Stroke Prevention: Managing Modifiable Risk Factors

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Silvia Di Legge

2012-01-01

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

Effect of an internally versus externally focused acl injury prevention program on injury risk

NARCIS (Netherlands)

Dallinga, J.; Benjaminse, A.; Gokeler, A.; Otten, Egbert; Lemmink, K.

2014-01-01

BACKGROUND: Anterior cruciate ligament (ACL) injury prevention programs have shown mixed results, which may be in part due to suboptimal training components. OBJECTIVE: Determine effects of a prevention program with external and internal focus of attention on (potential) biomechanical risk factors

Risk stratification in secondary cardiovascular prevention.

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Lazzeroni, Davide; Coruzzi, Paolo

2018-02-19

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

Endocrine therapy for breast cancer prevention in high-risk women: clinical and economic considerations.

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Groom, Amy G; Younis, Tallal

2016-01-01

The global burden of breast cancer highlights the need for primary prevention strategies that demonstrate both favorable clinical benefit/risk profile and good value for money. Endocrine therapy with selective estrogen-receptor modulators (SERMs) or aromatase inhibitors (AIs) has been associated with a favorable clinical benefit/risk profile in the prevention of breast cancer in women at high risk of developing the disease. The available endocrine therapy strategies differ in terms of their relative reductions of breast cancer risk, potential side effects, and upfront drug acquisition costs, among others. This review highlights the clinical trials of SERMs and AIs for the primary prevention of breast cancer, and the cost-effectiveness /cost-utility studies that have examined their "value for money" in various health care jurisdictions.

Risk factors for miscarriage from a prevention perspective

DEFF Research Database (Denmark)

Nilsson, Sandra Feodor; Andersen, Per Kragh; Strandberg-Larsen, K

2014-01-01

OBJECTIVE: To identify modifiable risk factors for miscarriage and to estimate the preventable proportion of miscarriages that could be attributed to these. DESIGN: Nationwide observational follow-up study. SETTING: Denmark. POPULATION: Ninety-one thousand four hundred and twenty seven pregnancies...... included in the Danish National Birth Cohort between 1996 and 2002. METHODS: Information on potentially modifiable risk factors before and during pregnancy was collected by means of computer-assisted telephone interviews and linkage with Danish registers, ensuring almost complete follow-up of pregnancy...... outcome. Modifiable risk factors for miscarriage were identified by multiple Cox regression analysis, which provided the background for our estimations of population attributable fractions. In all, 88 373 pregnancies had full information on all covariates and were included in this analysis. MAIN OUTCOME...

E-dating, identity and HIV prevention: theorising sexualities, risk and network society.

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Davis, Mark; Hart, Graham; Bolding, Graham; Sherr, Lorraine; Elford, Jonathan

2006-05-01

This paper addresses how London gay men use the internet to meet sexual partners, or for e-dating. Based on qualitative interviews conducted face-to-face or via the internet, this research develops an account of how information technologies mediate the negotiation of identity and risk in connection with sexual practice. E-dating itself is a bricolage, or heterogeneous DIY practice of internet-based-communication (IBC). A central aspect of IBC is "filtering" in and out prospective e-dates based on the images and texts used to depict sexual identities. Interpretations and depictions of personal HIV risk management approaches in IBC are framed by the meanings of different identities, such as the stigma associated with being HIV positive. This paper argues for a sexualities perspective in a theory of network society. Further, HIV prevention in e-dating can potentially be addressed by considering the interplay of the HIV prevention imperatives associated with different HIV serostatus identities. There is a case for encouraging more explicit IBC about risk in e-dating and incorporating the expertise of e-daters in prevention activity. There is also a need to rethink traditional conceptions of risk management in HIV prevention to make space for the risk management bricolage of network society.

Risk factors for addiction potential among college students

Directory of Open Access Journals (Sweden)

Mehdi Ranjbaran

2018-01-01

Full Text Available Background: Tendency toward addiction is provided before drug use begins. The present study aimed to identify the risk factors for addiction potential in the students of Arak University of Medical Sciences. Methods: We conducted this cross-sectional study among 305 students from Arak University of Medical Sciences, Iran in 2016. We selected the students by stratified random sampling and collected the data by family and sociodemographic factors questionnaires and Addiction Potential Scale. Results: Male students, students with low economic status and high family members were more prone to addiction. We identified variable; addiction in close friends, adverse family conditions (dispute with the family, poor economic condition of families, and family size by controlling the effect of other variables, as risk factors for addiction potential. Conclusions: Preventive and intervention actions appear necessary considering the mentioned factors.

Travellers and influenza: risks and prevention.

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Goeijenbier, M; van Genderen, P; Ward, B J; Wilder-Smith, A; Steffen, R; Osterhaus, A D M E

2017-01-01

Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers. © International Society of

Update on breast cancer risk prediction and prevention.

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Sestak, Ivana; Cuzick, Jack

2015-02-01

Breast cancer is the most common cancer in women worldwide. This review will focus on current prevention strategies for women at high risk. The identification of women who are at high risk of developing breast cancer is key to breast cancer prevention. Recent findings have shown that the inclusion of breast density and a panel of low-penetrance genetic polymorphisms can improve risk estimation compared with previous models. Preventive therapy with aromatase inhibitors has produced large reductions in breast cancer incidence in postmenopausal women. Tamoxifen confers long-term protection and is the only proven preventive treatment for premenopausal women. Several other agents, including metformin, bisphosphonates, aspirin and statins, have been found to be effective in nonrandomized settings. There are many options for the prevention of oestrogen-positive breast cancer, in postmenopausal women who can be given a selective oestrogen receptor modulator or an aromatase inhibitor. It still remains unclear how to prevent oestrogen-negative breast cancer, which occurs more often in premenopausal women. Identification of women at high risk of the disease is crucial, and the inclusion of breast density and a panel of genetic polymorphisms, which individually have low penetrance, can improve risk assessment.

Unintended benefits: the potential economic impact of addressing risk factors to prevent Alzheimer's disease.

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Lin, Pei-Jung; Yang, Zhou; Fillit, Howard M; Cohen, Joshua T; Neumann, Peter J

2014-04-01

Certain chronic conditions appear to be modifiable risk factors of Alzheimer's disease and related dementias. To understand the potential health and economic impacts of addressing those risk factors, we used data on a Medicare cohort to simulate four scenarios: a 10 percent reduction in the prevalence of diabetes, hypertension, cardiovascular diseases, respectively, and a 10 percent reduction in body mass index among beneficiaries who were overweight or obese. Our simulation demonstrated that reducing the prevalence of these conditions may yield "unintended benefits" by lowering the risk, delaying the onset, reducing the duration, and lowering the costs of dementia. More research is needed to clarify the exact relationship between various other chronic diseases and dementia. However, our findings highlight potential health gains and savings opportunities stemming from the better management of other conditions associated with dementia.

Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents.

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Cluver, Lucie Dale; Orkin, Frederick Mark; Meinck, Franziska; Boyes, Mark Edward; Sherr, Lorraine

2016-01-01

Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can "cash plus care" social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa. This study was a prospective observational study of 3515 10-to-17-year-olds (56.7% female; 96.8% one-year retention). Within randomly selected census areas in four rural and urban districts in two South African provinces, all homes with a resident adolescent were sampled between 2009/2010 and 2011/2012. Measures included 1) potential structural drivers of HIV infection such as poverty and community violence; 2) HIV risk behaviours; 3) hypothesized psychosocial mediating factors; and 4) types of social protection involving cash and care. Using gender-disaggregated analyses, longitudinal mediation models were tested for potential main and moderating effects of social protection. Structural drivers were associated with increased onset of adolescent HIV risk behaviour (psocial protection were associated with reductions in HIV risk behaviour and psychosocial deprivations. In addition, cash social protection moderated risk pathways: for adolescent girls and boys experiencing more acute structural deprivation, social protection had the greatest associations with HIV risk prevention (e.g. moderation effects for girls: B=-0.08, psocial protection has the greatest prevention effects for the most vulnerable. Social protection comprising unconditional cash plus care was associated with reduced risk pathways through moderation and main effects, respectively. Our findings suggest the importance of social protection within a combination package of HIV-prevention

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

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

2017-09-12

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

Bleeding Risks With Aspirin Use for Primary Prevention in Adults: A Systematic Review for the U.S. Preventive Services Task Force.

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Whitlock, Evelyn P; Burda, Brittany U; Williams, Selvi B; Guirguis-Blake, Janelle M; Evans, Corinne V

2016-06-21

The balance between potential aspirin-related risks and benefits is critical in primary prevention. To evaluate the risk for serious bleeding with regular aspirin use in cardiovascular disease (CVD) primary prevention. PubMed, MEDLINE, Cochrane Central Register of Controlled Trials (2010 through 6 January 2015), and relevant references from other reviews. Randomized, controlled trials; cohort studies; and meta-analyses comparing aspirin with placebo or no treatment to prevent CVD or cancer in adults. One investigator abstracted data, another checked for accuracy, and 2 assessed study quality. In CVD primary prevention studies, very-low-dose aspirin use (≤100 mg daily or every other day) increased major gastrointestinal (GI) bleeding risk by 58% (odds ratio [OR], 1.58 [95% CI, 1.29 to 1.95]) and hemorrhagic stroke risk by 27% (OR, 1.27 [CI, 0.96 to 1.68]). Projected excess bleeding events with aspirin depend on baseline assumptions. Estimated excess major bleeding events were 1.39 (CI, 0.70 to 2.28) for GI bleeding and 0.32 (CI, -0.05 to 0.82) for hemorrhagic stroke per 1000 person-years of aspirin exposure using baseline bleeding rates from a community-based observational sample. Such events could be greater among older persons, men, and those with CVD risk factors that also increase bleeding risk. Power to detect effects on hemorrhagic stroke was limited. Harms other than serious bleeding were not examined. Consideration of the safety of primary prevention with aspirin requires an individualized assessment of aspirin's effects on bleeding risks and expected benefits because absolute bleeding risk may vary considerably by patient. Agency for Healthcare Research and Quality.

Mechanisms, Prediction, and Prevention of ACL Injuries: Cut Risk With Three Sharpened and Validated Tools

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Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.

2017-01-01

Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The “Sequence of Prevention” Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries. Utilizing this model, our multidisciplinary collaborative research team has spent the last decade working to delineate injury mechanisms, identify injury risk factors, predict which athletes are at-risk for injury, and develop ACL injury prevention programs. Within this model of injury prevention, modifiable factors (biomechanical and neuromuscular) related to injury mechanisms likely provide the best opportunity for intervention strategies aimed to decrease the risk of ACL injury, particularly in female athletes. Knowledge advancements have led to the development of potential solutions that allow athletes to compete with lowered risk of ACL injury. Design and integration of personalized clinical assessment tools and targeted prevention strategies for athletes at high risk for ACL injury may transform current prevention practices and ultimately significantly reduce ACL injury incidence. This 2016 OREF Clinical Research Award focuses on the authors' work and contributions to the field. The author's acknowledge the many research groups who have contributed to the current state of knowledge in the fields of ACL injury mechanisms, injury risk screening and injury prevention strategies. PMID:27612195

Risk Factor Research and Prevention for Anxiety Disorders: Introduction to the Special Series on Risk and Prevention of Anxiety Pathology

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Schmidt, Norman B.; Zvolensky, Michael J.

2007-01-01

In relation to treatment-related research in the United States, there is relatively little systematic effort focused on the combination of risk and prevention for anxiety pathology. This article broadly discusses risk factor research and prevention program development for anxiety psychopathology. The authors also specifically discuss papers in…

Fungal Diseases: Ringworm Risk & Prevention

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... Testing Treatment & Outcomes Health Professionals Statistics More Resources Candidiasis Candida infections of the mouth, throat, and esophagus Vaginal candidiasis Invasive candidiasis Definition Symptoms Risk & Prevention Sources Diagnosis ...

Nutraceuticals and their preventive or potential therapeutic value in Parkinson's disease.

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Chao, Jianfei; Leung, Yen; Wang, Mingfu; Chang, Raymond Chuen-Chung

2012-07-01

Parkinson's disease (PD) is the second most common aging-related disorder in the world, after Alzheimer's disease. It is characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta and other parts of the brain, leading to motor impairment, cognitive impairment, and dementia. Current treatment methods, such as L-dopa therapy, are focused only on relieving symptoms and delaying progression of the disease. To date, there is no known cure for PD, making prevention of PD as important as ever. More than a decade of research has revealed a number of major risk factors, including oxidative stress and mitochondrial dysfunction. Moreover, numerous nutraceuticals have been found to target and attenuate these risk factors, thereby preventing or delaying the progression of PD. These nutraceuticals include vitamins C, D, E, coenzyme Q10, creatine, unsaturated fatty acids, sulfur-containing compounds, polyphenols, stilbenes, and phytoestrogens. This review examines the role of nutraceuticals in the prevention or delay of PD as well as the mechanisms of action of nutraceuticals and their potential applications as therapeutic agents, either alone or in combination with current treatment methods. © 2012 International Life Sciences Institute.

[Bibliografic resources on chemical risk administration and prevention].

Science.gov (United States)

Calera Rubio, Alfonso A; Juan Quilis, Verónica; López Samaniego, Luz M; Caballero Pérez, Pablo; Ronda Pérez, Elena

2005-01-01

The documentation produced by public and private institutions in relation to the chemical risk constitutes an essential tool for prevention. The objective of this research is to locate and to revise the documents related to the management of the prevention of chemical risk focus to PYMES in Spain from 1995 to 2004. The methodology carried out for the selection of the bibliographical materials has been the consultation of automated databases and Web pages. 812 documents have been identified. Most corresponds to grey literature. The thematic more frequent has been the security and the most frequent objective of the papers has been the prevention. Most of the documents go to the technical sector. The results suggest that although that there is a great diversity of documents in Spain dedicated to the prevention of chemical risk it seems convenient: 1) to increase their diffusion, 2) to pay attention to the communication of the risks, 3) to investigate and to translate the research in good practice.

The influence of risk labeling on risk perception and willingness to seek help in an experimental simulation of preventive medical examinations.

Science.gov (United States)

Nieuwenhuijsen, Karen; Hulshof, Carel T; Sluiter, Judith K

2018-07-01

To study the influence of the presentation of results of a preventive medical examination on risk perception and willingness to seek help for work-related fatigue or being overweight. A factorial design experiment was conducted, presenting workers (n = 82) with vignettes including eight scenarios of test results with and without an emphasis on the risk of a current or future health condition or a probe to seek help. Participants rated perceived risk and willingness to seek help (0-100 Visual Analogue Scale) as if these were their own results. Differences were tested with paired-sample t-tests. In scenarios emphasizing the risk of a current or future disorder, participants perceived higher risk and were more willing to seek help (p-values < .00). Slightly higher willingness to seek help scores was observed in all scenarios that included probes (p < .00). Risk perception and willingness to seek help of workers participating in a preventive medical examination were higher when they were told that the test results indicate a risk of a current or future disorder and after being advised to seek help. Healthcare providers should take the potential effects on risk perception and help-seeking into account in preventive settings. Copyright © 2018. Published by Elsevier B.V.

Aspirin and the Primary Prevention of Cardiovascular Diseases: An Approach Based on Individualized, Integrated Estimation of Risk.

