Paediatr Child Health. 2013 Dec;18(10):545-54), and is being re-published with permission from the original publisher, the Canadian Paediatric Society.

  11. Marijuana advertising exposure among current marijuana users in the U.S.

    Science.gov (United States)

    Krauss, Melissa J; Sowles, Shaina J; Sehi, Auriann; Spitznagel, Edward L; Berg, Carla J; Bierut, Laura J; Cavazos-Rehg, Patricia A

    2017-05-01

    Little is known about marijuana advertising exposure among users in the U.S. We examined the prevalence of advertising exposure among young adult marijuana users through traditional and new media, and identified characteristics associated with seeking advertisements. We conducted a cross-sectional survey of 18-34 year-old past-month marijuana users in the U.S. using a pre-existing online panel (N=742). The survey queried about passively viewing and actively seeking marijuana advertisements in the past month, sources of advertisements, and marijuana use characteristics. Over half of participants were exposed to marijuana advertising in the past month (28% passively observed advertisements, 26% actively sought advertisements). Common sources for observing advertisements were digital media (i.e., social media, online, text/emails; 77%). Similarly, those actively seeking advertisements often used Internet search engines (65%) and social media (53%). Seeking advertisements was more common among those who used medically (41% medical only, 36% medical and recreational) than recreational users (18%), who used concentrates or edibles (44% and 43%) compared to those who did not (20% and 19%), and who used multiple times per day (33%) compared to those who did not (19%) (all padvertising among users is common, especially via digital media, and is associated with medical use, heavier use, and use of novel products with higher THC concentrations (i.e., concentrates) or longer intoxication duration (i.e., edibles). As the U.S. marijuana policy landscape changes, it will be important to examine potential causal associations between advertising exposure and continuation or frequency/quantity of use. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries

    DEFF Research Database (Denmark)

    Twetman, Svante; Dhar, Vineet

    2015-01-01

    PURPOSE: The purpose of this paper was to systematically review the quality of evidence related to self-applied and professionally applied fluorides, antimicrobial agents, fissure sealants, temporary restorations, and restorative care for the prevention and management of early childhood caries (E...

  13. Crime Prevention and Criminological Theories: Three Issues for the Current Time

    Directory of Open Access Journals (Sweden)

    Emilio Jorge Ayos

    2014-06-01

    Full Text Available Any crime prevention strategy implies, explicitly or implicitly, the question about what crime is, the causes of it and how to avert it. In this paper we will focus on set, thru criminological theories, the “concepts” that have been renewal to build different answers to such questions, particularly on crime prevention’s policies in contemporary Argentina. We suggest three axes: first, the criminal positivist sociology of Enrico Ferri, particularly his idea of “ penalties equivalent,”; second, the discussion about crime prevention in the “Chicago School”, specially on Thrasher Frederich’s work; and finally, “multi-agency intervention” idea of the left realist criminology, especially Jock Young, Roger Matthews and John Lea. Such productions have in common the fact that the three have specifically discussed the issue of “crime prevention” on their work. The selection criteria and comparison axis emerges from a broader investigation, which aimed to analyze the modes of way that the association between crime and living conditions is addressed on the social crime prevention policies in Argentina, during the first decade of the new century. Three comparatives dimensions were analyzed: the way social policies appears on crime prevention strategies; the ways the target populations are delimited; and last, the ways the intervention territories are defined, building an specific idea of territory.

  14. Preventive measures against concrete damage to ASR in the Netherlands current state-of-affairs

    NARCIS (Netherlands)

    Heijnen, W.M.M.; Larbi, J.A.

    1999-01-01

    In CUR-Recommendation 38, various vital measures that need to be taken during design of new concrete-mixtures in order to prevent damage due to ASR in the concrete have been outlined. The most important of these measures are: - the use of blast furnace slag cement (with a high slag content: ≥50% by

  15. A randomized controlled Alzheimer's disease prevention trial's evolution into an exposure trial: the PREADViSE Trial.

    Science.gov (United States)

    Kryscio, R J; Abner, E L; Schmitt, F A; Goodman, P J; Mendiondo, M; Caban-Holt, A; Dennis, B C; Mathews, M; Klein, E A; Crowley, J J

    2013-01-01

    To summarize the ongoing prevention of Alzheimer's disease (AD) by vitamin E and selenium (PREADViSE) trial as an ancillary study to SELECT (a large prostate cancer prevention trial) and to present the blinded results of the first year as an exposure study. PREADViSE was designed as a double blind randomized controlled trial (RCT). SELECT terminated after median of 5.5 years of exposure to supplements due to a futility analysis. Both trials then converted into an exposure study. In the randomized component PREADViSE enrolled 7,547 men age 62 or older (60 if African American). Once the trial terminated 4,246 of these men volunteered for the exposure study. Demographics were similar for both groups with exposure volunteers having baseline mean age 67.3 ± 5.2 years, 15.3 ± 2.4 years of education, 9.8% African Americans, and 22.0% reporting a family history of dementia. In the RCT men were randomly assigned to either daily doses of 400 IU of vitamin E or placebo and 200 µg of selenium or placebo using a 2x2 factorial structure. In the RCT, participants completed the memory impairment screen (MIS), and if they failed, underwent a longer screening (based on an expanded Consortium to Establish a Registry in AD [CERAD] battery). CERAD failure resulted in visits to their clinician for medical examination with records of these examinations forwarded to the PREADViSE center for further review. In the exposure study, men are contacted by telephone and complete the telephone version of the memory impairment screen (MIS-T) screen. If they fail the MIS-T, a modified telephone interview of cognitive status (TICS-M) exam is given. A failed TICS-M exam also leads to a visit to their clinician for an in-depth examination and forwarding of records for a centralized consensus diagnosis by expert clinicians. A subgroup of the men who pass the MIS-T also take the TICS-M exam for validation purposes. While this ancillary trial was open to all 427 SELECT clinical sites, only 130 (30

  16. The promise of pre-exposure prophylaxis with antiretroviral drugs to prevent HIV transmission: a review

    NARCIS (Netherlands)

    Hankins, Catherine A.; Dybul, Mark R.

    2013-01-01

    Public health experts are wrestling with how to translate recent scientific findings from pre-exposure prophylaxis (PrEP) effectiveness trials into real-world programmes. This review summarizes clinical trial findings on oral and topical PrEP, discusses how decision-makers can evaluate the place of

  17. Ethical Implications of Social Stigma Associated with the Promotion and Use of Pre-Exposure Prophylaxis for HIV Prevention.

    Science.gov (United States)

    Herron, Patrick D

    2016-04-01

    Identifying sources of and eliminating social stigma associated with the promotion and use of pre-exposure prophylaxis (PrEP) for the prevention of sexually acquired HIV infection among men who have sex with men (MSM) is both a moral imperative and necessary requirement to ensure that public health objectives of HIV prevention can be met. This article will examine and address ethical concerns and criticisms regarding the use of PrEP, barriers to its promotion, and use among MSM and examine the types of social stigma associated with PrEP. An ethical justification for both healthcare and LGBT communities to address and overcome social stigma regarding the use of PrEP among MSM is offered.

  18. Short-term, daily exposure to cold temperature may be an efficient way to prevent muscle atrophy and bone loss in a microgravity environment

    Science.gov (United States)

    Deng, Claudia; Wang, Ping; Zhang, Xiangming; Wang, Ya

    2015-04-01

    Microgravity induces less pressure on muscle/bone, which is a major reason for muscle atrophy as well as bone loss. Currently, physical exercise is the only countermeasure used consistently in the U.S. human space program to counteract the microgravity-induced skeletal muscle atrophy and bone loss. However, the routinely almost daily time commitment is significant and represents a potential risk to the accomplishment of other mission operational tasks. Therefore, development of more efficient exercise programs (with less time) to prevent astronauts from muscle atrophy and bone loss are needed. Consider the two types of muscle contraction: exercising forces muscle contraction and prevents microgravity-induced muscle atrophy/bone loss, which is a voluntary response through the motor nervous system; and cold temperature exposure-induced muscle contraction is an involuntary response through the vegetative nervous system, we formed a new hypothesis. The main purpose of this pilot study was to test our hypothesis that exercise at 4 °C is more efficient than at room temperature to prevent microgravity-induced muscle atrophy/bone loss and, consequently reduces physical exercise time. Twenty mice were divided into two groups with or without daily short-term (10 min × 2, at 12 h interval) cold temperature (4 °C) exposure for 30 days. The whole bodyweight, muscle strength and bone density were measured after terminating the experiments. The results from the one-month pilot study support our hypothesis and suggest that it would be reasonable to use more mice, in a microgravity environment and observe for a longer period to obtain a conclusion. We believe that the results from such a study will help to develop efficient exercise, which will finally benefit astronauts' heath and NASA's missions.

  19. The association between alcohol exposure and self-reported health status: the effect of separating former and current drinkers.

    Directory of Open Access Journals (Sweden)

    Wenbin Liang

    Full Text Available To investigate the direction and degree of potential bias introducedto analyses of drinking and health status which exclude former drinkers from exposure groups.Pooled analysis of 14 waves (1997-2010 of the U.S. National Health Interview Survey (NHIS.General population-based study.404,462 participants, from 14 waves of the NHIS, who had knownself-reported health status and alcohol consumption status.Self-reported health status was used as the indicatorof health. Two approaches were used to classify alcohol consumption: (i separation of former drinkers and current drinkers, and (ii combined former and current drinkers. The prevalence of fair/poor health by alcohol use, gender and age with 95% confidence intervals was estimated. The difference in prevalence of fair/poor health status for lifetime abstainers, former drinkers, current drinkers and drinkers (former drinkers and current drinkers combined were compared using Poisson regression with robust estimations of variance.Excluding former drinkers from drinker groups exaggerates the difference in health status between abstainers and drinkers, especially for males.In cohort study analyses, former drinkers should be assigned to a drinking category based on their previous alcohol consumption patterns and not treated as a discrete exposure group.

  20. Human Embryonic Stem Cell Responses to Ionizing Radiation Exposures: Current State of Knowledge and Future Challenges

    Directory of Open Access Journals (Sweden)

    Mykyta V. Sokolov

    2012-01-01

    Full Text Available Human embryonic stem cells, which are derived from the inner cell mass of the blastocyst, have become an object of intense study over the last decade. They possess two unique properties that distinguish them from many other cell types: (i the ability to self-renew indefinitely in culture under permissive conditions, and (ii the pluripotency, defined as the capability of giving rise to all cell types of embryonic lineage under the guidance of the appropriate developmental cues. The focus of many recent efforts has been on the elucidating the signaling pathways and molecular networks operating in human embryonic stem cells. These cells hold great promise in cell-based regenerative therapies, disease modeling, drug screening and testing, assessing genotoxic and mutagenic risks associated with exposures to a variety of environmental factors, and so forth. Ionizing radiation is ubiquitous in nature, and it is widely used in diagnostic and therapeutic procedures in medicine. In this paper, our goal is to summarize the recent progress in understanding how human embryonic stem cells respond to ionizing radiation exposures, using novel methodologies based on “omics” approaches, and to provide a critical discussion of what remains unknown; thus proposing a roadmap for the future research in this area.

  1. VRdose: an exposure dose evaluation system based on virtual reality technology - current status and future possibilities

    International Nuclear Information System (INIS)

    Iguchi, Yukihiro; Louka, Michael; Johnsen, Terje

    2004-01-01

    The Fugen Nuclear Power Station (NPS) was shut down permanently in March 2003, and preparatory activities are underway to decommission the Fugen NPS. It is necessary to accomplish the decommissioning economically and rationally by optimizing the workload, exposure dose and waste mass. This is important at the planning stage of the decommissioning. Virtual reality (VR) technology may prove beneficial to this process with regard to minimizing the workers' radiation exposure as well as contributing towards achieving efficient use of manpower. It could also be a valuable tool in the actual dismantling phase. In addition to this, VR provides an effective medium in presentations for public acceptance as well as for communication with relevant engineers. The VRdose project conducted by Japan Nuclear Cycle Development Institute (JNC) and Halden Virtual Reality Centre is doing research and development of VR technology for use in the decommissioning process at the Fugen NPS. This is technically an extensive project, touching on many of the present challenges in the VR area such as visual simulation and animation, interaction with objects in a virtual environment and scenario generation and optimisation. This paper describes the present status and future of the system. (Author)

  2. Prevention of pin tract infection in external stainless steel fixator frames using electric current in a goat model.

    Science.gov (United States)

    van der Borden, Arnout J; Maathuis, Patrick G M; Engels, Eefje; Rakhorst, Gerhard; van der Mei, Henny C; Busscher, Henk J; Sharma, Prashant Kumar

    2007-04-01

    Pin tract infections of external fixators used in orthopaedic reconstructive bone surgery are serious complications that can eventually lead to periostitis and osteomyelitis. In vitro experiments have demonstrated that bacteria adhering to stainless steel in a biofilm mode of growth detach under the influence of small electric currents, while remaining bacteria become less viable upon current application. Therefore, we have investigated whether a 100microA electric current can prevent signs of clinical infection around percutaneous pins, implanted in the tibia of goats. Three pins were inserted into the lateral right tibia of nine goats, of which one served for additional frame support. Two pins were infected with a Staphylococcus epidermidis strain of which one pin was subjected to electric current, while the other pin was used as control. Pin sites were examined daily. The wound electrical resistance decreased with worsening of the infection from a dry condition to a purulent stage. After 21 days, animals were sacrificed and the pins taken out. Infection developed in 89% of the control pin sites, whereas only 11% of the pin sites in the current group showed infection. These results show that infection of percutaneous pin sites of external fixators in reconstructive bone surgery can be prevented by the application of a small DC electric current.

  3. Exposure of Bacterial Biofilms to Electrical Current Leads to Cell Death Mediated in Part by Reactive Oxygen Species.

    Science.gov (United States)

    Brinkman, Cassandra L; Schmidt-Malan, Suzannah M; Karau, Melissa J; Greenwood-Quaintance, Kerryl; Hassett, Daniel J; Mandrekar, Jayawant N; Patel, Robin

    2016-01-01

    Bacterial biofilms may form on indwelling medical devices such as prosthetic joints, heart valves and catheters, causing challenging-to-treat infections. We have previously described the 'electricidal effect', in which bacterial biofilms are decreased following exposure to direct electrical current. Herein, we sought to determine if the decreased bacterial quantities are due to detachment of biofilms or cell death and to investigate the role that reactive oxygen species (ROS) play in the observed effect. Using confocal and electron microscopy and flow cytometry, we found that direct current (DC) leads to cell death and changes in the architecture of biofilms formed by Gram-positive and Gram-negative bacteria. Reactive oxygen species (ROS) appear to play a role in DC-associated cell death, as there was an increase in ROS-production by Staphylococcus aureus and Staphylococcus epidermidis biofilms following exposure to DC. An increase in the production of ROS response enzymes catalase and superoxide dismutase (SOD) was observed for S. aureus, S. epidermidis and Pseudomonas aeruginosa biofilms following exposure to DC. Additionally, biofilms were protected from cell death when supplemented with antioxidants and oxidant scavengers, including catalase, mannitol and Tempol. Knocking out SOD (sodAB) in P. aeruginosa led to an enhanced DC effect. Microarray analysis of P. aeruginosa PAO1 showed transcriptional changes in genes related to the stress response and cell death. In conclusion, the electricidal effect results in death of bacteria in biofilms, mediated, at least in part, by production of ROS.

  4. Prevention and treatment of vitamin D deficiency in Dutch psychogeriatric nursing home residents by weekly half-body UVB exposure after showering: a pilot study

    NARCIS (Netherlands)

    Chel, V.G.M.; Ooms, M.E.; Pavel, S.; de Gruijl, F.; Brand, A.; Lips, P.T.A.M.

    2011-01-01

    Background: in older people, induction of cutaneous vitamin D production by ultraviolet B (UVB) exposure may be preferable to oral supplementation: it cannot cause toxic levels, it helps to prevent polypharmacy and, moreover, there are indications that UVB exposure has beneficial effects on health

  5. Ionizing radiation exposure in interventional cardiology: current radiation protection practice of invasive cardiology operators in Lithuania.

    Science.gov (United States)

    Valuckiene, Zivile; Jurenas, Martynas; Cibulskaite, Inga

    2016-09-01

    Ionizing radiation management is among the most important safety issues in interventional cardiology. Multiple radiation protection measures allow the minimization of x-ray exposure during interventional procedures. Our purpose was to assess the utilization and effectiveness of radiation protection and optimization techniques among interventional cardiologists in Lithuania. Interventional cardiologists of five cardiac centres were interviewed by anonymized questionnaire, addressing personal use of protective garments, shielding, table/detector positioning, frame rate (FR), resolution, field of view adjustment and collimation. Effective patient doses were compared between operators who work with and without x-ray optimization. Thirty one (68.9%) out of 45 Lithuanian interventional cardiologists participated in the survey. Protective aprons were universally used, but not the thyroid collars; 35.5% (n  =  11) operators use protective eyewear and 12.9% (n  =  4) wear radio-protective caps; 83.9% (n  =  26) use overhanging shields, 58.1% (n  =  18)-portable barriers; 12.9% (n  =  4)-abdominal patient's shielding; 35.5% (n  =  11) work at a high table position; 87.1% (n  =  27) keep an image intensifier/receiver close to the patient; 58.1% (n  =  18) reduce the fluoroscopy FR; 6.5% (n  =  2) reduce the fluoro image detail resolution; 83.9% (n  =  26) use a 'store fluoro' option; 41.9% (N  =  13) reduce magnification for catheter transit; 51.6% (n  =  16) limit image magnification; and 35.5% (n  =  11) use image collimation. Median effective patient doses were significantly lower with x-ray optimization techniques in both diagnostic and therapeutic interventions. Many of the ionizing radiation exposure reduction tools and techniques are underused by a considerable proportion of interventional cardiology operators. The application of basic radiation protection tools and

  6. Current and Ongoing Internet Crime Tendencies and Techniques. Preventive Legislation Measures in Romania

    Directory of Open Access Journals (Sweden)

    Florin Postolache

    2010-06-01

    Full Text Available Internet crime techniques that pilfer from victims millions each year continue to plague the Internet through a range of methods. Trends and techniques identified by many organizations along with itsdescription are followed by preventative measures that will support you in being informed prior to entering into dealings and transactions over the Internet. Techniques as Auction Fraud, Counterfeit Cashier's Check, Credit Card Fraud, Debt Elimination, Parcel Courier Email Scheme, Employment/Business Opportunities,Escrow Services Fraud, Identity Theft, Internet Extortion, Investment Fraud, Lotteries, Nigerian Letter or "419", Phishing/Spoofing, Ponzi/Pyramid, Reshipping, Spam, Third Party Receiver of Funds are clarified in this paper and, also the internet crime prevention and legislative measures are treated, too.

  7. Tenon advancement and duplication technique to prevent postoperative Ahmed valve tube exposure in patients with refractory glaucoma.

    Science.gov (United States)

    Tamcelik, Nevbahar; Ozkok, Ahmet; Sarıcı, Ahmet Murat; Atalay, Eray; Yetik, Huseyin; Gungor, Kivanc

    2013-07-01

    To present and compare the long-term results of Dr. Tamcelik's previously described technique of Tenon advancement and duplication with the conventional Ahmed glaucoma valve (AGV) implantation technique in patients with refractory glaucoma. This study was a multicenter, retrospective case series that included 303 eyes of 276 patients with refractory glaucoma who underwent glaucoma valve implantation surgery. The patients were divided into three groups according to the surgical technique applied and the outcomes compared. In group 1, 96 eyes of 86 patients underwent AGV implant surgery without patch graft; in group 2, 78 eyes of 72 patients underwent AGV implant surgery with donor scleral patch; in group 3, 129 eyes of 118 patients underwent Ahmed valve implant surgery with "combined short scleral tunnel with Tenon advancement and duplication technique". The endpoint assessed was tube exposure through the conjunctiva. In group 1, conjunctival tube exposure was seen in 11 eyes (12.9 %) after a mean 9.2 ± 3.7 years of follow-up. In group 2, conjunctival tube exposure was seen in six eyes (2.2 %) after a mean 8.9 ± 3.3 years of follow-up. In group 3, there was no conjunctival exposure after a mean 7.8 ± 2.8 years of follow-up. The difference between the groups was statistically significant. (P = 0.0001, Chi-square test). This novel surgical technique combining a short scleral tunnel with Tenon advancement and duplication was found to be effective and safe to prevent conjunctival tube exposure after AGV implantation surgery in patients with refractory glaucoma.

  8. NONINVASIVE NASAL MUCOSA EXPOSURE TO TREAT AND PREVENT RHINITIS AND RHINOSINUSITIS OF VARIOUS GENESIS

    Directory of Open Access Journals (Sweden)

    E. Yu. Radtsig

    2014-07-01

    Full Text Available The paper deals with the evaluation of the nasal mucosa in health and in different abnormalities. It describes the possibilities of using drugs of different groups to relieve symptoms in nasal mucosal and paranasal sinus abnormalities of different genesis, as well as the preventive effect of some of these drugs.

  9. Rethinking HIV-prevention for school-going young people based on current behaviour patterns.

    Science.gov (United States)

    Visser, Maretha

    2017-12-01

    The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5-12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8-12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices.

  10. Getting sports injury prevention on to public health agendas - addressing the shortfalls in current information sources.

    Science.gov (United States)

    Finch, Caroline F

    2012-01-01

    Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantification of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

  11. Rethinking HIV-prevention for school-going young people based on current behaviour patterns

    Science.gov (United States)

    Visser, Maretha

    2017-01-01

    Abstract The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5–12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8–12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices. PMID:28934898

  12. Male circumcision and HIV prevention: current knowledge and future research directions.

    Science.gov (United States)

    Bailey, R C; Plummer, F A; Moses, S

    2001-11-01

    Over the past decade, numerous epidemiological studies have reported a significant association between lack of male circumcision and risk for HIV infection, leading to recommendations for male circumcision to be added to the armamentarium of effective HIV prevention strategies. We review the epidemiological data from studies that have investigated this association, including ecological, cross-sectional/case-control, and prospective studies. We discuss problematic issues in interpreting the epidemiological data, including the presence of other sexually transmitted infections, age of circumcision, and potential confounders such as religion, cultural practices, and genital hygiene. In addition, we review studies of biological mechanisms by which the presence of the foreskin may increase HIV susceptibility, data on risks associated with the circumcision procedure, and available data on the acceptability and feasibility of introducing male circumcision in societies where it is traditionally not practised. Although the evidence in support of male circumcision as an effective HIV prevention measure is compelling, residual confounding in observational studies cannot be excluded. Taken together with concerns over the potential disinhibiting effect of male circumcision on risk behaviour, and safety of the circumcision procedure, randomised trials of male circumcision to prevent HIV infection are recommended. An individual's choice to undergo male circumcision or a community's decision to promote the practice should be made in the light of the best available scientific evidence. More knowledge is required to assist individuals and communities in making those decisions. We conclude with recommendations for future research.

  13. Are current health behavioral change models helpful in guiding prevention of weight gain efforts?

    Science.gov (United States)

    Baranowski, Tom; Cullen, Karen W; Nicklas, Theresa; Thompson, Deborah; Baranowski, Janice

    2003-10-01

    Effective procedures are needed to prevent the substantial increases in adiposity that have been occurring among children and adults. Behavioral change may occur as a result of changes in variables that mediate interventions. These mediating variables have typically come from the theories or models used to understand behavior. Seven categories of theories and models are reviewed to define the concepts and to identify the motivational mechanism(s), the resources that a person needs for change, the processes by which behavioral change is likely to occur, and the procedures necessary to promote change. Although each model has something to offer obesity prevention, the early promise can be achieved only with substantial additional research in which these models are applied to diet and physical activity in regard to obesity. The most promising avenues for such research seem to be using the latest variants of the Theory of Planned Behavior and Social Ecology. Synergy may be achieved by taking the most promising concepts from each model and integrating them for use with specific populations. Biology-based steps in an eating or physical activity event are identified, and research issues are suggested to integrate behavioral and biological approaches to understanding eating and physical activity behaviors. Social marketing procedures have much to offer in terms of organizing and strategizing behavioral change programs to incorporate these theoretical ideas. More research is needed to assess the true potential for these models to contribute to our understanding of obesity-related diet and physical activity practices, and in turn, to obesity prevention.

  14. Current Perspectives on Prevention of Mother-to-Child Transmission of Syphilis

    Science.gov (United States)

    2016-01-01

    This article aims to provide an update on the prevention of mother-to-child transmission of syphilis by drawing upon some important basic concepts and reviewing the most recent literature on the diagnosis and treatment of syphilis in pregnancy. New technologies, such as automated and point-of-care immunologic tests, are shifting some paradigms, which will certainly be further investigated in the forthcoming years. This is the time to carefully evaluate traditional as well as new strategies to prevent congenital syphilis. Adverse outcomes of mother-to-child transmission of syphilis can be prevented with antenatal screening and penicillin therapy, which proved to have an excellent cost-benefit ratio even in populations with a low prevalence of syphilis. However, syphilis epidemiology is influenced by socioeconomic and cultural factors, and major challenges are faced by poor and developing countries in which the severity of the problem is extremely alarming. On the other hand, the emergence of new technologies has raised doubts about the best algorithm to be used when proper laboratory resources are available. Conditions are quite heterogeneous across populations, and some procedures should not be generalized while there is no evidence that supports some changes and while in-depth studies about local conditions are not conducted. Official organizations need to be alert in order to avoid isolated decisions and ensure that evidence-based guidelines be used in the management of syphilis in pregnancy. PMID:27081586

  15. Current status of biological indicators to detect and quantify previous exposures to radiation

    International Nuclear Information System (INIS)

    Lushbaugh, C.; Eisele, G.; Burr, W. Jr.; Hubner, K.; Wachholz, B.

    1991-01-01

    As noted in the text of this paper, immunological concepts are in a state of rapid development, and it is possible that improved methods for applying immunologic procedures as biological indicators of radiation may be developed in the future. However, at the present time, immunological indicators are not useful, even in an early time period, for quantitating radiation dose after total-body irradiation. A semiquantitative effect is observable in the early phase after total-body irradiation over a period of days to weeks, but there is little data available to indicate whether any of the immunological parameters can be indicative of a dose when the test is applied several years after radiation exposure. More detailed information regarding immunological indicators for estimating irradiation dose has been summarized elsewhere

  16. Adequacy of current systems for monitoring extremity exposures at nuclear power plants

    International Nuclear Information System (INIS)

    Reece, W.D.; Harty, R.

    1985-01-01

    In general, only a small portion of workers at commercial nuclear power plants are limited by extremity exposures, and these workers can be readily identified. There seems to be no need for increased badging among the radiation workers. However, those workers who are extremity limited may not be receiving adequate dosimetry. For workers handling compact sources, unless contrary information is available, the tip of the thumb of the dominant hand can be assumed to be the limiting site, and dose to the thumb tip averaged over one square centimeter at the basal layer of the skin should be measured or estimated. As discussed briefly in this paper, the assessment of dose in high gradient fields can be a difficult task. The particular dosimeter studied is a band-aid type composed of a thermoluminescent material embedded in a carbon matrix under 4 mils of plastic. Advantages and disadvantages of the technique are discussed

  17. Non-invasive therapy for the prevention of moist desquamation following β-radiation exposure

    International Nuclear Information System (INIS)

    Ma, L.; Wilcock, S.; Rezvani, M.; Hsia, C.

    2003-01-01

    Full text: In an environment of potential nuclear mishap, effective therapies are lacking for radiation-induced skin burns. In this report we describe an effective, non-invasive therapy for post acute radiation exposure based on skin compression. A pig skin model of β-radiation-induced moist desquamation (MD) was employed in this study. Exposure to 30 Gy was used to induce skin lesions involving >80% MD in prescribed test sites on flank skin of female Large White pigs (n 18 per flank). The animals' left flank was placed under pressure from the weight of the pig's own body for 3 hours, immediately following radiation exposure. The right flank served as control, and was not subject to compression following irradiation. Percentage differences in MD were measured between sites on both flanks based on the the area of the test site containing 50% MD (severe) as determined by clinical assessment using blinded observers. The incidence of MD was significantly higher on the uncompressed right flank as compared to the compressed left flank (p < 0.005). A 61% and 45% reduction of MD was observed in both total and severe MD, respectively, during the 8-week study period. Radiation-induced MD was significantly reduced by immediate, mild skin compression (approx. 1.5 psi) for 3 hours immediately following exposure. This observation suggests that skin lesion development from radiation-induced oxidative damage cascades may be modulated non-invasively. Understanding the mechanism(s) at work and developing devices based on this non-invasive therapeutic principle may provide a novel treatment for consequent skin injury in radiation oncology, cosmetic and therapeutic UV, laser, glycolic and derm abrasion procedures

  18. Current costing models: are they suitable for allocating health resources? The example of fall injury prevention in Australia.

    Science.gov (United States)

    Moller, Jerry

    2005-01-01

    The example of fall injury among older people is used to define and illustrate how current Australian systems for allocation of health resources perform for funding emerging public health issues. While the examples are Australian, the allocation and priority setting methods are common in the health sector in all developed western nations. With an ageing population the number of falls injuries in Australia and the cost of treatment will rise dramatically over the next 20-50 years. Current methods of allocating funds within the health system are not well suited to meeting this coming epidemic. The information requirements for cost-benefit and cost-effectiveness measures cannot be met. Marginal approaches to health funding are likely to continue to fund already well-funded treatment or politically driven prevention processes and to miss the opportunity for new prevention initiatives in areas that do not have a high political profile. Fall injury is one of many emerging areas that struggle to make claims for funding because the critical mass of intervention and evidence of its impact is not available. The beneficiaries of allocation failure may be those who treat the disease burden that could have been easily prevented. Changes to allocation mechanisms, data systems and new initiative funding practices are required to ensure that preventative strategies are able to compete on an equal footing with treatment approaches for mainstream health funding.

  19. Positive benefits: preventive impact of post-exposure prophylaxis awareness among those with diagnosed HIV.

    Science.gov (United States)

    Dodds, C

    2008-04-01

    To consider the extent to which those presenting for post-exposure prophylaxis (PEP) after sexual risk had been encouraged to do so by their PEP-aware partners with (diagnosed) HIV. Thirty men who had completed the 2005 UK Gay Men's Sex Survey who said they had ever tried to get PEP took part in a 30 minute telephone interview. Fifteen men in the sample described a sexual exposure incident where they had knowledge that their partner was diagnosed with having HIV. Of these, only five knew about their partner's HIV diagnosis prior to sexual contact. The remaining 10 sought PEP because their sexual partner revealed his positive status following potential sexual exposure. Our analysis revealed that word of mouth from friends, sexual partners and health professionals played a key role in men's knowledge about the existence of PEP. It is important for HIV and sexual health specialists to ensure that PEP information is not only targeted at those who are tested negative for HIV or are untested but also to people with diagnosed HIV.

  20. The current status of exposure-driven approaches for chemical safety assessment: A cross-sector perspective.

    Science.gov (United States)

    Sewell, Fiona; Aggarwal, Manoj; Bachler, Gerald; Broadmeadow, Alan; Gellatly, Nichola; Moore, Emma; Robinson, Sally; Rooseboom, Martijn; Stevens, Alexander; Terry, Claire; Burden, Natalie

    2017-08-15

    For the purposes of chemical safety assessment, the value of using non-animal (in silico and in vitro) approaches and generating mechanistic information on toxic effects is being increasingly recognised. For sectors where in vivo toxicity tests continue to be a regulatory requirement, there has been a parallel focus on how to refine studies (i.e. reduce suffering and improve animal welfare) and increase the value that in vivo data adds to the safety assessment process, as well as where to reduce animal numbers where possible. A key element necessary to ensure the transition towards successfully utilising both non-animal and refined safety testing is the better understanding of chemical exposure. This includes approaches such as measuring chemical concentrations within cell-based assays and during in vivo studies, understanding how predicted human exposures relate to levels tested, and using existing information on human exposures to aid in toxicity study design. Such approaches promise to increase the human relevance of safety assessment, and shift the focus from hazard-driven to risk-driven strategies similar to those used in the pharmaceutical sectors. Human exposure-based safety assessment offers scientific and 3Rs benefits across all sectors marketing chemical or medicinal products. The UK's National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs) convened an expert working group of scientists across the agrochemical, industrial chemical and pharmaceutical industries plus a contract research organisation (CRO) to discuss the current status of the utilisation of exposure-driven approaches, and the challenges and potential next steps for wider uptake and acceptance. This paper summarises these discussions, highlights the challenges - particularly those identified by industry - and proposes initial steps for moving the field forward. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  1. The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study

    NARCIS (Netherlands)

    Gomez, Gabriela B.; Borquez, Annick; Caceres, Carlos F.; Segura, Eddy R.; Grant, Robert M.; Garnett, Geoff P.; Hallett, Timothy B.

    2012-01-01

    HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral drugs by uninfected individuals to prevent HIV infection, has demonstrated effectiveness in preventing acquisition in a high-risk population of men who have sex with men (MSM). Consequently, there is a need to understand if and how PrEP

  2. [Is it possible to improve the preventive usefulness of workers' health surveillance in the current regulatory framework?

    Science.gov (United States)

    Rodríguez Jareño, Mari Cruz; De Montserrat I Nonó, Jaume

    In Spain, the limited preventive usefulness of health surveillance is determined by the indiscriminate use of nonspecific "generic" health examinations aimed at producing a "fitness for work list", presumably allowing companies to comply with health and safety regulations. This study aimed to produce a technical interpretation of the Spanish Prevention of Risks at Work Act and propose a new conceptual framework to favour greater preventive usefulness of health surveillance within the current regulatory framework. Using qualitative techniques of content analysis, the text of the Law was studied, the key concepts that impeded the fulfilment of the preventive objectives of health surveillance were identified, and a technical interpretation adjusted to regulations was made in order to propose a new conceptual framework RESULTS: This conceptual framework would include: clearly differentiating health surveillance from health examinations (one of its instruments) and from fitness for work evaluations (an independent concept in itself); restricting mandatory health surveillance to situations in which it is "imperative" to carry it out because of the existence of a substantial risk to workers or third parties, including potentially vulnerable workers; and communicating the results of health surveillance through preventive recommendations to the company, reserving fitness for duty certificates -always based on clear, pre-established and justified criteria in relation to risk- for mandatory surveillance. The proposed new conceptual framework falls within the scope of the Spanish Prevention of Risks at Work Act, and its implementation could contribute to improving the preventive usefulness of health surveillance without the need to reform the legislation. Copyright belongs to the Societat Catalana de Salut Laboral.

  3. Does Digital Ad Exposure Influence Information-Seeking Behavior Online? Evidence From the 2012 Tips From Former Smokers National Tobacco Prevention Campaign.

    Science.gov (United States)

    Kim, Annice; Hansen, Heather; Duke, Jennifer; Davis, Kevin; Alexander, Robert; Rowland, Amy; Mitchko, Jane

    2016-03-16

    Measuring the impact of online health campaigns is challenging. Ad click-through rates are traditionally used to measure campaign reach, but few Internet users ever click on ads. Alternatively, self-reported exposure to digital ads would be prone to recall bias. Furthermore, there may be latency effects whereby people do not click on ads when exposed but visit the promoted website or conduct campaign-related searches later. Online panels that unobtrusively collect panelists' Web behavior data and link ad exposure to website visits and searches can more reliably assess the impact of digital ad exposure. From March to June 2012, the Centers for Disease Control and Prevention aired the national Tips From Former Smokers (Tips 2012) media campaign designed to encourage current smokers to quit. Advertisements ran across media channels, and the digital ads directed users to the Tips 2012 campaign website. Our aim was to examine whether exposure to Tips 2012 digital ads influenced information-seeking behaviors online. ComScore mined its panelists' Web behavior data for unique codes that would indicate exposure to Tips 2012 ads, regardless of whether panelists clicked the ad or not. A total of 15,319 US adults were identified as having been exposed to a Tips 2012 campaign ad. An equal number of unexposed adults (N=15,319) were identified and matched on demographics and Internet use behavior to the exposed group. Panelists' Web behavior data were mined for up to 4 weeks after initial Tips 2012 ad exposure to determine whether they visited the Tips 2012 campaign website or other cessation-related websites (eg, nicotine replacement therapy site) or conducted searches for campaign-related topics (eg, quit smoking). The proportion of exposed adults visiting the Tips 2012 sites increased from 0.4% in Week 1 to 0.9% 4 weeks after ad exposure, and these rates were significantly higher than in the unexposed group (0.1% in Week 1 to 0.4% in Week 4, P<.001) across all weeks examined

  4. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  5. Maternal L-glutamine supplementation prevents prenatal alcohol exposure-induced fetal growth restriction in an ovine model.