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Volpe, Massimo; Battistoni, Allegra; Gallo, Giovanna; Coluccia, Roberta; De Caterina, Raffaele

2017-09-01

While the use of aspirin in the secondary prevention of cardiovascular (CVD) is well established, aspirin in primary prevention is not systematically recommended because the absolute CV event reduction is similar to the absolute excess in major bleedings. Recently, emerging evidence suggests the possibility that the assumption of aspirin, may also be effective in the prevention of cancer. By adding to the CV prevention benefits the potential beneficial effect of aspirin in reducing the incidence of mortality and cancer could tip the balance between risks and benefits of aspirin therapy in the primary prevention in favour of the latter and broaden the indication for treatment with in populations at average risk. While prospective and randomized study are currently investigating the effect of aspirin in prevention of both cancer and CVD, clinical efforts at the individual level to promote the use of aspirin in global (or total) primary prevention could be already based on a balanced evaluation of the benefit/risk ratio.

Are we ready for the challenge of implementing risk-based breast cancer screening and primary prevention?

NARCIS (Netherlands)

Rainey, L.; Waal, D. van der; Jervaeus, A.; Wengstrom, Y.; Evans, D.G.; Donnelly, L.S.; Broeders, M.J.M.

2018-01-01

BACKGROUND: Increased knowledge of breast cancer risk factors provides opportunities to shift from a one-size-fits-all screening programme to a personalised approach, where screening and prevention is based on a woman's risk of developing breast cancer. However, potential implementation of this new

Preventable coronary heart disease events from control of cardiovascular risk factors in US adults with diabetes (projections from utilizing the UKPDS risk engine).

Science.gov (United States)

Wong, Nathan D; Patao, Christopher; Malik, Shaista; Iloeje, Uchenna

2014-04-15

Type 2 diabetes mellitus (T2DM) carries significant risks for coronary heart disease (CHD). We examined the potential US population impact of single and composite risk factor control. Among US adults with diagnosed T2DM aged≥30 years in the National Health and Nutrition Examination Survey 2007 to 2012, we assessed CHD events preventable using the United Kingdom Prospective Diabetes Study CHD risk engine. We examined in all those not at goal the impact of statistical control of smoking, glycated hemoglobin, systolic blood pressure, and total and high-density lipoprotein cholesterol, according to the predefined criteria setting risk factors at different levels of control representing (1) "All to Goal," (2) at "Nominal Control," or (3) at "Aggressive Control." Preventable CHD events represented the difference between the number of events estimated from the control of these risk factors versus current levels of the risk factors. Of 606 men (representing 6.2 million) and 603 women (6.3 million) with DM and no previous CHD, 1.3 million men and 0.7 million women would develop a CHD event within 10 years if left uncontrolled. Controlling all risk factors to goal was projected to prevent 35% and 45% of CHD events in men and women, respectively. Nominal risk factor control was projected to prevent 36% and 38% and aggressive control 51% and 61% of CHD events, respectively. In conclusion, a significant proportion of CHD events in adults with T2DM could be prevented from composite control of risk factors often not at goal. Copyright © 2014 Elsevier Inc. All rights reserved.

Contrast-induced nephropathy: risks, pathogenetic, prevention

International Nuclear Information System (INIS)

Paskalev, D.; Balev, B.

2006-01-01

Full text: The aim of the presentation is to review the contrast induced nephropathy ? nature, mechanisms of development, risk factors. Summary of the most important ways of prevention, diagnostics and treatment. The definition of CIN according the European Association of Urogenital Radiology is: 'A condition, in which renal function is impaired (elevation of serum creatinine with more than 25% or 44 μmol/l above the initial level) due to intravasal application of contrast media (CM) within 3 days following the application and when no other etiology factors are present'. We summarize the main risk factors of developing CIN - renal failure, diabetic nephropathy, dehydration, congestive heart failure, high blood pressure, age above 70 yrs, nephrotoxic medicines. The most effective ways of preventing CIN are the good hydratation of the patients and the usage of low-osmolar or iso-osmolar CM. Therapeutic treatment is with no proven preventive effect and currently is not routinely recommended. An early hem dialysis does not decrease the risk level of CIN development in patients with chronic renal failure (CRF). In such patients complete elimination of CM is achieved only after several hem dialyses. Hem filtration reliably decreases the risk of CIN in CRF patients, but is expensive and not widely available. We present a case from our hospital of a patient with diabetic nephropathy, who developed CIN following a coronary angiography

Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

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Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

2011-04-01

To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

American Society of Clinical Oncology Policy Statement: The Role of the Oncologist in Cancer Prevention and Risk Assessment

Science.gov (United States)

Zon, Robin T.; Goss, Elizabeth; Vogel, Victor G.; Chlebowski, Rowan T.; Jatoi, Ismail; Robson, Mark E.; Wollins, Dana S.; Garber, Judy E.; Brown, Powel; Kramer, Barnett S.

2009-01-01

Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities. Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services. The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services. PMID:19075281

Preventing Australian bat lyssavirus: community knowledge and risk perception of bats in South East Queensland.

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Young, Megan K; El Saadi, Debra; McCall, Bradley J

2014-04-01

Ongoing potential exposure of members of the public to Australian bat lyssavirus (ABLV) in South East Queensland, Australia, prompted investigation of community knowledge, risk perception, and intention to handle bats to inform future prevention efforts. After pilot testing, a computer-assisted telephone survey of a representative sample of 700 adults without previous potential exposure to ABLV was undertaken in the defined geographic region. Twenty-four percent of eligible contacted individuals participated. Basic knowledge of bats and ABLV was generally high, with 65% of participants answering nine or more of 12 knowledge questions correctly. The perceived risk that bats pose to human health was also high, with 93% indicating some degree of risk. Although 88% of participants indicated they would handle bats in one or more of the scripted situations, overall intention to handle bats was low, with 59% indicating they would handle a bat in four or less of the 12 scenarios. Younger males with lower risk perception of bats most frequently indicated intention to handle bats in varying situations. Knowledge score was not associated with intention to handle bats on multivariate modeling. Future public health prevention efforts, both in Australia and overseas, should focus further on conveying the risk to humans and to bats when nontrained, nonvaccinated people attempt to handle bats rather than attempting to purely convey knowledge about bats and ABLV or rabies. Suitable alternative measures to handling should be included. Younger adult males are a particular target group for prevention efforts.

The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men.

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Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P

2017-01-01

We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.

Classification tree analyses reveal limited potential for early targeted prevention against childhood overweight.

Science.gov (United States)

Beyerlein, Andreas; Kusian, Dennis; Ziegler, Anette-Gabriele; Schaffrath-Rosario, Angelika; von Kries, Rüdiger

2014-02-01

Whether specific combinations of risk factors in very early life might allow identification of high-risk target groups for overweight prevention programs was examined. Data of n = 8981 children from the German KiGGS study were analyzed. Using a classification tree approach, predictive risk factor combinations were assessed for overweight in 3-6, 7-10, and 11-17-year-old children. In preschool children, the subgroup with the highest overweight risk were migrant children with at least one obese parent, with a prevalence of 36.6 (95% confidence interval or CI: 22.9, 50.4)%, compared to an overall prevalence of 10.0 (8.9, 11.2)%. The prevalence of overweight increased from 18.3 (16.8, 19.8)% to 57.9 (46.6, 69.3)% in 7-10-year-old children, if at least one parent was obese and the child had been born large-for-gestational-age. In 11-17-year-olds, the overweight risk increased from 20.1 (18.9, 21.3)% to 63.0 (46.4, 79.7)% in the highest risk group. However, high prevalence ratios were found only in small subgroups, containing <10% of all overweight cases in the respective age group. Our results indicate only a limited potential for early targeted preventions against overweight in children and adolescents. Copyright © 2013 The Obesity Society.

A Risk and Prevention Counselor Training Program Model: Theory and Practice

Science.gov (United States)

Mason, Michael J.; Nakkula, Michael J.

2008-01-01

The need for training mental health counselors in risk and prevention is presented, and justification of the development of an innovative and integrative prevention training program is offered. Theoretical underpinnings that connect the counseling discipline to the field of prevention are described. A risk and prevention training model from…

Developing and evaluating polygenic risk prediction models for stratified disease prevention.

Science.gov (United States)

Chatterjee, Nilanjan; Shi, Jianxin; García-Closas, Montserrat

2016-07-01

Knowledge of genetics and its implications for human health is rapidly evolving in accordance with recent events, such as discoveries of large numbers of disease susceptibility loci from genome-wide association studies, the US Supreme Court ruling of the non-patentability of human genes, and the development of a regulatory framework for commercial genetic tests. In anticipation of the increasing relevance of genetic testing for the assessment of disease risks, this Review provides a summary of the methodologies used for building, evaluating and applying risk prediction models that include information from genetic testing and environmental risk factors. Potential applications of models for primary and secondary disease prevention are illustrated through several case studies, and future challenges and opportunities are discussed.

Exploring the Potential Emotional and Behavioural Impact of Providing Personalised Genomic Risk Information to the Public: A Focus Group Study.

Science.gov (United States)

Smit, Amelia K; Keogh, Louise A; Newson, Ainsley J; Hersch, Jolyn; Butow, Phyllis; Cust, Anne E

2015-01-01

To explore the potential emotional and behavioural impact of providing information on personalised genomic risk to the public, using melanoma as an example, to aid research translation. We conducted four focus groups in which 34 participants were presented with a hypothetical scenario of an individual's lifetime genomic risk of melanoma (using the term 'genetic risk'). We asked about understanding of genetic risk, who would choose to receive this risk information, potential emotional and behavioural impacts, and other concerns or potential benefits. Data were analysed thematically. Participants thought this risk information could potentially motivate preventive behaviours such as sun protection and related it to screening for other diseases including breast cancer. Factors identified as influencing the decision to receive genetic risk information included education level, children, age and gender. Participants identified potential negative impacts on the recipient such as anxiety and worry, and proposed that this could be mitigated by providing additional explanatory and prevention information, and contact details of a health professional for further discussion. Participants' concerns included workplace and insurance discrimination. Participants recognised the potential for both positive and negative emotional and behavioural impacts related to receiving information on the personalised genomic risk of melanoma. © 2015 S. Karger AG, Basel.

Common Genetic Risk for Melanoma Encourages Preventive Behavior Change

Directory of Open Access Journals (Sweden)

Lori Diseati

2015-02-01

Full Text Available There is currently great interest in using genetic risk estimates for common disease in personalized healthcare. Here we assess melanoma risk-related preventive behavioral change in the context of the Coriell Personalized Medicine Collaborative (CPMC. As part of on-going reporting activities within the project, participants received a personalized risk assessment including information related to their own self-reported family history of melanoma and a genetic risk variant showing a moderate effect size (1.7, 3.0 respectively for heterozygous and homozygous individuals. Participants who opted to view their report were sent an optional outcome survey assessing risk perception and behavioral change in the months that followed. Participants that report family history risk, genetic risk, or both risk factors for melanoma were significantly more likely to increase skin cancer preventive behaviors when compared to participants with neither risk factor (ORs = 2.04, 2.79, 4.06 and p-values = 0.02, 2.86 × 10−5, 4.67 × 10−5, respectively, and we found the relationship between risk information and behavior to be partially mediated by anxiety. Genomic risk assessments appear to encourage positive behavioral change in a manner that is complementary to family history risk information and therefore may represent a useful addition to standard of care for melanoma prevention.

Assessing the Effects of Information About Global Population Growth on Risk Perceptions and Support for Mitigation and Prevention Strategies.

Science.gov (United States)

Dawson, Ian G J

2018-05-16

The human population is forecast to increase by 3-4 billion people during this century and many scientists have expressed concerns that this could increase the likelihood of certain adverse events (e.g., climate change and resource shortages). Recent research shows that these concerns are mirrored in public risk perceptions and that these perceptions correlate with a willingness to adopt mitigation behaviors (e.g., reduce resource consumption) and preventative actions (e.g., support actions to limit growth). However, little research has assessed the factors that influence risk perceptions of global population growth (GPG). To contribute to this important goal, this article presents three studies that examined how risk perceptions of GPG might be influenced by textual-visual representations (like those in media and Internet articles) of the potential effects of GPG. Study 1 found that a textual narrative that highlighted the potential negative (cf. positive) consequences of GPG led to higher perceived risk and greater willingness to adopt mitigation behaviors, but not to support preventative actions. Notably, the influence of the narratives on perceived risk was largely moderated by the participant's prior knowledge and perceptions of GPG. Contrary to expectations, studies 2 and 3 revealed, respectively, that photographs depicting GPG-related imagery and graphs depicting GPG rates had no significant effect on the perceived risk of GPG or the willingness to embrace mitigation or preventative actions. However, study 3 found that individuals with higher "graph literacy" perceived GPG as a higher risk and were more willing to adopt mitigation behaviors and support preventative actions. © 2018 Society for Risk Analysis.

Individual Risk and Prevention of Complications

DEFF Research Database (Denmark)

Serup, Jørgen

2017-01-01

Doctors who are consulted about health and tattoo risks have an important role in the prevention of an individual's tattoo complications. Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals. The risk is related to a person's health condition, level o...... about tattoos, tattoo problems, how to reduce risk, and a checklist for the tattoo customer before decision-making. The sheets with keynote information are useful aids for doctors giving advice to persons curious about acquiring a tattoo....

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

LENUS (Irish Health Repository)

Zannad, Faiez

2012-04-01

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

Potential targets for colorectal cancer prevention.

Science.gov (United States)

Temraz, Sally; Mukherji, Deborah; Shamseddine, Ali

2013-08-22

The step-wise development of colorectal neoplasia from adenoma to carcinoma suggests that specific interventions could delay or prevent the development of invasive cancer. Several key factors involved in colorectal cancer pathogenesis have already been identified including cyclooxygenase 2 (COX-2), nuclear factor kappa B (NF-κB), survivin and insulin-like growth factor-I (IGF-I). Clinical trials of COX-2 inhibitors have provided the "proof of principle" that inhibition of this enzyme can prevent the formation of colonic adenomas and potentially carcinomas, however concerns regarding the potential toxicity of these drugs have limited their use as a chemopreventative strategy. Curcumin, resveratrol and quercetin are chemopreventive agents that are able to suppress multiple signaling pathways involved in carcinogenesis and hence are attractive candidates for further research.

Individualized Vascular Disease Prevention in High-Risk Patients

NARCIS (Netherlands)

Kaasenbrood, L

2016-01-01

In the pharmacologic prevention of vascular events, clinicians need to translate average effects from a clinical trial to the individual patient. Prediction models can contribute to individualized vascular disease prevention by selecting patients for treatment based on estimated risk or expected

Iatrogenic disease in the elderly: risk factors, consequences, and prevention

Directory of Open Access Journals (Sweden)

Sompol Permpongkosol

2011-03-01

Full Text Available Sompol PermpongkosolDivision of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandAbstract: The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.Keywords: iatrogenic disease, elderly, risk factors, prevention

Potential Targets for Colorectal Cancer Prevention

Directory of Open Access Journals (Sweden)

Ali Shamseddine

2013-08-01

Full Text Available The step-wise development of colorectal neoplasia from adenoma to carcinoma suggests that specific interventions could delay or prevent the development of invasive cancer. Several key factors involved in colorectal cancer pathogenesis have already been identified including cyclooxygenase 2 (COX-2, nuclear factor kappa B (NF-κB, survivin and insulin-like growth factor-I (IGF-I. Clinical trials of COX-2 inhibitors have provided the “proof of principle” that inhibition of this enzyme can prevent the formation of colonic adenomas and potentially carcinomas, however concerns regarding the potential toxicity of these drugs have limited their use as a chemopreventative strategy. Curcumin, resveratrol and quercetin are chemopreventive agents that are able to suppress multiple signaling pathways involved in carcinogenesis and hence are attractive candidates for further research.

Risk assessment for prevention of morbidity and mortality: lessons for pressure ulcer prevention.

Science.gov (United States)

Reynolds, T M

2008-11-01

Medicine has changed from being a reactive process that attempts to alleviate disease only when it is clinically evident to a proactive one in which it is hoped that early intervention may reduce the impact of disease or even it developing at all. In moving the focus of treatment, this inevitably means that a greater number of individuals with lesser disease burdens are treated. The logical end-point of this process is to provide preventative measures for the entire population but this can only be done if the economic costs and negative effects of treatment are out-weighed by the benefits. In the case of pressure ulcers, it is self-evident that prevention is extremely beneficial to patients. However, the cost of some of the equipment used for prevention can be high, and therefore, the balance between the optimum level of provision, the purposes of prevention and the available funding becomes critical. Consequently a screening mechanism to better match susceptible patients with resources is essential. There are, however, many problems with such screening techniques. By looking at other specialties, we can see that it is vital to know the natural history of the disease: PSA testing reveals many men who would have died never having known they had prostate cancer, thus giving them years of worry and morbidity they would probably not previously have suffered; cardiovascular risk screening is so imprecise that risk estimates are of questionable utility; antenatal Down's syndrome risk screening is prone to data-related problems that can unexpectedly reduce the effectiveness of the test. In pressure ulcer screening, there are many tools currently in use, but few (possibly none) are really effective. Finally, this paper details some suggestions for future research to combine risk tests that may offer a prospect for improving ulcer risk screening tools.

Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: balancing methodological rigor and research ethics.

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Underhill, Kristen

2013-10-01

The growing evidence base for biomedical HIV prevention interventions - such as oral pre-exposure prophylaxis, microbicides, male circumcision, treatment as prevention, and eventually prevention vaccines - has given rise to concerns about the ways in which users of these biomedical products may adjust their HIV risk behaviors based on the perception that they are prevented from infection. Known as risk compensation, this behavioral adjustment draws on the theory of "risk homeostasis," which has previously been applied to phenomena as diverse as Lyme disease vaccination, insurance mandates, and automobile safety. Little rigorous evidence exists to answer risk compensation concerns in the biomedical HIV prevention literature, in part because the field has not systematically evaluated the study designs available for testing these behaviors. The goals of this Commentary are to explain the origins of risk compensation behavior in risk homeostasis theory, to reframe risk compensation as a testable response to the perception of reduced risk, and to assess the methodological rigor and ethical justification of study designs aiming to isolate risk compensation responses. Although the most rigorous methodological designs for assessing risk compensation behavior may be unavailable due to ethical flaws, several strategies can help investigators identify potential risk compensation behavior during Phase II, Phase III, and Phase IV testing of new technologies. Where concerns arise regarding risk compensation behavior, empirical evidence about the incidence, types, and extent of these behavioral changes can illuminate opportunities to better support the users of new HIV prevention strategies. This Commentary concludes by suggesting a new way to conceptualize risk compensation behavior in the HIV prevention context. Copyright © 2013 Elsevier Ltd. All rights reserved.

Breast cancer risk accumulation starts early: prevention must also.

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Colditz, Graham A; Bohlke, Kari; Berkey, Catherine S

2014-06-01

Nearly one in four breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. This study follows the literature review methods and format. Exposures during childhood and adolescence affect a woman's long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies first pregnancy. Evidence on childhood diet and growth in height, and adolescent alcohol intake, among other adolescent factors is related to breast cancer risk and risk of premalignant proliferative benign lesions. Breast cancer prevention efforts will have the greatest effect when initiated at an early age and continued over a lifetime. Gaps in knowledge are identified and deserve increase attention to inform prevention.

Is bleeding a necessary evil? The inherent risk of antithrombotic pharmacotherapy used for stroke prevention in atrial fibrillation.

Science.gov (United States)

Myat, Aung; Ahmad, Yousif; Haldar, Shouvik; Tantry, Udaya S; Redwood, Simon R; Gurbel, Paul A; Lip, Gregory Yh

2013-08-01

Current European atrial fibrillation (AF) guidelines have assigned a strong recommendation for the initiation of antithrombotic therapy to prevent thromboembolism in all but those AF patients at low risk (or with contraindications). Furthermore, the selection of antithrombotic therapy is based on the absolute risks of thromboembolism and bleeding, and the relative risk and benefit for a given patient. By their very mechanism of action, antithrombotic agents used for stroke prevention in AF will potentially increase the risk of bleeding events. Moreover, the introduction of novel oral anticoagulation agents have introduced new, hitherto ill-defined, deficiencies in the authors' knowledge with respect to anticoagulation monitoring, availability of direct antidotes, drug-drug interactions and the ability to appropriately control and reverse their actions if bleeding events occur. The authors present a comprehensive review on all aspects of bleeding related to currently licensed antithrombotic agents used for stroke prevention in patients with AF.

Novel Method for Recruiting Representative At-Risk Individuals into Cancer Prevention Trials: Online Health Risk Assessment in Employee Wellness Programs.

Science.gov (United States)

Hui, Siu-Kuen Azor; Miller, Suzanne M; Hazuda, Leah; Engelman, Kimberly; Ellerbeck, Edward F

2016-09-01

Participation in cancer prevention trials (CPT) is lower than 3 % among high-risk healthy individuals, and racial/ethnic minorities are the most under-represented. Novel recruitment strategies are therefore needed. Online health risk assessment (HRA) serves as a gateway component of nearly all employee wellness programs (EWPs) and may be a missed opportunity. This study aimed to explore employees' interest, willingness, motivators, and barriers of releasing their HRA responses to an external secure research database for recruitment purpose. We used qualitative research methods (focus group and individual interviews) to examine employees' interest and willingness in releasing their online HRA responses to an external, secure database to register as potential CPT participants. Fifteen structured interviews (40 % of study participants were of racial/ethnic minority) were conducted, and responses reached saturation after four interviews. All employees showed interest and willingness to release their online HRA responses to register as a potential CPT participant. Content analyses revealed that 91 % of participants were motivated to do so, and the major motivators were to (1) obtain help in finding personally relevant prevention trials, (2) help people they know who are affected by cancer, and/or (3) increase knowledge about CPT. A subset of participants (45 %) expressed barriers of releasing their HRA responses due to concerns about credibility and security of the external database. Online HRA may be a feasible but underutilized recruitment method for cancer prevention trials. EWP-sponsored HRA shows promise for the development of a large, centralized registry of racially/ethnically representative CPT potential participants.

Optimization of the Anterior Cruciate Ligament Injury Prevention Paradigm : Novel Feedback Techniques to Enhance Motor Learning and Reduce Injury Risk

NARCIS (Netherlands)

Benjaminse, Anne; Gokeler, Alli; Dowling, Ariel V.; Faigenbaum, Avery; Ford, Kevin R.; Hewett, Timothy E.; Onate, James A.; Otten, Bert; Myer, Gregory D.

SYNOPSIS: Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence-is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current

Preventive risk assessment in forensic child and youth care

NARCIS (Netherlands)

Assink, M.

2017-01-01

Risk assessment is central to the work of forensic mental health professionals, since it serves as a guide for prevention and intervention strategies. For effective risk assessment, knowledge on risk factors and their effects as well as the availability of valid and reliable instruments for risk

Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

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... A-Glance Project Connect Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend on Facebook Tweet ... their risk for HIV , other STDs , and unintended pregnancy . The National HIV/AIDS Strategy calls for all Americans to be ...

The burden of disease preventable by risk factor reduction in Serbia

Directory of Open Access Journals (Sweden)

Šipetić Sandra

2013-01-01

Full Text Available Background/Aim. Reliable and comparable analysis of health risks is an important component of evidence-based and preventive programs. The aim of this study was to analyze the impact of the most relevant avoidable risk factors on the burden of the selected conditions in Serbia. Methods. Attributable fractions were calculated from the survey information on the prevalence of a risk factor and the relative risk of dying if exposed to a risk factor. The population-attributable risks were applied to deaths, years of life lost due to premature mortality (YLL, years of life with disability (YLD and disability adjusted life years (DALY. Results. More than 40% of all deaths and of the total YLL are attributable to cigarette smoking, overweight, physical inactivity, inadequate intake of fruit and vegetables, hypertension and high blood cholesterol. Alcohol consumption has in total a beneficial effect. According to the percent of DALY for the selected conditions attributable to the observed risk factors, their most harmful effects are as follows: alcohol consumption on road traffic accidents; cigarette smoking on lung cancer; physical inactivity on cerebrovascular disease (CVD, ischemic heart disease (IHD and colorectal cancer; overweight on type 2 diabetes; hypertension on renal failure and CVD; inadequate intake of fruit and vegetables on IHD and CVD, and high blood cholesterol on IHD. Conclusions. This study shows that a high percentage of disease and injury burden in Serbia is attributable to avoidable risk factors, which emphasizes the need for improvement of relevant preventive strategies and programs at both individual and population levels. Social preferences should be determined for a comprehensive set of conditions and cost effectiveness analyses of potential interventions should be carried out. Furthermore, positive measures, derived from health, disability and quality of life surveys, should be included. [Projekat Ministarstva nauke Republike

Effect of Interventions on Potential, Modifiable Risk Factors for Knee Injury in Team Ball Sports : A Systematic Review

NARCIS (Netherlands)

ter Stege, Marloes H. P.; Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.

2014-01-01

Background Knee injuries are one of the most common types of injuries in team ball sports, and prevention is crucial because of health and economic implications. To set up effective prevention programs, these programs must be designed to target potential, modifiable risk factors. In addition, it is

Personalized Genetic Risk Counseling to Motivate Diabetes Prevention

OpenAIRE

Grant, Richard W.; O’Brien, Kelsey E.; Waxler, Jessica L.; Vassy, Jason L.; Delahanty, Linda M.; Bissett, Laurie G.; Green, Robert C.; Stember, Katherine G.; Guiducci, Candace; Park, Elyse R.; Florez, Jose C.; Meigs, James B.

2012-01-01

OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top an...

Evaluating the benefits of risk prevention initiatives

Science.gov (United States)

Di Baldassarre, G.

2012-04-01

The likelihood and adverse impacts of water-related disasters, such as floods and landslides, are increasing in many countries because of changes in climate and land-use. This presentation illustrates some preliminary results of a comprehensive demonstration of the benefits of risk prevention measures, carried out within the European FP7 KULTURisk project. The study is performed by using a variety of case studies characterised by diverse socio-economic contexts, different types of water-related hazards (floods, debris flows and landslides, storm surges) and space-time scales. In particular, the benefits of state-of-the-art prevention initiatives, such as early warning systems, non-structural options (e.g. mapping and planning), risk transfer strategies (e.g. insurance policy), and structural measures, are showed. Lastly, the importance of homogenising criteria to create hazard inventories and build memory, efficient risk communication and warning methods as well as active dialogue with and between public and private stakeholders, is highlighted.

Lessons from obesity prevention for the prevention of mental disorders: the primordial prevention approach.

Science.gov (United States)

Hayward, Joshua; Jacka, Felice N; Waters, Elizabeth; Allender, Steven

2014-09-10

Emerging evidence supports a relationship between risk factors for obesity and the genesis of the common mental disorders, depression and anxiety. This suggests common mental disorders should be considered as a form of non-communicable disease, preventable through the modification of lifestyle behaviours, particularly diet and physical activity. Obesity prevention research since the 1970's represents a considerable body of knowledge regarding strategies to modify diet and physical activity and so there may be clear lessons from obesity prevention that apply to the prevention of mental disorders. For obesity, as for common mental disorders, adolescence represents a key period of vulnerability. In this paper we briefly discuss relationships between modifiable lifestyle risk factors and mental health, lifestyle risk factor interventions in obesity prevention research, the current state of mental health prevention, and the implications of current applications of systems thinking in obesity prevention research for lifestyle interventions. We propose a potential focus for future mental health promotion interventions and emphasise the importance of lessons available from other lifestyle modification intervention programmes.

Leptospirosis risk around a potential source of infection

Science.gov (United States)

Loaiza-Echeverry, Erica; Hincapié-Palacio, Doracelly; Ochoa Acosta, Jesús; Ospina Giraldo, Juan

2015-05-01

Leptospirosis is a bacterial zoonosis with world distribution and multiform clinical spectrum in men and animals. The etiology of this disease is the pathogenic species of Leptospira, which cause diverse manifestations of the disease, from mild to serious, such as the Weil disease and the lung hemorrhagic syndrome with lethal proportions of 10% - 50%. This is an emerging problem of urban health due to the growth of marginal neighborhoods without basic sanitary conditions and an increased number of rodents. The presence of rodents and the probability of having contact with their urine determine the likelihood for humans to get infected. In this paper, we simulate the spatial distribution of risk infection of human leptospirosis according to the proximity to rodent burrows considered as potential source of infection. The Bessel function K0 with an r distance from the potential point source, and the scale parameter α in meters was used. Simulation inputs were published data of leptospirosis incidence rate (range of 5 to 79 x 10 000), and a distance of 100 to 5000 meters from the source of infection. We obtained an adequate adjustment between the function and the simulated data. The risk of infection increases with the proximity of the potential source. This estimation can become a guide to propose effective measures of control and prevention.

The Struggle to Prevent and Evaluate: Application of Population Attributable Risk and Preventive Fraction to Suicide Prevention Research

Science.gov (United States)

Krysinska, Karolina; Martin, Graham

2009-01-01

Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness…

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

DEFF Research Database (Denmark)

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

2012-01-01

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

HIV/AIDS Risk and Prevention Issues Among Inuit Living in Nunavut Territory of Canada.

Science.gov (United States)

Kumar, Alexander

HIV infections occur across the Arctic but their incidence among aboriginal populations varies vastly. At the time this research was initiated there were no data on their occurrence, risk of HIV/AIDS or preventive strategies among Inuit living in the Nunavut territory of Canada. This review is the first to assess the risk of HIV infection among Inuit and evaluate current prevention strategies among Canadian-Inuit populations. The contents of this article are based on the author's own research, undertaken during 3 visits to the Canadian Arctic and the published literature. Disproportionately high rates of Chlamydia and Gonorrhoea within Inuit communities confirm the potential threat of silent HIV transmission. Inuit awareness of HIV/AIDS issues remains inadequate. It is easy to blame distorted perceptions fuelled by the media, religious influence and socio-cultural factors. Aboriginal and Inuit groups, including youth, women and injection drug abusers are at increased risk of infection. The adaptability of proven prevention methods including condom use and male circumcision are discussed. Access to treatment, adherence and resistance issues in the North Canada, require attention. HIV/AIDS poses a considerable threat to Canadian Inuit public health. The most important problem to be addressed is Inuit lack of awareness and understanding of HIV. Education is the single most effective means of prevention. Inuit-specific and culture-sensitive interventions are recommended. Further research opportunities exist to investigate Inuit understanding over HIV/AIDS issues and to assess local prevention efforts. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Interventions to prevent and manage psychosocial risks and work-related stress

NARCIS (Netherlands)

Klein Hesselink, J.; Jain, A.