    Science.gov (United States)

    Sawant, Onkar B; Wu, Guoyao; Washburn, Shannon E

    2015-06-01

    Prenatal alcohol exposure is known to cause fetal growth restriction and disturbances in amino acid bioavailability. Alterations in these parameters can persist into adulthood and low birth weight can lead to altered fetal programming. Glutamine has been associated with the synthesis of other amino acids, an increase in protein synthesis and it is used clinically as a nutrient supplement for low birth weight infants. The aim of this study was to explore the effect of repeated maternal alcohol exposure and L-glutamine supplementation on fetal growth and amino acid bioavailability during the third trimester-equivalent period in an ovine model. Pregnant sheep were randomly assigned to four groups, saline control, alcohol (1.75-2.5 g/kg), glutamine (100 mg/kg, three times daily) or alcohol + glutamine. In this study, a weekend binge drinking model was followed where treatment was done 3 days per week in succession from gestational day (GD) 109-132 (normal term ~147). Maternal alcohol exposure significantly reduced fetal body weight, height, length, thoracic girth and brain weight, and resulted in decreased amino acid bioavailability in fetal plasma and placental fluids. Maternal glutamine supplementation successfully mitigated alcohol-induced fetal growth restriction and improved the bioavailability of glutamine and glutamine-related amino acids such as glycine, arginine, and asparagine in the fetal compartment. All together, these findings show that L-glutamine supplementation enhances amino acid availability in the fetus and prevents alcohol-induced fetal growth restriction.

  6. Rethinking HIV-prevention for school-going young people based on current behaviour patterns

    OpenAIRE

    Visser, Maretha

    2017-01-01

    Abstract The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5–12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behavi...

  7. Preventive measures against concrete damage to ASR in the Netherlands current state-of-affairs

    OpenAIRE

    Heijnen, W.M.M.; Larbi, J.A.

    1999-01-01

    In CUR-Recommendation 38, various vital measures that need to be taken during design of new concrete-mixtures in order to prevent damage due to ASR in the concrete have been outlined. The most important of these measures are: - the use of blast furnace slag cement (with a high slag content: ≥50% by mass of cement as slag); - or the use of portland fly ash cement (containing at least 25% by mass of cement as fly ash). If one of these cement types is used, then the potential reactivity of the a...

  8. Current radiation exposure of man: a comparison between digital imaging and environmental, workplace and accidental radiation burden

    International Nuclear Information System (INIS)

    Regulla, Dieter; Hoeschen, Christoph; Wahl, Wolfgang

    2008-01-01

    X-ray imaging in diagnostic radiology is recognized worldwide as an outstanding tool for the early recognition and prevention of diseases. The reverse side is that radiography contributes essentially to the exposure of the public. Mean effective doses, averaged over patients and non-patients, are reaching or exceeding the level of natural radiation. This is particularly the case when digital imaging techniques are utilized, such as CT, coronary angiography and interventional radiology. Individual effective doses for a patient may occur between several mSv and several hundred mSv by one examination or a series of examinations, while individual organ doses of a patient may reach equivalent doses even up to several Sv, such as for the skin. The purpose of this review is to provide information on effective dose levels occurring in diagnostic radiology as compared with individual effective doses achieved from environmental radiation, radiation at workplaces and after major radiation incidents. (author)

  9. Viral Diseases of Public Health Importance in India: Current Priorities with Special Emphasis on Prevention

    Directory of Open Access Journals (Sweden)

    Mageshbabu Ramamurthy

    2017-10-01

    Full Text Available India faces problems with both communicable and non communicable diseases. The major non communicable diseases are cancer, cardiovascular disease and diabetes mellitus. This article focuses on communicable diseases (infectious diseases especially viral infections of public health importance. The infections include bacterial, parasitic and viruses. It could be said that fungal infections by the nature of the spread are not of public health concern. The viral infections are transmitted by the respiratory route, water and food borne route, vectors and blood and blood products, sexual route and are of major concern. Efforts are aimed at early detection, prevention by use of vaccines and sentinel surveillance. For the success of public health programmes sentinel surveillance of diseases is mandatory. India has got several programme initiatives addressing the problem. The programs include IDSP, VBDCP and NACO. The approximate cumulative annual prevalence of infectious disease in India ranges from 100 to 200 million individuals affected in one year. India should aim to improve case detection by strengthening laboratory services with manpower training and nationwide quality control scheme, sentinel surveillance activity and prevention by improving the efficiency and scope of UIP. Also, creation of a single portal of infectious disease data handling hub to collect information from different sources will help avoid overlap and duplication of reporting.

  10. Aripiprazole for relapse prevention and craving in alcohol use disorder: current evidence and future perspectives.

    Science.gov (United States)

    Martinotti, Giovanni; Orsolini, Laura; Fornaro, Michele; Vecchiotti, Roberta; De Berardis, Domenico; Iasevoli, Felice; Torrens, Marta; Di Giannantonio, Massimo

    2016-06-01

    Among other approaches, the modulation of the dopaminergic pathway has been advocated in the therapeutic management of Alcohol Use Disorders (AUD). A potential avenue toward the modulation of the dopaminergic pathway across varying substance disorders seems to be provided by aripiprazole, a second-generation antipsychotic characterized by a peculiar pharmacodynamics signature. In this review, the authors provided a qualitative synthesis and a critical perspective on the efficacy of aripiprazole in relapse prevention and craving in AUD. A systematic search was carried out through MEDLINE/Embase/PsycINFO/Cochrane Library from inception until September 2015, combining free terms and MESH headings for the topics of AUD and aripiprazole as following: (((Alcohol use Disorder) OR (Alcohol use)) AND aripiprazole). Based both on a qualitative synthesis and a critical interpretation of the evidence, the authors submit that aripiprazole would promote alcohol abstinence and reduce the alcohol seeking behaviour possibly via dopaminergic and serotoninergic modulations at the fronto-subcortical circuits underpinning alcohol reward and craving, impulsive behaviour as well as reduce alcohol-related anxiety/low mood and anhedonia. However, due to the lack of published studies, a conclusive statement about any direct effect of aripiprazole in the prevention of craving and/or alcohol consumption is not possible.

  11. Efficacy and safety of haloperidol for in-hospital delirium prevention and treatment: A systematic review of current evidence.

    Science.gov (United States)

    Schrijver, E J M; de Graaf, K; de Vries, O J; Maier, A B; Nanayakkara, P W B

    2016-01-01

    Haloperidol is generally considered the drug of choice for in-hospital delirium management. We conducted a systematic review to evaluate the evidence for the efficacy and safety of haloperidol for the prevention and treatment of delirium in hospitalized patients. PubMed, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, and the Cochrane Library were systematically searched up to April 21, 2015. We included English full-text randomized controlled trials using haloperidol for the prevention or treatment of delirium in adult hospitalized patients reporting on delirium incidence, duration, or severity as primary outcome. Quality of evidence was graded. Meta-analysis was not conducted because of between-study heterogeneity. Twelve studies met our inclusion criteria, four prevention and eight treatment trials. Methodological limitations decreased the graded quality of included studies. Results from placebo-controlled prevention studies suggest a haloperidol-induced protective effect for delirium in older patients scheduled for surgery: two studies reported a significant reduction in ICU delirium incidence and one study found a significant reduction in delirium severity and duration. Although placebo-controlled trials are missing, pharmacological treatment of established delirium reduced symptom severity. Haloperidol administration was not associated with treatment-limiting side-effects, but few studies used a systematic approach to identify adverse events. Although results on haloperidol for delirium management seem promising, current prevention trials lack external validity and treatment trials did not include a placebo arm on top of standard nonpharmacological care. We therefore conclude that the current use of haloperidol for in-hospital delirium is not based on robust and generalizable evidence. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. Pesticide exposure assessment for surface waters in the EU. Part 1: Some comments on the current procedure.

    Science.gov (United States)

    Bach, Martin; Diesner, Mirjam; Großmann, Dietlinde; Guerniche, Djamal; Hommen, Udo; Klein, Michael; Kubiak, Roland; Müller, Alexandra; Priegnitz, Jan; Reichenberger, Stefan; Thomas, Kai; Trapp, Matthias

    2016-07-01

    In 2001, the European Commission introduced a risk assessment project known as FOCUS (FOrum for the Coordination of pesticide fate models and their USe) for the surface water risk assessment of active substances in the European Union. Even for the national authorisation of plant protection products (PPPs), the vast majority of EU member states still refer to the four runoff and six drainage scenarios selected by the FOCUS Surface Water Workgroup. However, our study, as well as the European Food Safety Authority (EFSA), has stated the need for various improvements. Current developments in pesticide exposure assessment mainly relate to two processes. Firstly, predicted environmental concentrations (PECs) of pesticides are calculated by introducing model input variables such as weather conditions, soil properties and substance fate parameters that have a probabilistic nature. Secondly, spatially distributed PECs for soil-climate scenarios are derived on the basis of an analysis of geodata. Such approaches facilitate the calculation of a spatiotemporal cumulative distribution function (CDF) of PECs for a given area of interest and are subsequently used to determine an exposure concentration endpoint as a given percentile of the CDF. For national PPP authorisation, we propose that, in the future, exposure endpoints should be determined from the overall known statistical PEC population for an area of interest, and derived for soil and climate conditions specific to the particular member state. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  13. Prevention of hip fractures by exposure to sunlight and pharmacotherapy in patients with Alzheimer's disease.

    Science.gov (United States)

    Iwamoto, Jun; Sato, Yoshihiro; Tanaka, Kiyoshi; Takeda, Tsuyoshi; Matsumoto, Hideo

    2009-01-01

    Hypovitaminosis D and K due to malnutrition or sunlight deprivation, compensatory hyperparathyroidism, increased bone resorption, low bone mineral density (BMD), and an increased risk of falls may contribute to an increased risk of hip fractures in patients with Alzheimer's disease. The purpose of the present study was to clarify the efficacy of interventions against hip fractures in patients with Alzheimer's disease. With respect to randomized controlled trials (RCTs) regarding Alzheimer's disease and hip fractures, the literature was searched with PubMed. Three RCTs were identified, and the relative risk (RR) and 95% confidence interval (CI) were calculated for individual RCTs. Exposure to sunlight with calcium supplementation, menatetrenone (vitamin K2) plus calcium and vitamin D supplementation, and risedronate plus calcium and vitamin D supplementation improved hypovitaminosis D and hyperparathyroidism, contributing to a reduction in bone resorption. Risedronate itself strongly decreased bone resorption. Menatetrenone also decreased the serum level of undercarboxylated osteocalcin. The three interventions increased metacarpal BMD and reduced the incidence of hip fractures. The respective RRs (95% CI) were 0.22 (0.049-0.999), 0.13 (0.031-0.554), and 0.26 (0.100- 0.690). The present study clarified the efficacy of three interventions, including exposure to sunlight, menatetrenone, and risedronate with calcium and/or vitamin D supplementation against hip fractures in patients with Alzheimer's disease.

  14. Negotiating sexual safety in the era of biomedical HIV prevention: relationship dynamics among male couples using pre-exposure prophylaxis.

    Science.gov (United States)

    Malone, Jowanna; Syvertsen, Jennifer L; Johnson, Blake E; Mimiaga, Matthew J; Mayer, Kenneth H; Bazzi, Angela R

    2018-06-01

    Up to two-thirds of new cases of HIV transmission between gay, bisexual and other men who have sex with men in the USA are attributed to primary relationships. Understanding the relationship dynamics and sexual agreements of male-male couples can provide insight into HIV transmission patterns and prevention needs in this population. The daily use of antiretroviral pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV, but its negotiation and use within social and intimate relationship contexts remain understudied. We conducted semi-structured qualitative interviews with 20 male couples (n = 40 men) in which at least one partner was either using or in the process of initiating PrEP. Congruent with a theoretical focus on social theories of relationships and negotiated risk, couples were interviewed about relationship dynamics, trust, communication and sexual health practices, including their perception and use of PrEP. Overall, we found that couples showed heightened trust and communication when establishing open, sexual agreements and demonstrated high awareness of sexual risks and health practices in the context of PrEP use. This study demonstrates how understanding relationship dynamics can better inform HIV prevention and sexual health promotion efforts for male couples at risk of HIV.

  15. Changes in cue reactivity and attentional bias following experimental cue exposure and response prevention: a laboratory study of the effects of D-cycloserine in heavy drinkers.

    Science.gov (United States)

    Kamboj, Sunjeev K; Massey-Chase, Rachel; Rodney, Lydia; Das, Ravi; Almahdi, Basil; Curran, H Valerie; Morgan, Celia J A

    2011-09-01

    The effects of D-cycloserine (DCS) in animal models of anxiety disorders and addiction indicate a role for N-methyl D-aspartate (NMDA) receptors in extinction learning. Exposure/response prevention treatments for anxiety disorders in humans are enhanced by DCS, suggesting a promising co-therapy regime, mediated by NMDA receptors. Exposure/response prevention may also be effective in problematic drinkers, and DCS might enhance habituation to cues in these individuals. Since heavy drinkers show ostensible conditioned responses to alcohol cues, habituation following exposure/response prevention should be evident in these drinkers, with DCS enhancing this effect. The objective of this study is to investigate the effect of DCS on exposure/response prevention in heavy drinkers. In a randomised, double-blind, placebo-controlled study, heavy social drinkers recruited from the community received either DCS (125 mg; n = 19) or placebo (n = 17) 1 h prior to each of two sessions of exposure/response prevention. Cue reactivity and attentional bias were assessed during these two sessions and at a third follow-up session. Between-session drinking behaviour was recorded. Robust cue reactivity and attentional bias to alcohol cues was evident, as expected of heavy drinkers. Within- and between-session habituation of cue reactivity, as well as a reduction in attentional bias to alcohol cues over time was found. However, there was no evidence of greater habituation in the DCS group. Subtle stimulant effects (increased subjective contentedness and euphoria) which were unrelated to exposure/response prevention were found following DCS. DCS does not appear to enhance habituation of alcohol cue reactivity in heavy non-dependent drinkers. Its utility in enhancing treatments based on exposure/response prevention in dependent drinkers or drug users remains open.

  16. High Current Plasma Electrolytic Oxidation Coating Processes for Wear and Corrosion Prevention of Al 2024

    Science.gov (United States)

    Wang, Rui

    Plasma electrolytic oxidation (PEO) treatments have been used in the aerospace and automotive industries because the coating formed on light metals or alloys has great hardness, high wear, corrosion, and oxidation resistance, and a low friction coefficient that improves lifetime length and provide a higher surface quality. However, the PEO treatments that are presently used for industrial applications require a long period of time to confirm the quality of the coating. For this reason, the present study seeks to increase the current density of PEO treatments to improve their efficiency and explore the performance of the obtained coatings. It was found that for high current density (0.18A/cm2) PEO treatments, smaller ratio, such as 50% and 70%, is beneficial to obtaining a better performance coating. When compared with the coating of a "normal" (current density: 0.09A/cm2) PEO treatment, it had better wear resistance; however, for corrosion resistance, it had a lower performance than the coatings obtained by the "normal" current density PEO treatment which was attributed to the negative influence of porosity increase.

  17. In-situ electric field and current density in Japanese male and female models for uniform magnetic field exposures

    International Nuclear Information System (INIS)

    Hirata, A.; Wake, K.; Watanabe, S.; Taki, M.

    2009-01-01

    The present study quantified the in situ electric field and induced current density in anatomically based numeric Japanese male and female models for exposure to extremely low-frequency magnetic fields. A quasi-static FDTD method was applied to analyse this problem. The computational results obtained herein reveal that the 99. percentile value of the in situ electric field in the nerve tissue and the current density averaged over an area of 1 cm 2 of the nerve tissue (excluding non-nerve tissues in the averaging region) in the female models were less than 35 and 25%, respectively. These induced quantities in the Japanese models were smaller than those for European models reported in a previous study, which is mainly due to the difference in cross-sectional area of the body. (authors)

  18. Current healthcare in Bulgaria: time for predictive diagnostics and preventive medicine.

    Science.gov (United States)

    Dimitrov, Dimiter V

    2010-12-01

    Since 1990 Bulgaria gradually moved from monopolistic to market regulated economy and healthcare. In 2007 the country became member of the European Union and started to adopt EU legislations. However, significant gaps between the average European and Bulgarian level of social, health and economic efficiency remain to be narrowed. The major challenge is the demographic situation, where recent trends give alarming signals. Plans for reformation include transition towards out-patient palliative healthcare centers for the aging population as well as reduction of the costs with new electronic system of health insurance. The favorable location of the country at the Black Sea coast gives opportunities for medical tourism, which can provide quality health service for foreign customers. Finally, national platforms on prevention of major non-communicable diseases, such as obesity, cancer and diabetes, must be established as coordinated actions for the health and wellness of next generations.

  19. [Current status of the prevention and treatment of stoma complications. A narrative review].

    Science.gov (United States)

    de Miguel Velasco, Mario; Jiménez Escovar, Fernando; Parajó Calvo, Alberto

    2014-03-01

    The aim of our study was to perform a review of the literature to assess the results of prevention and treatment of stoma complications. Medline, EMBASE medical database and the Cochrane Library were searched up to December 2012. Stomal complications are prevalent and associated with a worse quality of life and increased health-economic burdens. The most common complications are attributed to stoma construction. Attention to the finer technical points performed by experienced surgeons reduces morbidity. The use of mesh reduces the risk of parastomal hernia and recurrence rates in hernia repair. Preoperative stoma site marking and postoperative care by a stomatherapist are crucial for the patients' successful adaption, improving quality of life, promoting their independence and reducing the rates of complications. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  20. Role of cancer awareness in prevention of its outbreak: current scenario in Pakistan

    International Nuclear Information System (INIS)

    Saif, R.; Yousaf, M.Z.

    2011-01-01

    Cancer is one of the major threats to mankind after heart diseases. In developing countries, malnutrition and parasitic infections are more serious but cancer has a unique significance because roughly one in the five persons on the face of earth expires due to this ailment. It is traditionally thought to be a disease that has a strong bond with industrial revolution, modem world and chemicals exposed life style on the planet. Excluding the other cancers, solely breast cancer contributes 45% of its cases and 55% deaths occur in low and middle income countries like Pakistan who are in the queue of that transition stage of modernism once faced by the nations. In this review, we discuss the epidemiology, causes, challenges, screening and managerial issues along with a bird's eye view of cancer status in Pakistan that might be helpful in devising preventive and treatment strategies in the future. (author)

  1. The peculiarities of pathogenesis of NSAID-induced gastrointestinal injuries and current prevention strategies

    Directory of Open Access Journals (Sweden)

    Anatol Święcicki

    2014-07-01

    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are among the most widely used medications. However, NSAID intake is accompanied by an increased risk of gastroduodenal side effects. These adverse events are largely attributed to the ability of these drugs to suppress prostaglandin synthesis, penetrate the mucosal layer in the acid media of the stomach and damage epithelial cells. However, it is becoming clear that such mediators as prostaglandins, NO and lipoxins can protect the stomach from injury. This injury can largely be prevented through suppression of gastric acid secretion (mainly with proton pump inhibitors. In contrast, the pathogenesis of intestinal injury induced by NSAIDs is less well understood. There is no evidence that suppression of gastric acid secretion will reduce the incidence or severity of NSAID enteropathy. In this review the results of recent studies are described, which will help to clarify some mechanisms of development of NSAID gastropathies and NSAID enteropathies and to improve the treatment of these patients.

  2. Nutritional advice for prevention of acute pancreatitis: review of current opinion

    Directory of Open Access Journals (Sweden)

    Lowe ME

    2012-12-01

    Full Text Available Mark E Lowe, Wednesday A SevillaDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USAAbstract: Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.Keywords: pancreatitis, nutrition, pancreatic enzyme replacement therapy, antioxidants, herbal supplements

  3. Microbicides in the prevention of HIV infection: current status and future directions.

    Science.gov (United States)

    Nuttall, Jeremy

    2010-07-09

    More than 28 years since the first cases of HIV/AIDS, there is still no cure or vaccine. The worst affected region is sub-Saharan Africa and, increasingly, it is young women who are bearing the brunt of the epidemic. Consequently, there is an urgent need for HIV prevention options for women in developing countries. Microbicides are topical products that can be used vaginally by women to impede sexual transmission of HIV and thus represent one of the most promising prevention strategies. Efficacy trials with early nonspecific microbicide gels have so far been unsuccessful, but the field has now switched its focus to products containing highly potent and highly specific antiretroviral drugs that are easier to use, and can be formulated in a variety of dosage forms to suit individual and regional preferences. However, these products have their own challenges, with a greater likelihood of absorption, and the potential for systemic toxicities or the development of resistance in infected individuals who are unaware of their HIV status. The conduct of clinical trials is complex for all microbicides, with limited availability of trial sites, difficulties in dose selection and safety monitoring, and a lack of a truly objective measure of adherence. Once a microbicide has been shown to be safe and effective, there will need to be a clear pathway to regulatory approval, and the successful launch of a product will depend on having in place appropriate methods for distribution to the women who need it, along with a strategy for ensuring that they use it correctly. This will require substantial effort in terms of education and community engagement, and these activities need to be initiated well in advance of microbicide rollout.

  4. Prevention of supine hypotensive syndrome in pregnant women undergoing computed tomography - A national survey of current practice

    International Nuclear Information System (INIS)

    McMahon, Michelle A.; Fenwick, Alison; Banks, Amelia; Dineen, Robert A.

    2009-01-01

    Aim: Supine hypotensive syndrome (SHS) can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. This results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse. SHS can be easily avoided by left lateral tilt positioning. We undertook a nationwide survey to assess the awareness amongst senior computed tomography (CT) radiographers of the potential risk of SHS in women in this patient group, and to identify the extent to which preventative practices and protocols are in place. Methods and materials: A questionnaire was sent to superintendent CT radiographers at all acute NHS Trusts in England and Wales examining awareness of the risk of SHS and the preventative practices and protocols currently used. Results: Completed questionnaires were received from 64% institutions. Of respondents who scan women in this patient group, only 44% were aware of the risk of SHS. No institution had a written protocol specifying positioning of women in this patient group. Seventy-five percent of institutions never employed oblique positioning. Eighty-five percent felt that specific guidelines from the Society of Radiographers or Royal College of Radiologists would be helpful. Conclusion: Current awareness and practices for preventing this easily avoidable but potentially harmful condition are inadequate. Central guidance would be welcomed by a large majority of respondents.

  5. Prevention of supine hypotensive syndrome in pregnant women undergoing computed tomography - A national survey of current practice

    Energy Technology Data Exchange (ETDEWEB)

    McMahon, Michelle A.; Fenwick, Alison [Department of Diagnostic Imaging, Queen' s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH (United Kingdom); Banks, Amelia [Department of Anaesthesia, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham, NG5 1PB (United Kingdom); Dineen, Robert A. [Department of Diagnostic Imaging, Queen' s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH (United Kingdom)], E-mail: Robert.dineen@nhs.net

    2009-05-15

    Aim: Supine hypotensive syndrome (SHS) can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. This results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse. SHS can be easily avoided by left lateral tilt positioning. We undertook a nationwide survey to assess the awareness amongst senior computed tomography (CT) radiographers of the potential risk of SHS in women in this patient group, and to identify the extent to which preventative practices and protocols are in place. Methods and materials: A questionnaire was sent to superintendent CT radiographers at all acute NHS Trusts in England and Wales examining awareness of the risk of SHS and the preventative practices and protocols currently used. Results: Completed questionnaires were received from 64% institutions. Of respondents who scan women in this patient group, only 44% were aware of the risk of SHS. No institution had a written protocol specifying positioning of women in this patient group. Seventy-five percent of institutions never employed oblique positioning. Eighty-five percent felt that specific guidelines from the Society of Radiographers or Royal College of Radiologists would be helpful. Conclusion: Current awareness and practices for preventing this easily avoidable but potentially harmful condition are inadequate. Central guidance would be welcomed by a large majority of respondents.

  6. Why are there lasting effects from exposure to stress during development? An analysis of current models of early stress.

    Science.gov (United States)

    Chaby, Lauren E

    2016-10-01

    The potential for stressful experiences in early life to cause lasting changes in phenotype is well documented, but the functional and evolutionary context of these changes is not well understood. Many hypotheses have been proposed to explain the role of lasting effects of stress exposure during gestation and early development; the purpose of this review is to discuss these hypotheses in the context of human and non-human animal research in the last three decades in order to (i) further dialogues between those approaching early stress from biomedical and evolutionary/ecological perspectives, (ii) outline strengths and limitations of current hypotheses, with respect to species and context-specific effects of exposure to stress in early development, and (iii) address recent evidence suggesting that stress in early development can have beneficial effects in adulthood. It is suggested that the hypotheses discussed are not mutually exclusive, but the applicability of each hypothesis will depend upon the environmental conditions and stability a species, or perhaps even an individual, experiences in their lifetime. Potential investigations to clarify applications of the current hypotheses are discussed, including longitudinal studies that span multiple developmental stages and investigations of species where measures of fitness are possible. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Examining impacts of current-use pesticides in Southern Ontario using in situ exposures of the amphipod Hyalella azteca.

    Science.gov (United States)

    Bartlett, Adrienne J; Struger, John; Grapentine, Lee C; Palace, Vince P

    2016-05-01

    In situ exposures with Hyalella azteca were used to assess impacts of current-use pesticides in Southern Ontario, Canada. Exposures were conducted over 2 growing seasons within areas of high pesticide use: 1 site on Prudhomme Creek and 3 sites on Twenty Mile Creek. Three sites on Spencer Creek, an area of low pesticide use, were added in the second season. Surface water samples were collected every 2 wk to 3 wk and analyzed for a suite of pesticides. Hyalella were exposed in situ for 1 wk every 4 wk to 6 wk, and survival and acetylcholinesterase (AChE) activity were measured. Pesticides in surface waters reflected seasonal use patterns: lower concentrations in spring and fall and higher concentrations during summer months. Organophosphate insecticides (chlorpyrifos, azinphos methyl, diazinon) and acid herbicides (2,4-dichlorophenoxyacetic acid [2,4-D], mecoprop) were routinely detected in Prudhomme Creek, whereas neutral herbicides (atrazine, metolachlor) dominated the pesticide signature of Twenty Mile Creek. Spencer Creek contained fewer pesticides, which were measured at lower concentrations. In situ effects also followed seasonal patterns: higher survival and AChE activity in spring and fall, and lower survival and AChE activity during summer months. The highest toxicity was observed at Prudhomme Creek and was primarily associated with organophosphates. The present study demonstrated that current-use pesticides in Southern Ontario were linked to in situ effects and identified sites of concern requiring further investigation. © 2015 Crown in the Right of Canada.

  8. Considerations on Preventing and Combating the Illegal Trafficking of Minors under the Current Economic and Financial Crisis

    Directory of Open Access Journals (Sweden)

    Tache BOCĂNIALĂ

    2011-08-01

    Full Text Available This work highlights the economic crisis problem that affects most states of the world, the crime problem that the society is facing, namely the human trafficking and in particular the child trafficking. This theme is particularly important in the context of amplifying the organized crime, it increasingly concerns the modern society and implicitly the specialists engaged in research of the phenomenon and for preventing and combating it. This paper is an analysis of the current financial crisis impact on human trafficking and the level of response that the society is ready to give through the regulatory framework, specialized institutions and their staff. The analysis concluded that Romania, as a result of its alignment with the acquis communautaire, is now a modern legislative and institutional system in preventing and combating trafficking in human beings. However, there is a need for legislative amendments in order to have a greater effectiveness in prevention and control measures, which represents a milestone in addressing other related issues. This study is also a warning for specialists to deepen their research for improving the prevention and combating trafficking in human beings which tends to grow.

  9. Fires in refugee and displaced persons settlements: The current situation and opportunities to improve fire prevention and control.

    Science.gov (United States)

    Kazerooni, Yasaman; Gyedu, Adam; Burnham, Gilbert; Nwomeh, Benedict; Charles, Anthony; Mishra, Brijesh; Kuah, Solomon S; Kushner, Adam L; Stewart, Barclay T

    2016-08-01

    We aimed to describe the burden of fires in displaced persons settlements and identify interventions/innovations that might address gaps in current humanitarian guidelines. We performed a systematic review of: (i) academic and non-academic literature databases; and (ii) guidelines from leading humanitarian agencies/initiatives regarding fire prevention/control. Of the 1521 records retrieved, 131 reports described settlement fires in 31 hosting countries since 1990. These incidents resulted in 487 deaths, 790 burn injuries, displacement of 382,486 individuals and destruction of 50,509 shelters. There was a 25-fold increase in the rate of settlement fires from 1990 to 2015 (0.002-0.051 per 100,000 refugees, respectively). Only 4 of the 15 leading humanitarian agencies provided recommendations about fire prevention/control strategies. Potentially useful interventions/innovations included safer stoves (e.g. solar cookers) and fire retardant shelter materials. The large and increasing number of fires in displaced persons settlements highlights the need to redress gaps in humanitarian fire prevention/control guidelines. The way forward includes: (i) developing consensus among aid agencies regarding fire prevention/control strategies; (ii) evaluating the impact of interventions/innovations on the burden of fires; and (iii) engaging agencies in a broader discussion about protecting camp residents from armed groups. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  10. Skin, eye, and testis: current exposure problems and recent advances in radiobiology

    International Nuclear Information System (INIS)

    Charles, M.W.

    1986-01-01

    Three organs, the skin, eye and testis are potentially at risk from poorly penetrating radiations such as beta particles or low energy X-Rays. They may be preferentially irradiated in fields with steep depth - dose gradients and thereby dictate radiological protection procedures. Since there is not a wide margin of safety in the annual permissible dose limits for these organs it is important to have clearly defensible methods of dose assessment. This requires both an adequate understanding of the radiobiology of these organs and the availability of experimental techniques for measuring doses at various depths near the surface of the body. This paper reviews the current state of knowledge in this field, drawing partly on information from two recent CEC workshops on the 'Dosimetry of Beta Particles and Low Energy X-Rays' and 'Radiation Damage to the Skin'. It is concluded that protection criteria for the limitation of skin dose are in need of revision. (author)

  11. Current Concepts for Injury Prevention in Athletes After Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Hewett, Timothy E.; Di Stasi, Stephanie L.; Myer, Gregory D.

    2012-01-01

    Ligament reconstruction is the current standard of care for active patients with an anterior cruciate ligament (ACL) rupture. Although the majority of ACL reconstruction (ACLR) surgeries successfully restore the mechanical stability of the injured knee, postsurgical outcomes remain widely varied. Less than half of athletes who undergo ACLR return to sport within the first year after surgery, and it is estimated that approximately 1 in 4 to 1 in 5 young, active athletes who undergo ACLR will g...

  12. Noise-based tube current reduction method with iterative reconstruction for reduction of radiation exposure in coronary CT angiography

    International Nuclear Information System (INIS)

    Shen, Junlin; Du, Xiangying; Guo, Daode; Cao, Lizhen; Gao, Yan; Bai, Mei; Li, Pengyu; Liu, Jiabin; Li, Kuncheng

    2013-01-01

    Purpose: To investigate the potential of noise-based tube current reduction method with iterative reconstruction to reduce radiation exposure while achieving consistent image quality in coronary CT angiography (CCTA). Materials and methods: 294 patients underwent CCTA on a 64-detector row CT equipped with iterative reconstruction. 102 patients with fixed tube current were assigned to Group 1, which was used to establish noise-based tube current modulation formulas, where tube current was modulated by the noise of test bolus image. 192 patients with noise-based tube current were randomly assigned to Group 2 and Group 3. Filtered back projection was applied for Group 2 and iterative reconstruction for Group 3. Qualitative image quality was assessed with a 5 point score. Image noise, signal intensity, volume CT dose index, and dose-length product were measured. Results: The noise-based tube current modulation formulas were established through regression analysis using image noise measurements in Group 1. Image noise was precisely maintained at the target value of 35.00 HU with small interquartile ranges for Group 2 (34.17–35.08 HU) and Group 3 (34.34–35.03 HU), while it was from 28.41 to 36.49 HU for Group 1. All images in the three groups were acceptable for diagnosis. A relative 14% and 41% reduction in effective dose for Group 2 and Group 3 were observed compared with Group 1. Conclusion: Adequate image quality could be maintained at a desired and consistent noise level with overall 14% dose reduction using noise-based tube current reduction method. The use of iterative reconstruction further achieved approximately 40% reduction in effective dose

  13. Virtual reality cue exposure for the relapse prevention of tobacco consumption: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Giovancarli, Camille; Malbos, Eric; Baumstarck, Karine; Parola, Nathalie; Pélissier, Marie-Florence; Lançon, Christophe; Auquier, Pascal; Boyer, Laurent

    2016-02-19

    Successful interventions have been developed for smoking cessation, but the success of smoking relapse prevention interventions has been limited. In particular, cognitive behavioural therapy (CBT) has been hampered by a high relapse rate. Because relapses can be due to the presence of conditions associated with tobacco consumption (such as drinking in bars with friends), virtual reality exposure therapy (VRET) can generate synthetic environments that represent risk situations for the patient in the context of relapse prevention. The primary objective of this study is to evaluate the effectiveness of CBT coupled with VRET, in comparison to CBT alone, in the prevention of smoking relapse. The secondary objectives are to assess the impact of CBT coupled with VRET on anxiety, depression, quality of life, self-esteem and addictive comorbidities (such as alcohol, cannabis, and gambling). A third objective examines the feasibility and acceptability of VR use considering elements such as presence, cybersickness and number of patients who complete the VRET program. The present study is a 14-month (2 months of therapy followed by 12 months of follow-up), prospective, comparative, randomized and open clinical trial, involving two parallel groups (CBT coupled with VRET versus CBT alone). The primary outcome is the proportion of individuals with tobacco abstinence at 6 months after the end of the therapy. Abstinence is defined by the total absence of tobacco consumption assessed during a post-test interview and with an apparatus that measures the carbon monoxide levels expired. A total of 60 individuals per group will be included. This study is the first to examine the efficacy of CBT coupled with VRET in the prevention of smoking relapse. Because VRET is simple to use and has a low cost, this interactive therapeutic method might be easily implemented in clinical practice if the study confirms its efficacy. ClinicalTrials.gov Identifier: NCT02205060 (registered 25 July 2014).

  14. HAMLET -Human Model MATROSHKA for Radiation Exposure Determination of Astronauts -Current status and results

    Science.gov (United States)

    Reitz, Guenther; Berger, Thomas; Bilski, Pawel; Burmeister, Soenke; Labrenz, Johannes; Hager, Luke; Palfalvi, Jozsef K.; Hajek, Michael; Puchalska, Monika; Sihver, Lembit

    The exploration of space as seen in specific projects from the European Space Agency (ESA) acts as groundwork for human long duration space missions. One of the main constraints for long duration human missions is radiation. The radiation load on astronauts and cosmonauts in space (as for the ISS) is a factor of 100 higher than the natural radiation on Earth and will further increase should humans travel to Mars. In preparation for long duration space missions it is important to evaluate the impact of space radiation in order to secure the safety of the astronauts and minimize their radiation risks. To determine the radiation risk on humans one has to measure the radiation doses to radiosensitive organs within the human body. One way to approach this is the ESA facility MATROSHKA (MTR), under the scientific and project lead of DLR. It is dedicated to determining the radiation load on astronauts within and outside the International Space Station (ISS), and was launched in January 2004. MTR is currently preparing for its fourth experimental phase inside the Japanese Experimental Module (JEM) in summer 2010. MTR, which mimics a human head and torso, is an anthropomorphic phantom containing over 6000 radiation detectors to determine the depth dose and organ dose distribution in the body. It is the largest international research initiative ever performed in the field of space dosimetry and combines the expertise of leading research institutions around the world, thereby generating a huge pool of data of potentially immense value for research. Aiming at optimal scientific exploitation, the FP7 project HAMLET aims to process and compile the data acquired individually by the participating laboratories of the MATROSHKA experiment. Based on experimental input from the MATROSHKA experiment phases as well as on radiation transport calculations, a three-dimensional model for the distribution of radiation dose in an astronaut's body will be built up. The scientific achievements

  15. [Therapeutic strategies. Evolution and current status of the European Guidelines on Cardiovascular disease prevention].