2014-01-01

Prevention is the cornerstone of the European approach to managing occupational safety and health. Prevention means anticipating and analysing the various aspects of work to identify short and long term risks, and then taking action to eliminate or mitigate those risks; that is identifying and

[Cardiac and metabolic risk factors in severe mental disorders. Task of a prevention manager].

Science.gov (United States)

Lederbogen, F; Schwarz, P; Häfner, S; Schweiger, U; Bohus, M; Deuschle, M

2015-07-01

People with severe mental disorders have a reduction in life expectancy of 13-30 % compared with the general population. This severe disadvantage is primarily due to an increased prevalence of cardiac and metabolic disorders, especially coronary heart disease (CHD) and type 2 diabetes mellitus and are the result of untoward health behavior characterized by smoking, low levels of physical activity and unhealthy dietary habits. Obesity, arterial hypertension and lipid disorders are also associated with this behavior and further increase the risk of CHD and type 2 diabetes. Thus, people with mental disorders constitute a population with a high risk of cardiovascular events. Appropriate measures for prevention and therapy are urgently indicated but rarely applied. This article presents new organizational structures to overcome this deficit with a prevention manager playing a central role in organizing and applying preventive and therapeutic care. Results from cardiology and diabetic medicine have shown the effectiveness of pooling this responsibility. The measure has the potential to reduce the increased mortality of people with severe mental disorders.

Elicitation of cognitions related to HIV risk behaviors in persons with mental illnesses: implications for prevention.

Science.gov (United States)

Tennille, Julie; Solomon, Phyllis; Fishbein, Martin; Blank, Michael

2009-01-01

An important step in research using the Theory of Reasoned Action and Theory of Planned Behavior (TRA/TPB) is conducting an elicitation process to identify topic and population specific cognitions. This study explored HIV risk behaviors in persons with mental illnesses and introduces findings from focus groups conducted during the development phase of an HIV primary and secondary prevention intervention study. Researchers held four focus groups with persons with mental illnesses focused on HIV risks and condom use. Participants discussed sexual side effects of psychotropic medications as a potential cause of both medication non-adherence and HIV risk behaviors. The intersection of these two issues is specific to this population. We conclude with the recommendation that HIV primary and secondary prevention intervention for persons with mental illnesses must incorporate the promotion of healthy sexuality, including attention to sexual side effects of psychotropic medications.

Pressure ulcer risk assessment and prevention: what difference does a risk scale make? A comparison between Norway and Ireland.

Science.gov (United States)

Johansen, E; Moore, Z; van Etten, M; Strapp, H

2014-07-01

To explore similarities and differences in nurses' views on risk assessment practices and preventive care activities in a context where patients' risk of developing pressure ulcers is assessed using clinical judgment (Norway) and a context where patients' risk of developing pressure ulcers is assessed using a formal structured risk assessment combined with clinical judgement (Ireland). A descriptive, qualitative design was employed across two different care settings with a total of 14 health care workers, nine from Norway and five from Ireland. Regardless of whether risk assessment was undertaken using clinical judgment or formal structured risk assessment, identified risk factors, at risk patients and appropriate preventive initiatives discussed by participant were similar across care settings. Furthermore, risk assessment did not necessarily result in the planning and implementation of appropriate pressure ulcer prevention initiatives. Thus, in this instance, use of a formal risk assessment tool does not seem to make any difference to the planning, initiation and evaluation of pressure ulcer prevention strategies. Regardless of the method of risk assessment, patients at risk of developing pressure ulcers are detected, suggesting that the practice of risk assessment should be re-evaluated. Moreover, appropriate preventive interventions were described. However, the missing link between risk assessment and documented care planning is of concern and barriers to appropriate pressure ulcer documentation should be explored further. This work is partly funded by a research grant from the Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare.

Mapping Global Potential Risk of Mango Sudden Decline Disease Caused by Ceratocystis fimbriata

Science.gov (United States)

Oliveira, Leonardo S. S.; Alfenas, Acelino C.; Neven, Lisa G.; Al-Sadi, Abdullah M.

2016-01-01

The Mango Sudden Decline (MSD), also referred to as Mango Wilt, is an important disease of mango in Brazil, Oman and Pakistan. This fungus is mainly disseminated by the mango bark beetle, Hypocryphalus mangiferae (Stebbing), by infected plant material, and the infested soils where it is able to survive for long periods. The best way to avoid losses due to MSD is to prevent its establishment in mango production areas. Our objectives in this study were to: (1) predict the global potential distribution of MSD, (2) identify the mango growing areas that are under potential risk of MSD establishment, and (3) identify climatic factors associated with MSD distribution. Occurrence records were collected from Brazil, Oman and Pakistan where the disease is currently known to occur in mango. We used the correlative maximum entropy based model (MaxEnt) algorithm to assess the global potential distribution of MSD. The MaxEnt model predicted suitable areas in countries where the disease does not already occur in mango, but where mango is grown. Among these areas are the largest mango producers in the world including India, China, Thailand, Indonesia, and Mexico. The mean annual temperature, precipitation of coldest quarter, precipitation seasonality, and precipitation of driest month variables contributed most to the potential distribution of MSD disease. The mango bark beetle vector is known to occur beyond the locations where MSD currently exists and where the model predicted suitable areas, thus showing a high likelihood for disease establishment in areas predicted by our model. Our study is the first to map the potential risk of MSD establishment on a global scale. This information can be used in designing strategies to prevent introduction and establishment of MSD disease, and in preparation of efficient pest risk assessments and monitoring programs. PMID:27415625

Efficiency or equity? Simulating the impact of high-risk and population intervention strategies for the prevention of disease

Directory of Open Access Journals (Sweden)

Jonathan M. Platt

2017-12-01

Full Text Available Maximizing both efficiency and equity are core considerations for population health. These considerations can result in tension in population health science as we seek to improve overall population health while achieving equitable health distributions within populations. Limited work has explored empirically the consequences of different population health intervention strategies on the burden of disease and on within- and between-group differences in disease. To address this gap, we compared the impact of four simulated interventions using data from the National Health and Nutrition Examination Survey. In particular, we focus on assessing how population and high-risk primary prevention and population and high-risk secondary interventions efforts to reduce smoking behavior influence systolic blood pressure (SBP and hypertension, and how such strategies influence inequalities in SBP by income. The greatest reductions in SBP mean and standard deviation resulted from the population secondary prevention. High-risk primary and secondary prevention and population secondary prevention programs all yielded substantial reductions in hypertension prevalence. The effect of population primary prevention did little to decrease population SBP mean and standard deviation, as well as hypertension prevalence. Both high-risk strategies had a larger impact in the low-income population, leading to the greatest narrowing the income-related gap in disease. The population prevention strategies had a larger impact in the high-income population. Population health approaches must consider the potential impact on both the whole population and also on those with different levels of risk for disease within a population, including those in under-represented or under-served groups.

Breast cancer risk accumulation starts early – Prevention must also

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Colditz, Graham A; Bohlke, Kari; Berkey, Catherine S.

2014-01-01

Purpose Nearly 1 in 4 breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. Methods Literature review Results Exposures during childhood and adolescence affect a woman’s long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies first pregnancy. Evidence on childhood diet and growth in height, and adolescent alcohol intake, among other adolescent factors are related to breast cancer risk and risk of premalignant proliferative benign lesions. Conclusion Breast cancer prevention efforts will have the greatest effect when initiated at an early age and continued over a lifetime. Gaps in knowledge are identified and deserve increase attention to inform prevention. PMID:24820413

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

Science.gov (United States)

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

2016-01-01

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

Shoulder dystocia: risk factors, predictability, and preventability.

Science.gov (United States)

Mehta, Shobha H; Sokol, Robert J

2014-06-01

Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.

POLLUTION PREVENTION RESEARCH ONGOING - EPA'S RISK REDUCTION ENGINEERING LABORATORY

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The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied researc...

Antioxidants as a Potential Preventive and Therapeutic Strategy for Cadmium.

Science.gov (United States)

Brzóska, Malgorzata M; Borowska, Sylwia; Tomczyk, Michal

2016-01-01

Epidemiological studies provide a growing number of evidences that chronic exposure to relatively low levels of cadmium (Cd), nowadays taking place in industrialized countries, may cause health hazard. Thus, growing interest has been focused on effective ways of protection from adverse effects of exposure to this heavy metal. Because numerous effects to Cd's toxic action result from its prooxidative properties, it seems reasonable that special attention should be directed to agents that can prevent or reduce this metal-induced oxidative stress and its consequences in tissues, organs and systems at risk of toxicity, including liver, kidneys, testes, ears, eyes, cardiovascular system and nervous system as well as bone tissue. This review discusses a wide range of natural (plant and animal origin) and synthetic antioxidants together with many plant extracts (e.g. black and green tea, Aronia melanocarpa, Allium sativum, Allium cepa, Ocimum sanctum, Phoenix dactylifera, Physalis peruviana, Zingiber officinale) that have been shown to prevent from Cd toxicity. Moreover, some attention has been focused on the fact that substances not possessing antioxidative potential may also prevent Cd-induced oxidative stress and its consequences. So far, most of the data on the protective effects of the natural and synthetic antioxidants and plant extracts come from studies in animals' models; however, numerous of them seem to be promising preventive/therapeutic strategies for Cd toxicity in humans. Further investigation of prophylactic and therapeutic use of antioxidants in populations exposed to Cd environmentally and occupationally is warranted, given that therapeutically effective chelation therapy for this toxic metal is currently lacking.

Mandatory Reporting of Human Trafficking: Potential Benefits and Risks of Harm.

Science.gov (United States)

English, Abigail

2017-01-01

Human trafficking, including both sex and labor trafficking, has profound consequences for the safety, health, and well-being of victims and survivors. Efforts to address human trafficking through prevention, protection, and prosecution are growing but remain insufficient. Mandatory reporting has the potential to bring victims and survivors to the attention of social service and law enforcement agencies but may discourage trafficked persons from seeking help, thereby limiting the ability of health care professionals to establish trust and provide needed care. States' experience in implementing child abuse laws can be useful in assessing the potential risks and benefits of mandatory reporting of human trafficking. © 2017 American Medical Association. All Rights Reserved.

Radiation induced cancer: risk assessment and prevention

International Nuclear Information System (INIS)

Shore, R.E.

1984-01-01

A number of factors have to be considered in defining the cancer risk from ionizing radiation. These include the radiation sensitivity of the target tissue(s), the temporal pattern of risk, the shape of the dose-incidence curve, the effects of low dose rates, host susceptibility factors, and synergism with other environmental exposures. For the population as a whole the largest sources of radiation exposure are natural background radiation and medical/dental radiation. Radiation exposures in the medical field make up the largest volume of occupational exposures as well. Although new technologies offer opportunities to lower exposures, worker training, careful exposure monitoring with remedial feedback, and monitoring to prevent unnecessary radiodiagnostic procedures may be even more important means of reducing radiation exposure. Screening of irradiated populations can serve a useful preventive function, but only for those who have received very high doses

[Stigma - risk factor and consequence of suicidal behavior : Implications for suicide prevention].

Science.gov (United States)

Oexle, N; Rüsch, N

2017-11-16

Mental illness, previous suicidal behavior and loss of a relative by suicide are strong risk factors for suicidality. Both mental illness and suicide are stigmatized, which is a burden for those affected and potentially contributes to suicidality among stigmatized individuals. Many consequences of stigma, e. g. social isolation, low self-esteem and hopelessness, are well-known predictors of suicidality. Interventions to reduce stigmatization might therefore be an important component of successful suicide prevention. This paper discusses the currently available knowledge regarding this hypothesis. Many studies confirmed the association between the stigmatization of mental illness and suicidality and there is initial evidence for the influence of suicide stigma and suicidality. Nevertheless, the effectiveness of anti-stigma interventions to reduce suicidality and prevent suicide has not yet been tested. Reducing stigma among members of the general population and mental health care professionals as well as programs to support individuals in coping with stigmatization could be important components of successful suicide prevention.

Decreases in tanning behaviors following a short online survey: Potential for prevention?

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Rodgers, Rachel F; Franko, Debra L; Gottlieb, Mark; Daynard, Richard

2015-01-01

To date, tanning prevention programs have led to limited success. The aim of the present study was to investigate potential unexpected prevention effects of completing an online survey focused on tanning attitudes, behaviors, and knowledge among female college tanners. A sample of 92 female undergraduate students from the USA, mean age = 20.09, SD = 1.41 years, who engaged in indoor tanning completed an online survey assessing awareness of tanning-related health risks, appearance-based motivations to tan and not to tan, media literacy related to tanning marketing, and tanning behaviors in 2013. Four months later, participants were invited to complete a follow-up survey assessing tanning intentions and behaviors since completing the initial survey. Fifty-one participants (55%) completed the follow-up questions, of whom 43 (84.3%) reported having decreased or ceased engaging in indoor tanning. In addition participants provided comments indicating that completing the survey had lead to decreases in their tanning behaviors. Our study presents novel and compelling support for using brief online surveys for decreasing health-risk behaviors such as sunbed use. Such measures are extremely cost-effective and easy to disseminate and implement. Replication and extension of these findings are warranted.

Impact of the Prevention Plan on Employee Health Risk Reduction

OpenAIRE

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

2010-01-01

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

The Risk Factors of Prostate Cancer and Its Prevention: A Literature Review

Directory of Open Access Journals (Sweden)

Noor Riza Perdana

2016-11-01

Numerous epidemiologic studies have linked PCa risk to various factors, i.e. age, ethnicity, family history, insulin like-growth factors, lifestyle, diet, environmental and occupational exposures. The results of epidemiological, In vivo, in vitro, and early clinical studies suggested that selected dietary products and supplementation may play a role in PCa prevention. More studies are still needed to explore and find the risk factors and preventive methods of PCa development. It is important for clinician to ellaborate these informations for education to lower PCa risks and prevent PCa.

Quantifying Construction Site Sediment Discharge Risk and Treatment Potential

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Ferrell, L.; Beighley, R. E.

2006-12-01

Dealing with soil erosion and sediment transport can be a significant challenge during the construction process due to the potentially large spatial and temporal extent and conditions of bare soils. Best Management Practices (BMP) are commonly used to eliminate or reduce offsite discharge of sediment. However, few efforts have investigated the time varying risk of sediment discharge from construction sites, which often have dynamic soil conditions and the potential for less than optimal BMP installations. The goal of this research is to improve the design, implementation and effectiveness of sediment and erosion control at construction sites using site specific, temporal distributions of sediment discharge risk. Sediment risk is determined from individual factors leading to sediment expert, such as rainfall frequency, the adequacy of BMP installations, and the extent and duration of bare soil conditions. This research specifically focuses on quantifying: (a) the effectiveness of temporary sediment and control erosion control BMPs in preventing, containing, and/or treating construction site sediment discharge at varying levels of "proper" installation, and (b) sediment discharge potential from construction sites during different phases of construction, (ex., disturbed earth operations). BMPs are evaluated at selected construction sites in southern California and at the Soil Erosion Research Laboratory (SERL) in the Civil and Environmental Engineering department at San Diego State University. SERL experiments are performed on a 3-m by 10-m tilting soil bed with soil depths up to 1 meter, slopes ranging from 0 to 50 percent, and rainfall rates up to 150 mm/hr (6 in/hr). BMP performance is assessed based on experiments where BMPs are installed per manufacture specifications, potential less than optimal installations, and no treatment conditions. Soil conditions are also varied to represent site conditions during different phases of construction (i.e., loose lifts

Perceptions of football players regarding injury risk factors and prevention strategies.

Directory of Open Access Journals (Sweden)

Astrid Zech

Full Text Available Current approaches regarding injury prevention focus on the transfer of evidence into daily practice. One promising approach is to influence attitudes and beliefs of players. The objective of this study was to record player's perceptions on injury prevention. A survey was performed among players of one German high-level football (soccer club. 139 professional and youth players between age 13 and 35 years completed a standardized questionnaire (response rate = 98%. It included categories with (1 history of lower extremity injuries, (2 perceptions regarding risk factors and (3 regularly used prevention strategies. The majority of players (84.2% had a previous injury. 47.5% of respondents believe that contact with other players is a risk factor, followed by fatigue (38.1% and environmental factors (25.9%. The relevance of previous injuries as a risk factor is differently perceived between injured (25% and uninjured players (0.0%. Nearly all players (91.5% perform stretching to prevent injuries, followed by neuromuscular warm up exercises (54.0%. Taping is used by 40.2% of previously injured players and 13.6% of players without a history of injuries. In conclusion, the perception of risk factors and performed preventive strategies are inconsistent with scientific evidence. Future transfer strategies should incorporate the players beliefs and attitudes.

Association Between Employee Dental Claims, Health Risks, Workplace Productivity, and Preventive Services Compliance.

Science.gov (United States)

Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B

2017-08-01

This study examined differences in health risks and workplace outcomes among employees who utilized preventive dental services compared with other employees. A retrospective observational study of employees of a large financial services corporation, with data from health risk appraisal questionnaires, medical claims, pharmacy claims, and dental claims. Employees with no dental claims were significantly more likely to have a variety of health risk factors (such as obesity and tobacco use), health conditions (such as diabetes), absenteeism, and lost on-the-job productivity, and were significantly less likely to be compliant with clinical preventive services compared with those with preventive dental claims. Employees with preventive dental claims had fewer health risks and medical conditions and better health and productivity measures. Study employees underutilized free dental care; employers should incorporate preventive dental care awareness into their worksite wellness programs.

[How can we prevent alveolar echinococcosis? Ecosystem and risk management viewpoints].

Science.gov (United States)

Konno, Keita; Oku, Yuzaburo; Kamiya, Masao; Doi, Rikuo; Tamashiro, Hidehiko

2002-01-01

This article focuses on understanding epidemiological features of alveolar echinococcosis and discussing its prevention and control, especially from a viewpoint of the ecosystem and risk management. Publications on alveolar echinococcosis throughout the world were systematically reviewed with special reference to ecology, epidemiology and countermeasures. Alveolar echinococcosis, caused by accidental infection with larva of the parasite Echinococcus multilocularis is fatal to humans unless diagnosed at an early stage. No effective control measures have been identified so far because it is difficult to fully understand the ecology of the parasite and its intermediate and definitive hosts. It is also not easy to determine the precise infection route to humans mainly because of the long latent period. In Hokkaido, infection rates among red foxes have recently risen even in low endemic districts. Not only stray and domestic dogs but also some pigs in Hokkaido have been found to be infected. While the number of reported human cases is still small, around 10 cases per year, local residents seem to be threatened with the risk of infection. We predict that the incidence of alveolar echinococcosis among humans in Japan will increase in the near future if no effective preventive measures are conducted. In addition, Echinococcus multilocularis infection has the potential to affect the economy of Hokkaido because of its impact on the agricultural and tourist industries. Well-designed epidemiological surveys are therefore urgently required, in the context of ecosystem and risk management prior to large outbreaks. International collaboration is also desired.

Trade-offs in Cervical Cancer Prevention: Balancing Benefits and Risks

Science.gov (United States)

Stout, Natasha K.; Goldhaber-Fiebert, Jeremy D.; Ortendahl, Jesse D.; Goldie, Sue J.

2009-01-01

Background New screening and vaccination technologies will provide women with more options for cervical cancer prevention. Because the risk of cervical cancer diminishes with effective routine screening, women may wish to consider additional attributes, such as the likelihood of false-positive results and diagnostic procedures for mild abnormalities likely to resolve without intervention in their screening choices. Methods We used an empirically calibrated simulation model of cervical cancer in the United States to assess the benefits and potential risks associated with prevention strategies differing by primary screening test, triage test for abnormal results (cytologic testing, human papillomavirus [HPV] DNA test), and screening frequency. Outcomes included colposcopy referrals, cervical intraepithelial neoplasia (CIN) types 1 and 2 or 3, lifetime cancer risk, and quality-adjusted life expectancy. Results Across strategies, colposcopy referrals and diagnostic workups varied 3-fold, although diagnostic rates of CIN 2 or 3 were similar and 95% of positive screening test results were for mild abnormalities likely to resolve on their own. For a representative group of a thousand 20-year-old women undergoing triennial screening for 10 years, we expect 1038 colposcopy referrals (7 CIN 2 or 3 diagnoses) from combined cytologic and HPV DNA testing and fewer than 200 referrals (6–7 CIN 2 or 3 diagnoses) for strategies that use triage testing. Similarly, for a thousand 40-year-old women, combined cytologic and HPV DNA testing led to 489 referrals (9 CIN 2 or 3), whereas alternative strategies resulted in fewer than 150 referrals (7–8 CIN 2 or 3). Using cytologic testing followed by triage testing in younger women minimizes both diagnostic workups and positive HPV test results, whereas in older women diagnostic workups are minimized with HPV DNA testing followed by cytologic triage testing. Conclusions Clinically relevant information highlighting trade-offs among

Prevention and risks limitation of the radioactive installations

International Nuclear Information System (INIS)

San Segundo, T.

1983-01-01

Associated risks to the ionizing radiation, in general, and to the radioactive installations, in particular, are exposed; as well as the prevention and limitation techniques applied in order to keep risk into acceptable levels are detatched. Finally, the effect in the human life of the radioactivity use and other activities are compared and man-made occupational and public exposures are explained. (author)

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis.

Science.gov (United States)

Asker, Martin; Brooke, Hannah L; Waldén, Markus; Tranaeus, Ulrika; Johansson, Fredrik; Skillgate, Eva; Holm, Lena W

2018-03-26

To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports. Systematic review with best-evidence synthesis. Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017. Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria. Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power. All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports. CRD42015026850. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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.

Obesity prevention: Comparison of techniques and potential solution

Science.gov (United States)

Zulkepli, Jafri; Abidin, Norhaslinda Zainal; Zaibidi, Nerda Zura

2014-12-01

Over the years, obesity prevention has been a broadly studied subject by both academicians and practitioners. It is one of the most serious public health issue as it can cause numerous chronic health and psychosocial problems. Research is needed to suggest a population-based strategy for obesity prevention. In the academic environment, the importance of obesity prevention has triggered various problem solving approaches. A good obesity prevention model, should comprehend and cater all complex and dynamics issues. Hence, the main purpose of this paper is to discuss the qualitative and quantitative approaches on obesity prevention study and to provide an extensive literature review on various recent modelling techniques for obesity prevention. Based on these literatures, the comparison of both quantitative and qualitative approahes are highlighted and the justification on the used of system dynamics technique to solve the population of obesity is discussed. Lastly, a potential framework solution based on system dynamics modelling is proposed.

Towards Prevention of Breast Cancer: What Are the Clinical Challenges?

Science.gov (United States)

Borgquist, Signe; Hall, Per; Lipkus, Isaac; Garber, Judy E

2018-05-01

The dramatic increase in breast cancer incidence compels a paradigm shift in our preventive efforts. There are several barriers to overcome before prevention becomes an established part of breast cancer management. The objective of this review is to identify the clinical challenges for improved breast cancer prevention and discuss current knowledge on breast cancer risk assessment methods, risk communication, ethics, and interventional efforts with the aim of covering the aspects relevant for a breast cancer prevention trial. Herein, the following five areas are discussed: (i) Adequate tools for identification of women at high risk of breast cancer suggestively entitled Prevent! Online. (ii) Consensus on the definition of high risk, which is regarded as mandatory for all risk communication and potential prophylactic interventions. (iii) Risk perception and communication regarding risk information. (iv) Potential ethical concerns relevant for future breast cancer prevention programs. (v) Risk-reducing programs involving multileveled prevention depending on identified risk. Taken together, devoted efforts from both policy makers and health care providers are warranted to improve risk assessment and risk counseling in women at risk for breast cancer to optimize the prevention of breast cancer. Cancer Prev Res; 11(5); 255-64. ©2018 AACR . ©2018 American Association for Cancer Research.

Maximum potential preventive effect of hip protectors

NARCIS (Netherlands)

van Schoor, N.M.; Smit, J.H.; Bouter, L.M.; Veenings, B.; Asma, G.B.; Lips, P.T.A.M.

2007-01-01

OBJECTIVES: To estimate the maximum potential preventive effect of hip protectors in older persons living in the community or homes for the elderly. DESIGN: Observational cohort study. SETTING: Emergency departments in the Netherlands. PARTICIPANTS: Hip fracture patients aged 70 and older who

Implementing Suicide Prevention Programs: Costs and Potential Life Years Saved in Canada.

Science.gov (United States)

Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique

2015-09-01

,979 per life year saved. Suicide prevention programs such as the NAD trial are cost-effective and can result in important potential cost-savings due to averted suicide deaths and reduced life years lost. Implementation of suicide prevention programs at the population level in Canada is cost-effective. Community mental health programs aimed at increasing awareness and the treatment of depression and better follow-up of high risk individuals for suicide are associated with a minimal per capita investment. These programs can result in important potential cost-savings due to averted suicide deaths and decreased disability due to depression. Additional research should focus on whether the outcomes of multi-modal suicide programs are specific or synergistic and most effective for which population subgroups. This may help inform how best to invest resources for the highest return.

An Insight into the Effect of Exercises on the Prevention of Osteoporosis and Associated Fractures in High-Risk Individuals

Directory of Open Access Journals (Sweden)

Helen Senderovich

2018-01-01

Full Text Available The purpose of this review was to investigate what type of exercises can potentially prevent osteoporosis (OP and its associated fractures in high-risk populations. MEDLINE was searched for work relevant to various types of exercises used to prevent osteoporotic fractures in high-risk population, from the year 1995 onwards. Twelve articles were identified, and, from them, four were deemed suitable to the objective. The studies reviewed show that various types of exercise are effective and safe in preventing the onset of OP. For example, high-intensity progressive resistance training (HiPRT has been shown to increase vertebral height and femoral neck bone mineral density (BMD, in addition to improving functional performance. Additional studies reviewed suggested that bone reabsorption levels may be positively impacted by low-impact exercise, such as walking. This review provides insight into the effectiveness of various types of exercise to combat and possibly prevent OP for high-risk individuals, which include postmenstrual Caucasian females, people with multiple comorbidities, individuals who smoke or consume alcohol, and the frail elderly population. The prevention of OP should reduce both the social (emotional and economic burdens faced by patients, caregivers, and health-care systems. Moving forward, research that identifies and bridges pharmaceutical treatment and exercise should be conducted, in addition to the comparison of passive versus active forms of exercise to determine which treatment best prevents OP in high-risk populations.

Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

Science.gov (United States)

Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

2016-08-01

Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

Potential ecological risk assessment and prediction of soil heavy-metal pollution around coal gangue dump

Science.gov (United States)

Jiang, X.; Lu, W. X.; Zhao, H. Q.; Yang, Q. C.; Yang, Z. P.

2014-06-01

The aim of the present study is to evaluate the potential ecological risk and trend of soil heavy-metal pollution around a coal gangue dump in Jilin Province (Northeast China). The concentrations of Cd, Pb, Cu, Cr and Zn were monitored by inductively coupled plasma mass spectrometry (ICP-MS). The potential ecological risk index method developed by Hakanson (1980) was employed to assess the potential risk of heavy-metal pollution. The potential ecological risk in the order of ER(Cd) > ER(Pb) > ER(Cu) > ER(Cr) > ER(Zn) have been obtained, which showed that Cd was the most important factor leading to risk. Based on the Cd pollution history, the cumulative acceleration and cumulative rate of Cd were estimated, then the fixed number of years exceeding the standard prediction model was established, which was used to predict the pollution trend of Cd under the accelerated accumulation mode and the uniform mode. Pearson correlation analysis and correspondence analysis are employed to identify the sources of heavy metals and the relationship between sampling points and variables. These findings provided some useful insights for making appropriate management strategies to prevent or decrease heavy-metal pollution around a coal gangue dump in the Yangcaogou coal mine and other similar areas elsewhere.

Functional foods for dyslipidaemia and cardiovascular risk prevention.

Science.gov (United States)

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

2009-12-01

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

Nanotechnology and HIV: potential applications for treatment and prevention.

Science.gov (United States)

Kim, Peter S; Read, Sarah W

2010-01-01

HIV/AIDS is a global pandemic and is the leading infectious cause of death among adults. Although antiretroviral (ARV) therapy has dramatically improved the quality of life and increased the life expectancy of those infected with HIV, life-long suppressive treatment is required and a cure for HIV infection remains elusive; frequency of dosing and drug toxicity as well as the development of viral resistance pose additional limitations. Furthermore, preventative measures such as a vaccine or microbicide are urgently needed to curb the rate of new infections. The capabilities inherent to nanotechnology hold much potential for impact in the field of HIV treatment and prevention. This article reviews the potential for the multidisciplinary field of nanotechnology to advance the fields of HIV treatment and prevention. © 2010 John Wiley & Sons, Inc.

A long-term risk-benefit analysis of low-dose aspirin in primary prevention.

Science.gov (United States)

Wu, I-Chen; Hsieh, Hui-Min; Yu, Fang-Jung; Wu, Meng-Chieh; Wu, Tzung-Shiun; Wu, Ming-Tsang

2016-02-01

The long-term risk-benefit effect of occasional and regular use of low-dose aspirin (≤ 100 mg per day) in primary prevention of vascular diseases and cancers was calculated. One representative database of 1 000 000 participants from Taiwan's National Health Insurance scheme in 1997-2000 was used. The potential study subjects were those aged 30-95 years, were found not to have been prescribed aspirin before 1 January 2000, but to have first been prescribed low-dose aspirin (≤ 100 mg per day) after that date and were followed up to 31 December 2009. Participants prescribed low-dose aspirin risk. A total of 1720 pairs were analysed. During the study period, haemorrhage and ischaemia occurred in 25 (1·45%) and 67 participants (3·90%) in occasional users and 69 (4·01%) and 100 participants (5·81%) in regular users, whereas cancer occurred in 32 participants (1·86%) in occasional users and 26 participants (1·51%) in regular users. The crude and adjusted net clinical risks of low-dose aspirin use between the two frequency of users (≥ 80% vs. prevention against major vascular diseases and cancer. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

Rib stress fractures among rowers: a systematic review on return to sports, risk factors and prevention.

Science.gov (United States)

D'Ailly, Philip N; Sluiter, Judith K; Kuijer, Paul P

2016-06-01

Rib stress fractures (RSFs) are injuries frequently sustained by elite rowers with an injury rate of 8-16% over the course of a rowing career, resulting in negative effects on training and performance. For clinical management, the aim of this review was to describe time to return to sports, summarize potentially preventive measures and appraise the evidence on risk factors. A search strategy was performed in PubMed, SportDiscus, Web of Science and Embase till June 1st 2015. All studies were graded on their quality. The search resulted in 124 studies, of which 17 were included: Ten reported on return to sports, 17 reported on risk factors and nine on preventive measures. For return to sports, nine studies mentioned a loss of training of 4-6 weeks. The shortest period was one week and the longest 16 weeks. For risk factors, insufficient or conflicting evidence was found for changes in the training program, incorrect rowing technique, female gender, low bone mineral density, inadequate equipment, and training type. For prevention, gradual changes in the training program, alertness on the part of coaches and clinicians, and supplementation of diet and hormones are suggested as effective measures. However, no effect studies have been found. The main outcome of this review on RSFs is that little evidence is available on return to sports, risk factors and preventive measures. Coaches and clinicians should carefully guide and assist rowers suffering from RSFs in off training and in the subsequent training period to regain their pre-injury level.