    Science.gov (United States)

    Guijarro, Carlos; García-Díaz, Juan de Dios

    2013-01-01

    The European Guidelines on Dyslipidaemias (2011) and Cardiovascular Prevention (2012) have incorporated important changes. Firstly, it highlights the identification of a group of "very high risk" patients: patients with atherosclerotic disease in any vascular area, diabetes with associated risk factors, advanced chronic renal failure, or a SCORE estimate >10%. Patients with diabetes and no other risk factors, moderate renal failure, severe hypertension, genetic dyslipidaemias, or a SCORE estimate 5-10%, are considered as "high risk". The HDL cholesterol and triglycerides levels are considered as modulators of risks, but not therapeutic objectives per se. The therapeutic objectives are set at LDL cholesterol levels < 70 mg/dl (or at least a reduction of at least 50%) for patients at very high risk, and an LDL < 100 mg/dl for high risk patients. As well as the changes in lifestyle, pharmacological treatment with statins is the focal point of lipid lowering treatments. Other pharmacological options may be considered if the treatment with the maximum tolerable doses of statins do not achieve the therapeutic objectives. Copyright © 2013 Elsevier España, S.L. y SEA. All rights reserved.

  16. Current status of radiation transport tools for proliferation and terrorism prevention

    International Nuclear Information System (INIS)

    Sale, K.E.

    2004-01-01

    Full text: We will present the current status and future plans for the set of calculational tools and databases developed and maintained at LLNL. The calculational tools include the Monte Carlo codes TART 1) and COG 2) as well as the deterministic code ARDRA 3) . In addition to these codes we use currently there is a major development effort for a new massively parallel transport code. An important part of the capability we're developing is a sophisticated user interface, based on a commercial 3-D modeling product, to improve the model development process. A major part of this user interface tool is being developed by Strela 4) under the Nuclear Cities Initiative. Strela has developed a hub-and-spoke technology for code input interconversions (between COG, TART and MCNP) and will produce the plug-ins that extend the capabilities of the 3-D modeler for use as a radiation transport input generator. The major advantages of this approach are the built-in user interface for 3-D modeling and the ability to read a large variety of CAD-file formats. In addition to supporting our current radiation transport codes and developing new capabilities we are working on some nuclear data needs for homeland security. These projects are carried out and the Lawrence Berkeley National Laboratory 88' cyclotron and at the Institute for Nuclear Research of the Nation Academy of Science of Ukraine under and STCU contract. Reference: 1. http://www.llnl.gov/cullen1/mc/htm; 2. http://www-phys.llnl.gov/N_Div/COG/ETR/ETR_9306.html; 3. http://www.llnl.gov/CASC/asciturb/talks/PPT-HTML.131596/tsld030.htm; 4. http://strela.snz.ru/

  17. Apocynin prevents vascular effects caused by chronic exposure to low concentrations of mercury.

    Directory of Open Access Journals (Sweden)

    Danize A Rizzetti

    Full Text Available UNLABELLED: Mercury increases the risk of cardiovascular disease and oxidative stress and alters vascular reactivity. This metal elicits endothelial dysfunction causing decreased NO bioavailability via increased oxidative stress and contractile prostanoid production. NADPH oxidase is the major source of reactive oxygen species (ROS in the vasculature. Our aim was to investigate whether treatment with apocynin, an NADPH oxidase inhibitor, prevents the vascular effects caused by chronic intoxication with low concentrations of mercury. Three-month-old male Wistar rats were treated for 30 days with a intramuscular injections (i.m. of saline; b HgCl(2 (i.m. 1(st dose: 4.6 µg/kg, subsequent doses: 0.07 µg/kg/day; c Apocynin (1.5 mM in drinking water plus saline i.m.; and d Apocynin plus HgCl(2. The mercury treatment resulted in 1 an increased aortic vasoconstrictor response to phenylephrine and reduced endothelium-dependent responses to acetylcholine; 2 the increased involvement of ROS and vasoconstrictor prostanoids in response to phenylephrine, whereas the endothelial NO modulation of such responses was reduced; and 3 the reduced activity of aortic superoxide dismutase (SOD and glutathione peroxidase (GPx and increased plasma malondialdehyde (MDA levels. Treatment with apocynin partially prevented the increased phenylephrine responses and reduced the endothelial dysfunction elicited by mercury treatment. In addition, apocynin treatment increased the NO modulation of vasoconstrictor responses and aortic SOD activity and reduced plasma MDA levels without affecting the increased participation of vasoconstrictor prostanoids observed in aortic segments from mercury-treated rats. CONCLUSIONS: Mercury increases the vasoconstrictor response to phenylephrine by reducing NO bioavailability and increasing the involvement of ROS and constrictor prostanoids. Apocynin protects the vessel from the deleterious effects caused by NADPH oxidase, but not from those

  18. Current Technologies and its Trends of Machine Vision in the Field of Security and Disaster Prevention

    Science.gov (United States)

    Hashimoto, Manabu; Fujino, Yozo

    Image sensing technologies are expected as useful and effective way to suppress damages by criminals and disasters in highly safe and relieved society. In this paper, we describe current important subjects, required functions, technical trends, and a couple of real examples of developed system. As for the video surveillance, recognition of human trajectory and human behavior using image processing techniques are introduced with real examples about the violence detection for elevators. In the field of facility monitoring technologies as civil engineering, useful machine vision applications such as automatic detection of concrete cracks on walls of a building or recognition of crowded people on bridge for effective guidance in emergency are shown.

  19. Increasing fine particulate air pollution in China and the potential use of exposure and biomarker data in disease prevention.

    Science.gov (United States)

    Wendt, Chris H; Ramachandran, Gurumurthy; Lo, Charles; Hertz, Marshall; Mandel, Jeffrey H

    2015-03-16

    Increased industrialization and urbanization have led to marked increases in air pollutants in China over the last decade. Pollutant levels in the north and eastern regions are often four times higher than current daily levels in the United States. Recent reports indicate a higher incidence of lung cancer and mortality in men and urban dwellers, but the contribution of air pollution to these findings remains unknown. Future studies that define individual exposures, combined with biomarkers linked to disease, will be essential to the understanding of risk posed by air pollution in China.

  20. Current status of radiation transport tools for proliferation and terrorism prevention

    International Nuclear Information System (INIS)

    Sale, K.E.

    2004-01-01

    We present the current status and future plans for the set of calculational tools and data bases developed and maintained at LLNL. The calculational tools include the Monte Carlo codes TART and COG as well as the deterministic code ARDRA. In addition to these codes presently in use there is a major development effort for a new massively parallel transport code. An important part of the capability we're developing is a sophisticated user interface, based on a commercial 3-D modeling product, to improve the model development process. A major part of this user interface tool is being developed by Strela under the Nuclear Cities Initiative. Strela has developed a hub-and-spoke technology for code input interconversions (between COG, TART and MCNP) and will produce the plug-ins that extend the capabilities of the 3-D modeler for use as a radiation transport input generator. The major advantages of this approach are the built-in user interface for 3-D modeling and the ability to read a large variety of CAD-file formats. In addition to supporting our current radiation transport codes and developing new capabilities we are working on some nuclear data needs for homeland security. These projects are carried out and the Lawrence Berkeley National Laboratory 88' cyclotron and at the Institute for Nuclear Research of the Nation Academy of Science of Ukraine under and STCU contract. (author)

  1. Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort

    Energy Technology Data Exchange (ETDEWEB)

    Teras, Lauren R., E-mail: lauren.teras@cancer.org [Epidemiology Research Program, American Cancer Society, Atlanta, GA (United States); Diver, W. Ryan [Epidemiology Research Program, American Cancer Society, Atlanta, GA (United States); Turner, Michelle C. [Centre for Research in Environmental Epidemiology (CREAL), Barcelona (Spain); Universitat Pompeu Fabra (UPF), Barcelona (Spain); CIBER Epidemiología y Salud Pública (CIBERESP), Madrid (Spain); McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa (Canada); Krewski, Daniel [McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa (Canada); School of Epidemiology, Public Health and Disease Prevention, University of Ottawa, Ottawa, Ontario (Canada); Sahar, Liora [Statistics and Evaluation Center, American Cancer Society, Atlanta, GA (United States); Ward, Elizabeth [Intramural Research, American Cancer Society, Atlanta, GA (United States); Gapstur, Susan M. [Epidemiology Research Program, American Cancer Society, Atlanta, GA (United States)

    2016-07-15

    Dosimetric models show that radon, an established cause of lung cancer, delivers a non-negligible dose of alpha radiation to the bone marrow, as well as to lymphocytes in the tracheobronchial epithelium, and therefore could be related to risk of hematologic cancers. Studies of radon and hematologic cancer risk, however, have produced inconsistent results. To date there is no published prospective, population-based study of residential radon exposure and hematologic malignancy incidence. We used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analytic cohort included 140,652 participants (66,572 men, 74,080 women) among which 3019 incident hematologic cancer cases (1711 men, 1308 women) were identified during 19 years of follow-up. Cox proportional hazard regression was used to calculate multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for radon exposure and hematologic cancer risk. Women living in counties with the highest mean radon concentrations (>148 Bq/m{sup 3}) had a statistically significant higher risk of hematologic cancer compared to those living in counties with the lowest (<74 Bq/m{sup 3}) radon levels (HR=1.63, 95% CI:1.23–2.18), and there was evidence of a dose-response relationship (HR{sub continuous}=1.38, 95% CI:1.15–1.65 per 100 Bq/m{sup 3}; p-trend=0.001). There was no association between county-level radon and hematologic cancer risk among men. The findings of this large, prospective study suggest residential radon may be a risk factor for lymphoid malignancies among women. Further study is needed to confirm these findings. - Highlights: • This is the first prospective, general population study of residential radon and risk of hematologic cancer. • Findings from this study suggest that residential radon exposure may be a risk factor

  2. Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort

    International Nuclear Information System (INIS)

    Teras, Lauren R.; Diver, W. Ryan; Turner, Michelle C.; Krewski, Daniel; Sahar, Liora; Ward, Elizabeth; Gapstur, Susan M.

    2016-01-01

    Dosimetric models show that radon, an established cause of lung cancer, delivers a non-negligible dose of alpha radiation to the bone marrow, as well as to lymphocytes in the tracheobronchial epithelium, and therefore could be related to risk of hematologic cancers. Studies of radon and hematologic cancer risk, however, have produced inconsistent results. To date there is no published prospective, population-based study of residential radon exposure and hematologic malignancy incidence. We used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analytic cohort included 140,652 participants (66,572 men, 74,080 women) among which 3019 incident hematologic cancer cases (1711 men, 1308 women) were identified during 19 years of follow-up. Cox proportional hazard regression was used to calculate multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for radon exposure and hematologic cancer risk. Women living in counties with the highest mean radon concentrations (>148 Bq/m 3 ) had a statistically significant higher risk of hematologic cancer compared to those living in counties with the lowest (<74 Bq/m 3 ) radon levels (HR=1.63, 95% CI:1.23–2.18), and there was evidence of a dose-response relationship (HR continuous =1.38, 95% CI:1.15–1.65 per 100 Bq/m 3 ; p-trend=0.001). There was no association between county-level radon and hematologic cancer risk among men. The findings of this large, prospective study suggest residential radon may be a risk factor for lymphoid malignancies among women. Further study is needed to confirm these findings. - Highlights: • This is the first prospective, general population study of residential radon and risk of hematologic cancer. • Findings from this study suggest that residential radon exposure may be a risk factor for lymphoid

  3. Early Oral Ovalbumin Exposure during Maternal Milk Feeding Prevents Spontaneous Allergic Sensitization in Allergy-Prone Rat Pups

    Directory of Open Access Journals (Sweden)

    Adaweyah El-Merhibi

    2012-01-01

    Full Text Available There are conflicting data to support the practice of delaying the introduction of allergenic foods into the infant diet to prevent allergy development. This study investigated immune response development after early oral egg antigen (Ovalbumin; OVA exposure in a rat pup model. Brown Norway (BN rat pups were randomly allocated into groups: dam reared (DR, DR pups challenged daily (days 4–13 with oral OVA (DR + OVAc, DR pups challenged intermittently (on day 4, 10, 12, and 13 with oral OVA (DR + OVAi, formula-fed pups (FF, and FF pups challenged daily with oral OVA (FF + OVA. Immune parameters assessed included OVA-specific serum IgE, IgG1, and IgA. Ileal and splenic messenger ribonucleic acid (mRNA expression of transforming growth factor-beta (TGF-β1, mothers against decapentaplegic (Smad 2/4/7, and forkhead box P3 (Foxp3 were determined. Ileum was stained for TGF-β1 and Smad4. Results. Feeding OVA daily to DR pups maintained systemic and local gut antibody and immunoregulatory marker mRNA responses. Systemic TGF-β1 was lower in DR + OVAi pups compared to DR and DR + OVAc pups. Feeding OVA to FF pups resulted in significantly greater OVA-specific IgE and IgG1, and lower IgA and TGF-β1 and Smad expression compared to DR pups. Conclusions. Early daily OVA exposure in the presence of maternal milk maintains immune markers associated with a regulated immune response, preventing early allergic sensitization.

  4. Prevention of venous thromboembolism in cancer patients: current approaches and opportunities for improvement

    Directory of Open Access Journals (Sweden)

    Alpesh N. Amin

    2011-09-01

    Full Text Available Venous thromboembolism (VTE, a common complication in patients with cancer, is associated with increased risk of morbidity, mortality, and recurrent VTE. Risk factors for VTE in cancer patients include the type and stage of cancer, comorbidities, age, major surgery, and active chemotherapy. Evidence-based guidelines for thromboprophylaxis in cancer patients have been published: the National Comprehensive Cancer Network and American Society for Clinical Oncology guidelines recommend thromboprophylaxis for hospitalized cancer patients, while the American College of Chest Physician guidelines recommend thromboprophylaxis for surgical patients with cancer and bedridden cancer patients with an acute medical illness. Guidelines do not generally recommend routine thromboprophylaxis in ambulatory patients during chemotherapy, but there is evidence that some of these patients are at risk of VTE; some may be at higher risk while on active chemotherapy. Approaches are needed to identify those patients most likely to benefit from thromboprophylaxis, and, to this end, a risk assessment model has been developed and validated. Despite the benefits, many at-risk patients do not receive any thromboprophylaxis, or receive prophylaxis that is not compliant with guideline recommendations. Quality improvement initiatives have been developed by the Centers for Medicare and Medicaid Services, National Quality Forum, and Joint Commission to encourage closure of the gap between guideline recommendations and clinical practice for prevention, diagnosis, and treatment of VTE in hospitalized patients. Health-care institutions and providers need to take seriously the burden of VTE, improve prophylaxis rates in patients with cancer, and address the need for prophylaxis across the patient continuum.

  5. Morbidity management and disability prevention for lymphatic filariasis in Sri Lanka: Current status and future prospects.

    Science.gov (United States)

    Chandrasena, Nilmini; Premaratna, Ranjan; Gunaratna, Indeewarie E; de Silva, Nilanthi R

    2018-05-01

    Sri Lanka was acknowledged to have eliminated lymphatic filariasis (LF) as a public health problem in 2016, largely due to its success in Mass Drug Administration (MDA) to interrupt disease transmission. Analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT) of the national Morbidity Management and Disability Prevention (MMDP) program, the other pillar of the LF control program, was carried out with the objective of evaluating it and providing recommendations to optimize the use of available resources. A situation analysis of the MMDP activities provided by the state health sector was carried out using published records, in-depth interviews with key informants of the Anti Filariasis Campaign, site-visits to filariasis clinics with informal discussions with clinic workforce and personal communications to identify strengths and weaknesses; and opportunities to overcome weaknesses and perceived threats to the program were explored. The principal strength of the MMDP program was the filariasis clinics operational in most endemic districts of Sri Lanka, providing free health care and health education to clinic attendees. The weaknesses identified were the low accessibility of clinics, incomplete coverage of the endemic region and lack of facilities for rehabilitation. The perceived threats were diversion of staff and resources for control of other vector-borne infections, under-utilization of clinics and non-compliance with recommended treatment. Enhanced high level commitment for MMDP, wider publicity and referral systems, integration of MMDP with other disease management services and collaboration with welfare organizations and research groups were identified as opportunities to overcome weaknesses and challenges. The recommended basic package of MMDP was functional in most of the LF-endemic region. The highlighted weaknesses and challenges, unless addressed, may threaten program sustainability. The identified opportunities for improvement of the

  6. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

    Science.gov (United States)

    Patel, Rupa R; Mena, Leandro; Nunn, Amy; McBride, Timothy; Harrison, Laura C; Oldenburg, Catherine E; Liu, Jingxia; Mayer, Kenneth H; Chan, Philip A

    2017-01-01

    Pre-exposure prophylaxis (PrEP) can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island) from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%), 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003). Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

  7. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

    Directory of Open Access Journals (Sweden)

    Rupa R Patel

    Full Text Available Pre-exposure prophylaxis (PrEP can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%, 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003. Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

  8. [The current situation and agendas in the prevention and control of non-communicable diseases in Vietnam].

    Science.gov (United States)

    Hattori, Kiyoko; Uda, Hidenori; Hitomi, Yoshiaki; Yano, Ryosuke; Saijo, Takao; Watanabe, Naoyuki; Satomi, Maki; Yoshida, Aya; Oishi, Osamu; Yamashita, Tsuyoshi; Kamenosono, Akira

    2018-01-01

    Objectives In Vietnam, the number of patients with non-communicable diseases (NCDs) has been increasing in recent years in association with the country's remarkable economic growth and corresponding changes in its population's lifestyle. The purposes of this research were to identify the challenges in the prevention and control of NCDs in Vietnam and to discuss countermeasures for NCDs in Vietnam and Japan.Methods As a 2015 Regional Public Health Overall Promotion Project, an investigation team consisting of 11 public health physicians visited Hanoi, the capital of Vietnam, and its vicinities from January 11, 2016 to January 15, 2016. In Hanoi and its vicinities, we visited local healthcare institutions, such as the World Health Organization(WHO) Representative Office in Vietnam and Ministry of Health of Vietnam, and discussed the prevention and control of NCDs in Vietnam and Japan.Results According to a survey in 2014, 73% of people of all age groups in Vietnam died from NCDs and the number of people suffering from NCDs has been sharply increasing in recent years. Major behavioral risk factors are dietary risks, tobacco smoke, alcohol use, and physical inactivity. There are four main problems with prevention and control of NCDs: 1) low awareness among the people of NCDs, 2) regional disparity of medical services, 3) shortage of healthcare staff members with professional knowledge, and 4) poor NCD surveillance. In Vietnam, an NCD program with screening methods and medical guidelines for respective diseases was developed in 2002. However, it only covered tertiary prevention and did not fully describe the primary and secondary prevention measures. Currently, with the technical assistance of the WHO, the implementation of countermeasures emphasizing prevention and control to reduce NCD risk factors has only just begun.Conclusion It was considered that educating each person in Vietnam on NCD prevention measures would be necessary and that a national policy

  9. Prevention of unnecessary pregnancy terminations by counselling women on drug, chemical, and radiation exposure during the first trimester

    International Nuclear Information System (INIS)

    Koren, G.; Pastuszak, A.

    1990-01-01

    As part of a new approach to counselling pregnant women concerned about antenatal exposure to drugs, chemicals, or radiation, we measured their tendency to terminate their pregnancy by using a visual analogue scale (VAS). Analysis of 78 cases where women had less than 50% tendency to continue pregnancy before they were advised by us reveals that 61 decided to continue their pregnancy after the consultation (57 normal, healthy infants, four miscarriages) and 17 terminated. Women who continued their pregnancy significantly changed their tendency after we discussed relevant information with them (from 34.3 +/- 2.5% to 84.5 +/- 3.3%, P less than 0.00001), whereas most of those who eventually terminated pregnancy did not change their tendency to continue pregnancy beyond the 50% mark (from 24.8 +/- 5.4% to 45.1 +/- 9.8%) (P greater than 0.1). Only two of the women who terminated their pregnancy were exposed to teratogenic drugs; however, in most other cases, other obvious reasons, unrelated to the exposure in question, were identified by the women as leading reasons for termination. An appropriate intervention in early pregnancy can prevent unnecessary pregnancy terminations by correcting misinformation and thereby decreasing the unrealistically high perception of risk by women exposed to nonteratogens

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

    Directory of Open Access Journals (Sweden)

    Boveé Lian

    2012-12-01

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

  11. Executive summary: Pre-exposure prophylaxis for prevention of HIV infection in adults in Spain: July 2016.

    Science.gov (United States)

    Moreno, Santiago; Antela, Antonio; García, Felipe; Del Amo, Julia; Boix, Vicente; Coll, Pep; Fortuny, Claudia; Sirvent, Juan L Gómez; Gutiérrez, Félix; Iribarren, José A; Llibre, Josep M; Quirós, Juan C López Bernaldo de; Losa, Juan Emilio; Lozano, Ana; Meulbroek, Michael; Olalla, Julián; Pujol, Ferran; Pulido, Federico; Crespo Casal, Manuel; García, Juan González; Aldeguer, José López; Molina, Jose A Pérez; Podzamczer Palter, Daniel; Román, Antonio Rivero

    Administration of antiretroviral drugs to individuals exposed to, but not infected by, HIV has been shown to reduce the risk of transmission. The efficacy of pre-exposure prophylaxis (PrEP) makes it obligatory to include it in an integral program of prevention of HIV transmission, together with other measures, such as use of the condom, training, counseling, and appropriate treatment of infected individuals. In this document, the AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) provides its views on this important subject. The available evidence on the usefulness of PrEP in the prevention of transmission of HIV is presented, and the components that should make up a PrEP program and whose development and implementation are feasible in Spain are set out. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. Current-use pesticides in stream water and suspended particles following runoff: exposure, effects, and mitigation requirements.

    Science.gov (United States)

    Bereswill, Renja; Streloke, Martin; Schulz, Ralf

    2013-06-01

    The European Union's directive for sustainable use of pesticides requires implementing risk mitigation measures at streams threatened by pesticide entries. The need for mitigation measures was investigated at 10 stream sites within an intensively used arable region in central Germany by characterizing pesticide exposure following edge-of-field runoff and effects on the aquatic macroinvertebrates. Moreover, the influence of riparian buffer strip width (as a mitigation measure) at the sampling sites was considered. Generally, invertebrate fauna was dominated by pesticide-tolerant species, suggesting a high pesticide exposure at almost all sites. This result is also reflected by the elevated levels of suspended particle contamination in terms of toxic units (logTUMax  > -2), corresponding to one-hundredth of the median lethal concentration (LC50) to Daphnia magna. At two sites that received high aqueous-phase entries of the pyrethroid lambda-cyhalothrin (logTUMax  > -0.6), the abundance and number of sensitive species in terms of the species at risk index decreased during the pesticide application period. In contrast, no acute significant negative effects on macroinvertebrates were observed at sites characterised by low water-phase toxicity (logTUMax  < -3.5). An influence of riparian buffer strip width on pesticide exposure was not observed, supposedly because of the presence of erosion rills and ephemeral ditches. In conclusion, results show that mitigation measures (such as the improvement of currently present riparian buffer strips) are needed in the study area. Copyright © 2013 SETAC.

  13. Bleaching susceptibility and recovery of Colombian Caribbean corals in response to water current exposure and seasonal upwelling.

    Science.gov (United States)

    Bayraktarov, Elisa; Pizarro, Valeria; Eidens, Corvin; Wilke, Thomas; Wild, Christian

    2013-01-01

    Coral bleaching events are globally occurring more frequently and with higher intensity, mainly caused by increases in seawater temperature. In Tayrona National Natural Park (TNNP) in the Colombian Caribbean, local coral communities are subjected to seasonal wind-triggered upwelling events coinciding with stronger water currents depending on location. This natural phenomenon offers the unique opportunity to study potential water current-induced mitigation mechanisms of coral bleaching in an upwelling influenced region. Therefore, coral bleaching susceptibility and recovery patterns were compared during a moderate and a mild bleaching event in December 2010 and 2011, and at the end of the subsequent upwelling periods at a water current-exposed and -sheltered site of an exemplary bay using permanent transect and labeling tools. This was accompanied by parallel monitoring of key environmental variables. Findings revealed that in 2010 overall coral bleaching before upwelling was significantly higher at the sheltered (34%) compared to the exposed site (8%). Whereas 97% of all previously bleached corals at the water current-exposed site had recovered from bleaching by April 2011, only 77% recovered at the sheltered site, but 12% had died there. In December 2011, only mild bleaching (corals recovered significantly at both sites in the course of upwelling. No differences in water temperatures between sites occurred, but water current exposure and turbidity were significantly higher at the exposed site, suggesting that these variables may be responsible for the observed site-specific mitigation of coral bleaching. This indicates the existence of local resilience patterns against coral bleaching in Caribbean reefs.

  14. Bleaching susceptibility and recovery of Colombian Caribbean corals in response to water current exposure and seasonal upwelling.

    Directory of Open Access Journals (Sweden)

    Elisa Bayraktarov

    Full Text Available Coral bleaching events are globally occurring more frequently and with higher intensity, mainly caused by increases in seawater temperature. In Tayrona National Natural Park (TNNP in the Colombian Caribbean, local coral communities are subjected to seasonal wind-triggered upwelling events coinciding with stronger water currents depending on location. This natural phenomenon offers the unique opportunity to study potential water current-induced mitigation mechanisms of coral bleaching in an upwelling influenced region. Therefore, coral bleaching susceptibility and recovery patterns were compared during a moderate and a mild bleaching event in December 2010 and 2011, and at the end of the subsequent upwelling periods at a water current-exposed and -sheltered site of an exemplary bay using permanent transect and labeling tools. This was accompanied by parallel monitoring of key environmental variables. Findings revealed that in 2010 overall coral bleaching before upwelling was significantly higher at the sheltered (34% compared to the exposed site (8%. Whereas 97% of all previously bleached corals at the water current-exposed site had recovered from bleaching by April 2011, only 77% recovered at the sheltered site, but 12% had died there. In December 2011, only mild bleaching (<10% at both sites was observed, but corals recovered significantly at both sites in the course of upwelling. No differences in water temperatures between sites occurred, but water current exposure and turbidity were significantly higher at the exposed site, suggesting that these variables may be responsible for the observed site-specific mitigation of coral bleaching. This indicates the existence of local resilience patterns against coral bleaching in Caribbean reefs.

  15. The promises and challenges of pre-exposure prophylaxis as part of the emerging paradigm of combination HIV prevention.

    Science.gov (United States)

    Cáceres, Carlos F; Koechlin, Florence; Goicochea, Pedro; Sow, Papa-Salif; O'Reilly, Kevin R; Mayer, Kenneth H; Godfrey-Faussett, Peter

    2015-01-01

    Towards the end of the twentieth century, significant success was achieved in reducing incidence in several global HIV epidemics through ongoing prevention strategies. However, further progress in risk reduction was uncertain. For one thing, it was clear that social vulnerability had to be addressed, through research on interventions addressing health systems and other structural barriers. As soon as antiretroviral treatment became available, researchers started to conceive that antiretrovirals might play a role in decreasing either susceptibility in uninfected people or infectiousness among people living with HIV. In this paper we focus on the origin, present status, and potential contribution of pre-exposure prophylaxis (PrEP) within the combination HIV prevention framework. After a phase of controversy, PrEP efficacy trials took off. By 2015, daily oral PrEP, using tenofovir alone or in combination with emtricitabine, has been proven efficacious, though efficacy seems heavily contingent upon adherence to pill uptake. Initial demonstration projects after release of efficacy results have shown that PrEP can be implemented in real settings and adherence can be high, leading to high effectiveness. Despite its substantial potential, beliefs persist about unfeasibility in real-life settings due to stigma, cost, adherence, and potential risk compensation barriers. The strategic synergy of behavioural change communication, biomedical strategies (including PrEP), and structural programmes is providing the basis for the combination HIV prevention framework. If PrEP is to ever become a key component of that framework, several negative beliefs must be confronted based on emerging evidence; moreover, research gaps regarding PrEP implementation must be filled, and appropriate prioritization strategies must be set up. Those challenges are significant, proportional to the impact that PrEP implementation may have in the global response to HIV.

  16. Adherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Setting.

    Directory of Open Access Journals (Sweden)

    Madeline C Montgomery

    Full Text Available The HIV epidemic in the United States (US disproportionately affects gay, bisexual, and other men who have sex with men (MSM. Pre-exposure prophylaxis (PrEP using co-formulated tenofovir disoproxil fumarate (TDF and emtricitabine (FTC has demonstrated high efficacy in reducing HIV incidence among MSM. However, low adherence was reported in major efficacy trials and may present a substantial barrier to successful PrEP implementation. Rates of adherence to PrEP in "real-world" clinical settings in the US remain largely unknown.We reviewed demographic and clinical data for the first 50 patients to enroll in a clinical PrEP program in Providence, Rhode Island. We analyzed self-reported drug adherence as well as drug concentrations in dried blood spots (DBS from patients who attended either a three- or six-month follow-up appointment. We further assessed drug concentrations and the resistance profile of a single patient who seroconverted while taking PrEP.Of the first 50 patients to be prescribed PrEP, 62% attended a follow-up appointment at three months and 38% at six months. Of those who attended an appointment at either time point (70%, n = 35, 92% and 95% reported taking ±4 doses/week at three and six months, respectively. Drug concentrations were performed on a random sample of 20 of the 35 patients who attended a follow-up appointment. TDF levels consistent with ±4 doses/week were found in 90% of these patients. There was a significant correlation between self-reported adherence and drug concentrations (r = 0.49, p = 0.02. One patient who had been prescribed PrEP seroconverted at his three-month follow-up visit. The patient's drug concentrations were consistent with daily dosing. Population sequencing and ultrasensitive allele-specific PCR detected the M184V mutation, but no other TDF- or FTC-associated mutations, including those present as minor variants.In this clinical PrEP program, adherence was high, and self-reported drug adherence

  17. Adherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Setting.

    Science.gov (United States)

    Montgomery, Madeline C; Oldenburg, Catherine E; Nunn, Amy S; Mena, Leandro; Anderson, Peter; Liegler, Teri; Mayer, Kenneth H; Patel, Rupa; Almonte, Alexi; Chan, Philip A

    2016-01-01

    The HIV epidemic in the United States (US) disproportionately affects gay, bisexual, and other men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) using co-formulated tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) has demonstrated high efficacy in reducing HIV incidence among MSM. However, low adherence was reported in major efficacy trials and may present a substantial barrier to successful PrEP implementation. Rates of adherence to PrEP in "real-world" clinical settings in the US remain largely unknown. We reviewed demographic and clinical data for the first 50 patients to enroll in a clinical PrEP program in Providence, Rhode Island. We analyzed self-reported drug adherence as well as drug concentrations in dried blood spots (DBS) from patients who attended either a three- or six-month follow-up appointment. We further assessed drug concentrations and the resistance profile of a single patient who seroconverted while taking PrEP. Of the first 50 patients to be prescribed PrEP, 62% attended a follow-up appointment at three months and 38% at six months. Of those who attended an appointment at either time point (70%, n = 35), 92% and 95% reported taking ±4 doses/week at three and six months, respectively. Drug concentrations were performed on a random sample of 20 of the 35 patients who attended a follow-up appointment. TDF levels consistent with ±4 doses/week were found in 90% of these patients. There was a significant correlation between self-reported adherence and drug concentrations (r = 0.49, p = 0.02). One patient who had been prescribed PrEP seroconverted at his three-month follow-up visit. The patient's drug concentrations were consistent with daily dosing. Population sequencing and ultrasensitive allele-specific PCR detected the M184V mutation, but no other TDF- or FTC-associated mutations, including those present as minor variants. In this clinical PrEP program, adherence was high, and self-reported drug adherence accurately

  18. Current status of personnel exposure at nuclear power plants and other medical, industrial and educational facilities in JAPAN

    International Nuclear Information System (INIS)

    Sasaki, Fumiaki

    1991-01-01

    The state of radiation exposure of the workers engaging in radiation works in Japanese nuclear power stations, the factors of the radiation exposure of the workers engaging in radiation works, the countermeasures for reducing exposure in nuclear power stations, the state of radiation exposure of doctors, the workers engaging in radiation works, researchers and others in medical, industrial, research and educational and other facilities in Japan, the factors of their radiation exposure and the countermeasures for reducing the exposure, and the comparison of the exposure in nuclear power stations with that in medical, industrial, research and educational facilities are reported. (K.I.)

  19. Preventing tomorrow's sudden cardiac death today: part I: Current data on risk stratification for sudden cardiac death.

    Science.gov (United States)

    Al-Khatib, Sana M; Sanders, Gillian D; Bigger, J Thomas; Buxton, Alfred E; Califf, Robert M; Carlson, Mark; Curtis, Anne; Curtis, Jeptha; Fain, Eric; Gersh, Bernard J; Gold, Michael R; Haghighi-Mood, Ali; Hammill, Stephen C; Healey, Jeff; Hlatky, Mark; Hohnloser, Stefan; Kim, Raymond J; Lee, Kerry; Mark, Daniel; Mianulli, Marcus; Mitchell, Brent; Prystowsky, Eric N; Smith, Joseph; Steinhaus, David; Zareba, Wojciech

    2007-06-01

    Accurate and timely prediction of sudden cardiac death (SCD) is a necessary prerequisite for effective prevention and therapy. Although the largest number of SCD events occurs in patients without overt heart disease, there are currently no tests that are of proven predictive value in this population. Efforts in risk stratification for SCD have focused primarily on predicting SCD in patients with known structural heart disease. Despite the ubiquity of tests that have been purported to predict SCD vulnerability in such patients, there is little consensus on which test, in addition to the left ventricular ejection fraction, should be used to determine which patients will benefit from an implantable cardioverter defibrillator. On July 20 and 21, 2006, a group of experts representing clinical cardiology, cardiac electrophysiology, biostatistics, economics, and health policy were joined by representatives of the US Food and Drug administration, Centers for Medicare Services, Agency for Health Research and Quality, the Heart Rhythm Society, and the device and pharmaceutical industry for a round table meeting to review current data on strategies of risk stratification for SCD, to explore methods to translate these strategies into practice and policy, and to identify areas that need to be addressed by future research studies. The meeting was organized by the Duke Center for the Prevention of SCD at the Duke Clinical Research Institute and was funded by industry participants. This article summarizes the presentations and discussions that occurred at that meeting.

  20. Current and historical individual data about exposure of workers in the rayon industry to carbon disulfide and their validity in calculating the cumulative dose.

    Science.gov (United States)

    Göen, Thomas; Schramm, Axel; Baumeister, Thomas; Uter, Wolfgang; Drexler, Hans

    2014-08-01

    The objective of the study was to investigate how exposure to carbon disulfide (CS2) in a rayon-manufacturing plant has changed within two decades and whether it is possible to calculate valid data for the individual cumulative exposure. The data for CS2 concentration in air and biological exposure monitoring (2-thio-1,3-thiaxolidine-4-carboxylic acid (TTCA) in urine) from two cross-sectional studies, performed in 1992 (n = 362) and 2009 (n = 212) in a German rayon-manufacturing plant, were compared to data obtained from company-internal measurements between the studies. Using the data from the cross-sectional studies and company-internal data, cumulative external exposure and the cumulative internal exposure were calculated for each worker. External and internal CS2 exposure of the employees decreased from 1992 (medians 4.0 ppm and 1.63 mgTTCA/g creatinine) to 2009 (medians 2.5 ppm and 0.86 mg/g). However, company-internal CS2 data do not show a straight trend for this period. The annual medians of the company-internal measurement of external exposure to CS2 have varied between 2.7 and 8.4 ppm, in which median values exceeded 5 ppm generally since 2000. The annual medians for the company-internal biomonitoring assessment ranged between 1.2 and 2.8 mg/g creatinine. The cumulative CS2 exposure ranged from 8.5 to 869.5 ppm years for external exposure and between 1.30 and 176.2 mg/g creatinine years for the internal exposure. Significant correlations were found between the current air pollution and the internal exposure in 2009 but also between the cumulative external and internal CS2 exposure. Current exposure data, usually collected in cross-sectional studies, rarely allow a reliable statement on the cumulative dose, because of higher exposure in the past and of fluctuating courses of exposure. On the other hand, company-internal exposure data may be affected by non-representative measurement strategies. Some verification of the reliability of

  1. Respirable coal dust exposure and respiratory symptoms in South-African coal miners: A comparison of current and ex-miners

    Energy Technology Data Exchange (ETDEWEB)

    Naidoo, R.N.; Robins, T.G.; Seixas, N.; Lalloo, U.G.; Becklake, M. [University of KwaZuluNatal, Congella (South Africa). Nelson R Mandela School of Medicine

    2006-06-15

    Dose-response associations between respirable dust exposure and respiratory symptoms and between symptoms and spirometry outcomes among currently employed and formerly employed South-African coal miners were investigated. Work histories, interviews, and spirometry and cumulative exposure were assessed among 684 current and 212 ex-miners. Results: Lower prevalences of symptoms were found among employed compared with ex-miners. Associations with increasing exposure for symptoms of phlegm and past history of tuberculosis were observed, whereas other symptom prevalences were higher in the higher exposure categories. Symptomatic ex-miners exhibited lower lung-function compared to the nonsymptomatic. Compared with published data, symptoms rates were low in current miners but high in ex-miners. Although explanations could include the low prevalence of smoking and/or reporting/selection bias, a 'Survivor' and/or a 'hire' effect is more likely, resulting in an underestimation of the dust-related effect.