Anterior cruciate ligament injuries in soccer: Loading mechanisms, risk factors, and prevention programs

Directory of Open Access Journals (Sweden)

Boyi Dai

2014-12-01

Full Text Available Anterior cruciate ligament (ACL injuries are common in soccer. Understanding ACL loading mechanisms and risk factors for ACL injury is critical for designing effective prevention programs. The purpose of this review is to summarize the relevant literature on ACL loading mechanisms, ACL injury risk factors, and current ACL injury prevention programs for soccer players. Literature has shown that tibial anterior translation due to shear force at the proximal end of tibia is the primary ACL loading mechanism. No evidence has been found showing that knee valgus moment is the primary ACL loading mechanism. ACL loading mechanisms are largely ignored in previous studies on risk factors for ACL injury. Identified risk factors have little connections to ACL loading mechanisms. The results of studies on ACL injury prevention programs for soccer players are inconsistent. Current ACL injury prevention programs for soccer players are clinically ineffective due to low compliance. Future studies are urgently needed to identify risk factors for ACL injury in soccer that are connected to ACL loading mechanisms and have cause-and-effect relationships with injury rate, and to develop new prevention programs to improve compliance.

Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes

Directory of Open Access Journals (Sweden)

Johansen Taber KA

2015-01-01

Full Text Available Katherine A Johansen Taber, Barry D DickinsonDepartment of Science and Biotechnology, American Medical Association, Chicago, IL, USAAbstract: Type 2 diabetes (T2D is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D.Keywords: diabetes, genomic, risk prediction, management

Fundamentals of risk/benefit analysis in radiation uses in preventive medicine

International Nuclear Information System (INIS)

Stieve, F.E.

1977-01-01

The term 'risk' stems from the insurance branch. It serves to estimate the probability of making statements about future events on the basis of events which have taken place. Risk estimations are increasingly being made in medicine, especially for determining the advantages and dangers brought to the population by preventive measures. The international radiation protection commission has, for some time, been expressing the dangers of ionising radiation in terms of risk and using these terms as basis for the dose limit values it determined for the professional and general population. This paper deals with possibilities of determining risks in preventive medicine. For doing this, acceptable risk values must be determined and risks resulting from diseases, esp. from those which were not recognized in time, must be compared with those resulting from the application of ionising radiation. (orig.) [de

Prevention of damage and 'residual risk' in nuclear power laws

International Nuclear Information System (INIS)

Greipl, C.

1992-01-01

The concept of prevention of damage within the framework of nuclear power laws includes averting danger for the protection of third parties and preventing risks for the partial protection of third parties with the proviso that still a desire to use the concept 'residual risk' in addition, it should be limited, on the grounds of what can be reasonably expected, to those risks which cannot be reduced any further by the government, i.e. to risks which the public in general and third parties ('actually') must accept. In the future, questions regarding safety systems should be taken into account exclusively withing the context of 'what is necessary for protection against damage in keeping with the latest developments in science and technology' and not at the discretion of the law in denying permission according to Article 7 Paragraph 2 Atomic Energy Law. (orig.) [de

Men's perspectives on fall risk and fall prevention following participation in a group-based programme conducted at Men's Sheds, Australia.

Science.gov (United States)

Liddle, Jeannine L M; Lovarini, Meryl; Clemson, Lindy M; Jang, Haeyoung; Willis, Karen; Lord, Stephen R; Sherrington, Catherine

2017-05-01

Research on older men's views regarding fall prevention is limited. The purpose of this qualitative study was to explore the experiences and perspectives of older men regarding fall risk and prevention so that fall prevention programmes can better engage older men. Eleven men who had taken part in a group-based fall prevention programme called Stepping On conducted at Men's Sheds in Sydney, Australia, participated in semi-structured interviews during June and July 2015 which were audio-recorded and transcribed. Data were coded and analysed using constant comparative methods. Over-arching theoretical categories were developed into a conceptual framework linking programme context and content with effects of programme participation on men. Men's Sheds facilitated participation in the programme by being inclusive, male-friendly places, where Stepping On was programmed into regular activities and was conducted in an enjoyable, supportive atmosphere. Programme content challenged participants to think differently about themselves and their personal fall risk, and provided practical options to address fall risk. Two major themes were identified: adjusting the mindset where men adopted a more cautious mindset paying greater attention to potential fall risks, being careful, concentrating and slowing down; and changing the ways where men acted purposefully on environmental hazards at home and incorporated fall prevention exercises into their routine schedules. Practitioners can engage and support older men to address falls by better understanding men's perspectives on personal fall risk and motivations for action. © 2016 John Wiley & Sons Ltd.

Colorectal Cancer Prevention (PDQ®)—Health Professional Version

Science.gov (United States)

Colorectal cancer (CRC) prevention strategies include avoiding known risk factors, adopting a healthy lifestyle, polyp removal, and aspirin. Get detailed information about risk factors for CRC and potential interventions for prevention in this summary for clinicians.

Improving flood risk communication by focusing on prevention-focused motivation

NARCIS (Netherlands)

de Boer, J.; Botzen, W.J.W.; Terpstra, T.

2014-01-01

This article proposes an approach to flood risk communication that gives particular emphasis to the distinction between prevention and promotion motivation. According to E. Tory Higgins, the promotion system and the prevention system are assumed to coexist in every person, but one or the other may

Risk communication and decision-making in the prevention of invasive breast cancer.

Science.gov (United States)

Partridge, Ann H

2017-08-01

Risk communication surrounding the prevention of invasive breast cancer entails not only understanding of the disease, risks and opportunities for intervention. But it also requires understanding and implementation of optimal strategies for communication with patients who are making these decisions. In this article, available evidence for the issues surrounding risk communication and decision making in the prevention of invasive breast cancer are reviewed and strategies for improvement are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Travel health risk perceptions and prevention behaviors of US study abroad students.

Science.gov (United States)

Hartjes, Laurie B; Baumann, Linda C; Henriques, Jeffrey B

2009-01-01

The number of American study abroad students increased more than 150% in the past decade, along with growth in destinations with increased health risks. This study investigated travel health risk perceptions and prevention behaviors to guide interventions that address the emerging health needs of US study abroad students. A cross-sectional design was used to collect data from 318 American study abroad students using a Web-based survey. The primary source of travel health information was youth-oriented travel guidebooks (85%). The grand mean risk perception score for 18 travel health threats was 1.7 on a 1 to 4 scale, with top-rated threats being contaminated food/water, psychological distress, personal assault, and excessive sun exposure. Predeparture advice was received from primary care providers (52%) and travel health specialists (18%). Additional prevention measures were vaccines (42%) and medication (24%). Of 114 students listing their travel vaccinations, 11% described receiving a malaria vaccine and 4% a hepatitis C vaccine, although no such vaccines exist. Most respondents were confident/very confident in their ability to engage in prevention behaviors (94%). Health problems were primarily infectious disease (70%), psychological distress (10%), and injuries (8%). When asked if prior travel destinations involved areas where malaria transmission occurs, 20% responded, "Don't know." Identified gaps in travel health knowledge and prevention behaviors may produce hazardous consequences when combined with low-perceived risk, reliance on travel guidebooks for health information, and high ratings for prevention self-efficacy. Future research is needed to test the effectiveness of educational interventions designed for student travelers who would benefit from guided practice with destination-specific risk appraisal and prevention planning. Web-based educational resources are a good fit for this population because they are easily updated, available in all phases of

Prevention of pressure sores by identifying patients at risk

DEFF Research Database (Denmark)

Andersen, Klaus Ejner; Jensen, O; Kvorning, S A

1982-01-01

The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical stu...... of pressure sores prevents their development.......The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical study...

Disclosure and rationality: comparative risk information and decision-making about prevention.

Science.gov (United States)

Schwartz, Peter H

2009-01-01

With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients "comparative risk information," such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the "personal risk"), the risk reduction the treatment provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine.

Fall risk and prevention agreement: engaging patients and families with a partnership for patient safety.

Science.gov (United States)

Vonnes, Cassandra; Wolf, Darcy

2017-01-01

Falls are multifactorial in medical oncology units and are potentiated by an older adult's response to anxiolytics, opiates and chemotherapy protocols. In addition, the oncology patient is at an increased risk for injury from a fall due to coagulopathy, thrombocytopenia and advanced age. At our National Cancer Institute-designated inpatient cancer treatment centre located in the southeastern USA, 40% of the total discharges are over the age of 65. As part of a comprehensive fall prevention programme, bimonthly individual fall reports have been presented with the Chief Nursing Officer (CNO), nursing directors, nurse managers, physical therapists and front-line providers in attendance. As a result of these case discussions, in some cases, safety recommendations have not been followed by patients and families and identified as an implication in individual falls. Impulsive behaviour was acknowledged only after a fall occurred. A medical oncology unit was targeted for this initiative due to a prolonged length of stay. This patient population receives chemotherapeutic interventions, management of oncological treatment consequences and cancer progression care. The aim of this project was to explore if initiation of a Fall Prevention Agreement between the nursing team and older adults being admitted to medical oncology units would reduce the incidence of falls and the incidence of falls with injury. In order to promote patient and family participation in the fall reduction and safety plan, the Fall Risk and Prevention Agreement was introduced upon admission. Using the Morse Fall Scoring system, patient's risk for fall was communicated on the Fall Risk and Prevention Agreement. Besides admission, patients were reassessed based on change of status, transfer or after a fall occurs. Fall and fall injuries rates were compared two-quarters prior to implementation of the fall agreement and eight-quarters post implementation. Falls and fall injuries on the medical oncology unit

Comprehensive sector-wide strategies to prevent and control obesity: what are the potential health and broader societal benefits? A case study from Australia.

Science.gov (United States)

Kite, James; Hector, Debra J; St George, Alexis; Pedisic, Zeljko; Phongsavan, Philayrath; Bauman, Adrian; Mitchell, Jo; Bellew, Bill

2015-09-30

Several countries have recently established multistakeholder strategies to prevent or control overweight and obesity; however, studies have not yet been done on their effectiveness and likely impact. This study's objectives were to (i) explore sector-wide benefits and impacts likely to accrue from implementing an obesity prevention strategy in the Australian state of New South Wales; (ii) discuss the wider implications of the findings for research and practice; and (iii) strengthen the case for sustained implementation of a comprehensive, intersectoral approach. A case study approach, including evidence reviews and illustrative epidemiological models, was used to show potential benefits from meeting selected targets and objectives specified in the strategy. For adults, improved health outcomes potentially include reductions in all-cause mortality, cardiovascular disease, type 2 diabetes, various cancers, osteoarthritis, infant mortality and healthcare costs. Potential benefits beyond the health sector involve disability payments, absenteeism, worker productivity, workplace injuries and insurance claims. For children and adolescents, improved health outcomes potentially include metabolic risk factors, dental health, prehypertension/hypertension, cardiovascular disease risk factors, depression, rates of mortality in hospitalised children, bullying and otitis media. Sector-wide health, social and economic benefits from successful implementation of multisector obesity prevention strategies are likely to be substantial if specified targets are achieved. Epidemiological modelling described in this paper for selected examples provides illustrative rather than comprehensive evidence for potential benefits. Process evaluation of the extent of implementation of these multisectoral strategies, together with the accumulated data on intervention effectiveness, will determine their potential population health benefit. Quantifying the health and social benefits that are likely to

Risk Factors for Gout and Prevention: A Systematic Review of the Literature

Science.gov (United States)

Singh, Jasvinder A.; Reddy, Supriya G.; Kundukulam, Joseph

2014-01-01

Purpose Our objective was to perform a systematic review of risk factors and prevention of gout. We searched Medline for fully published reports in English using keywords including but not limited to “gout”, “epidemiology”, “primary prevention”, “secondary prevention”, “risk factors’. Data from relevant articles meeting inclusion criteria was extracted using standardized forms. Main Findings Of the 751 titles and abstracts, 53 studies met the criteria and were included in the review. Several risk factors were studied. Alcohol consumption increased the risk of incident gout, especially beer and hard liquor. Several dietary factors increased the risk of incident gout, including meat intake, seafood intake, sugar sweetened soft drinks, and consumption of foods high in fructose. Diary intake, folate intake and coffee consumption were each associated with a lower risk of incident gout and in some cases a lower rate of gout flares. Thiazide and loop diuretics were associated with higher risk of incident gout and higher rate of gout flares. Hypertension, renal insufficiency, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, diabetes, obesity and early menopause were each associated with a higher risk of incident gout and/or gout flares. Summary Several dietary risk factors for incident gout and gout flares are modifiable. Prevention and optimal management of comorbidities is likely to decreased risk of gout. Research in preventive strategies for the treatment of gout is needed. PMID:21285714

Menopause and risk of diabetes in the Diabetes Prevention Program.

Science.gov (United States)

Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

2011-08-01

The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

Pediatric unintentional injury: behavioral risk factors and implications for prevention.

Science.gov (United States)

Schwebel, David C; Gaines, Joanna

2007-06-01

Unintentional injury is the leading cause of death for children and adolescents between the ages of 1 and 18 in the United States, accounting for more deaths than the next 20 causes of mortality combined. It is estimated that pediatric injury accounts for more than $50 billion in annual losses from medical care costs, future wages, and quality of life. Despite these numbers, much remains to be learned about the behavioral risks for pediatric unintentional injury. This article reviews behavioral risk factors for pediatric unintentional injury risk, with a particular focus on four broad areas. First, we discuss the effects of demographic risk factors, including gender, socioeconomic status, and ethnicity. Second, we present information about child-specific risk factors, including temperament, personality, psychopathology, and cognitive development. Third, we discuss the influence of parents and other primary caregivers on childhood injury risk, with a particular focus on the effects of supervision and parenting quality and style. Finally, we discuss the role of peers on child injury risk. We conclude with a discussion of the ways in which the material reviewed has been translated into injury prevention techniques, with a focus on how pediatricians might use knowledge about etiological risk to prioritize safety counseling topics. We also present thoughts on four priorities for future research: injury risk in diverse nations and cultures; developmental effects of injury; the influence of multiple risk factors together on injury risk; and translation of knowledge about risk for injury into intervention and prevention techniques.

Potential risk factors associated with risk for drop-out and relapse during and following withdrawal of opioid prescription medication.