  2. Potential exposure to Australian bat lyssavirus is unlikely to prevent future bat handling among adults in South East Queensland.

    Science.gov (United States)

    Young, M K; Banu, S; McCall, B J; Vlack, S; Carroll, H; Bennett, S; Davison, R; Francis, D

    2018-02-01

    Despite ongoing public health messages about the risks associated with bat contact, the number of potential exposures to Australian bat lyssavirus (ABLV) due to intentional handling by members of the general public in Queensland has remained high. We sought to better understand the reasons for intentional handling among these members of the public who reported their potential exposure to inform future public health messages. We interviewed adults who resided in a defined geographic area in South East Queensland and notified potential exposure to ABLV due to intentional handling of bats by telephone between 1 January 2012 and 31 December 2013. The participation rate was 54%. Adults who reported they had intentionally handled bats in South East Queensland indicated high levels of knowledge and perception of a moderately high risk associated with bats with overall low intentions to handle bats in the future. However, substantial proportions of people would attempt to handle bats again in some circumstances, particularly to protect their children or pets. Fifty-two percent indicated that they would handle a bat if a child was about to pick up or touch a live bat, and 49% would intervene if a pet was interacting with a bat. Future public health communications should recognize the situations in which even people with highrisk perceptions of bats will attempt to handle them. Public health messages currently focus on avoidance of bats in all circumstances and recommend calling in a trained vaccinated handler, but messaging directed at adults for circumstances where children or pets may be potentially exposed should provide safe immediate management options. © 2017 Blackwell Verlag GmbH.

  3. Soil intervention as a strategy for lead exposure prevention: The New Orleans lead-safe childcare playground project

    Energy Technology Data Exchange (ETDEWEB)

    Mielke, Howard W., E-mail: howard.mielke@gmail.com [Department of Chemistry, Tulane University, New Orleans, LA 70118 (United States); Center for Bioenvironmental Research at Tulane and Xavier Universities, 1430 Tulane Avenue SL-3, New Orleans, LA 70112 (United States); Covington, Tina P. [Charity School of Nursing, Delgado Community College, New Orleans, LA 70112-1397 (United States); College of Nursing, University of South Alabama, Doctor of Nursing Practice Program (student), Mobile AL 36688-0002 (United States); Mielke, Paul W. [Department of Statistics, Colorado State University, Fort Collins, CO 80523-1877 (United States); Wolman, Fredericka J. [Director of Pediatrics, Department of Children and Families, State of Connecticut, Hartford, CT 06473 (United States); Powell, Eric T.; Gonzales, Chris R. [Lead Lab, Inc., New Orleans, LA 70179-1125 (United States)

    2011-08-15

    The feasibility of reducing children's exposure to lead (Pb) polluted soil in New Orleans is tested. Childcare centers (median = 48 children) are often located in former residences. The extent of soil Pb was determined by selecting centers in both the core and outlying areas. The initial 558 mg/kg median soil Pb (range 14-3692 mg/kg) decreased to median 4.1 mg/kg (range 2.2-26.1 mg/kg) after intervention with geotextile covered by 15 cm of river alluvium. Pb loading decreased from a median of 4887 {mu}g/m{sup 2} (454 {mu}g/ft{sup 2}) range 603-56650 {mu}g/m{sup 2} (56-5263 {mu}g/ft{sup 2}) to a median of 398 {mu}g/m{sup 2} (37 {mu}g/ft{sup 2}) range 86-980 {mu}g/m{sup 2} (8-91 {mu}g/ft{sup 2}). Multi-Response Permutation Procedures indicate similar (P-values = 0.160-0.231) soil Pb at childcare centers compared to soil Pb of nearby residential communities. At {approx}$100 per child, soil Pb and surface loading were reduced within hours, advancing an upstream intervention conceptualization about Pb exposure prevention. - Highlights: > Upstream thinking refers to attending to causative agents that affect outcomes. > New Orleans has a high density soil Pb map of all residential communities. > Many childcare centers are located in Pb polluted residential communities. > Evaluation of childcare center playground soils substantiated severe Pb pollution. > Pursuing upstream thinking, low Pb soil was put on playgrounds to protect children. - Within hours, at a cost of about U.S. $100 (2010) per child, it is feasible to transform exterior play areas at childcare centers from Pb contaminated to Pb-safe with a large margin of safety.

  4. Identifying inequitable exposure to toxic air pollution in racialized and low-income neighbourhoods to support pollution prevention

    Directory of Open Access Journals (Sweden)

    Suzanne Kershaw

    2013-05-01

    Full Text Available Numerous environmental justice studies have confirmed a relationship between population characteristics such as low-income or minority status and the location of environmental health hazards. However, studies of the health risks from exposure to harmful substances often do not consider their toxicological characteristics. We used two different methods, the unit-hazard and the distance-based approach, to evaluate demographic and socio-economic characteristics of the population residing near industrial facilities in the City of Toronto, Canada. In addition to the mass of air emissions obtained from the national pollutant release inventory (NPRI, we also considered their toxicity using toxic equivalency potential (TEP scores. Results from the unit-hazard approach indicate no significant difference in the proportion of low-income individuals living in host versus non-host census tracts (t(107 = 0.3, P = 0.735. However, using the distance-based approach, the proportion of low-income individuals was significantly higher (+5.1%, t(522 = 6.0, P <0.001 in host tracts, while the indicator for “racialized” communities (“visible minority” was 16.1% greater (t(521 = 7.2, P <0.001 within 2 km of a NPRI facility. When the most toxic facilities by non-carcinogenic TEP score were selected, the rate of visible minorities living near the most toxic NPRI facilities was significantly higher (+12.9%, t(352 = 3.5, P = 0.001 than near all other NPRI facilities. TEP scores were also used to identify areas in Toronto that face a double burden of poverty and air toxics exposure in order to prioritise pollution prevention.

  5. Assessment of preventive measures for accidental blood exposure in operating theaters: a survey of 20 hospitals in Northern France.

    Science.gov (United States)

    Tarantola, Arnaud; Golliot, Franck; L'Heriteau, François; Lebascle, Karin; Ha, Catherine; Farret, Danièle; Bignon, Sylvie; Smaïl, Amar; Doutrellot-Philippon, Catherine; Astagneau, Pascal; Bouvet, Elisabeth

    2006-08-01

    Accidental exposures to blood of body fluids (ABE) expose health care workers (HCW) to the risk of occupational infection. Our aim was to assess the prevention equipment available in the operating theater (OT) with reference to guidelines or recommendations and its use by the staff in that OT on that day and past history of ABE. Correspondents of the Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN) Paris-Nord ABE Surveillance Taskforce carried out an observational multicenter survey in 20 volunteer French hospitals. In total, 260 operating staff (including 151 surgeons) were investigated. Forty-nine of the 260 (18.8%) staff said they double-gloved for all patients and procedures, changing gloves hourly. Blunt-tipped suture needles were available in 49.1% of OT; 42 of 76 (55.3%) of the surgeons in these OT said they never used them. Overall, 60% and 64% of surgeons had never self-tested for HIV and hepatitis C virus (HCV), respectively. Fifty-five surgeons said they had sustained a total of 96 needlestick injuries during the month preceding the survey. Ten of these surgeons had notified of 1 needlestick injury each to the occupational health department of their hospital (notification rate, 10.4%). The occurrence of needlestick injury remained high in operating personnel in France in 2000. Although hospitals may improve access to protective devices, operating staff mindful of safety in the OT should increase their use of available devices, their knowledge of their own serostatus, and their ABE notification rate to guide well-targeted prevention efforts.

  6. Current standard rules of combined anteversion prevent prosthetic impingement but ignore osseous contact in total hip arthroplasty.

    Science.gov (United States)

    Weber, Markus; Woerner, Michael; Craiovan, Benjamin; Voellner, Florian; Worlicek, Michael; Springorum, Hans-Robert; Grifka, Joachim; Renkawitz, Tobias

    2016-12-01

    In this prospective study of 135 patients undergoing cementless total hip arthroplasty (THA) we asked whether six current definitions of combined anteversion prevent impingement and increase postoperative patient individual impingement-free range-of-motion (ROM). Implant position was measured by an independent, external institute on 3D-CT performed six weeks post-operatively. Post-operative ROM was calculated using a CT-based algorithm detecting osseous and/or prosthetic impingement by virtual hip movement. Additionally, clinical ROM was evaluated pre-operatively and one-year post-operatively by a blinded observer. Combined component position of cup and stem according to the definitions of Ranawat, Widmer, Dorr, Hisatome and Yoshimine inhibited prosthetic impingement in over 90 %, while combined osseous and prosthetic impingement still occurred in over 40 % of the cases. The recommendations by Jolles, Widmer, Dorr, Yoshimine and Hisatome enabled higher flexion (p ≤ 0.001) and internal rotation (p ≤ 0.006). Clinically, anteversion rules of Widmer and Yoshimine provided one-year post-operatively statistically but not clinically relevant higher internal rotation (p ≤0.034). Standard rules of combined anteversion detect prosthetic but fail to prevent combined osseous and prosthetic impingement in THA. Future models will have to account for the patient-individual anatomic situation to ensure impingement-free ROM.

  7. Current-day precision oncology: from cancer prevention, screening, drug development, and treatment - have we fallen short of the promise?

    Science.gov (United States)

    Morgan, Gilberto; Aftimos, Philippe; Awada, Ahmad

    2016-09-01

    Precision oncology has been a strategy of prevention, screening, and treatment. Although much has been invested, have the results fallen so far short of the promise? The advancement of technology and research has opened new doors, yet a variety of pitfalls are present. This review presents the successes, failures, and opportunities of precision oncology in the current landscape. The use of targeted gene sequencing and the overwhelming results of superresponders have generated much excitement and support for precision oncology from the medical community. Despite notable successes, many challenges still pave the way of precision oncology: intratumoral heterogeneity, the need for serial biopsies, availability of treatments, target prioritization, ethical issues with germline incidental findings, medical education, clinical trial design, and costs. Precision oncology shows much potential through the use of next-generation sequencing and molecular advances, but does this potential warrant the investment? There are many obstacles on the way of this technology that should make us question if the investment (both monetary and man-hours) will live up to the promise. The review aims to not criticize this technology, but to give a realistic view of where we are, especially regarding cancer treatment and prevention.

  8. Cost-effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV-1 infections in rural Zambia: a modeling study

    NARCIS (Netherlands)

    Nichols, B.E.; Boucher, C.A.B.; van Dijk, J.H.; Thuma, P.E.; Nouwen, J.L.; Baltussen, R.; van de Wijgert, J.; Sloot, P.M.A.; van de Vijver, D.A.M.C.

    2013-01-01

    Background: Pre-exposure prophylaxis (PrEP) with tenofovir and emtricitabine effectively prevents new HIV infections. The optimal scenario for implementing PrEP where most infections are averted at the lowest cost is unknown. We determined the impact of different PrEP strategies on averting new

  9. The current status of syphilis prevention and control in Jiangsu province, China: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Yuan-Fang Chen

    Full Text Available To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010-2020 and evaluate the current status of syphilis prevention and control in Jiangsu province, China.We collected data via (1 field surveys conducted in 2015 and (2 data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control.The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000 to 2015 (30.1 per 100,000, with an annual growth of -1.17% (x2trend = -7.52, P<0.001 in Jiangsu province. The incidence of primary and secondary syphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963. Rural residents had the lowest awareness rate (83.5%, 1875/2245 and commercial sex workers had the highest awareness rate (92.1%, 7804/8474 in 2015. Only 47.8% (33908/70894 of patients received provider-initiated syphilis counseling and testing (PISTC services in sexually transmitted disease (STD clinics, but 94.5% (87927/93020 of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648 of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345 of patients diagnosed with syphilis at medical institutions received treatment with penicillin.The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province.

  10. The current status of syphilis prevention and control in Jiangsu province, China: A cross-sectional study.

    Science.gov (United States)

    Chen, Yuan-Fang; Ding, Jian-Ping; Yan, Hong-Jing; Lu, Jing; Ding, Ping; Chen, Guo-Hong; Li, Jian-Jun; Huan, Xi-Ping; Yang, Hai-Tao; Tang, Wei-Ming; Fu, Geng-Feng

    2017-01-01

    To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010-2020) and evaluate the current status of syphilis prevention and control in Jiangsu province, China. We collected data via (1) field surveys conducted in 2015 and (2) data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control. The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000) to 2015 (30.1 per 100,000), with an annual growth of -1.17% (x2trend = -7.52, Psyphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963). Rural residents had the lowest awareness rate (83.5%, 1875/2245) and commercial sex workers had the highest awareness rate (92.1%, 7804/8474) in 2015. Only 47.8% (33908/70894) of patients received provider-initiated syphilis counseling and testing (PISTC) services in sexually transmitted disease (STD) clinics, but 94.5% (87927/93020) of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648) of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345) of patients diagnosed with syphilis at medical institutions received treatment with penicillin. The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province.

  11. Low willingness and actual uptake of pre-exposure prophylaxis for HIV-1 prevention among men who have sex with men in Shanghai, China.

    Science.gov (United States)

    Ding, Yingying; Yan, Huamei; Ning, Zhen; Cai, Xiaofeng; Yang, Yin; Pan, Rong; Zhou, Yanqiu; Zheng, Huang; Gao, Meiyang; Rou, Keming; Wu, Zunyou; He, Na

    2016-05-23

    Little is known about the acceptance and actual uptake of pre-exposure prophylaxis (PrEP) and associated factors in men who have sex with men (MSM) in China. This study is the baseline survey of an intervention study designed to evaluate the effectiveness of tenofovirdisoproxil fumarate (TDF) on a daily use for human immunodeficiency virus (HIV) prevention among MSM in Shanghai, China. From October 2012 to December 2013, a total of 1,033 MSM in Shanghai were recruited by local district Centers for Disease Control and Prevention (CDC) and a MSM community-based non-governmental organization (NGO). Among them, 197 (19.1%) participants expressed willingness to use the TDF group at baseline survey, but only 26 (2.5%) participated in the TDF group and took TDF one tablet a day. Higher willingness to use PrEP was associated with being 45 years or older, non-local residents, having more male sex partners in the past 6 months and not using condom at last anal sex with man. Acutal uptake of PrEP was associated with having ≥ 11 male sex partners in lifetime and reporting no female sex partners in lifetime. Reasons for not participating in TDF group among those who expressed willingness to use PrEP at baseline survey included loss of contact, ineligiblity because of abnormal results for liver or renal function tests, change of mind, and HIV seroconversion before uptake of PrEP. Our findings suggest that promotion of PrEP in MSM remains challenging at current circumstancein China. Future research is needed to solicit effective education and intervention programs to promote acceptance of PrEP among Chinese MSM.

  12. Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.

    Science.gov (United States)

    Pinto, Anthony; Liebowitz, Michael R; Foa, Edna B; Simpson, H Blair

    2011-08-01

    Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Configuring the users of new HIV-prevention technologies: the case of HIV pre-exposure prophylaxis.

    Science.gov (United States)

    Holt, Martin

    2015-01-01

    HIV pre-exposure prophylaxis (PrEP) is a prevention technology that involves prescribing antiretroviral drugs to HIV-negative people to protect them from infection. This paper considers how the development of the technology has necessitated the parallel configuration of its users, and how this process has affected the perception and uptake of the technology. In designing a technology, potential users are typically defined, enabled and constrained, partly to create a target population (or market) for the technology, but also to reassure people that it can be used safely and effectively. This process may or may not be helpful for the uptake and use of the technology. Published research on PrEP indicates that while the technology was under trial, the primary focus was on the 'at-risk' subject in need of PrEP, with little or no consideration of the other qualities necessary for successful use. Post-trial accounts of PrEP have begun to outline desirable qualities of successful PrEP use, such as caution, compliance and being organised. It appears that the PrEP user was only partially configured during the technology's development, and the initial focus on risk has done little to counter fears of the technology, which may partially account for its slow uptake.

  14. Potassium iodide (KI) to block the thyroid from exposure to I-131: current questions and answers to be discussed

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, Christoph; Schneider, Rita [Hospital of the University of Wuerzburg, Department of Nuclear Medicine, German WHO-REMPAN Collaboration Center, Wuerzburg (Germany)

    2013-05-15

    Thyroid cancer in children and adolescents has to be considered as the most severe health consequence of a nuclear reactor emergency with release of radioiodine into the atmosphere. High doses of potassium iodide are effective to block radioiodine thyroid uptake and to prevent development of thyroid cancer years later. However, there are controversies concerning thyroid cancer risk induced by radioiodine exposure in adults. Further, the interaction of nutritional supply of potassium iodide and radioiodine uptake as well as the interaction of radioiodine with certain drugs has not been addressed properly in existing guidelines and recommendations. How to proceed in case of repeated release of radioiodine is an open, very important question which came up again recently during the Fukushima accident. Lastly, the side effects of iodine thyroid blocking and alternatives of this procedure have not been addressed systematically up to now in guidelines and recommendations. These questions can be answered as follows: in adults, the risk to develop thyroid cancer is negligible. In countries, where nutritional iodine deficiency is still an issue, the risk to develop thyroid cancer after a nuclear reactor emergency has to be considered higher because the thyroid takes up more radioiodine as in the replete condition. Similarly, in patients suffering from thyrotoxicosis, hypothyroidism or endemic goitre not being adequately treated radioiodine uptake is higher than in healthy people. In case of repeated or continued radioiodine release, more than one dose of potassium iodide may be necessary and be taken up to 1 week. Repeated iodine thyroid blocking obviously is not harmful. Side effects of iodine thyroid blocking should not be overestimated; there is little evidence for adverse effects in adults. Newborns and babies, however, may be more sensitive to side effects. In the rare case of iodine hypersensitivity, potassium perchlorate may be applied as an alternative to iodine for

  15. HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report.

    Science.gov (United States)

    Adams, Leah M; Balderson, Benjamin H

    2016-09-01

    Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers for Disease Control (CDC) have released detailed guidelines to aid providers in prescribing PrEP for their high-risk patients, including men who have sex with men (MSM), high-risk heterosexuals, and injection drug users (IDUs). Given that much attention in PrEP has focused on MSM patients, the present study used an online survey to assess factors involved in HIV care providers' (n = 363) decisions about prescribing PrEP, along with their willingness to prescribe PrEP to patients from various risk populations (e.g., MSM, heterosexuals, IDUs). The efficacy of PrEP was an important factor in providers' decisions about prescribing PrEP, as were considerations about patients' adherence to the regimen, regular follow-up for care, and medication costs. This survey's findings also suggest that providers' willingness to prescribe PrEP varies by patient group, with providers most willing to initiate the regimen with MSM who have an HIV-positive partner, and least willing to prescribe to high-risk heterosexuals or IDUs. In the context of the current CDC recommendations for PrEP that include MSM, heterosexuals, and IDUs, examining providers' rationales for and barriers against supporting this HIV prevention strategy across patient groups merits further attention.

  16. Maternal exposure to GOS/inulin mixture prevents food allergies and promotes tolerance in offspring in mice.

    Science.gov (United States)

    Bouchaud, G; Castan, L; Chesné, J; Braza, F; Aubert, P; Neunlist, M; Magnan, A; Bodinier, M

    2016-01-01

    Food allergies affect 4-8% of children and are constantly on the rise, thus making allergies a timely issue. Most importantly, prevention strategies are nonexistent, and current therapeutic strategies have limited efficacy and need to be improved. One alternative to prevent or reduce allergies, particularly during infancy, could consist of modulating maternal immunity and microbiota using nondigestible food ingredients, such as prebiotics. For this purpose, we studied the preventive effects of prebiotics in Balb/c mothers during pregnancy and breastfeeding on food allergy development in offspring mice. After weaning, the offspring from mothers that were exposed to GOS/inulin mixture or fed a control diet were intraperitoneally sensitized to wheat proteins to induce a systemic allergic response and orally exposed to the same allergen. Immunological, physiological, and microbial parameters were analyzed. GOS/inulin mixture diet modified the microbiota of mothers and their offspring. Offspring from mothers that received GOS/inulin prebiotics were protected against food allergies and displayed lower clinical scores, specifically of IgE and histamine levels, compared to offspring from mothers fed a control diet. Moreover, GOS/inulin supplementation for the mother resulted in stronger intestinal permeability in the offspring. Enhancement of the regulatory response to allergic inflammation and changes in the Th2/Th1 balance toward a dampened Th2 response were observed in mice from GOS/inulin mixture-exposed mothers. The treatment of pregnant and lactating mice with nondigestible GOS/inulin prebiotics promotes a long-term protective effect against food allergies in the offspring. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Human immunodeficiency virus and hepatitis B virus infection prevention following occupational exposure among staff at a regional referral hospital in Western Kenya

    Directory of Open Access Journals (Sweden)

    Barbara Kabai Burmen

    2018-01-01

    Full Text Available Background: Postexposure prophylaxis (PEP with antiretroviral therapy (ART and vaccination against hepatitis B virus (HBV aides in preventing human immunodeficiency virus (HIV infection and HBV, respectively, from accidental or occupational exposure. We assessed compliance to guidelines for HIV and HBV prevention after occupational exposure among hospital staff at a referral Kenyan hospital. Methods: We reviewed PEP registers for hospital staff reporting an occupational injury at a referral hospital in Western Kenya between January 2011 and December 2012. Proportions were used to summarize number of participants receiving the recommended services, Kaplan–Meier curves were used to describe time to ART initiation, and Chi-square statistics was used to describe the association between participant characteristics and PEP completion rates. P < 0.05 was considered statistically significant. Results: Majority of documented hospital staff (n = 52 were health workers (63% and students (27% and had high HIV risk exposures (97%. All had timely PEP initiation with 50% completing PEP. Completion rates did not vary by gender (P = 0.78, exposure type (P = 1.0, or department of exposure (P = 0.75. Retesting for HIV and negativity rates at months 1.5, 3, and 6 were 96%, 25%, and 17% and 100%, 100%, and 100%, respectively. At the time of exposure, 17% (9 of staff were HBV vaccinated and HBV status of sources was unknown; no intervention was provided for HBV prevention. Conclusions: Low rates of completion and follow-up negate intended benefits of PEP. Efforts should be directed to enforce universal precaution practices and completion of PEP. Low rates of HBV testing and vaccination illustrate the need for support for the implementation of HBV prevention guidelines.

  18. Preventing Firefighter Exposure Hazards

    Science.gov (United States)

    2017-09-01

    exposed to whenever they remove their self- contained breathing equipment at the scene of a fire. If the high percentage of synthetic materials used...from their self- contained portable breathing apparatus.56 In February 1991, three firefighters died at the Meridian high -rise fire in Philadelphia... AVAILABILITY STATEMENT Approved for public release. Distribution is unlimited. 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200words) This thesis

  19. Ursodeoxycholic acid prevents ventricular conduction slowing and arrhythmia by restoring T-type calcium current in fetuses during cholestasis

    Science.gov (United States)

    Adeyemi, Oladipupo; Alvarez-Laviada, Anita; Schultz, Francisca; Ibrahim, Effendi; Trauner, Michael; Williamson, Catherine; Glukhov, Alexey V.

    2017-01-01

    Background Increased maternal serum bile acid concentrations in intrahepatic cholestasis of pregnancy (ICP) are associated with fetal cardiac arrhythmias. Ursodeoxycholic acid (UDCA) has been shown to demonstrate anti-arrhythmic properties via preventing ICP-associated cardiac conduction slowing and development of reentrant arrhythmias, although the cellular mechanism is still being elucidated. Methods High-resolution fluorescent optical mapping of electrical activity and electrocardiogram measurements were used to characterize effects of UDCA on one-day-old neonatal and adult female Langendorff-perfused rat hearts. ICP was modelled by perfusion of taurocholic acid (TC, 400μM). Whole-cell calcium currents were recorded from neonatal rat and human fetal cardiomyocytes. Results TC significantly prolonged the PR interval by 11.0±3.5% (P<0.05) and slowed ventricular conduction velocity (CV) by 38.9±5.1% (P<0.05) exclusively in neonatal and not in maternal hearts. A similar CV decline was observed with the selective T-type calcium current (ICa,T) blocker mibefradil 1μM (23.0±6.2%, P<0.05), but not with the L-type calcium current (ICa,L) blocker nifedipine 1μM (6.9±6.6%, NS). The sodium channel blocker lidocaine (30μM) reduced CV by 60.4±4.5% (P<0.05). UDCA co-treatment was protective against CV slowing induced by TC and mibefradil, but not against lidocaine. UDCA prevented the TC-induced reduction in the ICa,T density in both isolated human fetal (−10.2±1.5 versus −5.5±0.9 pA/pF, P<0.05) and neonatal rat ventricular myocytes (−22.3±1.1 versus −9.6±0.8 pA/pF, P<0.0001), whereas UDCA had limited efficacy on the ICa,L. Conclusion Our findings demonstrate that ICa,T plays a significant role in ICP-associated fetal cardiac conduction slowing and arrhythmogenesis, and is an important component of the fetus-specific anti-arrhythmic activity of UDCA. PMID:28934223

  20. Ursodeoxycholic acid prevents ventricular conduction slowing and arrhythmia by restoring T-type calcium current in fetuses during cholestasis.

    Directory of Open Access Journals (Sweden)

    Oladipupo Adeyemi

    Full Text Available Increased maternal serum bile acid concentrations in intrahepatic cholestasis of pregnancy (ICP are associated with fetal cardiac arrhythmias. Ursodeoxycholic acid (UDCA has been shown to demonstrate anti-arrhythmic properties via preventing ICP-associated cardiac conduction slowing and development of reentrant arrhythmias, although the cellular mechanism is still being elucidated.High-resolution fluorescent optical mapping of electrical activity and electrocardiogram measurements were used to characterize effects of UDCA on one-day-old neonatal and adult female Langendorff-perfused rat hearts. ICP was modelled by perfusion of taurocholic acid (TC, 400μM. Whole-cell calcium currents were recorded from neonatal rat and human fetal cardiomyocytes.TC significantly prolonged the PR interval by 11.0±3.5% (P<0.05 and slowed ventricular conduction velocity (CV by 38.9±5.1% (P<0.05 exclusively in neonatal and not in maternal hearts. A similar CV decline was observed with the selective T-type calcium current (ICa,T blocker mibefradil 1μM (23.0±6.2%, P<0.05, but not with the L-type calcium current (ICa,L blocker nifedipine 1μM (6.9±6.6%, NS. The sodium channel blocker lidocaine (30μM reduced CV by 60.4±4.5% (P<0.05. UDCA co-treatment was protective against CV slowing induced by TC and mibefradil, but not against lidocaine. UDCA prevented the TC-induced reduction in the ICa,T density in both isolated human fetal (-10.2±1.5 versus -5.5±0.9 pA/pF, P<0.05 and neonatal rat ventricular myocytes (-22.3±1.1 versus -9.6±0.8 pA/pF, P<0.0001, whereas UDCA had limited efficacy on the ICa,L.Our findings demonstrate that ICa,T plays a significant role in ICP-associated fetal cardiac conduction slowing and arrhythmogenesis, and is an important component of the fetus-specific anti-arrhythmic activity of UDCA.

  1. Physiologically based pharmacokinetic modeling of human exposure to perfluorooctanoic acid suggests historical non drinking-water exposures are important for predicting current serum concentrations.

    Science.gov (United States)

    Worley, Rachel Rogers; Yang, Xiaoxia; Fisher, Jeffrey

    2017-09-01

    Manufacturing of perfluorooctanoic acid (PFOA), a synthetic chemical with a long half-life in humans, peaked between 1970 and 2002, and has since diminished. In the United States, PFOA is detected in the blood of >99% of people tested, but serum concentrations have decreased since 1999. Much is known about exposure to PFOA in drinking water; however, the impact of non-drinking water PFOA exposure on serum PFOA concentrations is not well characterized. The objective of this research is to apply physiologically based pharmacokinetic (PBPK) modeling and Monte Carlo analysis to evaluate the impact of historic non-drinking water PFOA exposure on serum PFOA concentrations. In vitro to in vivo extrapolation was utilized to inform descriptions of PFOA transport in the kidney. Monte Carlo simulations were incorporated to evaluate factors that account for the large inter-individual variability of serum PFOA concentrations measured in individuals from North Alabama in 2010 and 2016, and the Mid-Ohio River Valley between 2005 and 2008. Predicted serum PFOA concentrations were within two-fold of experimental data. With incorporation of Monte Carlo simulations, the model successfully tracked the large variability of serum PFOA concentrations measured in populations from the Mid-Ohio River Valley. Simulation of exposure in a population of 45 adults from North Alabama successfully predicted 98% of individual serum PFOA concentrations measured in 2010 and 2016, respectively, when non-drinking water ingestion of PFOA exposure was included. Variation in serum PFOA concentrations may be due to inter-individual variability in the disposition of PFOA and potentially elevated historical non-drinking water exposures. Published by Elsevier Inc.

  2. Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention

    Directory of Open Access Journals (Sweden)

    Kalysha Closson

    2016-11-01

    Full Text Available Abstract Background Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Methods Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS, prevalence of “ever” experiencing a traumatic event among adolescents (aged 14–19 was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C scale (19 items, study alpha = 0.63. We assessed self-reported number of potentially traumatic events (PTEs experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of ‘high PTE score’ (≥7 PTEs. Results Overall, 767/830 (92% participants were included (58% adolescent women. Nearly all (99.7% reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19. Adolescent men reported more violent PTEs (e.g., “seen an act of violence in the community” whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., “family member or someone close died of HIV/AIDS”. High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively. For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63; and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76. Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03, and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37. Conclusion Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with

  3. Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention.

    Science.gov (United States)

    Closson, Kalysha; Dietrich, Janan Janine; Nkala, Busi; Musuku, Addy; Cui, Zishan; Chia, Jason; Gray, Glenda; Lachowsky, Nathan J; Hogg, Robert S; Miller, Cari L; Kaida, Angela

    2016-11-25

    Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV

  4. N-Acetyl Cysteine does not prevent liver toxicity from chronic low dose plus sub-acute high dose paracetamol exposure in young or old mice

    Science.gov (United States)

    Kane, Alice-Elizabeth; Huizer-Pajkos, Aniko; Mach, John; McKenzie, Catriona; Mitchell, Sarah-Jayne; de Cabo, Rafael; Jones, Brett; Cogger, Victoria; Le Couteur, David G; Hilmer, Sarah-Nicole

    2016-01-01

    Paracetamol is an analgesic commonly used by people of all ages, which is well documented to cause severe hepatotoxicity with acute over-exposures. The risk of hepatotoxicity from non-acute paracetamol exposures is less extensively studied, and this is the exposure most common in older adults. Evidence on the effectiveness of N-acetyl cysteine (NAC) for non-acute paracetamol exposures, in any age group, is lacking. This study aimed to examine the effect of long-term exposure to therapeutic doses of paracetamol and sub-acute paracetamol over-exposure, in young and old mice, and to investigate whether NAC was effective at preventing paracetamol hepatotoxicity induced by these exposures. Young and old male C57BL/6 mice were fed a paracetamol-containing (1.33g/kg food) or control diet for 6 weeks. Mice were then dosed orally 8 times over 3 days with additional paracetamol (250mg/kg) or saline, followed by either one or two doses of oral NAC (1200mg/kg) or saline. Chronic low-dose paracetamol exposure did not cause hepatotoxicity in young or old mice, measured by serum alanine aminotransferase (ALT) elevation, and confirmed by histology and a DNA fragmentation assay. Sub-acute paracetamol exposure caused significant hepatotoxicity in young and old mice, measured by biochemistry (ALT) and histology. Neither a single nor double dose of NAC protected against this toxicity from sub-acute paracetamol in young or old mice. This finding has important clinical implications for treating toxicity due to different paracetamol exposure types in patients of all ages, and implies a need to develop new treatments for sub-acute paracetamol toxicity. PMID:26821200

  5. High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy?

    Science.gov (United States)

    Girometti, Nicolò; Gutierrez, Angela; Nwokolo, Nneka; McOwan, Alan; Whitlock, Gary

    2017-08-01

    HIV pre-exposure prophylaxis (PrEP) is becoming a pivotal strategy for HIV prevention. Understanding the impact of risk factors for HIV transmission to identify those at highest risk would favour the implementation of PrEP, currently limited by costs. In this service evaluation, we estimated the incidence of bacterial STIs in men who have sex with men (MSM) diagnosed with early syphilis attending a London sexual health clinic according to their HIV status. In addition, we estimated the incidence of HIV infection in HIV-negative MSM, following a diagnosis of early syphilis. We undertook a retrospective case note review of all MSM patients diagnosed with early syphilis between January and June 2014. A number of sexual health screens and diagnoses of chlamydia, gonorrhoea and HIV were prospectively analysed following the syphilis diagnosis. 206 MSM were diagnosed with early syphilis. 110 (53%) were HIV-negative at baseline, 96 (47%) were HIV-positive. Only age (37 vs 32 years, p=0.0005) was significantly different according to HIV status of MSM at baseline. In HIV-negative versus HIV-positive MSM, incidence of rectal chlamydia infection at follow-up was 27 cases vs 50/100 person-years of follow-up (PYFU) (p=0.0039), 33 vs 66/100 PYFU (p=0.0044) for rectal gonorrhoea and 10 vs 26/100 PYFU (p=0.0044) for syphilis reinfection, respectively. Total follow-up for 110 HIV-negative MSM was 144 person-years. HIV incidence was 8.3/100 PYFU (CI 4.2 to 14). A diagnosis of early syphilis carries a high risk of consequent HIV seroconversion and should warrant prioritised access to prevention measures such as PrEP and regular STI screening to prevent HIV transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Project Date SMART: a Dating Violence (DV) and Sexual Risk Prevention Program for Adolescent Girls with Prior DV Exposure.

    Science.gov (United States)

    Rizzo, Christie J; Joppa, Meredith; Barker, David; Collibee, Charlene; Zlotnick, Caron; Brown, Larry K

    2018-05-01

    This study assessed the initial feasibility, acceptability, and efficacy of an intervention aimed at reducing dating violence and sexual risk behavior in a sample of adolescent girls (ages 14-17) with prior exposure to physical dating violence (DV). One hundred and nine girls were randomly assigned to Date SMART (Skills to Manage Aggression in Relationships for Teens) or a Knowledge-only (KO) comparison group. Both intervention arms consisted of six, weekly 2-h sessions and one "booster" session 6 weeks later. Based on principles of cognitive behavioral therapy, the Date SMART intervention was designed to target common underlying skills deficits linked to both DV and sexual risk behavior in adolescent females: depression, self-regulation deficits, and interpersonal skills deficits. Assessments were administered at four time points (baseline, 3, 6, and 9 months). The Date SMART group was effective as reducing sexual DV involvement across the 9-month follow-up period. Both groups evidenced clinically meaningful reductions in physical, emotional, and digital DV involvement, total time in dating relationships, as well as reductions in depression. Findings indicate that delivering a DV and sexual risk prevention intervention to DV-affected adolescent girls is feasible and well-received. Furthermore, a skills-based approach that addresses the co-occurrence of DV and sexual risk behavior may be particularly useful for promoting reductions of sexual DV among high-risk adolescent girls. A future, large-scale trial with an inactive comparison condition is needed to evaluate the efficacy of Date SMART further. Clinical Trials, NCT01326195, and http://www.clinicaltrials.gov.

  7. Computational assessment of pregnant woman models exposed to uniform ELF-magnetic fields: compliance with the European current exposure regulations for the general public and occupational exposures at 50 Hz

    International Nuclear Information System (INIS)

    Liorni, Ilaria; Parazzini, Marta; Fiocchi, Serena; Ravazzani, Paolo; Douglas, Mark; Capstick, Myles; Kuster, Niels

    2016-01-01

    The Recommendation 1999/529/EU and the Directive 2013/35/EU suggest limits for both general public and occupational exposures to extremely low-frequency magnetic fields, but without special limits for pregnant women. This study aimed to assess the compliance of pregnant women to the current regulations, when exposed to uniform MF at 50 Hz (100 μT for EU Recommendation and 1 and 6 mT for EU Directive). For general public, exposure of pregnant women and fetus always resulted in compliance with EU Recommendation. For occupational exposures, (1) Electric fields in pregnant women were in compliance with the Directive, with exposure variations due to fetal posture of 40 % in head tissues, (3) Electric fields in fetal CNS tissues of head are above the ICNIRP 2010 limits for general public at 1 mT (in 7 and 9 months gestational age) and at 6 mT (in all gestational ages). (authors)

  8. Current employment status, occupational category, occupational hazard exposure, and job stress in relation to telomere length: The Multiethnic Study of Atherosclerosis (MESA)

    Science.gov (United States)

    Fujishiro, Kaori; Diez-Roux, Ana V; Landsbergis, Paul; Jenny, Nancy Swords; Seeman, Teresa

    2014-01-01

    Objective Telomere length has been proposed as a biomarker of cell senescence, which is associated with a wide array of adverse health outcomes. While work is a major determinant of health, few studies have investigated the association of telomere length with various dimensions of occupation. Accelerated cellular aging could be a common pathway linking occupational exposure to several health outcomes. Methods Leukocyte telomere length was assessed using quantitative polymerase chain reaction (Q-PCR) in a community-based sample of 981 individuals (age: 45–84 years old). Questionnaires were used to collect information on current employment status, current or main occupation before retirement, and job strain. The O*NET (Occupational Resource Network) database was linked to the questionnaire data to create 5 exposure measures: physical activity on the job, physical hazard exposure, interpersonal stressors, job control, and job demands. Linear regression was used to estimate associations of occupational characteristics with telomere lengths after adjustment for age, sex, race, socioeconomic position, and several behavioral risk factors. Results There were no mean differences in telomere lengths across current employment status, occupational category, job strain categories or levels of most O*NET exposure measures. There was also no evidence that being in lower status occupational categories or being exposed to higher levels of adverse physical or psychosocial exposures accelerated the association between age and telomere shortening. Conclusions Cellular aging as reflected by shorter telomeres does not appear to be an important pathway linking occupation to various health outcomes. PMID:23686115

  9. TRADITIONAL CANISTER-BASED OPEN WASTE MANAGEMENT SYSTEM VERSUS CLOSED SYSTEM: HAZARDOUS EXPOSURE PREVENTION AND OPERATING THEATRE STAFF SATISFACTION.

    Science.gov (United States)

    Horn, M; Patel, N; MacLellan, D M; Millard, N

    2016-06-01

    Exposure to blood and body fluids is a major concern to health care professionals working in operating rooms (ORs). Thus, it is essential that hospitals use fluid waste management systems that minimise risk to staff, while maximising efficiency. The current study compared the utility of a 'closed' system with a traditional canister-based 'open' system in the OR in a private hospital setting. A total of 30 arthroscopy, urology, and orthopaedic cases were observed. The closed system was used in five, four, and six cases, respectively and the open system was used in nine, two, and four cases, respectively. The average number of opportunities for staff to be exposed to hazardous fluids were fewer for the closed system when compared to the open during arthroscopy and urology procedures. The open system required nearly 3.5 times as much staff time for set-up, maintenance during procedures, and post-procedure disposal of waste. Theatre staff expressed greater satisfaction with the closed system than with the open. In conclusion, compared with the open system, the closed system offers a less hazardous and more efficient method of disposing of fluid waste generated in the OR.

  10. Binge Alcohol Exposure Transiently Changes the Endocannabinoid System: A Potential Target to Prevent Alcohol-Induced Neurodegeneration

    Directory of Open Access Journals (Sweden)

    Daniel J. Liput

    2017-11-01

    Full Text Available Excessive alcohol consumption leads to neurodegeneration, which contributes to cognitive decline that is associated with alcohol use disorders (AUDs. The endocannabinoid system has been implicated in the development of AUDs, but little is known about how the neurotoxic effects of alcohol impact the endocannabinoid system. Therefore, the current study investigated the effects of neurotoxic, binge-like alcohol exposure on components of the endocannabinoid system and related N-acylethanolamines (NAEs, and then evaluated the efficacy of fatty acid amide hydrolase (FAAH inhibition on attenuating alcohol-induced neurodegeneration. Male rats were administered alcohol according to a binge model, which resulted in a transient decrease in [3H]-CP-55,940 binding in the entorhinal cortex and hippocampus following two days, but not four days, of treatment. Furthermore, binge alcohol treatment did not change the tissue content of the three NAEs quantified, including the endocannabinoid and anandamide. In a separate study, the FAAH inhibitor, URB597 was administered to rats during alcohol treatment and neuroprotection was assessed by FluoroJade B (FJB staining. The administration of URB597 during binge treatment did not significantly reduce FJB+ cells in the entorhinal cortex or hippocampus, however, a follow up “target engagement” study found that NAE augmentation by URB597 was impaired in alcohol intoxicated rats. Thus, potential alcohol induced alterations in URB597 pharmacodynamics may have contributed to the lack of neuroprotection by FAAH inhibition.

  11. Current evidence for the use of coffee and caffeine to prevent age-related cognitive decline and Alzheimer's disease.

    Science.gov (United States)

    Carman, A J; Dacks, P A; Lane, R F; Shineman, D W; Fillit, H M

    2014-04-01

    Although nothing has been proven conclusively to protect against cognitive aging, Alzheimer's disease or related dementias, decades of research suggest that specific approaches including the consumption of coffee may be effective. While coffee and caffeine are known to enhance short-term memory and cognition, some limited research also suggests that long-term use may protect against cognitive decline or dementia. In vitro and pre-clinical animal models have identified plausible neuroprotective mechanisms of action of both caffeine and other bioactive components of coffee, though epidemiology has produced mixed results. Some studies suggest a protective association while others report no benefit. To our knowledge, no evidence has been gathered from randomized controlled trials. Although moderate consumption of caffeinated coffee is generally safe for healthy people, it may not be for everyone, since comorbidities and personal genetics influence potential benefits and risks. Future studies could include short-term clinical trials with biomarker outcomes to validate findings from pre-clinical models and improved epidemiological studies that incorporate more standardized methods of data collection and analysis. Given the enormous economic and emotional toll threatened by the current epidemic of Alzheimer's disease and other dementias, it is critically important to validate potential prevention strategies such as coffee and caffeine.

  12. Astragalus Granule Prevents Ca2+ Current Remodeling in Heart Failure by the Downregulation of CaMKII

    Directory of Open Access Journals (Sweden)

    Sinai Li

    2017-01-01

    Full Text Available Background. Astragalus was broadly used for treating heart failure (HF and arrhythmias in East Asia for thousands of years. Astragalus granule (AG, extracted from Astragalus, shows beneficial effect on the treatment of HF in clinical research. We hypothesized that administration of AG prevents the remodeling of L-type Ca2+ current (ICa-L in HF mice by the downregulation of Ca2+/calmodulin-dependent protein kinase II (CaMKII. Methods. HF mice were induced by thoracic aortic constriction (TAC. After 4 weeks of AG treatment, cardiac function and QT interval were evaluated. Single cardiac ventricular myocyte was then isolated and whole-cell patch clamp was used to record action potential (AP and ICa-L. The expressions of L-type calcium channel alpha 1C subunit (Cav1.2, CaMKII, and phosphorylated protein kinase A (p-PKA were examined by western blot. Results. The failing heart manifested distinct electrical remodeling including prolonged repolarization time and altered ICa-L kinetics. AG treatment attenuated this electrical remodeling, supported by AG-related shortened repolarization time, decreased peak ICa-L, accelerated ICa-L inactivation, and positive frequency-dependent ICa-L facilitation. In addition, AG treatment suppressed the overexpression of CaMKII, but not p-PKA, in the failing heart. Conclusion. AG treatment protected the failing heart against electrical remodeling and ICa-L remodeling by downregulating CaMKII.

  13. Exposure to a multi-level multi-component childhood obesity prevention community-randomized controlled trial: patterns, determinants, and implications.

    Science.gov (United States)

    Trude, Angela Cristina Bizzotto; Kharmats, Anna Yevgenyevna; Jones-Smith, Jessica C; Gittelsohn, Joel

    2018-05-22

    For community interventions to be effective in real-world conditions, participants need to have sufficient exposure to the intervention. It is unclear how the dose and intensity of the intervention differ among study participants in low-income areas. We aimed to understand patterns of exposure to different components of a multi-level multi-component obesity prevention program to inform our future impact analyses. B'more Healthy Communities for Kids (BHCK) was a community-randomized controlled trial implemented in 28 low-income zones in Baltimore in two rounds (waves). Exposure to three different intervention components (corner store/carryout restaurants, social media/text messaging, and youth-led nutrition education) was assessed via post-intervention interviews with 385 low-income urban youths and their caregivers. Exposure scores were generated based on self-reported viewing of BHCK materials (posters, handouts, educational displays, and social media posts) and participating in activities, including taste tests during the intervention. For each intervention component, points were assigned for exposure to study materials and activities, then scaled (0-1 range), yielding an overall BHCK exposure score [youths: mean 1.1 (range 0-7.6 points); caregivers: 1.1 (0-6.7), possible highest score: 13]. Ordered logit regression analyses were used to investigate correlates of youths' and caregivers' exposure level (quartile of exposure). Mean intervention exposure scores were significantly higher for intervention than comparison youths (mean 1.6 vs 0.5, p selection bias may exist affecting causal inference. ClinicalTrials.gov, NCT02181010 . Retrospectively registered on 2 July 2014.

  14. Potential role of reduced environmental UV exposure as a driver of the current epidemic of atopic dermatitis

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Zirwas, Matthew J; Elias, Peter M

    2015-01-01

    The basis for the sudden and dramatic increase in atopic dermatitis (AD) and related atopic diseases in the second half of the 20th century is unclear. The hygiene hypothesis proposes that the transition from rural to urban living leads to reduced childhood exposure to pathogenic microorganisms....... Hence instead of having the normal TH1 bias and immune tolerance because of repeated exposure to pathogens, urban dwellers have TH2 cell immune activity and atopic disease in a more sterile environment. Various other environmental exposures have been implicated in the explosion of AD (and atopic...

  15. Hombres Sanos: exposure and response to a social marketing HIV prevention campaign targeting heterosexually identified Latino men who have sex with men and women.

    Science.gov (United States)

    Martínez-Donate, Ana P; Zellner, Jennifer A; Fernández-Cerdeño, Araceli; Sañudo, Fernando; Hovell, Melbourne F; Sipan, Carol L; Engelberg, Moshe; Ji, Ming

    2009-10-01

    This study examined the reach and impact of a social marketing intervention to reduce HIV risk among heterosexually identified (HI) Latino men who have sex with men and women (MSMW). Repeated cross-sectional intercept surveys were conducted in selected community venues during and after the campaign with 1,137 HI Latino men. Of them, 6% were classified as HI Latino MSMW. On average, 85.9% of the heterosexual respondents and 86.8% of the HI MSMW subsample reported exposure to the campaign. Responses to the campaign included having made an appointment for a male health exam that included HIV testing and using condoms. Campaign exposure was significantly associated with HIV testing behavior and intentions and with knowledge of where to get tested. The campaign reached its underserved target audience and stimulated preventive behaviors. Social marketing represents a promising approach for HIV prevention among HI Latinos, in general, and HI Latino MSMW, in particular.

  16. Cannabinoids prevent the differential long-term effects of exposure to severe stress on hippocampal- and amygdala-dependent memory and plasticity.

    Science.gov (United States)

    Shoshan, Noa; Segev, Amir; Abush, Hila; Mizrachi Zer-Aviv, Tomer; Akirav, Irit

    2017-10-01

    Exposure to excessive or uncontrolled stress is a major factor associated with various diseases including posttraumatic stress disorder (PTSD). The consequences of exposure to trauma are affected not only by aspects of the event itself, but also by the frequency and severity of trauma reminders. It was suggested that in PTSD, hippocampal-dependent memory is compromised while amygdala-dependent memory is strengthened. Several lines of evidence support the role of the endocannabinoid (eCB) system as a modulator of the stress response. In this study we aimed to examine cannabinoids modulation of the long-term effects (i.e., 1 month) of exposure to a traumatic event on memory and plasticity in the hippocampus and amygdala. Following exposure to the shock and reminders model of PTSD in an inhibitory avoidance light-dark apparatus rats demonstrated: (i) enhanced fear retrieval and impaired inhibitory extinction (Ext), (ii) no long-term potentiation (LTP) in the CA1, (iii) impaired hippocampal-dependent short-term memory in the object location task, (iv) enhanced LTP in the amygdala, and (v) enhanced amygdala-dependent conditioned taste aversion memory. The cannabinoid CB1/2 receptor agonist WIN55-212,2 (0.5mg/kg, i.p.) and the fatty acid amide hydrolase (FAAH) inhibitor URB597 (0.3mg/kg, i.p.), administered 2 hr after shock exposure prevented these opposing effects on hippocampal- and amygdala-dependent processes. Moreover, the effects of WIN55-212,2 and URB597 on Ext and acoustic startle were prevented by co-administration of a low dose of the CB1 receptor antagonist AM251 (0.5mg/kg, i.p.), suggesting that the preventing effects of both drugs are mediated by CB1 receptors. Exposure to shock and reminders increased CB1 receptor levels in the CA1 and basolateral amygdala 1 month after shock exposure and this increase was also prevented by administering WIN55-212,2 or URB597. Taken together, these findings suggest the involvement of the eCB system, and specifically CB1

  17. Current state of knowledge when it comes to consumer exposure to nanomaterial embedded in a solid matrix

    DEFF Research Database (Denmark)

    Mackevica, Aiga; Hansen, Steffen Foss

    2015-01-01

    form. For studies that report enough information, we developed potential exposure scenarios and derived exposure estimates according to REACH R.16 using the Tier 1 equations for consumer exposure estimation and Tier 1 tools i.e. ECETOX TRA and Consexpo. In general, we find that the information and data......Little is known about consumer exposure to engineered nanomaterials (ENMs) stemming from NM-containing consumer products. Here, we focus especially on studies that have investigated the release of ENMs from consumer products, investigating to what extent the information in the open literature can...... be used to fulfill the requirements outlined in the European chemical legislation, REACH. In total, we have identified about 75 publications of relevance and the number of publications is increasing every year. The most studied materials include silver and titanium dioxide NPs, CNTs and SiO2. If reported...

  18. Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

    OpenAIRE

    Adam Bourne; Matteo Cassolato; Clayton Koh Thuan Wei; Bangyuan Wang; Joselyn Pang; Sin How Lim; Iskandar Azwa; Ilias Yee; Gitau Mburu

    2017-01-01

    Abstract Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers t...

  19. Assessment of knowledge of skin cancer prevention and its relation with sun exposure and photo protection amongst gym academy members on the south of Santa Catarina, Brazil.

    Science.gov (United States)

    Fabris, Mariana Rocha; Durães, Edson Souza Machado; Martignago, Beatriz Castellar de Faria; Blanco, Luiz Felipe de Oliveira; Fabris, Thiago Rocha

    2012-01-01

    Skin cancer is the most frequent neoplasia in several parts of the world and also in Brazil. There is evidence of an increase in morbidity and mortality from skin cancer. Although the incidence of skin cancer is increasing, it is estimated that 45% of all preventable cancers worldwide are skin neoplasias. Several studies have emphasized the need for campaigns to encourage sun protection. To assess the knowledge about skin cancer prevention and its association with sun exposure and photo protection in gym members. We conducted a cross-sectional, descriptive and quantitative study during January to July 2009, including gym members of both sexes in the city of Criciuma. A self-administered questionnaire was used. The statistical analysis was conducted in a descriptive way in regards to the absolute and relative frequencies of the variables under study. Of the 317 questionnaires studied, 62% were from women and 38% from men. Skin types II and III predominated, and the average age was 27.6 years. 94.3% of the participants reported that they had heard about the risks of sun exposure, mostly in terms of skin cancer risk (80.8%). Most participants, especially women, reported some form of sun protective measure. The population studied, similar to that in other regions of Brazil and the world, is aware of the risks of excessive sun exposure and skin cancer prevention, but has not yet incorporated appropriate sun protection measures into their daily habits.

  20. A broad-spectrum sunscreen prevents cumulative damage from repeated exposure to sub-erythemal solar ultraviolet radiation representative of temperate latitudes.

    Science.gov (United States)

    Seité, S; Christiaens, F; Bredoux, C; Compan, D; Zucchi, H; Lombard, D; Fourtanier, A; Young, A R

    2010-02-01

    We have previously shown the detrimental effects of 19 sub-erythemal exposures to daily ultraviolet radiation (DUVR, which mimics non-extreme exposure conditions), delivered over 4 weeks to volunteers. This source had UVA (320-400 nm) to UVB (290-320 nm) irradiance ratio of 25, instead of that close to 10 that is typically the case with solar-simulated radiation (SSR) that represents summer global sunlight with a clear sky and quasi-zenith solar irradiance. Here, we report on an extension of this previous study, in which we evaluated the photoprotection afforded by a broad-spectrum daily-care product with a low-sun protection factor (SPF 8, UVA-PF 7 and 3* rated UVA protection). We assessed cellular and molecular markers of photodamage that are relevant to skin cancer and photoageing. This study shows that biological effects of repeated exposure to DUVR can be prevented by a broad-spectrum daily-care product and that the level of protection afforded varies with the studied endpoint. Efficient daily UVR protection, as provided by a broad-spectrum daily-care product, is necessary to prevent the 'silent' sub-erythemal cumulative effects of UVR from inadvertent sun exposure.

  1. Awareness and attitudes of pre-exposure prophylaxis for HIV prevention among physicians in Guatemala: Implications for country-wide implementation.

    Science.gov (United States)

    Ross, Ian; Mejia, Carlos; Melendez, Johanna; Chan, Philip A; Nunn, Amy C; Powderly, William; Goodenberger, Katherine; Liu, Jingxia; Mayer, Kenneth H; Patel, Rupa R

    2017-01-01

    HIV continues to be a major health concern with approximately 2.1 million new infections occurring worldwide in 2015. In Central America, Guatemala had the highest incident number of HIV infections (3,700) in 2015. Antiretroviral pre-exposure prophylaxis (PrEP) was recently recommended by the World Health Organization (WHO) as an efficacious intervention to prevent HIV transmission. PrEP implementation efforts are underway in Guatemala and success will require providers that are knowledgeable and willing to prescribe PrEP. We sought to explore current PrEP awareness and prescribing attitudes among Guatemalan physicians in order to inform future PrEP implementation efforts. We conducted a cross-sectional survey of adult internal medicine physicians at the main teaching hospital in Guatemala City in March 2015. The survey included demographics, medical specialty, years of HIV patient care, PrEP awareness, willingness to prescribe PrEP, previous experience with post-exposure prophylaxis, and concerns about PrEP. The primary outcome was willingness to prescribe PrEP, which was assessed using a 5-point Likert scale for different at-risk population scenarios. Univariate and multivariate logistic regression was performed to identify predictors for willingness to prescribe PrEP. Eighty-seven physicians completed the survey; 66% were male, 64% were internal medicine residency trainees, and 10% were infectious disease (ID) specialists. Sixty-nine percent of physicians were PrEP aware, of which 9% had previously prescribed PrEP. Most (87%) of respondents were willing to prescribe PrEP to men who have sex with men (MSM), sex workers, injection drug users, or HIV-uninfected persons having known HIV-positive sexual partners. Concerns regarding PrEP included development of resistance (92%), risk compensation (90%), and cost (64%). Univariate logistic regression showed that younger age, being a resident trainee, and being a non-ID specialist were significant predictors for

  2. Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.

    Science.gov (United States)

    Koechlin, Florence M; Fonner, Virginia A; Dalglish, Sarah L; O'Reilly, Kevin R; Baggaley, Rachel; Grant, Robert M; Rodolph, Michelle; Hodges-Mameletzis, Ioannis; Kennedy, Caitlin E

    2017-05-01

    Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

  3. Prevention and Control Strategies to Counter Zika Virus, a Special Focus on Intervention Approaches against Vector Mosquitoes—Current Updates

    Directory of Open Access Journals (Sweden)

    Raj K. Singh

    2018-02-01

    Full Text Available Zika virus (ZIKV is the most recent intruder that acquired the status of global threat creating panic and frightening situation to public owing to its rapid spread, attaining higher virulence and causing complex clinical manifestations including microcephaly in newborns and Guillain Barré Syndrome. Alike other flaviviruses, the principal mode of ZIKV transmission is by mosquitoes. Advances in research have provided reliable diagnostics for detecting ZIKV infection, while several drug/therapeutic targets and vaccine candidates have been identified recently. Despite these progresses, currently there is neither any effective drug nor any vaccine available against ZIKV. Under such circumstances and to tackle the problem at large, control measures of which mosquito population control need to be strengthened following appropriate mechanical, chemical, biological and genetic control measures. Apart from this, several other known modes of ZIKV transmission which have gained importance in recent past such as intrauterine, sexual intercourse, and blood-borne spread need to be checked and kept under control by adopting appropriate precautions and utmost care during sexual intercourse, blood transfusion and organ transplantation. The virus inactivation by pasteurization, detergents, chemicals, and filtration can effectively reduce viral load in plasma-derived medicinal products. Added to this, strengthening of the surveillance and monitoring of ZIKV as well as avoiding travel to Zika infected areas would aid in keeping viral infection under check. Here, we discuss the salient advances in the prevention and control strategies to combat ZIKV with a focus on highlighting various intervention approaches against the vector mosquitoes of this viral pathogen along with presenting an overview regarding human intervention measures to counter other modes of ZIKV transmission and spread. Additionally, owing to the success of vaccines for a number of infections

  4. Cobalt exposure and lung disease in tungsten carbide production. A cross-sectional study of current workers

    International Nuclear Information System (INIS)

    Sprince, N.L.; Oliver, L.C.; Eisen, E.A.; Greene, R.E.; Chamberlin, R.I.

    1988-01-01

    A cross-sectional study of 1,039 tungsten carbide (TC) production workers was carried out. The purposes were (1) to evaluate the prevalence of interstitial lung disease (ILD) and work-related wheezing, (2) to assess correlations between cobalt exposure and pulmonary disease, (3) to compare lung disease in grinders of hard carbide versus nongrinders, and (4) to evaluate the effects of new and previous threshold limit values for cobalt of 50 and 100 micrograms/m3. We obtained medical and occupational histories, flow-volume loops, single breath carbon monoxide diffusing capacity (DLCO), and chest radiographs. Time-weighted average cobalt levels were determined at every step in the production process. Work-related wheeze occurred in 113 participants (10.9%). Profusion greater than or equal to 1/0 occurred in 26 (2.6%) and interstitial lung disease (defined as profusion greater than or equal to 1M, FVC or DLCO less than or equal to 70%, and FEV1/FVC% greater than or equal to 75) in 7 (0.7%). The relative odds of work-related wheeze was 2.1 times for present cobalt exposures exceeding 50 micrograms/m3 compared with exposures less than or equal to 50 micrograms/m3. The relative odds of profusion greater than or equal to 1/0 was 5.1 times for average lifetime cobalt exposures exceeding 100 micrograms/m3 compared with exposures less than or equal to 100 micrograms/m3 in those with latency exceeding 10 yr. ILD was found in three workers with very low average lifetime exposures (less than 8 micrograms/m3) and shorter latencies. Grinders of hard carbide had lower mean DLCO than nongrinders, even though their cobalt exposures were lower

  5. Pre-exposure prophylaxis (PrEP) for men who have sex with men in Europe: review of evidence for a much needed prevention tool.

    Science.gov (United States)

    Reyniers, Thijs; Hoornenborg, Elske; Vuylsteke, Bea; Wouters, Kristien; Laga, Marie

    2017-08-01

    In many Western countries with good coverage of antiretroviral treatment (ART) programmes the annual number of HIV infections is still high and not (yet) declining among men who have sex with men (MSM). This might indicate that antiretroviral treatment roll-out alone will not turn around the course of the epidemic and that new, additional tools are needed. Antiretrovirals used as prevention tools for people not yet infected with HIV, such as pre-exposure prophylaxis (PrEP) could be such important additional tools. PrEP is a new type of biomedical prevention, which involves the use of antiretrovirals before, during and after (periods of) sexual exposure to HIV. In this review, we will focus on PrEP as a new prevention tool for MSM at high risk in Europe, including its evidence for effectiveness, challenges for implementation, ongoing European demonstration studies; as well as how PrEP relates to other existing prevention tools. In light of European Medicines Agency's recent recommendation for approval of PrEP we briefly review the potential implications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Biomedical HIV Prevention Including Pre-exposure Prophylaxis and Opiate Agonist Therapy for Women Who Inject Drugs: State of Research and Future Directions.

    Science.gov (United States)

    Page, Kimberly; Tsui, Judith; Maher, Lisa; Choopanya, Kachit; Vanichseni, Suphak; Mock, Philip A; Celum, Connie; Martin, Michael

    2015-06-01

    Women who inject drugs (WWID) are at higher risk of HIV compared with their male counterparts as a result of multiple factors, including biological, behavioral, and sociostructural factors, yet comparatively little effort has been invested in testing and delivering prevention methods that directly target this group. In this article, we discuss the need for expanded prevention interventions for WWID, focusing on 2 safe, effective, and approved, yet underutilized biomedical prevention methods: opiate agonist therapy (OAT) and oral pre-exposure prophylaxis (PrEP). Although both interventions are well researched, they have not been well examined in the context of gender. We discuss the drivers of women injectors' higher HIV risk, review the effectiveness of OAT and PrEP interventions among women, and explain why these new HIV prevention tools should be prioritized for WWID. There is substantial potential for impact of OAT and PrEP programs for WWID in the context of broader gender-responsive HIV prevention initiatives. Although awaiting efficacy data on other biomedical approaches in the HIV prevention research "pipeline," we propose that the scale-up and implementation of these proven, safe, and effective interventions are needed now.

  7. Occupational exposure to electric fields and induced currents associated with 400 kV substation tasks from different service platforms.

    Science.gov (United States)

    Korpinen, Leena H; Elovaara, Jarmo A; Kuisti, Harri A

    2011-01-01

    The aim of the study was to investigate the occupational exposure to electric fields, average current densities, and average total contact currents at 400 kV substation tasks from different service platforms (main transformer inspection, maintenance of operating device of disconnector, maintenance of operating device of circuit breaker). The average values are calculated over measured periods (about 2.5 min). In many work tasks, the maximum electric field strengths exceeded the action values proposed in the EU Directive 2004/40/EC, but the average electric fields (0.2-24.5 kV/m) were at least 40% lower than the maximum values. The average current densities were 0.1-2.3 mA/m² and the average total contact currents 2.0-143.2 µA, that is, clearly less than the limit values of the EU Directive. The average values of the currents in head and contact currents were 16-68% lower than the maximum values when we compared the average value from all cases in the same substation. In the future it is important to pay attention to the fact that the action and limit values of the EU Directive differ significantly. It is also important to take into account that generally, the workers' exposure to the electric fields, current densities, and total contact currents are obviously lower if we use the average values from a certain measured time period (e.g., 2.5 min) than in the case where exposure is defined with only the help of the maximum values. © 2010 Wiley-Liss, Inc.

  8. Heat wave exposure in India in current, 1.5 °C, and 2.0 °C worlds

    Science.gov (United States)

    Mishra, Vimal; Mukherjee, Sourav; Kumar, Rohini; Stone, Dáithí A.

    2017-12-01

    Heatwaves with large impacts have increased in the recent past and will continue to increase under future warming. However, the implication for population exposure to severe heatwaves remains unexplored. Here, we characterize maximum potential human exposure (without passive/active reduction measures) to severe heatwaves in India. We show that if the global mean temperature is limited to 2.0 °C above pre-industrial conditions, the frequency of severe heatwaves will rise by 30 times the current climate by the end-21st century. In contrast, the frequency is projected to be about 2.5 times more (than the low-warming scenario of 2 °C) under conditions expected if the RCP8.5 ‘business-as-usual’ emissions scenario is followed. Under the 2.0 °C low-warming target, population exposure to severe heatwaves is projected to increase by about 15 and 92 times the current level by the mid and end-21st century respectively. Strategies to reduce population growth in India during the 21st century may provide only limited mitigation of heatwave exposure mostly late in the century. Limiting global temperatures to 1.5 °C above preindustrial would reduce the exposure by half relative to RCP8.5 by the mid-21st century. If global temperatures are to exceed 1.5 °C then substantial measures will be required to offset the large increase in exposure to severe heatwaves in India.

  9. Accident prevention in nuclear power plants and appropriate provisions in the current legal regime of the FRG

    International Nuclear Information System (INIS)

    Hohlefelder, W.

    1984-01-01

    Technology and hazards is a topic of concern to everybody, and legal experts are called upon to contribute their share to problem solving. Efforts towards creating a law on technical safety have to deal with the definition of terms such as: Hazards, damage, risk, probability, preventive measures. Sometimes, the question of whether an event should be judged to belong to accident prevention, risk abatement, or accepted remaining risk, is very difficult to answer. A system developed by experts is explained which offers a line of orientation along the following principles: The greater the risk, the more comprehensive and the more definite preventive measures are required. Measures to prevent damage are necessary in case of individual risks involved, such as the right to personal safety. In case of risks not affecting the individual, the principle of risk minimization is to be applied, taking into account the principle of reasonableness. (orig./HSCH) [de

  10. Role of amino acid supplementation in the prevention of necrotizing enterocolitis in preterm neonates - a review of current evidences.

    Science.gov (United States)

    Garg, Bhawan Deep; Kabra, Nandkishor S

    2018-09-01

    Necrotizing enterocolitis (NEC) is one of the most common acute and fatal gastrointestinal emergency in very low birth weight (VLBW) preterm neonates with mortality range from 15 to 30%. NEC is likely due to multifactorial process such as oxidative injury, ischemic necrosis, and over-reactive inflammatory response to intestinal microbes. To evaluate the role of amino acid supplementation for reduction of neonatal NEC in preterm neonates. The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS) and other database. This review included 15 RCTs that fulfilled inclusion criteria. The total neonates enrolled in these different RCT are 3424 (amino acid group 1711 and control 1713). Almost all participating neonates were of VLBW or extremely low birth weight (ELBW). In two trials, birth weight was between 1500-2000 grams. The intervention was started within first few days after birth and continued up to 30th day of postnatal age in most of the trials. In two trials, intervention was continued up to 120th day of postnatal age. Arginine, glutamine and N-acetyl cysteine (NAC) were used at the dose of 1.5 mol/kg/day (261 mg/kg/day), 0.3 grams/kg/day and 16-32 mg/kg/day, respectively. Role of amino acid in the prevention of neonatal NEC is not exclusively supported by the current evidence. Only three studies were able to show reduction in the incidence of NEC with amino acid supplementation (arginine, glutamine), and the remaining studies did not report any positive effect. Amino acid supplementation was not associated with significant reduction in mortality due to any causes. However, arginine supplementation was associated with significant reduction in mortality due to NEC. Two studies on glutamine were reported significant reduction in

  11. Lead toxicity: current concerns.

    OpenAIRE

    Goyer, R A

    1993-01-01

    Over the 20-year period since the first issue of Environmental Health Perspectives was published, there has been considerable progress in the understanding of the potential toxicity of exposure to lead. Many of these advances have been reviewed in published symposia, conferences, and review papers in EHP. This brief review identifies major advances as well as a number of current concerns that present opportunities for prevention and intervention strategies. The major scientific advance has be...

  12. Pre-exposure and postexposure prophylaxes and the combination HIV prevention methods (The Combine! Study): protocol for a pragmatic clinical trial at public healthcare clinics in Brazil.

    Science.gov (United States)

    Grangeiro, Alexandre; Couto, Márcia Thereza; Peres, Maria Fernanda; Luiz, Olinda; Zucchi, Eliana Miura; de Castilho, Euclides Ayres; Estevam, Denize Lotufo; Alencar, Rosa; Wolffenbüttel, Karina; Escuder, Maria Mercedes; Calazans, Gabriela; Ferraz, Dulce; Arruda, Érico; Corrêa, Maria da Gloria; Amaral, Fabiana Rezende; Santos, Juliane Cardoso Villela; Alvarez, Vivian Salles; Kietzmann, Tiago

    2015-08-25

    Few results from programmes based on combination prevention methods are available. We propose to analyse the degree of protection provided by postexposure prophylaxis (PEP) for consensual sexual activity at healthcare clinics, its compensatory effects on sexual behaviour; and the effectiveness of combination prevention methods and pre-exposure prophylaxis (PrEP), compared with exclusively using traditional methods. A total of 3200 individuals aged 16 years or older presenting for PEP at 5 sexually transmitted disease (STD)/HIV clinics in 3 regions of Brazil will be allocated to one of two groups: the PEP group-individuals who come to the clinic within 72 h after a sexual exposure and start PEP; and the non-PEP group-individuals who come after 72 h but within 30 days of exposure and do not start PEP. Clinical follow-up will be conducted initially for 6 months and comprise educational interventions based on information and counselling for using prevention methods, including PrEP. In the second study phase, individuals who remain HIV negative will be regrouped according to the reported use of prevention methods and observed for 18 months: only traditional methods; combined methods; and PrEP. Effectiveness will be analysed according to the incidence of HIV, syphilis and hepatitis B and C and protected sexual behaviour. A structured questionnaire will be administered to participants at baseline and every 6 months thereafter. Qualitative methods will be employed to provide a comprehensive understanding of PEP-seeking behaviour, preventive choices and exposure to HIV. This study will be conducted in accordance with the resolution of the School of Medicine Research Ethics Commission of Universidade de São Paulo (protocol no. 251/14). The databases will be available for specific studies, after management committee approval. Findings will be presented to researchers, health managers and civil society members by means of newspapers, electronic media and scientific journals

  13. HIV pre-exposure prophylaxis for women and infants prevents vaginal and oral HIV transmission in a preclinical model of HIV infection.

    Science.gov (United States)

    Kovarova, Martina; Shanmugasundaram, Uma; Baker, Caroline E; Spagnuolo, Rae Ann; De, Chandrav; Nixon, Christopher C; Wahl, Angela; Garcia, J Victor

    2016-11-01

    Approximately 1.5 million HIV-positive women become pregnant annually. Without treatment, up to 45% will transmit HIV to their infants, primarily through breastfeeding. These numbers highlight that HIV acquisition is a major health concern for women and children globally. They also emphasize the urgent need for novel approaches to prevent HIV acquisition that are safe, effective and convenient to use by women and children in places where they are most needed. 4'-Ethynyl-2-fluoro-2'-deoxyadenosine, a potent NRTI with low cytotoxicity, was administered orally to NOD/SCID/γc -/- mice and to bone marrow/liver/thymus (BLT) humanized mice, a preclinical model of HIV infection. HIV inhibitory activity in serum, cervicovaginal secretions and saliva was evaluated 4 h after administration. 4'-Ethynyl-2-fluoro-2'-deoxyadenosine's ability to prevent vaginal and oral HIV transmission was evaluated using highly relevant transmitted/founder viruses in BLT mice. Strong HIV inhibitory activity in serum, cervicovaginal secretions and saliva obtained from animals after a single oral dose of 4'-ethynyl-2-fluoro-2'-deoxyadenosine (10 mg/kg) demonstrated efficient drug penetration into relevant mucosal sites. A single daily oral dose of 4'-ethynyl-2-fluoro-2'-deoxyadenosine resulted in efficient prevention of vaginal and oral HIV transmission after multiple high-dose exposures to transmitted/founder viruses in BLT humanized mice. Our data demonstrated that 4'-ethynyl-2-fluoro-2'-deoxyadenosine efficiently prevents both vaginal and oral HIV transmission. Together with 4'-ethynyl-2-fluoro-2'-deoxyadenosine's relatively low toxicity and high potency against drug-resistant HIV strains, these data support further clinical development of 4'-ethynyl-2-fluoro-2'-deoxyadenosine as a potential pre-exposure prophylaxis agent to prevent HIV transmission in women and their infants. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial

  14. 78 FR 11611 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-02-19

    ... related to the proposed rule on ``Current Good Manufacturing Practice and Hazard Analysis and Risk-Based... . All comments should be identified with the title ``Current Good Manufacturing Practice and Hazard... rulemaking to modernize the regulation for ``Current Good Manufacturing Practice In Manufacturing, Packing...