Science.gov (United States)

Heiwe, Susanne; Lönnquist, Ingeborg; Källmén, Håkan

2011-10-01

Withdrawal of opioid medication in patients with chronic pain has a drop-out and relapse problem. To evaluate if depressive symptoms, anxiety and pain intensity are potential risk factors for drop-out or relapse during the withdrawal process. Further, to assess internal consistency of scales for assessment of these potential risk factors. Twenty-nine patients were included. After 2 years 28 of these were followed-up. Those with depressive symptoms at baseline had a significant risk for drop-out from the withdrawal program (odds ratio 1.37) and relapse into use of opioids at follow-up (odds ratio 1.44). Drop-outs rated depressive symptoms significantly higher before detoxification. Those who relapsed rated significantly higher for pain intensity, depressive symptoms and abstinence prior to withdrawal. All scales had high reliability. To avoid drop-out and relapse clinical practice need to screen for depressive symptoms, pain intensity, and abstinence. This article presents significant reliability of scales useful within dependency centers. They can be used to identify these risk factors for drop-out and relapse, respectively, when initiating the withdrawal process. Taking these risk factors into consideration could improve the outcome of the withdrawal process by preventing drop-out and relapse. Copyright © 2011 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

Setting the Threshold for Surgical Prevention in Women at Increased Risk of Ovarian Cancer.

Science.gov (United States)

Manchanda, Ranjit; Menon, Usha

2018-01-01

The number of ovarian cancer cases is predicted to rise by 14% in Europe and 55% worldwide over the next 2 decades. The current absence of a screening program, rising drug/treatment costs, and only marginal improvements in survival seen over the past 30 years suggest the need for maximizing primary surgical prevention to reduce the burden of ovarian cancer. Primary surgical prevention through risk-reducing salpingo-oophorectomy (RRSO) is well established as the most effective method for preventing ovarian cancer. In the UK, it has traditionally been offered to high-risk women (>10% lifetime risk of ovarian cancer) who have completed their family. The cost-effectiveness of RRSO in BRCA1/BRCA2 carriers older than 35 years is well established. Recently, RRSO has been shown to be cost-effective in postmenopausal women at lifetime ovarian cancer risks of 5% or greater and in premenopausal women at lifetime risks greater than 4%. The acceptability, uptake, and satisfaction with RRSO at these intermediate-risk levels remain to be established. Prospective outcome data on risk-reducing salpingectomy and delayed-oophorectomy for preventing ovarian cancer is lacking, and hence, this is best offered for primary prevention within the context and safe environment of a clinical trial. An estimated 63% of ovarian cancers occur in women with greater than 4% lifetime risk and 53% in those with 5% or greater lifetime-risk. Risk-reducing salpingo-oophorectomy can be offered for primary surgical prevention to women at intermediate risk levels (4%-5% to 10%). This includes unaffected women who have completed their family and have RAD51C, RAD51D, or BRIP1 gene mutations; first-degree relatives of women with invasive epithelial ovarian cancer; BRCA mutation-negative women from high-risk breast-and-ovarian cancer or ovarian-cancer-only families. In those with BRCA1, RAD51C/RAD51D/MMR mutations and the occasional families with a history of ovarian cancer in their 40s, surgery needs to be

Illness Among Paralympic Athletes: Epidemiology, Risk Markers, and Preventative Strategies.

Science.gov (United States)

Janse Van Rensburg, Dina Christina; Schwellnus, Martin; Derman, Wayne; Webborn, Nick

2018-05-01

Paralympic athletes have unique preexisting medical conditions that predispose them to increased risk of illness, but data are limited to studies conducted during the last 3 Paralympic Games. This article reviews the epidemiology of illness (risk, patterns, and predictors) in Paralympic athletes and provides practical guidelines for illness prevention. The incidence rate of illness (per 1000 athlete-days) in Paralympic athletes is high in Summer (10.0-13.2) and Winter (18.7) Paralympic Games. The authors propose general and specific guidelines on preventative strategies regarding illness in these athletes. Copyright © 2018 Elsevier Inc. All rights reserved.

Assessment of risk of potential exposures on facilities industries; Estimativa do risco de exposicao potencial em instalacoes industriais

Energy Technology Data Exchange (ETDEWEB)

Leocadio, Joao Carlos

2007-03-15

This work develops a model to evaluate potential exposures on open facilities of industrial radiography in Brazil. This model will decisively contribute to optimize operational, radiological protection and safety procedures, to prevent radiation accidents and to reduce human errors in industrial radiography. The probabilistic safety assessment (PSA) methodology was very useful to assess potential exposures. The open facilities of industrial radiography were identified as the scenario to be analyzed in what concerns the evaluation of potential exposures, due to their high accidents indices. The results of the assessment of potential exposures confirm that the industrial radiography in Brazil is a high-risk practice as classified by the IAEA. The risk of potential exposure was estimated to be 40,5 x 10{sup -2} per year in Brazil, having as main consequences injuries to the workers' hands and arms. In the world scene, the consequences are worst, leading to fatalities of people, thus emphasizing the high risk of industrial radiography. (author)

Assessment of risk of potential exposures on facilities industries; Estimativa do risco de exposicao potencial em instalacoes industriais

Energy Technology Data Exchange (ETDEWEB)

Leocadio, Joao Carlos

2007-03-15

This work develops a model to evaluate potential exposures on open facilities of industrial radiography in Brazil. This model will decisively contribute to optimize operational, radiological protection and safety procedures, to prevent radiation accidents and to reduce human errors in industrial radiography. The probabilistic safety assessment (PSA) methodology was very useful to assess potential exposures. The open facilities of industrial radiography were identified as the scenario to be analyzed in what concerns the evaluation of potential exposures, due to their high accidents indices. The results of the assessment of potential exposures confirm that the industrial radiography in Brazil is a high-risk practice as classified by the IAEA. The risk of potential exposure was estimated to be 40,5 x 10{sup -2} per year in Brazil, having as main consequences injuries to the workers' hands and arms. In the world scene, the consequences are worst, leading to fatalities of people, thus emphasizing the high risk of industrial radiography. (author)

Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

Science.gov (United States)

Tasanarong, Adis

2014-01-01

Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given. PMID:24895606

Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

Directory of Open Access Journals (Sweden)

Michele Andreucci

2014-01-01

Full Text Available Radiocontrast media (RCM are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN. We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given.

Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children.

Science.gov (United States)

Wu, Yelena P; Parsons, Bridget G; Mooney, Ryan; Aspinwall, Lisa G; Cloyes, Kristin; Hay, Jennifer L; Kohlmann, Wendy; Grossman, Douglas; Leachman, Sancy A

2018-04-06

Melanoma prevention is essential for children who are at elevated risk for the disease due to family history. However, children who carry a familial risk for the disease do not optimally adhere to recommended melanoma preventive behaviors. The current study sought to identify perceived barriers to and facilitators of children's engagement in melanoma preventive behaviors among children at elevated risk for melanoma due to family history of the disease (i.e., having a parent with a history of melanoma) from both parents' and childrens' perspectives. Qualitative methods were employed and consisted of separate focus group discussions with children (ages 8-17 years, n = 37) and their parents (n = 39). Focus group transcripts were coded using content analysis. Parents and children reported a number of barriers and facilitators, including on the individual (e.g., knowledge and awareness, preferences), social (e.g., peer influences, family modeling and communication), and contextual (e.g., healthcare provider communication) levels. The identified categories of barriers and facilitators both confirm and extend the literature documenting the reasons children who are at elevated risk for melanoma do not engage in melanoma prevention and control behaviors. Programs aiming to decrease melanoma risk among children of melanoma survivors could help families address their barriers to preventive behavior implementation and build on facilitators. Melanoma survivors and their children could benefit from support on their interactions with healthcare providers, schools, peers, and other caregivers about melanoma prevention.

Prevention of pressure sores by identifying patients at risk.

Science.gov (United States)

Andersen, K E; Jensen, O; Kvorning, S A; Bach, E

1982-01-01

The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical study. During seven months in 1977, 600 of 3571 patients were classified as at risk. Of these 35 (5.8%) developed sores compared with five (0.2%) of those not at risk. The results of this study compared with those over the same period in 1976 show that close observation of at-risk patients and early detection of pressure sores prevents their development. PMID:6803980

Primary prevention of food allergy in infants who are at risk

DEFF Research Database (Denmark)

Høst, Arne; Halken, Susanne

2005-01-01

on primary prevention of food allergy. RECENT FINDINGS: In prospective observational controlled studies of high quality of birth cohorts, exclusive breastfeeding for at least 4 months combined with introduction of solid foods after 4 months of age is associated with a reduced risk of food allergy and atopic......: Breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented hypoallergenic hydrolysed formula is recommended if exclusively breastfeeding is not possible for the first 4 months. As regards primary prevention of food allergy there is no evidence for preventive dietary intervention during......PURPOSE OF REVIEW: Allergic diseases represent a major burden of health problems in industrialized countries. Though several studies have focused on possible preventive measure and strategies much controversy still exists on this topic. The aim of this review is to discuss the recent literature...

Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

Science.gov (United States)

Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

2016-08-01

Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism. Copyright © 2016 Elsevier Ltd. All rights reserved.

Dutch monitor on stress and physical load: risk factors, consequences, and preventive action.

Science.gov (United States)

Houtman, I L; Goudswaard, A; Dhondt, S; van der Grinten, M P; Hildebrandt, V H; van der Poel, E G

1998-02-01

Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.

Impact of the new Sendai framework for disaster risk reduction on Paris flood prevention program

Directory of Open Access Journals (Sweden)

Thepot Regis

2016-01-01

Full Text Available The greater Paris region faces a significant risk of flooding due to potential spill-over from the Seine and the Marne. Because the last major flood occurred in 1910, the event has faded in the collective memory. Consequently, the population and the public authorities have difficulty imagining that such a catastrophe might repeat itself. In parallel, widespread urban expansion into flood zones has considerably aggravated the foreseeable damage if an event of a comparable intensity were to hit the region.In response to this situation, the EPTB Seine Grands Lacs – a public territorial basin establishment– decided to take action to reduce this risk.It began by commissioning a study from the OECD on flood risk prevention in the Seine Basin. This study was presented in January 2014 and highlighted the considerable risk of flooding in or near Paris, which could, affect a total of nearly 5 million people, cause up to €30 billion in direct damage and affect up to 400.000 jobs. It also put forward 14 recommendations that are being implemented by the public authorities, at either the national, basin or local level.The EPTB launched in partnership with the government a second initiative for which it steers and coordinates a coherent, balanced, relevant and gradual programme of 78 flood prevention actions. As a new post-2015 framework for disaster risk reduction was adopted in Sendai in March 2015 taking in account lessons learned during the 2005-2015 period, gaps identified and future challenges, this paper addresses the question of the impact of this new international framework on the implementation of the flood prevention of Paris region. One of the main points developed is the necessity to increase public awareness, to enhance disaster preparedness for effective response and to “build back better” in recovery rehabilitation and reconstruction.

Core Competencies and the Prevention of High-Risk Sexual Behavior

Science.gov (United States)

Charles, Vignetta Eugenia; Blum, Robert Wm.

2008-01-01

Adolescent sexual risk-taking behavior has numerous individual, family, community, and societal consequences. In an effort to contribute to the research and propose new directions, this chapter applies the core competencies framework to the prevention of high-risk sexual behavior. It describes the magnitude of the problem, summarizes explanatory…

Do screening-preventative interventions in asymptomatic pregnancies reduce the risk of preterm delivery--a critical appraisal of the literature.

Science.gov (United States)

Varma, Rajesh; Gupta, Janesh K; James, David K; Kilby, Mark D

2006-08-01

Recent research has suggested that women who experience preterm delivery (PTD) may be identified earlier in pregnancy and before onset of symptoms. Interventions commenced at this earlier asymptomatic stage may offer an opportunity to prevent PTD or lengthen gestation sufficiently to reduce adverse perinatal outcome. Our objective was to examine the evidence that supports or refutes this approach to preventing PTD. We therefore conducted a systematic search and critical appraisal of the identified literature. We found evidence that introducing screening-preventative strategies for asymptomatic pregnancies may reduce the rate of PTD. Evidence for screening and selective treatment exists for: asymptomatic bacteriuria; bacterial vaginosis in low-risk population groups; elective cervical cerclage in high-risk pregnancies; indicated cervical cerclage in women with short cervical length on ultrasound; prophylactic progesterone supplementation in high-risk pregnancies, and smoking cessation. However, for most other strategies, such as increased antenatal attendance, or routine administration of prophylactic micronutrients, the evidence is inconsistent and conflicting. Information on neonatal outcomes apart from PTD (such as serious neonatal morbidity and mortality) was found to be lacking in most studies. It was therefore not possible to establish whether preventing PTD or prolonging gestation would correlate to improved perinatal outcome, and this lessened the potential clinical usefulness of any proposed preventative strategy. No studies were found that evaluated the effectiveness of combining screening-preventative strategies. The review concludes with a suggested an antenatal management plan designed to prevent PTD based on current practice and the evidence presented in this article.

Risk scoring for the primary prevention of cardiovascular disease.

Science.gov (United States)

Karmali, Kunal N; Persell, Stephen D; Perel, Pablo; Lloyd-Jones, Donald M; Berendsen, Mark A; Huffman, Mark D

2017-03-14

The current paradigm for cardiovascular disease (CVD) emphasises absolute risk assessment to guide treatment decisions in primary prevention. Although the derivation and validation of multivariable risk assessment tools, or CVD risk scores, have attracted considerable attention, their effect on clinical outcomes is uncertain. To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (2016, Issue 2), MEDLINE Ovid (1946 to March week 1 2016), Embase (embase.com) (1974 to 15 March 2016), and Conference Proceedings Citation Index-Science (CPCI-S) (1990 to 15 March 2016). We imposed no language restrictions. We searched clinical trial registers in March 2016 and handsearched reference lists of primary studies to identify additional reports. We included randomised and quasi-randomised trials comparing the systematic provision of CVD risk scores by a clinician, healthcare professional, or healthcare system compared with usual care (i.e. no systematic provision of CVD risk scores) in adults without CVD. Three review authors independently selected studies, extracted data, and evaluated study quality. We used the Cochrane 'Risk of bias' tool to assess study limitations. The primary outcomes were: CVD events, change in CVD risk factor levels (total cholesterol, systolic blood pressure, and multivariable CVD risk), and adverse events. Secondary outcomes included: lipid-lowering and antihypertensive medication prescribing in higher-risk people. We calculated risk ratios (RR) for dichotomous data and mean differences (MD) or standardised mean differences (SMD) for continuous data using 95% confidence intervals. We used a fixed-effects model when heterogeneity (I²) was at least 50% and a random-effects model for substantial heterogeneity

Communication Technology Used among Parents and Their College Teens: Implications for College Health Promotion and Risk Prevention Programs

Science.gov (United States)

Abar, Caitlin C.; Abar, Beau; Turrisi, Robert; Belden, Calum

2013-01-01

The current study examined the nature of parent-teen communication in college to re-evaluate the potential for parent inclusion in college success and risk prevention programs. During September 2006, 290 first-year college students were assessed for the frequency and form (e.g., cell phone, e-mail, text) of communication with their parents. Latent…

In Their Own Words: Adolescents Strategies to Prevent Friend's Risk Taking

Science.gov (United States)

Buckley, Lisa; Chapman, Rebekah L.; Sheehan, Mary C.; Reveruzzi, Bianca N.