  15. 78 FR 69604 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-11-20

    ... Federal Register of January 16, 2013 (78 FR 3646), entitled ``Current Good Manufacturing Practice and... a proposed rule entitled ``Current Good Manufacturing Practice and Hazard Analysis and Risk-Based..., 114, 117, 120, 123, 129, 179, and 211 [Docket No. FDA-2011-N-0920] RIN 0910-AG36 Current Good...

  16. 78 FR 48636 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-08-09

    ... collection related to the proposed rule, ``Current Good Manufacturing Practice and Hazard Analysis and Risk... period. These two proposals are related to the proposed rule ``Current Good Manufacturing Practice and... final extension of the comment period for the ``Current Good Manufacturing Practice and Hazard Analysis...

  17. Current status of biological indicators to detect and quantify previous exposures to radiation. Biological Indicators Working Group

    International Nuclear Information System (INIS)

    Lushbaugh, C.; Eisele, G.; Burr, W. Jr.; Hubner, K.; Wachholz, B.

    1991-01-01

    Hematologic changes following whole-body exposure to gamma or x-ray radiation have been used to estimate dose. The usefulness of this biological indicator is limited because of the recovery of these cells with time, thus making it unsuitable for estimation of dose years after exposure. The same is true for spermatogenic indicators; recovery and restoration of sperm numbers and fertility makes this biological indicator impractical for assessing radiation dose decades after radiation exposure. As noted in the text of the report, immunological concepts are in a state of rapid development, and it is possible that improved methods for applying immunologic procedures as biological indicators of radiation may be developed in the future. However, at the time, immunological indicators are not useful, even in an early time period, for quantitating radiation dose after total-body irradiation. A semiquantitative effect is observable in the early phase after total-body irradiation over a period of days to weeks, but there is little data available to indicate whether any of the immunological parameters can be indicative of a dose when the test is applied several years after radiation exposure. More detailed information regarding immunological indicators for estimating irradiation dose has been summarized elsewhere (Wasserman 1986). There is good agreement that ionizing radiation causes biochemical changes in the body; however, attempts to apply these changes to provide a reliable biological dosimetry system have not been particularly successful. The status of this research has been summarized by Gerber (1986). One of the difficulties has been the problem of establishing clear dose-effect relationships in humans. The lack of specificity in the response for radiation is another problem

  18. Child marriage prevention in Amhara Region, Ethiopia: association of communication exposure and social influence with parents/guardians' knowledge and attitudes.

    Science.gov (United States)

    Gage, Anastasia J

    2013-11-01

    Despite increasing international attention to child marriage and its negative health and social consequences, little is known about the knowledge and beliefs of individuals who are in control of negotiating children's marriages and of the social context in which these individuals function. Using data from a 2007 cross-sectional household survey and multilevel logistic regression models, this paper examined the associations of communication exposure and measures of social influence with knowledge of marriage legislation, perceptions that marriage before age 18 was "too early", and beliefs in daughters' rights to individual marriage choice among parents/guardians in Amhara Region, Ethiopia. The study found that mass media and interpersonal communication exposure were positively associated with all outcomes. The influence of communication exposure on knowledge of the legal minimum age at marriage and the perception that marriage before 18 was "too early" varied significantly across communities. Community pressure to stop child marriages and awareness of marriage law enforcement were positively associated with endorsing daughters' rights to choose their marriage age and partner. Perceived social norms regarding early marriage, normative beliefs and perceived benefits of delayed marriage were at least as important as communication exposure for endorsing daughters' rights to marriage choice. Gender and education differences were detected. The findings imply that child marriage-prevention programs should diversify information channels, reinforce perceived advantages of delayed marriage, and adopt a social influence perspective. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. DGT/ASN circular n. 04 of the 21. of April 2010 related to provisions for the prevention to ionizing ray exposure risks

    International Nuclear Information System (INIS)

    2010-01-01

    After an overview of the context of risk of exposure to ionizing radiation (potentially concerned activities, prevention policy based on radioprotection principles, regulation origin, radioprotection organization, specific inspection), this document presents the different regulatory provisions for the protection of workers against ionizing radiation hazards (scope of application, risk assessment, technical rules for workspace design, collective and individual protections, conditions for the follow-up of exposed workers, medical follow-up, work abnormal condition, radioprotection operating organisation, exposure to natural radioactivity). Then, a set of sheets is proposed, respectively containing regulatory information on employer obligations in terms of radioprotection, technical controls of radioprotection, individual protection equipment, worker information and education, radiological follow-up of classified workers, worker medical follow-up, work abnormal conditions, person with abilities in radioprotection, and a list of application decisions and orders

  20. Association of tobacco advertising, promotion and sponsorship (TAPS) exposure and cigarette use among Nigerian adolescents: implications for current practices, products and policies.

    Science.gov (United States)

    Chido-Amajuoyi, Onyema G; Mantey, Dale S; Clendennen, Stephanie L; Pérez, Adriana

    2017-01-01

    This study investigates the association between exposure to tobacco advertising, promotion and sponsorship (TAPS) and cigarette use behaviours among adolescents in five Nigerian regions. This is imperative given a 2015 WHO report on the global tobacco epidemic, revealing Nigeria has not met any of the MPOWER TAPS ban indicators instituted since 2008. Secondary data analysis of the 2008 Global Youth Tobacco Survey for Nigeria. Participants were 1399 adolescents, representative of 5 Nigerian regions. Weighted multivariable logistic regression models were used to assess the relationship between TAPS exposure and (1) past 30-day (current) cigarette use, (2) ever cigarette use and (3) susceptibility to use cigarettes among never cigarette users. Sensitivity analysis via complete case analysis and multiple imputation were conducted. Ninety-five per cent of Nigerian adolescents reported exposure to TAPS. Among adolescents who had never smoked, 15% were susceptible to use cigarettes. Cumulative TAPS exposure was significantly associated with both an increased odds of current cigarette use (AOR: 1.73; 95% CI 1.09 to2.99) and ever cigarette use (AOR: 1.29; 95% CI 1.15 to1.45); as well as increased susceptibility to cigarette smoking (AOR: 1.18; 95% CI 1.03 to 1.34), among non-smokers. Given study results, the emergence of new tobacco products and novel platforms for TAPS globally, implementation of existing policies and enhancement of efforts to attain comprehensive bans on all forms of direct and indirect TAPS in line with article 13 of the WHO Framework Convention on Tobacco Control are needed to reduce TAPS exposure and curtail tobacco use in Nigeria.

  1. Evaluation of the individual tube current setting in electrocardiogram-gated cardiac computed tomography estimated from plain chest computed tomography using computed tomography automatic exposure control

    International Nuclear Information System (INIS)

    Kishimoto, Junichi; Sakou, Toshio; Ohta, Yasutoshi

    2013-01-01

    The aim of this study was to estimate the tube current on a cardiac computed tomography (CT) from a plain chest CT using CT-automatic exposure control (CT-AEC), to obtain consistent image noise, and to optimize the scan tube current by individualizing the tube current. Sixty-five patients (Group A) underwent cardiac CT at fixed tube current. The mAs value for plain chest CT using CT-AEC (AEC value) and cardiac CT image noise were measured. The tube current needed to obtain the intended level of image noise in the cardiac CT was determined from their correlation. Another 65 patients (Group B) underwent cardiac CT with tube currents individually determined from the AEC value. Image noise was compared among Group A and B. Image noise of cardiac CT in Group B was 24.4±3.1 Hounsfield unit (HU) and was more uniform than in Group A (21.2±6.1 HU). The error with the desired image noise of 25 HU was lower in Group B (2.4%) than in Group A (15.2%). Individualized tube current selection based on AEC value thus provided consistent image noise and a scan tube current optimized for cardiac CT. (author)

  2. FEASIBILITY AND EFFECTIVENESS OF DYADIC PROLONGED EXPOSURE INTERVENTION FOR PREVENTING POSTTRAUMATIC GRIEF IN YOUNG CHILDREN: A CASE REPORT OF TWO SIBLINGS.

    Science.gov (United States)

    Rachamim, Lilach

    2017-09-01

    This article highlights the feasibility of a dyadic prolonged exposure (DPE) intervention (L. Rachamim, I. Mirochnik, L. Helpman, N. Nacasch, & E. Yadin, ) in a 3-year-old preschooler and in a 6-year-old kindergartener immediately following the traumatic death of their younger sibling. It presents a detailed case description of the DPE treatment addressing traumatic grief and includes transcribed treatment dialogue. At the time of treatment termination, both children and caregivers resumed normal functioning. The results suggest that DPE intervention may ameliorate posttraumatic grief symptoms in young children. Controlled studies of preventive interventions for this population are clearly warranted. © 2017 Michigan Association for Infant Mental Health.

  3. Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

    Science.gov (United States)

    Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

    2016-03-01

    The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

  4. Gynecologic Cancer Prevention and Control in the National Comprehensive Cancer Control Program: Progress, Current Activities, and Future Directions

    OpenAIRE

    Stewart, Sherri L.; Lakhani, Naheed; Brown, Phaeydra M.; Larkin, O. Ann; Moore, Angela R.; Hayes, Nikki S.

    2013-01-01

    Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer.

  5. Gynecologic cancer prevention and control in the National Comprehensive Cancer Control Program: progress, current activities, and future directions.

    Science.gov (United States)

    Stewart, Sherri L; Lakhani, Naheed; Brown, Phaeydra M; Larkin, O Ann; Moore, Angela R; Hayes, Nikki S

    2013-08-01

    Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer.

  6. Measures to prevent concrete damage due to alkali-silica reaction in the Netherlands: Current state-of-affairs

    NARCIS (Netherlands)

    Heijnen, W.M.M.; Larbi, J.A.

    1999-01-01

    In CUR-Recommendation 38, various vital measures that need to be taken during design of new concrete-mixtures in order to prevent damage due to ASR in the concrete have been outlined. The most important of these measures are: • the use of blast furnace slag cement (with a high slag content: 50 % by

  7. Correlation between practice location as a surrogate for UV exposure and practice patterns to prevent corneal haze after photorefractive keratectomy (PRK).

    Science.gov (United States)

    Al-Sharif, Eman M; Stone, Donald U

    2016-01-01

    PRK is a refractive surgery that reshapes the corneal surface by excimer laser photoablation to correct refractive errors. The effect of increased ultraviolet (UV) exposure on promoting post-PRK corneal haze has been reported in the literature; however, information is lacking regarding the effect of ambient UV exposure on physician practice patterns. The aim of this study was to evaluate the effect of ophthalmologists' practice location on their reported practice patterns to prevent post-PRK corneal haze. A cross-sectional observational study was conducted through an online survey sent to ophthalmologists performing PRK. The survey recorded the primary city of practice from which the two independent variables, latitude and average annual sunshine days, were determined. It also measured the frequency of use of postoperative preventive interventions (dependent variables) which are as follows: intraoperative Mitomycin-C, oral vitamin C, sunglasses, topical corticosteroids, topical cyclosporine, oral tetracyclines and amniotic membrane graft. Fifty-one ophthalmologists completed the survey. Practice locations' mean latitude was 36.4 degrees north, and average sunshine days annually accounted for 60% of year days. There was no significant relation between latitude/average annual sunshine days and usual post-PRK prophylactic treatments ( P  > 0.05). The commonest protective maneuvers were sunglasses (78%), prolonged topical corticosteroids (57%), Mitomycin-C (39%) and oral vitamin C (37%). We found no significant difference in ophthalmologists' practice patterns to prevent post-PRK corneal haze in relation to practice location latitude and average sunshine days. Moreover, the results demonstrated that the most widely used postoperative measures to prevent post-PRK haze are sunglasses, Mitomycin-C, topical corticosteroids, and oral Vitamin C.

  8. Bleaching Susceptibility and Recovery of Colombian Caribbean Corals in Response to Water Current Exposure and Seasonal Upwelling

    OpenAIRE

    Bayraktarov, Elisa; Pizarro, Valeria; Eidens, Corvin; Wilke, Thomas; Wild, Christian

    2013-01-01

    Coral bleaching events are globally occurring more frequently and with higher intensity, mainly caused by increases in seawater temperature. In Tayrona National Natural Park (TNNP) in the Colombian Caribbean, local coral communities are subjected to seasonal wind-triggered upwelling events coinciding with stronger water currents depending on location. This natural phenomenon offers the unique opportunity to study potential water current-induced mitigation mechanisms of coral bleaching in an u...

  9. Transmission of chimeric HIV by mating in conventional mice: prevention by pre-exposure antiretroviral therapy and reduced susceptibility during estrus

    Directory of Open Access Journals (Sweden)

    Eran Hadas

    2013-09-01

    Heterosexual transmission accounts for the majority of new human immunodeficiency virus (HIV cases worldwide. The current approach to investigate HIV heterosexual transmission in animals involves application of virus stock to the vaginal surface, a method that does not reproduce the physiological conditions of vaginal intercourse that influence the rate of transmission. We have previously described efficient infection of conventional mice using EcoHIV/NL4-3 and EcoHIV/NDK, chimeric HIV molecular clones constructed to express all HIV structural and regulatory genes except envelope, which is replaced by a rodent-tropic envelope gene. Here we investigated whether EcoHIV/NDK-infected male mice transmit virus to females during coitus, and the sensitivity of this transmission to HIV pre-exposure prophylaxis and the estrus state. Our general approach was to allow mating between EcoHIV/NDK-infected male mice and uninfected females for 1–7 nights. At 1–6 weeks after mating, mice were euthanized and virus burdens were measured by quantitative PCR (qPCR amplification of HIV RNA or DNA in peritoneal macrophages, inguinal lymph node cells, spleen cells or vas deferens, or by ELISA for antibodies to HIV Gag. We found that 70–100% of female mice mated to EcoHIV/NDK-infected males acquired infection. Pericoital treatment of females with either 2′,3′-dideoxcytidine (ddC or tenofovir largely prevented their EcoHIV/NDK infection by mating (P<0.05 and P<0.003, respectively. In males, T cells were dispensable for virus transmission. The rate of EcoHIV/NDK sexual transmission to females in estrus declined sharply (P=0.003 but their infection by injection was unaffected, indicating that the local environment in the female reproductive tract influences susceptibility to HIV. We conclude that this system of EcoHIV/NDK transmission during mouse mating reproduces key features of heterosexual transmission of HIV in humans and can be used to investigate its biology and control.

  10. Oral Pre-Exposure Prophylaxis (PrEP) for Prevention of HIV in Serodiscordant Heterosexual Couples in the United States: Opportunities and Challenges

    Science.gov (United States)

    Myers, Julie E.; Kurth, Ann E.; Cohen, Stephanie E.; Mannheimer, Sharon B.; Simmons, Janie; Pouget, Enrique R.; Trabold, Nicole; Haberer, Jessica E.

    2014-01-01

    Abstract Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP—injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US. PMID:25045996

  11. A motivational interviewing intervention to PREvent PAssive Smoke Exposure (PREPASE) in children with a high risk of asthma: design of a randomised controlled trial.

    Science.gov (United States)

    Hutchinson, Sasha G; Mesters, Ilse; van Breukelen, Gerard; Muris, Jean Wm; Feron, Frans Jm; Hammond, S Katharine; van Schayck, Constant P; Dompeling, Edward

    2013-02-27

    Especially children at risk for asthma are sensitive to the detrimental health effects of passive smoke (PS) exposure, like respiratory complaints and allergic sensitisation. Therefore, effective prevention of PS exposure in this group of vulnerable children is important. Based on previous studies, we hypothesized that an effective intervention program to prevent PS exposure in children is possible by means of a motivational interviewing tailored program with repeated contacts focussing on awareness, knowledge, beliefs (pros/cons), perceived barriers and needs of parents, in combination with feedback about urine cotinine levels of the children. The aim of the PREPASE study is to test the effectiveness of such an intervention program towards eliminating or reducing of PS exposure in children at risk for asthma. This article describes the protocol of the PREPASE study. The study is a one-year follow-up randomized controlled trial. Families with children (0-13 years of age) having an asthma predisposition who experience PS exposure at home are randomized into an intervention group receiving an intervention or a control group receiving care as usual. The intervention is given by trained research assistants. The intervention starts one month after a baseline measurement and takes place once per month for an hour during six home based counselling sessions. The primary outcome measure is the percentage of families curtailing PS exposure in children (parental report verified with the urine cotinine concentrations of the children) after 6 months. The secondary outcome measures include: household nicotine level, the child's lung function, airway inflammation and oxidative stress, presence of wheezing and questionnaires on respiratory symptoms, and quality of life. A process evaluation is included. Most of the measurements take place every 3 months (baseline and after 3, 6, 9 and 12 months of study). The PREPASE study incorporates successful elements of previous interventions

  12. Evaluation of the Relationship between Current Internal 137Cs Exposure in Residents and Soil Contamination West of Chernobyl in Northern Ukraine.

    Science.gov (United States)

    Kimura, Yuko; Okubo, Yuka; Hayashida, Naomi; Takahashi, Jumpei; Gutevich, Alexander; Chorniy, Sergiy; Kudo, Takashi; Takamura, Noboru

    2015-01-01

    After the Chernobyl Nuclear Power Plant accident, the residents living around the Chernobyl were revealed to have been internally exposed to 137Cs through the intake of contaminated local foods. To evaluate the current situation of internal 137Cs exposure and the relationship between the 137Cs soil contamination and internal exposure in residents, we investigated the 137Cs body burden in residents who were living in 10 selected cities from the northern part of the Zhitomir region, Ukraine, and collected soil samples from three family farms and wild forests of each city to measured 137Cs concentrations. The total number of study participants was 36,862, of which 68.9% of them were female. After 2010, the annual effective doses were less than 0.1 mSv in over 90% of the residents. The 137Cs body burden was significantly higher in autumn than other seasons (p Chernobyl accident, the internal exposure doses to residents living in contaminated areas of northern Ukraine is limited but still related to 137Cs soil contamination. Furthermore, the consumption of local foods is considered to be the cause of internal exposure.

  13. Traumatic brain injury produced by exposure to blasts, a critical problem in current wars: biomarkers, clinical studies, and animal models

    Science.gov (United States)

    Dixon, C. Edward

    2011-06-01

    Traumatic brain injury (TBI) resulting from exposure to blast energy released by Improvised Explosive Devices (IEDs) has been recognized as the "signature injury" of Operation Iraqi Freedom and Operation Enduring Freedom. Repeated exposure to mild blasts may produce subtle deficits that are difficult to detect and quantify. Several techniques have been used to detect subtle brain dysfunction including neuropsychological assessments, computerized function testing and neuroimaging. Another approach is based on measurement of biologic substances (e.g. proteins) that are released into the body after a TBI. Recent studies measuring biomarkers in CSF and serum from patients with severe TBI have demonstrated the diagnostic, prognostic, and monitoring potential. Advancement of the field will require 1) biochemical mining for new biomarker candidates, 2) clinical validation of utility, 3) technical advances for more sensitive, portable detectors, 4) novel statistical approach to evaluate multiple biomarkers, and 5) commercialization. Animal models have been developed to simulate elements of blast-relevant TBI including gas-driven shock tubes to generate pressure waves similar to those produced by explosives. These models can reproduce hallmark clinical neuropathological responses such as neuronal degeneration and inflammation, as well as behavioral impairments. An important application of these models is to screen novel therapies and conduct proteomic, genomic, and lipodomic studies to mine for new biomarker candidates specific to blast relevant TBI.

  14. Information sources, awareness and preventive health behaviors in a population at risk of Arsenic exposure: The role of gender and social networks.

    Directory of Open Access Journals (Sweden)

    Frédéric Mertens

    Full Text Available The population of Paracatu is at risk of Arsenic (As exposure associated with long-term exploration of the largest open pit gold mine in Brazil. As part of the interdisciplinary research "The Paracatu project: Arsenic environmental contamination and human health risks assessment in Paracatu-MG", carried out between 2011 and 2013, we used data disaggregated by gender to identify the sources of As-related information being accessed by inhabitants of Paracatu and to examine if access to these sources was correlated to awareness of As health effects and adoption of behaviors to reduce risk of As exposure. Semi-structured, face-to-face interviews were carried out with 460 participants (294 women and 166 men to collect data on respondent's socio-demographic characteristics, use of mass media and social communication networks as sources of information on As issues, the trustworthiness of these information sources, awareness of As health effects, and adoption of behaviors to reduce As exposure. For both men and women, interpersonal communication was used and trusted more frequently than mass media to obtain information on As. Discussion of As issues occurred preferentially among individuals of the same gender and was associated with awareness of As health risks. There are marked differences in variables correlated with the adoption of behaviors to reduce the risk of As exposure between men and women. Discussing As issues with women was associated with adoption of risk-reduction practices for both genders. In contrast, men who discuss As issues with other men were less likely to adopt As exposure prevention behaviors. Finally, adoption was associated with awareness of As health effects for women, but this was not the case for men. Policy implications for decision makers, practitioners and researchers are discussed, based on concrete examples of how gender-specific approaches can effectively guide the formulation and implementation of health promotion

  15. Exposure to a Mnemonic Interferes with Recall of Suicide Warning Signs in a Community-Based Suicide Prevention Program

    Science.gov (United States)

    Bryan, Craig J.; Steiner-Pappalardo, Nicole; Rudd, M. David

    2009-01-01

    The incremental impact of adding a mnemonic to remember suicide warning signs to the Air Force Suicide Prevention Program (AFSPP) community awareness briefing was investigated with a sample of young, junior-enlisted airmen. Participants in the standard briefing significantly increased their ability to list suicide warning signs and improved…

  16. Allergy prevention.

    Science.gov (United States)

    Muche-Borowski, Cathleen; Kopp, Matthias; Reese, Imke; Sitter, Helmut; Werfel, Thomas; Schäfer, Torsten

    2010-09-01

    The further increase of allergies in industrialized countries demands evidence-based measures of primary prevention. The recommendations as published in the guideline of 2004 were updated and consented on the basis of a systematic literature search. Evidence from the period February 2003-May 2008 was searched in the electronic databases Cochrane and MEDLINE as well as in reference lists of recent reviews and by contacting experts. The retrieved citations were screened for relevance first by title and abstract and in a second step as full paper. Levels of evidence were assigned to each included study and the methodological quality of the studies was assessed as high or low. Finally the revised recommendations were formally consented (nominal group process) by representatives of relevant societies and organizations including a self-help group. Of originally 4556 hits, 217 studies (4 Cochrane Reviews, 14 meta-analyses, 19 randomized controlled trials, 135 cohort and 45 case-control studies) were included and critically appraised. Grossly unchanged remained the recommendations on avoiding environmental tobacco smoke, breast-feeding over 4 months (alternatively hypoallergenic formulas for children at risk), avoiding a mold-promoting indoor climate, vaccination according to current recommendations, and avoidance of furry pets (especially cats) in children at risk. The recommendation on reducing the house dust mite allergen exposure as a measure of primary prevention was omitted and the impact of a delayed introduction of supplementary food was reduced. New recommendations were adopted concerning fish consumption (during pregnancy / breast-feeding and as supplementary food in the first year), avoidance of overweight, and reducing the exposure to indoor and outdoor air pollutants. The revision of this guideline on a profound evidence basis led to (1) a confirmation of existing recommendations, (2) substantial revisions, and (3) new recommendations. Thereby it is possible

  17. Neutralisation of interleukin-13 in mice prevents airway pathology caused by chronic exposure to house dust mite.

    Directory of Open Access Journals (Sweden)

    Kate L Tomlinson

    Full Text Available BACKGROUND: Repeated exposure to inhaled allergen can cause airway inflammation, remodeling and dysfunction that manifests as the symptoms of allergic asthma. We have investigated the role of the cytokine interleukin-13 (IL-13 in the generation and persistence of airway cellular inflammation, bronchial remodeling and deterioration in airway function in a model of allergic asthma caused by chronic exposure to the aeroallergen House Dust Mite (HDM. METHODOLOGY/PRINCIPAL FINDINGS: Mice were exposed to HDM via the intranasal route for 4 consecutive days per week for up to 8 consecutive weeks. Mice were treated either prophylactically or therapeutically with a potent neutralising anti-IL-13 monoclonal antibody (mAb administered subcutaneously (s.c.. Airway cellular inflammation was assessed by flow cytometry, peribronchial collagen deposition by histocytochemistry and airway hyperreactivity (AHR by invasive measurement of lung resistance (R(L and dynamic compliance (C(dyn. Both prophylactic and therapeutic treatment with an anti-IL-13 mAb significantly inhibited (P<0.05 the generation and maintenance of chronic HDM-induced airway cellular inflammation, peribronchial collagen deposition, epithelial goblet cell upregulation. AHR to inhaled methacholine was reversed by prophylactic but not therapeutic treatment with anti-IL-13 mAb. Both prophylactic and therapeutic treatment with anti-IL-13 mAb significantly reversed (P<0.05 the increase in baseline R(L and the decrease in baseline C(dyn caused by chronic exposure to inhaled HDM. CONCLUSIONS/SIGNIFICANCE: These data demonstrate that in a model of allergic lung disease driven by chronic exposure to a clinically relevant aeroallergen, IL-13 plays a significant role in the generation and persistence of airway inflammation, remodeling and dysfunction.

  18. Sunlight exposure is important for preventing hip fractures in patients with Alzheimer's disease, Parkinson's disease, or stroke.

    Science.gov (United States)

    Iwamoto, J; Takeda, T; Matsumoto, H

    2012-04-01

    Hypovitaminosis D as a result of malnutrition or sunlight deprivation, increased bone resorption, low bone mineral density (BMD), or an increased risk of falls may contribute to an increased risk of hip fractures in patients with neurological diseases, including Alzheimer's disease, Parkinson's disease, and stroke. The purpose of this study was to clarify the efficacy of sunlight exposure for reducing the risk of hip fractures in patients with such neurological diseases. The English literature was searched using PubMed, and randomized controlled trials evaluating the efficacy of sunlight exposure for reducing the risk of hip fractures in patients with Alzheimer's disease, Parkinson's disease, and stroke were identified. The relative risk and the 95% confidence interval were calculated for individual randomized controlled trials, and a pooled data analysis (meta-analysis) was performed. Three randomized controlled trials were identified. Sunlight exposure improved hypovitaminosis D and increased the BMD. The relative risk (95% confidence interval) of hip fractures was 0.22 (0.05, 1.01) for Alzheimer's disease, 0.27 (0.08, 0.96) for Parkinson's disease, and 0.17 (0.02, 1.36) for stroke. The relative risk (95% confidence interval) calculated for the pooled data analysis was 0.23 (0.10, 0.56) (P = 0.0012), suggesting a significant risk reduction rate of 77%. The present meta-analysis added additional evidence indicating the efficacy of sunlight exposure for reducing the risk of hip fractures in patients with Alzheimer's disease, Parkinson's disease, and stroke. © 2011 John Wiley & Sons A/S.

  19. Current evidence on the health-beneficial effects of berry fruits in the prevention and treatment of metabolic syndrome.

    Science.gov (United States)

    Kowalska, Katarzyna; Olejnik, Anna

    2016-11-01

    Berries belong to the best dietary sources of bioactive compounds, which exert a synergistic and cumulative effect on promotion of human health and prevention of diseases. The present review presents the most recent findings of animal and human studies regarding the health benefits of berries in terms of prevention and treatment of obesity, hypertension, type 2 diabetes, dyslipidemia, and nonalcoholic fatty liver disease. In the last years, there was a growing number of evidence from human epidemiological and interventional studies, which emphasized the role of berries in the management of metabolic diseases. Based on the results from recent clinical trials, it can be established that a berry diet rich in antioxidants and bioactive phytochemicals has beneficial effects on hepatic function, increase of insulin sensitivity and high-density lipoprotein-cholesterol, decrease of serum glucose and low-density lipoprotein-cholesterol, and finally is inversely associated with the incidence of type 2 diabetes. Numerous recent studies have shown that berries provide great benefits in preventing or mitigating metabolic disorders. The results of this review indicate that regular long-term consumption of different berries could potentially delay the progression of metabolic syndrome and comorbidities.

  20. Radiation-induced emesis in cats prevented by 24-hour prior exposure but not by ablation of the area postrema

    International Nuclear Information System (INIS)

    McCarthy, L.E.; Borison, H.L.; Douple, E.B.

    1985-01-01

    The acute emetic response induced by whole body exposure to cobalt radiation was quantified in cats at doses ranging from 1500 to 9000 rad (100 rad/min). Emesis occurred in a dose-related manner with a maximum incidence of 94% at 4500 rad (11 of 12 cats, mean latency of 98 min). At 6000 rad emesis occurred in 7 of 10 cats (mean latency of 69 min); however, a second exposure to this dose on the following day failed to induce vomiting in all of 5 cats (difference between groups significant at p = .01). After chronic ablation of the area postrema (chemoreceptor trigger zone for vomiting), 4 of 5 cats vomited in response to 4500 rad with a mean latency of 48 min. As was the case with the normal cats, all the postrema-ablated animals failed to vomit in response to a repeated dose of radiation delivered on the next day. The suppression of emesis observed on the second exposure was radiation-specific because 11 of 12 normal cats vomited appropriately in response to xylazine (0.6 mg/kg, im) during the period of refractoriness to radiation

  1. Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs

    Directory of Open Access Journals (Sweden)

    Jiaojiao Lü

    2015-11-01

    Full Text Available Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

  2. Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs.

    Science.gov (United States)

    Lü, Jiaojiao; Liang, Leichao; Feng, Yi; Li, Rena; Liu, Yu

    2015-11-20

    Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

  3. Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession.

    Science.gov (United States)

    Hecker, Tobias; Braitmayer, Lars; van Duijl, Marjolein

    2015-01-01

    We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013-2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients' sociodemographic characteristics, and its relation to traumatic experiences. The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review.

  4. Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession

    Science.gov (United States)

    Hecker, Tobias; Braitmayer, Lars; van Duijl, Marjolein

    2015-01-01

    Background We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. Objective The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Methods Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. Results The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. Conclusions More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review

  5. Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession

    Directory of Open Access Journals (Sweden)

    Tobias Hecker

    2015-11-01

    Full Text Available Background: We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs. Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. Objective: The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Methods: Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. Results: The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. Conclusions: More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this

  6. Evaluation of the antioxidant capacity and preventive effects of a topical emulsion and its vehicle control on the skin response to UV exposure.

    Science.gov (United States)

    Zhai, H; Behnam, S; Villarama, C D; Arens-Corell, M; Choi, M J; Maibach, H I

    2005-01-01

    Supplying topical exogenous antioxidants to the skin may prevent or minimize free radical-induced damaging. This study determines antioxidative capacity of a topical skin care emulsion (an oil-in-water vitamin E-containing formulation) versus its vehicle on human skin that was exposed to ultraviolet radiation (UVR) by utilizing a photochemiluminescence device and biophysical methods. Ten healthy Caucasians (3 male and 7 female; mean age 47 +/- 10 years) were enrolled. In a randomized and double-blind manner, a pH-balanced vitamin E emulsion or its vehicle control was applied onto predesignated forearm prior to UVR exposure. Thirty minutes after application, these test sites were exposed to a UV light to induce the minimal erythema dose. One untreated site served as a blank control. Visual scoring and instrumental measurements were recorded at baseline and at 24 h and 48 h thereafter. At day 3, after completing instrumental measurements, each test site was stripped three times in a consecutive manner with a proprietary adhesive tape disc. These tapes were quantified for antioxidant capacity using a photochemiluminescence device. Vitamin E emulsion and vehicle control significantly (p emulsion showed significantly (p emulsion and its vehicle control significantly (p emulsion significantly (p emulsion and its vehicle control showed significant (p emulsion and its vehicle control proved effective in preventing induction of erythema and reducing inflammatory damage caused by UV exposure. The effect of vitamin E emulsion exceeded that of an 'active control'. Copyright 2005 S. Karger AG, Basel

  7. A current approach to using additional foods for the early prevention of deficiency states in infants during the first year of life

    Directory of Open Access Journals (Sweden)

    L. V. Levchuk

    2014-01-01

    Full Text Available The paper considers how to organize properly balanced feeding in infants during the first year of life, by using additional foods. It highlights current approaches to using the latter in the babies and provides a rationale for the tune of giving additional foods, by taking into account the readiness of an infant to eat new foods and the need to incorporate micronutrients for the prevention of anemia, rickets, and food allergy. The benefits of using commercial products are discussed.

  8. Influence of current input-output and age of first exposure on phonological acquisition in early bilingual Spanish-English-speaking kindergarteners.

    Science.gov (United States)

    Ruiz-Felter, Roxanna; Cooperson, Solaman J; Bedore, Lisa M; Peña, Elizabeth D

    2016-07-01

    Although some investigations of phonological development have found that segmental accuracy is comparable in monolingual children and their bilingual peers, there is evidence that language use affects segmental accuracy in both languages. To investigate the influence of age of first exposure to English and the amount of current input-output on phonological accuracy in English and Spanish in early bilingual Spanish-English kindergarteners. Also whether parent and teacher ratings of the children's intelligibility are correlated with phonological accuracy and the amount of experience with each language. Data for 91 kindergarteners (mean age = 5;6 years) were selected from a larger dataset focusing on Spanish-English bilingual language development. All children were from Central Texas, spoke a Mexican Spanish dialect and were learning American English. Children completed a single-word phonological assessment with separate forms for English and Spanish. The assessment was analyzed for segmental accuracy: percentage of consonants and vowels correct and percentage of early-, middle- and late-developing (EML) sounds correct were calculated. Children were more accurate on vowel production than consonant production and showed a decrease in accuracy from early to middle to late sounds. The amount of current input-output explained more of the variance in phonological accuracy than age of first English exposure. Although greater current input-output of a language was associated with greater accuracy in that language, English-dominant children were only significantly more accurate in English than Spanish on late sounds, whereas Spanish-dominant children were only significantly more accurate in Spanish than English on early sounds. Higher parent and teacher ratings of intelligibility in Spanish were correlated with greater consonant accuracy in Spanish, but the same did not hold for English. Higher intelligibility ratings in English were correlated with greater current English

  9. Bleaching Susceptibility and Recovery of Colombian Caribbean Corals in Response to Water Current Exposure and Seasonal Upwelling

    Science.gov (United States)

    Bayraktarov, Elisa; Pizarro, Valeria; Eidens, Corvin; Wilke, Thomas; Wild, Christian

    2013-01-01

    Coral bleaching events are globally occurring more frequently and with higher intensity, mainly caused by increases in seawater temperature. In Tayrona National Natural Park (TNNP) in the Colombian Caribbean, local coral communities are subjected to seasonal wind-triggered upwelling events coinciding with stronger water currents depending on location. This natural phenomenon offers the unique opportunity to study potential water current-induced mitigation mechanisms of coral bleaching in an upwelling influenced region. Therefore, coral bleaching susceptibility and recovery patterns were compared during a moderate and a mild bleaching event in December 2010 and 2011, and at the end of the subsequent upwelling periods at a water current-exposed and -sheltered site of an exemplary bay using permanent transect and labeling tools. This was accompanied by parallel monitoring of key environmental variables. Findings revealed that in 2010 overall coral bleaching before upwelling was significantly higher at the sheltered (34%) compared to the exposed site (8%). Whereas 97% of all previously bleached corals at the water current-exposed site had recovered from bleaching by April 2011, only 77% recovered at the sheltered site, but 12% had died there. In December 2011, only mild bleaching (bleaching. This indicates the existence of local resilience patterns against coral bleaching in Caribbean reefs. PMID:24282551

  10. Anti-retroviral Therapy Based HIV Prevention Among a Sample of Men Who Have Sex with Men in Cape Town, South Africa: Use of Post-exposure Prophylaxis and Knowledge on Pre-exposure Prophylaxis.

    Science.gov (United States)

    Hugo, J M; Stall, R D; Rebe, K; Egan, J E; De Swardt, G; Struthers, H; McIntyre, J A

    2016-12-01

    Men who have Sex with Men (MSM) have been affected disproportionately by the global HIV pandemic. Rates of consistent condom-use are low and there is a need for further biomedical prevention interventions to prevent new HIV infections. Post exposure prophylaxis (PEP) can reduce the risk of HIV, but uptake among MSM is low. Pre-exposure prophylaxis (PrEP), an innovative anti-retroviral-based HIV prevention tool might be an appropriate intervention for MSM who have recently accessed PEP that involves HIV negative individuals taking daily tenofovir+emtricitabine for HIV prevention. 44 MSM, attending a primary health-care level MSM-focused sexual health clinic in Cape Town, South Africa, who had initiated PEP were enrolled in this study. Participants were followed up after 2, 4 and 12 weeks. Self-administered electronic surveys were completed at the initial, 4 and 12 week visit. Barriers and facilitators to accessing PEP and remaining adherent were examined, as was knowledge about PrEP. Thirty-two participants (80 %) were <40 years of age (range 20-65 years). 35 % of the participants reported their reason for requiring PEP as condomless receptive anal intercourse. A further 20 % required PEP following condomless penetrative anal intercourse; 27.5 % required PEP due to a broken condom during receptive anal sex and 2 participants during insertive anal sex. Three participants did not complete 28 days of PEP or were lost to follow up. Over half (58.5 %) of the participants reported being completely adherent to their regime; under a third (31.7 %) reported missing one PEP dose; and 9.8 % reported missing more than one dose. 36/40 (90 %) had heard of PrEP and 30/40 (75 %) indicated that they would use PrEP if it were accessible to them. That we enrolled 44 MSM who accessed PEP from a Department of Health affiliated clinic over 12 months, speaks to the low uptake by MSM of PEP services in South Africa. Adherence was high and demonstrates that adherence

  11. The promises and challenges of pre-exposure prophylaxis as part of the emerging paradigm of combination HIV prevention

    OpenAIRE

    C?ceres, Carlos F; Koechlin, Florence; Goicochea, Pedro; Sow, Papa-Salif; O'Reilly, Kevin R; Mayer, Kenneth H; Godfrey-Faussett, Peter

    2015-01-01

    Introduction: Towards the end of the twentieth century, significant success was achieved in reducing incidence in several global HIV epidemics through ongoing prevention strategies. However, further progress in risk reduction was uncertain. For one thing, it was clear that social vulnerability had to be addressed, through research on interventions addressing health systems and other structural barriers. As soon as antiretroviral treatment became available, researchers started to conceive that...

  12. Benchmarking of Percutaneous Injuries at the Ministry of Health Hospitals of Saudi Arabia in Comparison with the United States Hospitals Participating in Exposure Prevention Information Network (EPINet™

    Directory of Open Access Journals (Sweden)

    ZA Memish

    2015-01-01

    Full Text Available Background: Exposure to blood-borne pathogens from needle-stick and sharp injuries continues to pose a significant risk to health care workers. These events are of concern because of the risk to transmit blood-borne diseases such as hepatitis B virus, hepatitis C virus, and the human immunodeficiency virus. Objective: To benchmark different risk factors associated with needle-stick incidents among health care workers in the Ministry of Health hospitals in the Kingdom of Saudi Arabia compared to the US hospitals participating in Exposure Prevention Information Network (EPINet ™. Methods: Prospective surveillance of needle-stick and sharp incidents carried out during the year 2012 using EPINet™ ver 1.5 that provides uniform needle stick and sharp injury report form. Results: The annual percutaneous incidents (PIs rate per 100 occupied beds was 3.2 at the studied MOH hospitals. Nurses were the most affected job category by PIs (59.4%. Most PIs happened in patients' wards in the Ministry of Health hospitals (34.6%. Disposable syringes were the most common cause of PIs (47.20%. Most PIs occurred during use of the syringes (36.4%. Conclusion: Among health care workers, nurses and physicians appear especially at risk of exposure to PIs. Important risk factors of injuries include working in patient room, using disposable syringes, devices without safety features. Preventive strategies such as continuous training of health care workers with special emphasis on nurses and physicians, encouragement of reporting of such incidents, observation of sharp handling, their use and implementation of safety devices are warranted.

  13. Prevention and diagnosis of ventilator-associated pneumonia: a survey on current practices in Southern Spanish ICUs.

    Science.gov (United States)

    Sierra, Rafael; Benítez, Encarnación; León, Cristóbal; Rello, Jordi

    2005-09-01

    To assess the implementation of selected ventilator-associated pneumonia (VAP) prevention strategies, and to learn how VAP is diagnosed in the ICUs of Southern Spain. Multicentric survey. The ICUs of 32 hospitals of the public health-care system of Southern Spain. Directors of ICUs. None. Twenty-eight ICUs (87.5%) returned completed questionnaires. Ventilator circuits were changed every 72 h or longer in 75% of ICUs. Use of heat and moisture exchangers and open endotracheal suction systems were reported in 96% of ICUs. Subglottic secretion drainage was never used, and 57% of ICUs checked endotracheal tube cuff pressure at least daily. Semi-recumbent position was common (93%), and 67.5% of ICUs used frequently noninvasive ventilation. Continuous enteral feeding was reported in all ICUs. Sedative infusions were usually interrupted every day in 11% of ICUs. Seventy-five percent of ICUs had specific guidelines for antibiotic therapy of VAP, but rotation of antibiotics was uncommon (11%). Twenty-nine percent of ICUs diagnosed VAP without microbiological confirmation. The most used technique for microbiologic diagnosis was qualitative culture of endotracheal aspirates (42.8%). The centers with a larger structural complexity reported using VAP therapy guidelines more frequently than the smaller centers, but they did not utilized bronchoscopic techniques for diagnosing VAP. Common prevention and diagnostic procedures in clinical practice, including large teaching institutions, significantly differed from evidence-based recommendations and reports by research groups of excellence. In addition, our study suggests that clinical practice for preventing and diagnosing VAP is variable and many opportunities exist to improve the care of patients receiving mechanical ventilation.

  14. Evaluation of the role of risk perception in stakeholder engagement to prevent lead exposure in an urban setting.

    Science.gov (United States)

    Harclerode, Melissa A; Lal, Pankaj; Vedwan, Neeraj; Wolde, Bernabas; Miller, Michael E

    2016-12-15

    Stakeholder engagement is a vital sustainable remediation practice for obtaining useful feedback and identifying societal needs. Evaluating and integrating risk perception of stakeholders into remediation and outreach efforts allows for greater insight, increases the likelihood of success and ultimately, benefits the community by protecting its members from environmental hazards. In this study, we identified risk perception factors that influenced residents' level of concern for mitigating their exposure to elevated concentrations of lead in household paint and historic fill material. Risk perception factors were assessed by an in-person survey conducted in public green spaces. The analysis of survey participants' responses indicated that their perception of risk to exposed lead was mostly influenced by the presence of hazardous materials in close proximity to their residence, the ability to address pollution, and awareness, interest, and individual accountability in mitigating environmental risks. Responses also revealed that residents considered risk of lead and soil pollution as less menacing than the presence of more immediate and perceptible risks posed by factors such as air and water pollution. In addition, the community seemed to exhibit "optimism bias" and did not identify itself at high risk to susceptible and immediate hazards, including lead exposure. This lack of concern over lead exposure created a significant obstacle to community participation in state-led education and outreach programs. By integrating risk perception analysis and increasing stakeholder engagement, we can bring more attention to this issue, educate the public about the threat of lead pollution, and efficiently use financial resources to implement a more sustainable solution. Copyright © 2016. Published by Elsevier Ltd.

  15. Application of radioactive substances in research in nuclear medicine: current trends and radiation exposure to the study subjects

    International Nuclear Information System (INIS)

    Minkov, V.; Schwarz, E.R.; Bauer, B.; Nosske, D.; Erzberger, A.; Brix, G.

    2001-01-01

    Aim: Analysis of the application of radioactive substances in research in the field of nuclear medicine in human beings and of the resulting radiation exposure to study subjects. Methods: Assessment of applications for approval submitted in accordance with Paragraph 41 of the Radiation Protection Ordinance, evaluated by the Federal office for Radiation Protection together with the Federal Institute for Pharmaceuticals and Medical Products, within the period from 1997 to 1999. Results: The focus of the studies on the diagnostic application of radioactive substances in medicine evaluated has, since 1998, shifted from oncological to neurological and psychological aspects, while, at the same time, the number of PET studies increased constantly The proportion of healthy study subjects included in the diagnostic studies increased from 7 to 22%. The number of therapeutic applications of radioactive substances has, since 1997, undergone a three-fold increase, and in the process of this, the focus of attention lay within the area of radioimmuno-therapy and endovascular brachytherapy. The effective dose was, among up to 49% of the investigated healthy study subjects higher than 5 mSv, and among up to 6% of these subjects was at levels of over 20 mSv. Up to 22% of the patients received, within the scope of diagnostic studies, an effective dose of between 20 and 50 mSv. An exceeding of the 50 mSv limit occurred among up to 3% of the patients. Conclusions: In spite of the increasing numbers of PET applications, conventional nuclear medicine has maintained its importance in the field of medical research. Further developments in the areas of radiochemistry and molecular biology led to an increase in the importance of radio-immuno therapy. The evaluation of new radiopharmaceuticals and the extension of basic biomedical research, resulted in an increase in the proportion of healthy study subjects included in the studies. The radiation exposure among subjects resulting directly from

  16. Information to prevent human exposure to disease agents associated with wildlife—U.S. Geological Survey circulars on zoonotic disease

    Science.gov (United States)

    Meteyer, Carol U.; Moede Rogall, Gail

    2018-03-05

    The U.S. Geological Survey in collaboration with the U.S. Fish and Wildlife Service and others have published reports with information about geographic distribution, specific pathogens, disease ecology, and strategies to avoid exposure and infection for a selection of zoonotic diseases. Zoonotic diseases are diseases that can be passed from animals to humans, such as rabies and plague. This summary factsheet highlights the reports on plague, bat rabies, and raccoon roundworm with links to all seven zoonotic diseases covered in this series.

  17. Prevention of diabetes in NOD mice by repeated exposures to a contact allergen inducing a sub-clinical dermatitis

    DEFF Research Database (Denmark)

    Engkilde, Kaare; Buschard, Karsten; Hansen, Axel Jacob Kornerup

    2010-01-01

    Type 1 diabetes is an autoimmune disease, while allergic contact dermatitis although immune mediated, is considered an exposure driven disease that develops due to epicutaneous contact with reactive low-molecular chemicals. The objective of the present study was to experimentally study the effect...... of contact allergens on the development of diabetes in NOD mice. As the link between contact allergy and diabetes is yet unexplained we also examined the effect of provocation with allergens on Natural Killer T (NKT) cells, since involvement of NKT cells could suggest an innate connection between the two...

  18. Do Coffee Polyphenols Have a Preventive Action on Metabolic Syndrome Associated Endothelial Dysfunctions? An Assessment of the Current Evidence.

    Science.gov (United States)

    Yamagata, Kazuo

    2018-02-04

    Epidemiologic studies from several countries have found that mortality rates associated with the metabolic syndrome are inversely associated with coffee consumption. Metabolic syndrome can lead to arteriosclerosis by endothelial dysfunction, and increases the risk for myocardial and cerebral infarction. Accordingly, it is important to understand the possible protective effects of coffee against components of the metabolic syndrome, including vascular endothelial function impairment, obesity and diabetes. Coffee contains many components, including caffeine, chlorogenic acid, diterpenes and trigonelline. Studies have found that coffee polyphenols, such as chlorogenic acids, have many health-promoting properties, such as antioxidant, anti-inflammatory, anti-cancer, anti-diabetes, and antihypertensive properties. Chlorogenic acids may exert protective effects against metabolic syndrome risk through their antioxidant properties, in particular toward vascular endothelial cells, in which nitric oxide production may be enhanced, by promoting endothelial nitric oxide synthase expression. These effects indicate that coffee components may support the maintenance of normal endothelial function and play an important role in the prevention of metabolic syndrome. However, results related to coffee consumption and the metabolic syndrome are heterogeneous among studies, and the mechanisms of its functions and corresponding molecular targets remain largely elusive. This review describes the results of studies exploring the putative effects of coffee components, especially in protecting vascular endothelial function and preventing metabolic syndrome.

  19. Occupational hand injuries: a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals.

    Science.gov (United States)

    Gyer, Giles; Michael, Jimmy; Inklebarger, James

    2018-03-01

    Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

  20. Nanoparticle Delivery of Natural Products in the Prevention and Treatment of Cancers: Current Status and Future Prospects

    International Nuclear Information System (INIS)

    Bharali, Dhruba J.; Siddiqui, Imtiaz A.; Adhami, Vaqar M.; Chamcheu, Jean Christopher; Aldahmash, Abdullah M.; Mukhtar, Hasan; Mousa, Shaker A.

    2011-01-01

    The advent of nanotechnology has had a revolutionary impact on many aspects of 21 st century life. Nanotechnology has provided an opportunity to explore new avenues that conventional technologies have been unable to make an impact on for diagnosis, prevention, and therapy of different diseases, and of cancer in particular. Entities in nanometer sizes are excellent platforms to incorporate various drugs or active materials that can be delivered effectively to the desired action site without compromising the activity of the incorporated drug or material. In particular, nanotechnology entities can be used to deliver conventional natural products that have poor solubility or a short half life. Conventional natural products used with entities in nanometer sizes enable us to solve many of the inherent problems (stability, solubility, toxicity) associated with natural products, and also provide a platform for targeted delivery to tumor sites. We recently introduced the novel concept of using nanotechnology for enhancing the outcome of chemoprevention, which we called ‘nanochemoprevention’. This idea was subsequently exploited by several laboratories worldwide and has now become an advancing field in chemoprevention research. This review examines some of the applications of nanotechnology for cancer prevention and therapy using natural products

  1. Nanoparticle Delivery of Natural Products in the Prevention and Treatment of Cancers: Current Status and Future Prospects

    Directory of Open Access Journals (Sweden)

    Hasan Mukhtar

    2011-10-01

    Full Text Available The advent of nanotechnology has had a revolutionary impact on many aspects of 21st century life. Nanotechnology has provided an opportunity to explore new avenues that conventional technologies have been unable to make an impact on for diagnosis, prevention, and therapy of different diseases, and of cancer in particular. Entities in nanometer sizes are excellent platforms to incorporate various drugs or active materials that can be delivered effectively to the desired action site without compromising the activity of the incorporated drug or material. In particular, nanotechnology entities can be used to deliver conventional natural products that have poor solubility or a short half life. Conventional natural products used with entities in nanometer sizes enable us to solve many of the inherent problems (stability, solubility, toxicity associated with natural products, and also provide a platform for targeted delivery to tumor sites. We recently introduced the novel concept of using nanotechnology for enhancing the outcome of chemoprevention, which we called ‘nanochemoprevention’. This idea was subsequently exploited by several laboratories worldwide and has now become an advancing field in chemoprevention research. This review examines some of the applications of nanotechnology for cancer prevention and therapy using natural products.

  2. Nanoparticle Delivery of Natural Products in the Prevention and Treatment of Cancers: Current Status and Future Prospects

    Energy Technology Data Exchange (ETDEWEB)

    Bharali, Dhruba J. [The Pharmaceutical Research Institute at Albany College of Pharmacy and Health Sciences, 1 Discovery Drive, Rensselaer, NY 12144 (United States); Siddiqui, Imtiaz A.; Adhami, Vaqar M.; Chamcheu, Jean Christopher [Department of Dermatology, University of Wisconsin, Madison, WI 53706 (United States); Aldahmash, Abdullah M. [Stem Cell Unit, College of Medicine, King Saud University, Riyadh, 11461 (Saudi Arabia); University Hospital of Odense & Medical Biotechnology Center, Winslowsparken 25, DK-5000, Odense (Denmark); Mukhtar, Hasan [Department of Dermatology, University of Wisconsin, Madison, WI 53706 (United States); Mousa, Shaker A., E-mail: shaker.mousa@acphs.edu [The Pharmaceutical Research Institute at Albany College of Pharmacy and Health Sciences, 1 Discovery Drive, Rensselaer, NY 12144 (United States); Stem Cell Unit, College of Medicine, King Saud University, Riyadh, 11461 (Saudi Arabia)

    2011-10-26

    The advent of nanotechnology has had a revolutionary impact on many aspects of 21{sup st} century life. Nanotechnology has provided an opportunity to explore new avenues that conventional technologies have been unable to make an impact on for diagnosis, prevention, and therapy of different diseases, and of cancer in particular. Entities in nanometer sizes are excellent platforms to incorporate various drugs or active materials that can be delivered effectively to the desired action site without compromising the activity of the incorporated drug or material. In particular, nanotechnology entities can be used to deliver conventional natural products that have poor solubility or a short half life. Conventional natural products used with entities in nanometer sizes enable us to solve many of the inherent problems (stability, solubility, toxicity) associated with natural products, and also provide a platform for targeted delivery to tumor sites. We recently introduced the novel concept of using nanotechnology for enhancing the outcome of chemoprevention, which we called ‘nanochemoprevention’. This idea was subsequently exploited by several laboratories worldwide and has now become an advancing field in chemoprevention research. This review examines some of the applications of nanotechnology for cancer prevention and therapy using natural products.

  3. Do Coffee Polyphenols Have a Preventive Action on Metabolic Syndrome Associated Endothelial Dysfunctions? An Assessment of the Current Evidence

    Science.gov (United States)

    Yamagata, Kazuo

    2018-01-01

    Epidemiologic studies from several countries have found that mortality rates associated with the metabolic syndrome are inversely associated with coffee consumption. Metabolic syndrome can lead to arteriosclerosis by endothelial dysfunction, and increases the risk for myocardial and cerebral infarction. Accordingly, it is important to understand the possible protective effects of coffee against components of the metabolic syndrome, including vascular endothelial function impairment, obesity and diabetes. Coffee contains many components, including caffeine, chlorogenic acid, diterpenes and trigonelline. Studies have found that coffee polyphenols, such as chlorogenic acids, have many health-promoting properties, such as antioxidant, anti-inflammatory, anti-cancer, anti-diabetes, and antihypertensive properties. Chlorogenic acids may exert protective effects against metabolic syndrome risk through their antioxidant properties, in particular toward vascular endothelial cells, in which nitric oxide production may be enhanced, by promoting endothelial nitric oxide synthase expression. These effects indicate that coffee components may support the maintenance of normal endothelial function and play an important role in the prevention of metabolic syndrome. However, results related to coffee consumption and the metabolic syndrome are heterogeneous among studies, and the mechanisms of its functions and corresponding molecular targets remain largely elusive. This review describes the results of studies exploring the putative effects of coffee components, especially in protecting vascular endothelial function and preventing metabolic syndrome. PMID:29401716

  4. Prevention and treatment of demineralisation during fixed appliance therapy: a review of current methods and future applications.

    Science.gov (United States)

    Chambers, C; Stewart, S; Su, B; Sandy, J; Ireland, A

    2013-11-01

    Orthodontic treatment, like all aspects of dentistry, exposes the clinician to the risk of malpractice and litigation. Demineralisation of tooth enamel is still one of the main complications of orthodontic treatment and it is essential patients are made aware of this risk during the consent process. There are a variety of fluoride delivery systems (mouthrinse, varnish, bonding system, and elastics), which can be used to prevent white spot lesion (WSL) formation. Glass-ionomer bonding cements (GIC) have also been shown to reduce WSL formation and have the benefit of not relying on patient compliance. However, these materials have not found widespread acceptance, possibly due to handling characteristics. A number of new technologies, principally fillers and coatings, have recently become available with potential antimicrobial and antibiofilm properties. Coatings can be applied to brackets and wires, which prevent bacterial adhesion. However, the longevity of these coatings is questionable. There are a number of methods available aimed at reducing the incidence of WSL, but they all have limitations. Capitalising on technological advances will enable the production of tailor made orthodontic brackets and adhesive systems, which provide long-term protection against WSL without relying on patient compliance.

  5. The Potential Impact of Pre-Exposure Prophylaxis for HIV Prevention among Men Who Have Sex with Men and Transwomen in Lima, Peru: A Mathematical Modelling Study

    Science.gov (United States)

    Caceres, Carlos F.; Segura, Eddy R.; Grant, Robert M.; Garnett, Geoff P.; Hallett, Timothy B.

    2012-01-01

    Background HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral drugs by uninfected individuals to prevent HIV infection, has demonstrated effectiveness in preventing acquisition in a high-risk population of men who have sex with men (MSM). Consequently, there is a need to understand if and how PrEP can be used cost-effectively to prevent HIV infection in such populations. Methods and Findings We developed a mathematical model representing the HIV epidemic among MSM and transwomen (male-to-female transgender individuals) in Lima, Peru, as a test case. PrEP effectiveness in the model is assumed to result from the combination of a “conditional efficacy” parameter and an adherence parameter. Annual operating costs from a health provider perspective were based on the US Centers for Disease Control and Prevention interim guidelines for PrEP use. The model was used to investigate the population-level impact, cost, and cost-effectiveness of PrEP under a range of implementation scenarios. The epidemiological impact of PrEP is largely driven by programme characteristics. For a modest PrEP coverage of 5%, over 8% of infections could be averted in a programme prioritising those at higher risk and attaining the adherence levels of the Pre-Exposure Prophylaxis Initiative study. Across all scenarios, the highest estimated cost per disability-adjusted life year averted (uniform strategy for a coverage level of 20%, US$1,036–US$4,254) is below the World Health Organization recommended threshold for cost-effective interventions, while only certain optimistic scenarios (low coverage of 5% and some or high prioritisation) are likely to be cost-effective using the World Bank threshold. The impact of PrEP is reduced if those on PrEP decrease condom use, but only extreme behaviour changes among non-adherers (over 80% reduction in condom use) and a low PrEP conditional efficacy (40%) would adversely impact the epidemic. However, PrEP will not arrest HIV transmission in

  6. The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study.

    Directory of Open Access Journals (Sweden)

    Gabriela B Gomez

    Full Text Available HIV pre-exposure prophylaxis (PrEP, the use of antiretroviral drugs by uninfected individuals to prevent HIV infection, has demonstrated effectiveness in preventing acquisition in a high-risk population of men who have sex with men (MSM. Consequently, there is a need to understand if and how PrEP can be used cost-effectively to prevent HIV infection in such populations.We developed a mathematical model representing the HIV epidemic among MSM and transwomen (male-to-female transgender individuals in Lima, Peru, as a test case. PrEP effectiveness in the model is assumed to result from the combination of a "conditional efficacy" parameter and an adherence parameter. Annual operating costs from a health provider perspective were based on the US Centers for Disease Control and Prevention interim guidelines for PrEP use. The model was used to investigate the population-level impact, cost, and cost-effectiveness of PrEP under a range of implementation scenarios. The epidemiological impact of PrEP is largely driven by programme characteristics. For a modest PrEP coverage of 5%, over 8% of infections could be averted in a programme prioritising those at higher risk and attaining the adherence levels of the Pre-Exposure Prophylaxis Initiative study. Across all scenarios, the highest estimated cost per disability-adjusted life year averted (uniform strategy for a coverage level of 20%, US$1,036-US$4,254 is below the World Health Organization recommended threshold for cost-effective interventions, while only certain optimistic scenarios (low coverage of 5% and some or high prioritisation are likely to be cost-effective using the World Bank threshold. The impact of PrEP is reduced if those on PrEP decrease condom use, but only extreme behaviour changes among non-adherers (over 80% reduction in condom use and a low PrEP conditional efficacy (40% would adversely impact the epidemic. However, PrEP will not arrest HIV transmission in isolation because of its

  7. Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans

    Directory of Open Access Journals (Sweden)

    Monnica T. Williams

    2014-05-01

    Full Text Available Posttraumatic stress disorder (PTSD is a highly disabling disorder, afflicting African Americans at disproportionately higher rates than the general population. When receiving treatment, African Americans may feel differently towards a European American clinician due to cultural mistrust. Furthermore, racism and discrimination experienced before or during the traumatic event may compound posttrauma reactions, impacting the severity of symptoms. Failure to adapt treatment approaches to encompass cultural differences and racism-related traumas may decrease treatment success for African American clients. Cognitive behavioral treatment approaches are highly effective, and Prolonged Exposure (PE in particular has the most empirical support for the treatment of PTSD. This article discusses culturally-informed adaptations of PE that incorporates race-related trauma themes specific to the Black experience. These include adding more sessions at the front end to better establish rapport, asking directly about race-related themes during the assessment process, and deliberately bringing to the forefront race-related experiences and discrimination during treatment when indicated. Guidelines for assessment and the development of appropriate exposures are provided. Case examples are presented demonstrating adaptation of PE for a survivor of race-related trauma and for a woman who developed internalized racism following a sexual assault. Both individuals experienced improvement in their posttrauma reactions using culturally-informed adaptations to PE.

  8. Chronic Exposure to Rhodobacter Sphaeroides Extract Lycogen™ Prevents UVA-Induced Malondialdehyde Accumulation and Procollagen I Down-Regulation in Human Dermal Fibroblasts

    Science.gov (United States)

    Yang, Tsai-Hsiu; Lai, Ying-Hsiu; Lin, Tsuey-Pin; Liu, Wen-Sheng; Kuan, Li-Chun; Liu, Chia-Chyuan

    2014-01-01

    UVA contributes to the pathogenesis of skin aging by downregulation of procollagen I content and induction of matrix metalloproteinase (MMP)-associated responses. Application of antioxidants such as lycopene has been demonstrated as a convenient way to achieve protection against skin aging. Lycogen™, derived from the extracts of Rhodobacter sphaeroides, exerts several biological effects similar to that of lycopene whereas most of its anti-aging efficacy remains uncertain. In this study, we attempted to examine whether Lycogen™ could suppress malondialdehyde (MDA) accumulation and restore downregulated procollagen I expression induced by UVA exposure. In human dermal fibroblasts Hs68 cells, UVA repressed cell viability and decreased procollagen I protein content accompanied with the induction of MMP-1 and MDA accumulation. Remarkably, incubation with 50 μM Lycogen™ for 24 h ameliorated UVA-induced cell death and restored UVA-induced downregulation of procollagen in a dose-related manner. Lycogen™ treatment also prevented the UVA-induced MMP-1 upregulation and intracellular MDA generation in Hs68 cells. Activation of NFκB levels, one of the downstream events induced by UVA irradiation and MMP-1 induction, were also prevented by Lycogen™ administration. Taken together, our findings demonstrate that Lycogen™ may be an alternative agent that prevents UVA-induced skin aging and could be used in cosmetic and pharmaceutical applications. PMID:24463291

  9. 78 FR 3646 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-01-16

    ... proposing to revise certain definitions in FDA's current regulation for Registration of Food Facilities to.... Proposed Revisions for Consistency With the Definition of ``Food'' F. Proposed Revisions To Address... globalization, which has resulted in approximately 15 percent of the U.S. food supply being imported, including...

  10. Inhibition of the Rho/ROCK pathway prevents neuronal degeneration in vitro and in vivo following methylmercury exposure

    International Nuclear Information System (INIS)

    Fujimura, Masatake; Usuki, Fusako; Kawamura, Miwako; Izumo, Shuji

    2011-01-01

    Methylmercury (MeHg) is an environmental neurotoxicant which induces neuropathological changes in both the central nervous and peripheral sensory nervous systems. Our recent study demonstrated that down-regulation of Ras-related C3 botulinum toxin substrate 1 (Rac1), which is known to promote neuritic extension, preceded MeHg-induced damage in cultured cortical neurons, suggesting that MeHg-mediated axonal degeneration is due to the disturbance of neuritic extension. Therefore we hypothesized that MeHg-induced axonal degeneration might be caused by neuritic extension/retraction incoordination. This idea brought our attention to the Ras homolog gene (Rho)/Rho-associated coiled coil-forming protein kinase (ROCK) pathway because it has been known to be associated with the development of axon and apoptotic neuronal cell death. Here we show that inhibition of the Rho/ROCK pathway prevents MeHg-intoxication both in vitro and in vivo. A Rho inhibitor, C3 toxin, and 2 ROCK inhibitors, Fasudil and Y-27632, significantly protected against MeHg-induced axonal degeneration and apoptotic neuronal cell death in cultured cortical neuronal cells exposed to 100 nM MeHg for 3 days. Furthermore, Fasudil partially prevented the loss of large pale neurons in dorsal root ganglia, axonal degeneration in dorsal spinal root nerves, and vacuolar degeneration in the dorsal columns of the spinal cord in MeHg-intoxicated model rats (20 ppm MeHg in drinking water for 28 days). Hind limb crossing sign, a characteristic MeHg-intoxicated sign, was significantly suppressed in this model. The results suggest that inhibition of the Rho/ROCK pathway rescues MeHg-mediated neuritic extension/retraction incoordination and is effective for the prevention of MeHg-induced axonal degeneration and apoptotic neuronal cell death.

  11. [Historical development and current demands on medical training, further and advanced training in hygiene and infection prevention].

    Science.gov (United States)

    Exner, M; Kramer, A

    2012-11-01

    New risks in nosocomial infections and the dramatic increase in antibiotic-resistant pathogens in healthcare facilities have pointed to the urgent need for a good education of students and practitioners in the basics of hospital hygiene and infection prevention. On the other hand in the last 10 years a large number of institutes of hygiene in universities were closed with remarkable consequences concerning the decreased education in modern hygiene and public health. A broad historical overview over the last 200 years of teaching hygiene and public health at German universities is given which was integrated into the education of medical students. Nowadays many universities do not teach modern hygiene and public health. The demand of re-establishing new institutes of hygiene by the German Medical Council is discussed. The curriculum for the formation of hospital hygienists is presented.

  12. Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Junjun Jiang

    Full Text Available Nearly ten randomized controlled trials (RCTs of pre-exposure prophylaxis (PrEP have been completed or are ongoing worldwide to evaluate the effectiveness of PrEP in HIV transmission among HIV-uninfected high risk populations. The purpose of this study was to evaluate the role of PrEP to prevent HIV transmission through a Mata-analysis.A comprehensive computerized literature search was carried out in PubMed, EMbase, Ovid, Web of Science, Science Direct, Wan Fang, CNKI and related websites to collect relevant articles (from their establishment date to August 30, 2013. The search terms were "pre-exposure prophylaxis", "high risk population", "HIV infection", "reduction", "relative risk" and "efficacy". We included any RCT assessing PrEP for the prevention of HIV infection in high risk populations. Interventions of the studies were continuously daily or intermittent doses of single or compound antiretrovirals (ARVs before HIV exposure or during HIV exposure. A meta-analysis was conducted using Stata 10.0. A random-effects method was used to calculate the pooled relative risk (RR and 95% confidence intervals (CI for all studies included.Seven RCTs involving 14,804 individuals in high risk populations were eligible for this study. The number of subjects in the experimental groups was 8,195, with HIV infection rate of 2.03%. The number of subjects in the control groups was 6,609, with HIV infection rate of 4.07%. The pooled RR was 0.53 (95% CI = 0.40 ∼ 0.71, P<0.001. The re-analyzed pooled RR were 0.61 (95% CI = 0.48 ∼ 0.77, P<0.001, 0.49 (95% CI = 0.38 ∼ 0.63, P<0.001, respectively, by excluding the largest study or two studies without statistical significance. Publication bias analysis revealed a symmetry funnel plot. The fail-safe number was 1,022.These results show that PrEP is an effective strategy for reducing new HIV infections in high risk populations.

  13. Estimating patient dose from CT exams that use automatic exposure control: Development and validation of methods to accurately estimate tube current values.

    Science.gov (United States)

    McMillan, Kyle; Bostani, Maryam; Cagnon, Christopher H; Yu, Lifeng; Leng, Shuai; McCollough, Cynthia H; McNitt-Gray, Michael F

    2017-08-01

    The vast majority of body CT exams are performed with automatic exposure control (AEC), which adapts the mean tube current to the patient size and modulates the tube current either angularly, longitudinally or both. However, most radiation dose estimation tools are based on fixed tube current scans. Accurate estimates of patient dose from AEC scans require knowledge of the tube current values, which is usually unavailable. The purpose of this work was to develop and validate methods to accurately estimate the tube current values prescribed by one manufacturer's AEC system to enable accurate estimates of patient dose. Methods were developed that took into account available patient attenuation information, user selected image quality reference parameters and x-ray system limits to estimate tube current values for patient scans. Methods consistent with AAPM Report 220 were developed that used patient attenuation data that were: (a) supplied by the manufacturer in the CT localizer radiograph and (b) based on a simulated CT localizer radiograph derived from image data. For comparison, actual tube current values were extracted from the projection data of each patient. Validation of each approach was based on data collected from 40 pediatric and adult patients who received clinically indicated chest (n = 20) and abdomen/pelvis (n = 20) scans on a 64 slice multidetector row CT (Sensation 64, Siemens Healthcare, Forchheim, Germany). For each patient dataset, the following were collected with Institutional Review Board (IRB) approval: (a) projection data containing actual tube current values at each projection view, (b) CT localizer radiograph (topogram) and (c) reconstructed image data. Tube current values were estimated based on the actual topogram (actual-topo) as well as the simulated topogram based on image data (sim-topo). Each of these was compared to the actual tube current values from the patient scan. In addition, to assess the accuracy of each method in estimating

  14. Ethanol exposure induces the cancer-associated fibroblast phenotype and lethal tumor metabolism: implications for breast cancer prevention.

    Science.gov (United States)

    Sanchez-Alvarez, Rosa; Martinez-Outschoorn, Ubaldo E; Lin, Zhao; Lamb, Rebecca; Hulit, James; Howell, Anthony; Sotgia, Federica; Rubin, Emanuel; Lisanti, Michael P

    2013-01-15

    Little is known about how alcohol consumption promotes the onset of human breast cancer(s). One hypothesis is that ethanol induces metabolic changes in the tumor microenvironment, which then enhances epithelial tumor growth. To experimentally test this hypothesis, we used a co-culture system consisting of human breast cancer cells (MCF7) and hTERT-immortalized fibroblasts. Here, we show that ethanol treatment (100 mM) promotes ROS production and oxidative stress in cancer-associated fibroblasts, which is sufficient to induce myofibroblastic differentiation. Oxidative stress in stromal fibroblasts also results in the onset of autophagy/mitophagy, driving the induction of ketone body production in the tumor microenvironment. Interestingly, ethanol has just the opposite effect in epithelial cancer cells, where it confers autophagy resistance, elevates mitochondrial biogenesis and induces key enzymes associated with ketone re-utilization (ACAT1/OXCT1). During co-culture, ethanol treatment also converts MCF7 cells from an ER(+) to an ER(-) status, which is thought to be associated with "stemness," more aggressive behavior and a worse prognosis. Thus, ethanol treatment induces ketone production in cancer-associated fibroblasts and ketone re-utilization in epithelial cancer cells, fueling tumor cell growth via oxidative mitochondrial metabolism (OXPHOS). This "two-compartment" metabolic model is consistent with previous historical observations that ethanol is first converted to acetaldehyde (which induces oxidative stress) and then ultimately to acetyl-CoA (a high-energy mitochondrial fuel), or can be used to synthesize ketone bodies. As such, our results provide a novel mechanism by which alcohol consumption could metabolically convert "low-risk" breast cancer patients to "high-risk" status, explaining tumor recurrence or disease progression. Hence, our findings have clear implications for both breast cancer prevention and therapy. Remarkably, our results also show that

  15. Effective Leadership and Management of an ACS Injury Prevention Program: Current Opinions and Perspectives From Where the Rubber Meets the Road.

    Science.gov (United States)

    Wolfe, Elizabeth S; Bryant, Elizabeth A

    The American College of Surgeons (ACS) mandates that each verified trauma center must have an injury prevention coordinator (IPC); however, Chapter 18 in the Resources for Optimal Care of the Injured Patient (2014) provides minimal information on how to effectively lead or manage an injury prevention (IP) program. This opinion article addresses 3 fundamental components of an effective IP program: (1) construction of an innovative vision of IP programming using current technology; (2) intentional investment and involvement; and (3) stakeholder leadership, engagement, and sustainability. This article also provides leadership and management methods from other professions both within and outside of the health care field that can be translated into sustainable IP program planning, implementation, and longevity.

  16. Prevention of healthcare-associated infections in general practice: Current practice and drivers for change in a French study

    Directory of Open Access Journals (Sweden)

    M Gignon

    2012-01-01

    Full Text Available Purpose: The fight against Healthcare-associated infections is a public health priority and a major challenge for the safety and quality of care. The objective was to assess hygiene in general practitioners′ (GPs′ office and identify barriers to and drivers for better practice. Materials and Methods: We performed a cross-sectional study in which a questionnaire was sent to a randomly selected, representative sample of 800 GPs. We used a self-administered questionnaire. The first part assessed current practice and the second part focused on barriers and motivating factors for better practice. We performed a descriptive statistical analysis of the responses to closed questions and a qualitative analysis of the responses to open-ended questions. Results: Only a third of the GPs were aware of the current guidelines. Disposable equipment was used by 31% of the GPs. For the remainder, only 38% complied with the recommended procedures for sterilisation or disinfection. Seventy-two percent of the GPs washed their hands between consultations in the office. A significant minority of physicians disregarded the guidelines by never wearing gloves to perform sutures (11%, treat wounds (10%, fit intrauterine devices (18% or perform injections (18%. The main barriers to good practice were the high cost of modifications and lack of time/space. Two third of the GPs did not intend to change their practices. The drivers for change were pressure from patients (4.8 on a scale of 1 to 7, inspection by the health authorities (4.8 and the fear of legal action (4.4. Conclusions: Our results show that there are significant differences between current practice and laid-down professional guidelines. Policies for improvement of hygiene must take into account barriers and motivating factors.

  17. Assessing informed consent in an opioid relapse prevention study with adults under current or recent criminal justice supervision.

    Science.gov (United States)

    Allen, Ashleigh A; Chen, Donna T; Bonnie, Richard J; Ko, Tomohiro M; Suratt, Colleen E; Lee, Joshua D; Friedmann, Peter D; Gordon, Michael; McDonald, Ryan; Murphy, Sean M; Boney, Tamara Y; Nunes, Edward V; O'Brien, Charles P

    2017-10-01

    Concerns persist that individuals with substance use disorders who are under community criminal justice supervision experience circumstances that might compromise their provision of valid, informed consent for research participation. These concerns include the possibilities that desire to obtain access to treatment might lead individuals to ignore important information about research participation, including information about risks, or that cognitive impairment associated with substance use might interfere with attending to important information. We report results from a consent quiz (CQ) administered in a multisite randomized clinical trial of long-acting naltrexone to prevent relapse to opioid use disorder among adults under community criminal justice supervision-a treatment option difficult to access by this population of individuals. Participants were required to answer all 11 items correctly before randomization. On average, participants answered 9.8 items correctly (89%) at baseline first attempt (n=306). At week 21 (n=212), participants scored 87% (9.5 items correct) without review. Performance was equivalent to, or better than, published results from other populations on a basic consent quiz instrument across multiple content domains. The consent quiz is an efficient method to screen for adequate knowledge of consent information as part of the informed consent process. Clinical researchers who are concerned about these issues should consider using a consent quiz with corrected feedback to enhance the informed consent process. Overall, while primarily useful as an educational tool, employing a CQ as part of the gateway to participation in research may be particularly important as the field continues to advance and tests novel experimental treatments with significant risks and uncertain potential for benefit. Copyright © 2017. Published by Elsevier Inc.

  18. Radiation exposure during transmission measurements: comparison between CT- and germanium-based techniques with a current PET scanner

    International Nuclear Information System (INIS)

    Wu, Tung-Hsin; Huang, Yung-Hui; Lee, Jason J.S.; Wang, Shih-Yuan; Wang, Su-Cheng; Su, Cheng-Tau; Chen, Liang-Kung; Chu, Tieh-Chi

    2004-01-01

    In positron emission tomographic (PET) scanning, transmission measurements for attenuation correction are commonly performed by using external germanium-68 rod sources. Recently, combined PET and computed tomographic (CT) scanners have been developed in which the CT data can be used for both anatomical-metabolic image formation and attenuation correction of the PET data. The purpose of this study was to evaluate the difference between germanium- and CT-based transmission scanning in terms of their radiation doses by using the same measurement technique and to compare the doses that patients receive during brain, cardiac and whole-body scans. Measurement of absorbed doses to organs was conducted by using a Rando Alderson phantom with thermoluminescent dosimeters. Effective doses were calculated according to the guidelines in the International Commission on Radiation Protection Publication Number 60. Compared with radionuclide doses used in routine 2-[fluorine-18]-fluoro-2-deoxy-d-glucose PET imaging, doses absorbed during germanium-based transmission scans were almost negligible. On the other hand, absorbed doses from CT-based transmission scans were significantly higher, particularly with a whole-body scanning protocol. Effective doses were 8.81 mSv in the high-speed mode and 18.97 mSv in the high-quality mode for whole-body CT-based transmission scans. These measurements revealed that the doses received by a patient during CT-based transmission scanning are more than those received in a typical PET examination. Therefore, the radiation doses represent a limitation to the generalised use of CT-based transmission measurements with current PET/CT scanner systems. (orig.)

  19. Field evaluation of a new point-of-use faucet filter for preventing exposure to Legionella and other waterborne pathogens in health care facilities.

    Science.gov (United States)

    Baron, Julianne L; Peters, Tammy; Shafer, Raymond; MacMurray, Brian; Stout, Janet E

    2014-11-01

    Opportunistic waterborne pathogens (eg, Legionella, Pseudomonas) may persist in water distribution systems despite municipal chlorination and secondary disinfection and can cause health care-acquired infections. Point-of-use (POU) filtration can limit exposure to pathogens; however, their short maximum lifetime and membrane clogging have limited their use. A new faucet filter rated at 62 days was evaluated at a cancer center in Northwestern Pennsylvania. Five sinks were equipped with filters, and 5 sinks served as controls. Hot water was collected weekly for 17 weeks and cultured for Legionella, Pseudomonas, and total bacteria. Legionella was removed from all filtered samples for 12 weeks. One colony was recovered from 1 site at 13 weeks; however, subsequent tests were negative through 17 weeks of testing. Total bacteria were excluded for the first 2 weeks, followed by an average of 1.86 log reduction in total bacteria compared with controls. No Pseudomonas was recovered from filtered or control faucets. This next generation faucet filter eliminated Legionella beyond the 62 day manufacturers' recommended maximum duration of use. These new POU filters will require fewer change-outs than standard filters and could be a cost-effective method for preventing exposure to Legionella and other opportunistic waterborne pathogens in hospitals with high-risk patients. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Occupational exposure to benzene: a prevention program for employees and contractors; PPEOB - Programa de Prevencao a Exposicao Ocupacional ao Benzeno para Empregados Proprios e Contratados

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Paulo Sergio de; Silva, Edson Ferreira da; Patto, Claudio Monteiro [TRANSPETRO, Rio de Janeiro, RJ (Brazil)

    2004-07-01

    PETROBRAS/TRANSPETRO Pipelines and Terminals has 500 regular employees and 5.064 out sourced workers in its Southeast Division. The out sourced employees work through 125 contracts involving a wide range of activities such as maintenance, operational, pipeline launching , engineering, administrative and auxiliary services. Among these workers, 200 people are subjected to benzene occupational exposure, which might be present in the products we transport in our pipelines. Benzene is recognized as a carcinogen according to ACGIH and Brazilian Ministry of Labour regulation NR- 15. Exposure to benzene in an uncontrolled way, be it chronic or sharp, may affect the worker's health such as: hematological alterations, neoplasys, neurobehavior alterations. Our program PPEOB (acronym in Portuguese for benzene occupational exposure prevention program) involved the work force and fosters health by anticipation, recognition, evaluation and control of the situations that may result in injuries. Further actions include the acquisition of equipment for benzene detection in the air or diluted in liquids and the introduction of new technologies for process control. The priority is the acquisition of equipment for collective protection not forgetting the individual protection equipment (IPE) and the required training. Implementation of this program counted with the effective participation of managers, contract supervisors and HSE professionals whose main task was to advise all involved parts. Furthermore, an auto-evaluation was released in order to assess the adherence of the PPEOB related to the facility reality. Since a suitable level of adherence is reached, the PPEOB can be used as a standard in the whole TRANSPETRO. (author)

  1. Pilot study of a novel classroom designed to prevent myopia by increasing children's exposure to outdoor light.

    Science.gov (United States)

    Zhou, Zhongqiang; Chen, Tingting; Wang, Mengrui; Jin, Ling; Zhao, Yongyi; Chen, Shangji; Wang, Congyao; Zhang, Guoshan; Wang, Qilin; Deng, Qiaoming; Liu, Yubo; Morgan, Ian G; He, Mingguang; Liu, Yizhi; Congdon, Nathan

    2017-01-01

    We sought to assess light characteristics and user acceptability of a prototype Bright Classroom (BC), designed to prevent children's myopia by exposing them to light conditions resembling the outdoors. Conditions were measured throughout the school year in the glass-constructed BC, a traditional classroom (TC) and outdoors. Teachers and children completed user questionnaires, and children rated reading comfort at different light intensities. A total of 230 children (mean age 10.2 years, 57.4% boys) and 13 teachers (36.8 years, 15.4% men) completed questionnaires. The median (Inter Quartile Range) light intensity in the BC (2,540 [1,330-4,060] lux) was greater than the TC (477 [245-738] lux, P 500 [8,960-36,000] lux, P summer and on sunny days (>5,000 lux) was at the upper limit of children's comfort for reading. In summary, light intensity in the BC exceeds TC, and is at the practical upper limit for routine use. Children and teachers prefer the BC.

  2. Exposure to chronic mild stress prevents kappa opioid-mediated reinstatement of cocaine and nicotine place preference

    Directory of Open Access Journals (Sweden)

    Ream eAl-Hasani

    2013-08-01

    Full Text Available Stress increases the risk of drug abuse, causes relapse to drug seeking, and potentiates the rewarding properties of both nicotine and cocaine. Understanding the mechanisms by which stress regulates the rewarding properties of drugs of abuse provides valuable insight into potential treatments for drug abuse. Prior reports have demonstrated that stress causes dynorphin release, activating kappa-opioid receptors (KOR in monoamine circuits resulting in both potentiation and reinstatement of cocaine and nicotine conditioned place preference. Here we report that kappa-opioid dependent reinstatement of cocaine and nicotine place preference is reduced when the mice are exposed to a randomized chronic mild stress regime prior to training in a conditioned place preference-reinstatement paradigm. The chronic mild stress schedule involves seven different stressors (removal of nesting for 24hr, 5min forced swim stress at 15°C, 8hr food and water deprivation, damp bedding overnight, white noise, cage tilt and disrupted home cage lighting rotated over a three-week period. This response is KOR-selective, because chronic mild stress does not protect against cocaine or nicotine drug-primed reinstatement. This protection from reinstatement is also observed following sub-chronic social defeat stress, where each mouse is placed in an aggressor mouse home cage for a period of 20 min over five days. In contrast, a single acute stressor resulted in a potentiation of KOR-induced reinstatement, similarly to previously reported. Prior studies have shown that stress alters sensitivity to opioids and prior stress can influence the pharmacodynamics of the opioid receptor system. Together, these findings suggest that exposure to different forms of stress may cause a dysregulation of kappa opioid circuitry and that changes resulting from mild stress can have protective and adaptive effects against drug relapse.

  3. Current practices in the prediction and prevention of preterm birth in patients with higher-order multiple gestations.

    Science.gov (United States)

    Baker, Emily; Hunter, Tiffany; Okun, Nanette; Farine, Dan

    2015-05-01

    We sought to determine the interventions utilized by maternal-fetal medicine specialists in the prediction and prevention of preterm labor in higher-order multiple (HOM) gestations. Online questionnaires and email surveys were sent to all the maternal-fetal medicine specialists in Canada (n=122). Questionnaire items included interventions physicians routinely recommended for HOM gestations including: (1) bed rest; (2) cervical length measurement on transvaginal ultrasound; (3) corticosteroids use; (4) cerclage; and (5) tocolytic therapy. Response rate was 66% (81/122), with 68% of respondents in practice for >10 years. Of physicians, 91% did not routinely recommend bed rest (95% confidence interval [CI], 84.7-97.2). In all, 82% (95% CI, 73.63-90.4%) recommended routine cervical length assessment with 32.3% (95% CI, 20.7-43.2) and 37.1% (95% CI, 25.3-48.6) of this group suggesting assessment at 16-18 and 19-21 weeks, respectively. Frequency of assessment varied from biweekly (53.3%; 95% CI, 40.9-65.0), to monthly (23.3%; 95% CI, 12.8-33.1), to a single measurement repeated only if abnormal (12.5%; 95% CI, 4.5-20.8). In all, 28% (95% CI, 18.2-37.8) recommended routine administration of corticosteroids for lung maturation. Timing of administration varied, with 24% initiating steroids between 24-26 weeks, 59% between 27-28 weeks, and 17% after 28 weeks. None reported routine cerclage placement. However, 71% (95% CI, 61.1-80.8) would perform cerclage based on history or ultrasound. Of respondents, 81% (95% CI, 72.4-89.5) would consider using tocolytic agents for threatened preterm labor including calcium channel blockers (94%), nonsteroidal antiinflammatory drugs (5%), and nitroglycerin transdermal patch (24%). The variable practice guidelines and paucity of data for management of HOM pregnancy places the onus on individual practitioners to develop their own management schemes. This results in heterogeneous management, which is based on conflicting international

  4. Comparing corporal punishment and children's exposure to violence between caregivers: Towards better diagnosis and prevention of intrafamilial physical abuse of children.

    Science.gov (United States)

    Ribeiro, Cristina Silveira; Coelho, Luís; Magalhães, Teresa

    2016-02-01

    Any intervention involving child victims of intrafamilial abuse must take the alleged underlying motives for the abuse into account. The aim of this study is to further our understanding of intrafamilial physical abuse of children, by comparing its various aspects while considering the alleged underlying motives. A preliminary sample of 1656 cases of alleged physical abuse in the northern region of Portugal was analysed, with two main motives being identified: corporal punishment (CP) (G1 = 927) and exposure to violence between caregivers (EVC) (G2 = 308). Statistically significant differences were found between the two motives (p < 0.05) for the following variables: (1) age of the alleged victims, (2) sex of the alleged abuser, (3) risk factors affecting the alleged abuser, (4) abuser/victim relationship, (5) injury-producing mechanism, (6) time between last abuse and forensic medical examination and (7) location of injuries. Evidence-based knowledge of these differences may help in accurate diagnosis by doctors (particularly forensic physicians) and prevention of this type of violence through support strategies (including tertiary prevention strategies). Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  5. Motivators, concerns, and barriers to adoption of pre-exposure prophylaxis for HIV prevention among gay and bisexual men in HIV serodiscordant male relationships

    Science.gov (United States)

    Brooks, Ronald A.; Kaplan, Rachel L.; Lieber, Eli; Landovitz, Raphael J.; Lee, Sung-Jae; Leibowitz, Arleen A.

    2011-01-01

    The purpose of this study was to identify factors that may facilitate or impede future adoption of pre-exposure prophylaxis (PrEP) for HIV prevention among gay and bisexual men in HIV-serodiscordant relationships. This qualitative study utilized semi-structured interviews conducted with a multi-racial/ethnic sample of 25 gay and bisexual HIV serodiscordant male couples (n=50 individuals) recruited from community settings in Los Angeles, California. A modified grounded theory approach was employed to identify major themes relating to future adoption of PrEP for HIV prevention. Motivators for adoption included protection against HIV infection, less concern and fear regarding HIV transmission, the opportunity to engage in unprotected sex, and endorsements of PrEP’s effectiveness. Concerns and barriers to adoption included the cost of PrEP, short- and long-term side effects, adverse effects of intermittent use or discontinuing PrEP, and accessibility of PrEP. The findings suggest the need for a carefully planned implementation program along with educational and counseling interventions in the dissemination of an effective PrEP agent. PMID:21476147

  6. Knowledge of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men in Denver, Colorado

    Science.gov (United States)

    Al-Tayyib, Alia A.; Thrun, Mark W.; Haukoos, Jason S.; Walls, N. Eugene

    2014-01-01

    As part of the National HIV Behavioral Surveillance System among men who have sex with men (MSM) in Denver, Colorado, we assessed knowledge of pre-exposure prophylaxis (PrEP); willingness to use PrEP; and potential changes in risk behaviors among HIV-negative participants reporting sexual activity with a male partner in the preceding 12 months. We examined knowledge of PrEP before (2008) and after (2011) results of the iPrEx trial were available. Of the 425 participants in the 2008 sample, 91 (21 %) were aware of PrEP compared to 131 (28 %) of the 461 participants in the 2011 sample (adjusted prevalence ratio: 1.43, 95 % confidence interval: 1.18, 1.72). Despite the increase in 2011, few MSM in Denver were aware of PrEP. Educating high-risk MSM about the potential utility of PrEP as an adjunct to other effective prevention methods is needed when considering the addition of PrEP to the HIV prevention arsenal. PMID:23824227

  7. Infant feeding and allergy prevention: a review of current knowledge and recommendations. A EuroPrevall state of the art paper.

    LENUS (Irish Health Repository)

    Grimshaw, K E C

    2009-10-01

    The relationship between infant feeding patterns and the later development of food allergies has been the focus of much debate and research over the last decade. National recommendations have been made by many countries on how to feed infants to reduce the risk of food allergy but due to the lack of firm evidence the recommendations differ widely. This review has been developed as part of EuroPrevall, a European multicentre research project funded by the European Union, to document the differing feeding recommendations made across Europe, to investigate the current evidence base for any allergy prevention feeding recommendations and to identify areas where further research is needed. This review will also provide information which, when combined with the infant feeding data collected as part of EuroPrevall, will give an indication of compliance to national feeding guidelines which can be utilised to assess the effectiveness of current dissemination and implementation strategies.

  8. Current issues in patient adherence and persistence: focus on anticoagulants for the treatment and prevention of thromboembolism

    Directory of Open Access Journals (Sweden)

    Patrick P Kneeland

    2010-03-01

    Full Text Available Patrick P Kneeland, Margaret C FangThe University of California, San Francisco Division of Hospital Medicine, San Francisco, CA, USAAbstract: Warfarin therapy reduces morbidity and mortality related to thromboembolism. Yet adherence to long-term warfarin therapy remains challenging due to the risks of anticoagulantassociated complications and the burden of monitoring. The aim of this paper is to review determinants of adherence and persistence on long-term anticoagulant therapy for atrial fibrillation and venous thromboembolism. We evaluate what the current literature reveals about the impact of warfarin on quality of life, examine warfarin trial data for patterns of adherence, and summarize known risk factors for warfarin discontinuation. Studies suggest only modest adverse effects of warfarin on quality of life, but highlight the variability of individual lifestyle experiences of patients on warfarin. Interestingly, clinical trials comparing anticoagulant adherence to alternatives (such as aspirin show that discontinuation rates on warfarin are not consistently higher than in control arms. Observational studies link a number of risk factors to warfarin non-adherence including younger age, male sex, lower stroke risk, poor cognitive function, poverty, and higher educational attainment. In addition to differentiating the relative impact of warfarin-associated complications (such as bleeding versus the lifestyle burdens of warfarin monitoring on adherence, future investigation should focus on optimizing patient education and enhancing models of physician–patient shared-decision making around anticoagulation.Keywords: anticoagulation, warfarin, adherence, persistence, thromboembolism

  9. S-adenosyl methionine prevents ASD like behaviors triggered by early postnatal valproic acid exposure in very young mice.

    Science.gov (United States)

    Ornoy, Asher; Weinstein-Fudim, Liza; Tfilin, Matanel; Ergaz, Zivanit; Yanai, Joseph; Szyf, Moshe; Turgeman, Gadi

    2018-01-16

    A common animal model of ASD is the one induced by valproic acid (VPA), inducing epigenetic changes and oxidative stress. We studied the possible preventive effect of the methyl donor for epigenetic enzymatic reactions, S-adenosine methionine (SAM), on ASD like behavioral changes and on redox potential in the brain and liver in this model. ICR albino mice were injected on postnatal day 4 with one dose of 300 mg/kg of VPA, with normal saline (controls) or with VPA and SAM that was given orally for 3 days at the dose of 30 mg/kg body weight. From day 50, we carried out neurobehavioral tests and assessment of the antioxidant status of the prefrontal cerebral cortex, liver assessing SOD and CAT activity, lipid peroxidation and the expression of antioxidant genes. Mice injected with VPA exhibited neurobehavioral deficits typical of ASD that were more prominent in males. Changes in the activity of SOD and CAT increased lipid peroxidation and changes in the expression of antioxidant genes were observed in the prefrontal cortex of VPA treated mice, more prominent in females, while ASD like behavior was more prominent in males. There were no changes in the redox potential of the liver. The co-administration of VPA and SAM alleviated most ASD like neurobehavioral symptoms and normalized the redox potential in the prefrontal cortex. Early postnatal VPA administration induces ASD like behavior that is more severe in males, while the redox status changes are more severe in females; SAM corrects both. VPA-induced ASD seems to result from epigenetic changes, while the redox status changes may be secondary. Copyright © 2018. Published by Elsevier Inc.

  10. Mindfulness-based relapse prevention combined with virtual reality cue exposure for methamphetamine addiction: Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Chen, XiJing; Wang, Dongmei; Zhou, Lidan; Winkler, Markus; Pauli, Paul; Sui, Nan; Li, Yonghui

    2018-04-18

    Mindfulness-based relapse prevention (MBRP) is a method that combines cognitive behavioral relapse prevention with mindfulness practice. Research shows that MBRP can effectively reduce negative emotions and craving in people with substance use disorders (SUDs). An important part of MBRP is to practice mindfulness meditation to cope with high-risk situations for relapse, such as stimuli and situations associated with drug taking. Virtual reality cue exposure (VRCE) may be a complementary approach to MBRP as it allows for controlled and graded presentations of various high-risk situations with distal and proximal drug cues. The aim of the study is to investigate the effects of MBRP combined with VRCE, in comparison to MBRP alone or treatment as usual, on craving and emotional responses in people with methamphetamine use disorders. The study is a parallel randomized controlled study including 180 participants with methamphetamine use disorders. Three parallel groups will receive 8 weeks of MBRP combined with VRCE, MBRP alone, or treatment as usual, respectively. Craving, virtual cue reactivity, anxiety, depression, emotion regulation, mindfulness and drug-related attention bias will be assessed at pre-treatment, post-treatment, and 3 and 6 months of follow-up. This innovative study aims at investigating the effects of MBRP combined with VRCE in people with SUDs. The combined intervention may have important clinical implications for relapse prevention due to its ease of application and high cost-effectiveness. This study may also stimulate research on the neuronal and psychological mechanisms of MBRP in drug addiction. ChiCTR-INR-17013041. Copyright © 2018. Published by Elsevier Inc.

  11. Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.

    Science.gov (United States)

    Walters, Suzan M; Reilly, Kathleen H; Neaigus, Alan; Braunstein, Sarah

    2017-06-29

    Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

  12. Regulatory approaches to obesity prevention: A systematic overview of current laws addressing diet-related risk factors in the European Union and the United States.

    Science.gov (United States)

    Sisnowski, Jana; Handsley, Elizabeth; Street, Jackie M

    2015-06-01

    High prevalence of overweight and obesity remains a significant international public health problem. Law has been identified as a tool for obesity prevention and selected high-profile measures have been reported. However, the nature and extent of enacted legislation internationally are unclear. This research provides an overview of regulatory approaches enacted in the United States, the European Union, and EU Member States since 2004. To this end, relevant databases of primary and secondary legislation were systematically searched to identify and explore laws addressing dietary risk factors for obesity. Across jurisdictions, current regulatory approaches to obesity prevention are limited in reach and scope. Target groups are rarely the general population, but instead sub-populations in government-supported settings. Consumer information provision is preferred over taxation and marketing restrictions other than the regulation of health and nutrition claims. In the EU in particular, product reformulation with industry consent has also emerged as a popular small-scale measure. While consistent and widespread use of law is lacking, governments have employed a range of regulatory measures in the name of obesity prevention, indicating that there is, in principle, political will. Results from this study may serve as a starting point for future research and policy development. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Preventing preterm births: trends and potential reductions with current interventionsin 39 very high human development index countries

    Science.gov (United States)

    Chang, Hannah H.; Larson, Jim; Blencowe, Hannah; Spong, Catherine Y.; Howson, Christopher P.; Cairns-Smith, Sarah; Lackritz, Eve M.; Lee, Shoo K.; Mason, Elizabeth; Serazin, Andrew C.; Walani, Salimah; Simpson, Joe Leigh; Lawn, Joy E.

    2013-01-01

    Summary Background Each year,1.1 million babies die from prematurity, andmany survivors are disabled. Worldwide, 15 million babies are preterm(10,000 births, country-by-country analyses were performed based on target population, incremental coverage increase,and intervention efficacy. Cost savings were estimated based on reported costs for preterm care in the USAadjusted usingWorld Bank purchasing power parity. Findings From 2010, even if all VHHDI countries achieved annual preterm birth rate reductions of the best performers, (Sweden and Netherlands), 2000-2010 or 2005-2010(Lithuania, Estonia)), rates would experience a relative reduction of<5% by 2015 on average across the 39 countries.Our analysis of preterm birth rise 1998-2004 in USA suggests half the change is unexplained, but important drivers includeinductions/cesareandelivery and ART.For all 39 VHHDI countries, five interventionsmodeling at high coveragepredicted 5%preterm birth rate relative reduction from 9.59 to 9.07% of live births:smoking cessation (0.01 rate reduction), decreasing multiple embryo transfers during assisted reproductive technologies (0.06), cervical cerclage (0.15), progesterone supplementation (0.01), and reduction of non-medically indicated labour induction or caesarean delivery (0.29).These translate to 58,000 preterm births averted and total annual economic cost savings of ~US$ 3 billion. Interpretation Even with optimal coverage of current interventions, many being complex to implement, the estimated potential reduction in preterm birth is tiny. Hence we recommenda conservative target of 5% preterm birth rate relative reductionby 2015. Our findings highlight the urgent need for discovery research into underlying mechanisms of preterm birth, and developmentof innovative interventions. Furthermore, the highest preterm birth rates occur in low-income settings where the causes of prematurity may differand have simpler solutions, such as birth spacing and treatment of infections in

  14. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering

    Directory of Open Access Journals (Sweden)

    Bosma-den Boer Margarethe M

    2012-04-01

    Full Text Available Abstract Serhan and colleagues introduced the term "Resoleomics" in 1996 as the process of inflammation resolution. The major discovery of Serhan's work is that onset to conclusion of an inflammation is a controlled process of the immune system (IS and not simply the consequence of an extinguished or "exhausted" immune reaction. Resoleomics can be considered as the evolutionary mechanism of restoring homeostatic balances after injury, inflammation and infection. Under normal circumstances, Resoleomics should be able to conclude inflammatory responses. Considering the modern pandemic increase of chronic medical and psychiatric illnesses involving chronic inflammation, it has become apparent that Resoleomics is not fulfilling its potential resolving capacity. We suggest that recent drastic changes in lifestyle, including diet and psycho-emotional stress, are responsible for inflammation and for disturbances in Resoleomics. In addition, current interventions, like chronic use of anti-inflammatory medication, suppress Resoleomics. These new lifestyle factors, including the use of medication, should be considered health hazards, as they are capable of long-term or chronic activation of the central stress axes. The IS is designed to produce solutions for fast, intensive hazards, not to cope with long-term, chronic stimulation. The never-ending stress factors of recent lifestyle changes have pushed the IS and the central stress system into a constant state of activity, leading to chronically unresolved inflammation and increased vulnerability for chronic disease. Our hypothesis is that modern diet, increased psycho-emotional stress and chronic use of anti-inflammatory medication disrupt the natural process of inflammation resolution ie Resoleomics.

  15. Very Low Dose Fetal Exposure to Chernobyl Contamination Resulted in Increases in Infant Leukemia in Europe and Raises Questions about Current Radiation Risk Models

    Directory of Open Access Journals (Sweden)

    Christopher C. Busby

    2009-12-01

    Full Text Available Following contamination from the Chernobyl accident in April 1986 excess infant leukemia (0–1 y was reported from five different countries, Scotland, Greece, Germany, Belarus and Wales and Scotland combined. The cumulative absorbed doses to the fetus, as conventionally assessed, varied from 0.02 mSv in the UK through 0.06 mSv in Germany, 0.2 mSv in Greece and 2 mSv in Belarus, where it was highest. Nevertheless, the effect was real and given the specificity of the cohort raised questions about the safety of applying the current radiation risk model of the International Commission on Radiological Protection (ICRP to these internal exposures, a matter which was discussed in 2000 by Busby and Cato [7,8] and also in the reports of the UK Committee examining Radiation Risk from Internal Emitters. Data on infant leukemia in the United Kingdom, chosen on the basis of the cohorts defined by the study of Greece were supplied by the UK Childhood Cancer Research Group. This has enabled a study of leukemia in the combined infant population of 15,466,845 born in the UK, Greece, and Germany between 1980 and 1990. Results show a statistically significant excess risk RR = 1.43 (95% CI 1.13 < RR < 1.80 (2-tailed; p = 0.0025 in those born during the defined peak exposure period of 01/07/86 to 31/12/87 compared with those born between 01/01/80 and 31/12/85 and 01/01/88 and 31/12/90. The excess risks in individual countries do not increase monotonically with the conventionally calculated doses, the relation being biphasic, increasing sharply at low doses and falling at high doses. This result is discussed in relation to fetal/cell death at higher doses and also to induction of DNA repair. Since the cohort is chosen specifically on the basis of exposure to internal radionuclides, the result can be expressed as evidence for a significant error in the conventional modeling for such internal fetal exposures.

  16. Changes in the expression and current of the Na+/K+ pump in the snail nervous system after exposure to a static magnetic field.

    Science.gov (United States)

    Nikolić, Ljiljana; Bataveljić, Danijela; Andjus, Pavle R; Nedeljković, Miodrag; Todorović, Dajana; Janać, Branka

    2013-09-15

    Compelling evidence supports the use of a moderate static magnetic field (SMF) for therapeutic purposes. In order to provide insight into the mechanisms underlying SMF treatment, it is essential to examine the cellular responses elicited by therapeutically applied SMF, especially in the nervous system. The Na(+)/K(+) pump, by creating and maintaining the gradient of Na(+) and K(+) ions across the plasma membrane, regulates the physiological properties of neurons. In this study, we examined the expression of the Na(+)/K(+) pump in the isolated brain-subesophageal ganglion complex of the garden snail Helix pomatia, along with the immunoreactivity and current of the Na(+)/K(+) pump in isolated snail neurons after 15 min exposure to a moderate (10 mT) SMF. Western blot and immunofluorescence analysis revealed that 10 mT SMF did not significantly change the expression of the Na(+)/K(+) pump α-subunit in the snail brain and the neuronal cell body. However, our immunofluorescence data showed that SMF treatment induced a significant increase in the Na(+)/K(+) pump α-subunit expression in the neuronal plasma membrane area. This change in Na(+)/K(+) pump expression was reflected in pump activity as demonstrated by the pump current measurements. Whole-cell patch-clamp recordings from isolated snail neurons revealed that Na(+)/K(+) pump current density was significantly increased after the 10 mT SMF treatment. The SMF-induced increase was different in the two groups of control snail neurons, as defined by the pump current level. The results obtained could represent a physiologically important response of neurons to 10 mT SMF comparable in strength to therapeutic applications.

  17. Effect of pre-exposure prophylaxis and combination HIV prevention for men who have sex with men in the UK: a mathematical modelling study.

    Science.gov (United States)

    Punyacharoensin, Narat; Edmunds, William John; De Angelis, Daniela; Delpech, Valerie; Hart, Graham; Elford, Jonathan; Brown, Alison; Gill, O Noel; White, Richard Guy

    2016-02-01

    HIV transmission in men who have sex with men (MSM) in the UK has shown no sign of decreasing in the past decade. Additional prevention measures are needed. We aimed to estimate the effect of various potential interventions implemented individually and in combination on prevention of HIV infection. We extended a deterministic partnership-based mathematical model for HIV transmission, informed by detailed behavioural and surveillance data, to assess the effect of seven different HIV interventions implemented in MSM (aged 15-64 years) in the UK during 2014-20, including increasing rates of HIV testing, test-and-treat programmes, pre-exposure prophylaxis (PrEP), and sexual behavioural changes. We did sensitivity analyses on risk compensation. We predicted a baseline of 16 955 new infections (IQR 13 156-21 669) in MSM in the UK during 2014-20. At a coverage of ≤50%, testing twice a year outperformed all other interventions. Of all intervention combinations, only the combined effect of test and treat and annual HIV testing (61·8%, IQR 47·2-81·8, of total incidence) was greater than the sum of effects of the two interventions individually (32·6%, 23·7-46·0, and 23·9%, 16·5-33·3, respectively). Simultaneous PrEP, expansion of HIV testing, and initiation of test-and-treat programme in 25% of high-activity MSM could save 7399 (IQR 5587-9813) UK MSM from HIV infection (43·6%, IQR 32·9-57·9, of total incidence). An increase in unsafe sex or sexual partners to 50% or more could substantially reduce the effect of interventions, but is unlikely to negate the prevention benefit completely. PrEP could prevent a large number of new HIV infections if other key strategies including HIV testing and treatment are simultaneously expanded and improved. Without PrEP, HIV incidence in MSM in the UK is unlikely to decrease substantially by the end of this decade. Health Protection Agency (now Public Health England). Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Allergy and asthma prevention 2014

    DEFF Research Database (Denmark)

    Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht

    2014-01-01

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

  19. Automatic exposure control in CT: the effect of patient size, anatomical region and prescribed modulation strength on tube current and image quality

    International Nuclear Information System (INIS)

    Papadakis, Antonios E.; Perisinakis, Kostas; Damilakis, John

    2014-01-01

    To study the effect of patient size, body region and modulation strength on tube current and image quality on CT examinations that use automatic tube current modulation (ATCM). Ten physical anthropomorphic phantoms that simulate an individual as neonate, 1-, 5-, 10-year-old and adult at various body habitus were employed. CT acquisition of head, neck, thorax and abdomen/pelvis was performed with ATCM activated at weak, average and strong modulation strength. The mean modulated mAs (mAs mod ) values were recorded. Image noise was measured at selected anatomical sites. The mAs mod recorded for neonate compared to 10-year-old increased by 30 %, 14 %, 6 % and 53 % for head, neck, thorax and abdomen/pelvis, respectively, (P mod was lower than the preselected mAs with the exception of the 10-year-old phantom. In paediatric and adult phantoms, the mAs mod ranged from 44 and 53 for weak to 117 and 93 for strong modulation strength, respectively. At the same exposure parameters image noise increased with body size (P < 0.05). The ATCM system studied here may affect dose differently for different patient habitus. Dose may decrease for overweight adults but increase for children older than 5 years old. Care should be taken when implementing ATCM protocols to ensure that image quality is maintained. circle ATCM efficiency is related to the size of the patient's body. (orig.)

  20. Automatic exposure control in CT: the effect of patient size, anatomical region and prescribed modulation strength on tube current and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Papadakis, Antonios E. [University Hospital of Heraklion, Department of Medical Physics, Stavrakia, P.O. Box 1352, Heraklion, Crete (Greece); Perisinakis, Kostas; Damilakis, John [University of Crete, Faculty of Medicine, Department of Medical Physics, P.O. Box 2208, Heraklion, Crete (Greece)

    2014-10-15

    To study the effect of patient size, body region and modulation strength on tube current and image quality on CT examinations that use automatic tube current modulation (ATCM). Ten physical anthropomorphic phantoms that simulate an individual as neonate, 1-, 5-, 10-year-old and adult at various body habitus were employed. CT acquisition of head, neck, thorax and abdomen/pelvis was performed with ATCM activated at weak, average and strong modulation strength. The mean modulated mAs (mAs{sub mod}) values were recorded. Image noise was measured at selected anatomical sites. The mAs{sub mod} recorded for neonate compared to 10-year-old increased by 30 %, 14 %, 6 % and 53 % for head, neck, thorax and abdomen/pelvis, respectively, (P < 0.05). The mAs{sub mod} was lower than the preselected mAs with the exception of the 10-year-old phantom. In paediatric and adult phantoms, the mAs{sub mod} ranged from 44 and 53 for weak to 117 and 93 for strong modulation strength, respectively. At the same exposure parameters image noise increased with body size (P < 0.05). The ATCM system studied here may affect dose differently for different patient habitus. Dose may decrease for overweight adults but increase for children older than 5 years old. Care should be taken when implementing ATCM protocols to ensure that image quality is maintained. circle ATCM efficiency is related to the size of the patient's body. (orig.)

  1. Occupational exposure prevention program to oil and gas industry; Antecipacao, reconhecimento, avaliacao e controle dos riscos ambientais em uma planta de petroleo e gas

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Paulo Sergio de [TRANSPETRO - PETROBRAS Transporte S.A., Rio de Janeiro, RJ (Brazil); Palierini, Renato Martins [TWA Brasil, Sao Caetano do Sul, SP (Brazil)

    2005-07-01

    PETROBRAS/TRANSPETRO Pipelines and Terminals have 500 regular employees and 5.064 out sourced workers in its Southeast Division. The out sourced employees work under 125 contracts involving a wide range of activities such as maintenance, pipeline operation, pipeline launching, engineering, administrative and auxiliary services. Among these workers, 1.200 peoples are subjected to occupational exposure, which may be present in the industrial process or in the products transported in our pipelines, e