2014-01-01

Injury is a significant public health problem among youth. A primary cause of adolescent injury is risk-taking behavior, including alcohol use, interpersonal violence and road-related risks. A novel approach to prevention is building on friendships by encouraging adolescents to intervene into their friends' risk taking. Fifty-one early adolescents…

HIV risk and preventive interventions in transgender women sex workers

Science.gov (United States)

Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

2015-01-01

Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

Genetic Testing for Type 2 Diabetes in High-Risk Children: the Case for Primordial Prevention

Directory of Open Access Journals (Sweden)

Jennifer Wessel

2017-09-01

Full Text Available Extensive research now demonstrates that lifestyle modification can significantly lower risk of developing type 2 diabetes (T2D in high-risk adults. In children, the evidence for lifestyle modification is not as robust, but the rapidly rising rate of obesity in children coupled with the substantial difficulty in changing behaviors later in life illuminates the need to implement prevention efforts early in the life course of children. Genetic data can now be used early in the life course to identify children at high-risk of developing T2D before traditional clinical measures can detect the presence of prediabetes; a metabolic condition associated with obesity that significantly increases risk for developing T2D.  Such early detection of risk may enable the promotion of “primordial prevention” in which parents implement behavior change for their at risk children.  Young children with genetic risk are a novel target population.  Here we review the literature on genetic testing for prevention as it relates to chronic diseases and specifically use T2D as a model. We discuss the history of primordial prevention, the need for primordial prevention of T2D and the role genetic testing has in primordial prevention of high-risk families.

Knowledge of Risk Factors and Preventive Measures of ...

African Journals Online (AJOL)

The purpose of the study was to elicit the knowledge of risk factors and preventive measures of hypertension among Child Bearing Mothers (CBMs) in Udenu Local Government Area of Enugu State, Nigeria. The study adopted the descriptive research design. Specifically, three objectives with three corresponding research ...

Dosimetry on the radiological risks prevention in radiotherapy

International Nuclear Information System (INIS)

Fornet R, O. M.; Perez G, F.

2014-08-01

Dosimetry in its various forms plays a determining role on the radiological risks prevention in radiotherapy. To prove this in this paper is shown an analysis based on the risk matrix method, how the dosimetry can influence in each stages of a radiotherapy service; installation and acceptance, operation, maintenance and calibration. For each one of these stages the role that can play is analyzed as either the initiating event of a radiological accident or limiting barrier of these events of the dosimetric processes used for the individual dosimetry, the area monitoring, fixed or portable, for radiation beam dosimetry and of the patients for a radiotherapy service with cobalt-therapy equipment. The result of the study shows that the application of a prospective approach in the role evaluation of dosimetry in the prevention and mitigation of the consequences of a radiological accident in radiotherapy is crucial and should be subject to permanent evaluation at each development stage of these services. (author)

Indoor radon risk potential of Hawaii

International Nuclear Information System (INIS)

Reimer, G.M.; Szarzi, S.L.

2005-01-01

A comprehensive evaluation of radon risk potential in the State of Hawaii indicates that the potential for Hawaii is low. Using a combination of factors including geology, soils, source-rock type, soil-gas radon concentrations, and indoor measurements throughout the state, a general model was developed that permits prediction for various regions in Hawaii. For the nearly 3,100 counties in the coterminous U.S., National Uranium Resource Evaluation (NURE) aerorad data was the primary input factor. However, NURE aerorad data was not collected in Hawaii, therefore, this study used geology and soil type as the primary and secondary components of potential prediction. Although the radon potential of some Hawaiian soils suggests moderate risk, most houses are built above ground level and the radon soil potential is effectively decoupled from the house. Only underground facilities or those with closed or recirculating ventilation systems might have elevated radon potential. (author)

Risk and benefit associated with preventive mammography examinations

International Nuclear Information System (INIS)

Vladar, M.; Nikodemova, D.

1998-01-01

The risk of mammographic examination was estimated. It is concluded that a mean glandular dose (MGD) of 1 mGy per exposure can be associated with a risk of 1 radiation-induced carcinoma per less than 100 positive detected by the preventive examination. The variability of actual MGD at various hospitals can be quite large. Although the majority of measurements were made on phantoms it is assumed that the national MGD average will exceed 3 mGy for the average breast size of 55 mm

Decision making for breast cancer prevention among women at elevated risk.

Science.gov (United States)

Padamsee, Tasleem J; Wills, Celia E; Yee, Lisa D; Paskett, Electra D

2017-03-24

Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women. It also highlights important areas for future research, detailing the types of studies that are particularly needed in four key areas: documenting women's perspectives on their own perceptions of risk and prevention decisions; explicit comparisons of available prevention pathways and their likely health effects; the psychological, interpersonal, and social processes of prevention decision making; and the dynamics of subgroup variation. Ultimately, this research could support the development of interventions that more fully empower women to make informed and values-consistent decisions, and to move towards favorable health outcomes.

High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

Directory of Open Access Journals (Sweden)

Andrew T. Taylor

2011-01-01

Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

Potential contaminants in the food chain: identification, prevention and issue management.

Science.gov (United States)

Scanlan, Francis P

2007-01-01

Contaminants are a vast subject area of food safety and quality. They are generally divided into chemical, microbiological and physical classes and are present in our food chain from raw materials to finished products. They are the subject of international and national legislation that has widened to cover more and more contaminant classes and food categories. In addition, consumers have become increasingly aware of and alarmed by their risks, whether rightly or not. What is the food industry doing to ensure the safety and quality of the products we feed our children? This is a valid question which this article attempts to address from an industrial viewpoint. Chemical food safety is considered a complex field where the risk perception of consumers is often the highest. The effects of chronic or acute exposure to chemical carcinogens may cause disease conditions long after exposure that can be permanently debilitating or even fatal. It is also a moving target, as knowledge about the toxicity and occurrence data of new chemical contaminants continues to be generated. Their identification, prevention and management are challenges to the food industry as a whole. A reminder of the known chemical hazards in the food chain will be presented with an emphasis on the use of early warning to identify potential new contaminants. Early warning is also a means of prevention, anticipating food safety concerns before they become issues to manage. Current best management practices including Hazard Analysis and Critical Control Points relating to the supply chain of baby foods and infant formulae will be developed. Finally, key lessons from a case study on recent contamination issues in baby food products will be presented.

Pedestrian deaths in children--potential for prevention.

LENUS (Irish Health Repository)

Hamilton, K

2015-01-01

The National Paediatric Mortality Database was reviewed for the six year period 1st January 2006 to 31st December 2011 and all pedestrian deaths extracted, after review of available data the deaths were categorized as either traffic or non-traffic related. There were 45 child pedestrian fatalities in the period examined. Traffic related deaths accounted for 26 (58%) vs. 19 (42%) non-traffic related. Analysis of the deaths showed there was a male preponderance 28 (62%), weekend trend 22 (49%) with an evening 16 (35%) and summer peak 20 (44%). The highest proportion of deaths occurred in the 1-4 year age group 24 (53%), with 13 (28%) due to low speed vehicle rollovers, mainly occurring in residential driveways 8 (61%). Child pedestrian fatalities are highly preventable through the modification of risk factors including behavioural, social and environmental. Preventative action needs to be addressed, particularly in relation to non-traffic related deaths i.e, low speed vehicle rollovers.

Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines.

Science.gov (United States)

Frame, P S; Sawai, R; Bowen, W H; Meyerowitz, C

2000-02-01

The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling

Rape Prevention with College Men: Evaluating Risk Status

Science.gov (United States)

Stephens, Kari A.; George, William H.

2009-01-01

This study evaluates the effectiveness of a theoretically based rape prevention intervention with college men who were at high or low risk to perpetrate sexually coercive behavior. Participants (N = 146) are randomly assigned to the intervention or control group. Outcomes include rape myth acceptance, victim empathy, attraction to sexual…

Injury prevention risk communication: A mental models approach

DEFF Research Database (Denmark)

Austin, Laurel Cecelia; Fischhoff, Baruch

2012-01-01

fail to see risks, do not make use of available protective interventions or misjudge the effectiveness of protective measures. If these misunderstandings can be reduced through context-appropriate risk communications, then their improved mental models may help people to engage more effectively...... and create an expert model of the risk situation, interviewing lay people to elicit their comparable mental models, and developing and evaluating communication interventions designed to close the gaps between lay people and experts. This paper reviews the theory and method behind this research stream...... interventions on the most critical opportunities to reduce risks. That research often seeks to identify the ‘mental models’ that underlie individuals' interpretations of their circumstances and the outcomes of possible actions. In the context of injury prevention, a mental models approach would ask why people...

Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake.

Science.gov (United States)

Leaf, Alexander; Albert, Christine M; Josephson, Mark; Steinhaus, David; Kluger, Jeffrey; Kang, Jing X; Cox, Benjamin; Zhang, Hui; Schoenfeld, David

2005-11-01

The long-chain n-3 fatty acids in fish have been demonstrated to have antiarrhythmic properties in experimental models and to prevent sudden cardiac death in a randomized trial of post-myocardial infarction patients. Therefore, we hypothesized that these n-3 fatty acids might prevent potentially fatal ventricular arrhythmias in high-risk patients. Four hundred two patients with implanted cardioverter/defibrillators (ICDs) were randomly assigned to double-blind treatment with either a fish oil or an olive oil daily supplement for 12 months. The primary end point, time to first ICD event for ventricular tachycardia or fibrillation (VT or VF) confirmed by stored electrograms or death from any cause, was analyzed by intention to treat. Secondary analyses were performed for "probable" ventricular arrhythmias, "on-treatment" analyses for all subjects who had taken any of their oil supplements, and "on-treatment" analyses only of those subjects who were on treatment for at least 11 months. Compliance with double-blind treatment was similar in the 2 groups; however, the noncompliance rate was high (35% of all enrollees). In the primary analysis, assignment to treatment with the fish oil supplement showed a trend toward a prolonged time to the first ICD event (VT or VF) or of death from any cause (risk reduction of 28%; P=0.057). When therapies for probable episodes of VT or VF were included, the risk reduction became significant at 31%; P=0.033. For those who stayed on protocol for at least 11 months, the antiarrhythmic benefit of fish oil was improved for those with confirmed events (risk reduction of 38%; P=0.034). Although significance was not achieved for the primary end point, this study provides evidence that for individuals at high risk of fatal ventricular arrhythmias, regular daily ingestion of fish oil fatty acids may significantly reduce potentially fatal ventricular arrhythmias.

Identification of potentially hazardous human gene products in GMO risk assessment.

Science.gov (United States)

Bergmans, Hans; Logie, Colin; Van Maanen, Kees; Hermsen, Harm; Meredyth, Michelle; Van Der Vlugt, Cécile

2008-01-01

Genetically modified organisms (GMOs), e.g. viral vectors, could threaten the environment if by their release they spread hazardous gene products. Even in contained use, to prevent adverse consequences, viral vectors carrying genes from mammals or humans should be especially scrutinized as to whether gene products that they synthesize could be hazardous in their new context. Examples of such potentially hazardous gene products (PHGPs) are: protein toxins, products of dominant alleles that have a role in hereditary diseases, gene products and sequences involved in genome rearrangements, gene products involved in immunomodulation or with an endocrine function, gene products involved in apoptosis, activated proto-oncogenes. For contained use of a GMO that carries a construct encoding a PHGP, the precautionary principle dictates that safety measures should be applied on a "worst case" basis, until the risks of the specific case have been assessed. The potential hazard of cloned genes can be estimated before empirical data on the actual GMO become available. Preliminary data may be used to focus hazard identification and risk assessment. Both predictive and empirical data may also help to identify what further information is needed to assess the risk of the GMO. A two-step approach, whereby a PHGP is evaluated for its conceptual dangers, then checked by data bank searches, is delineated here.

HIV in Indian prisons: Risk behaviour, prevalence, prevention & treatment

OpenAIRE

Dolan, Kate; Larney, Sarah

2010-01-01

Background & Objectives: HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Methods: Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered...

Preventive fraction of physical fitness on risk factors in cardiac patients: Retrospective epidemiological study.

Science.gov (United States)

Caru, Maxime; Kern, Laurence; Bousquet, Marc; Curnier, Daniel

2018-04-26

To quantify the preventive fraction of physical fitness on the risk factors in patients with cardiovascular diseases (CVDs). A total of 249 subjects (205 men and 44 women) suffering from CVD were categorized into four groups, according to their percentage of physical fitness. We calculated the odds ratio to obtain the preventive fraction in order to evaluate the impact of the physical fitness level on the risk factors ( i.e ., abdominal obesity, depression, diabetes, dyslipidemia, hypertension, obesity, overweight and smoking). It is observed that a normal physical fitness level is sufficient to induce a preventive action on abdominal obesity (38%), diabetes (12%), hypertension (33%), obesity (12%) and overweight (11%). Also, the preventive fraction increases with the level of physical fitness, in particular for hypertension (36%) and overweight (16%). A high physical fitness level does not necessarily induce a preventive action in most risk factors, excluding depression. This is the first study which demonstrates that reaching a normal physical fitness level is enough to induce a protection for some risk factors, despite having a CVD.

[Individuals, structures, and risks: an overview of primary HIV prevention in Portugal].

Science.gov (United States)

Sacramento, Octávio

2016-06-20

This article debates the principal guidelines and procedures that shape HIV/AIDS prevention in Portugal, focusing on risk reduction in the two major scenarios for spread of the epidemic: sexuality and injection drug use. The analysis views the risks of infection as expressions of practices that are densely interwoven into social structures and cultural frameworks. Based on this conception, the article seeks to evaluate and understand the extent to which preventive strategies take a broad and integrative underlying approach by including individuals and their circumstances. Meanwhile, the study identifies some of the main structural constraints impeding the achievement of more favorable conditions for minimizing risks and adopting safe behaviors. These analytical exercises include not only policy and program guidelines, but also processes in daily reality, showing how the non-implementation of measures already guaranteed by law poses powerful structural barriers to HIV prevention.

Preventing mood and anxiety disorders in youth: a multi-centre RCT in the high risk offspring of depressed and anxious patients

Directory of Open Access Journals (Sweden)

Nauta Maaike H

2012-04-01

Full Text Available Abstract Background Anxiety and mood disorders are highly prevalent and pose a huge burden on patients. Their offspring is at increased risk of developing these disorders as well, indicating a clear need for prevention of psychopathology in this group. Given high comorbidity and non-specificity of intergenerational transmission of disorders, prevention programs should target both anxiety and depression. Further, while the indication for preventive interventions is often elevated symptoms, offspring with other high risk profiles may also benefit from resilience-based prevention programs. Method/design The current STERK-study (Screening and Training: Enhancing Resilience in Kids is a randomized controlled clinical trial combining selected and indicated prevention: it is targeted at both high risk individuals without symptoms and at those with subsyndromal symptoms. Individuals without symptoms meet two of three criteria of the High Risk Index (HRI; female gender, both parents affected, history of a parental suicide (attempt. This index was developed in an earlier study and corresponds with elevated risk in offspring of depressed patients. Children aged 8–17 years (n = 204 with subthreshold symptoms or meeting the criteria on the HRI are randomised to one of two treatment conditions, namely (a 10 weekly individual child CBT sessions and 2 parent sessions or (b minimal information. Assessments are held at pre-test, post-test and at 12 and 24 months follow-up. Primary outcome is the time to onset of a mood or anxiety disorder in the offspring. Secondary outcome measures include number of days with depression or anxiety, child and parent symptom levels, quality of life, and cost-effectiveness. Based on models of aetiology of mood and anxiety disorders as well as mechanisms of change during interventions, we selected potential mediators and moderators of treatment outcome, namely coping, parent–child interaction, self-associations, optimism

Back to Basics: Preventing Surgical Fires.

Science.gov (United States)

Spruce, Lisa

2016-09-01

When fires occur in the OR, they are devastating and potentially fatal to both patients and health care workers. Fires can be prevented by understanding the fire triangle and methods of reducing fire risk, conducting fire risk assessments, and knowing how to respond if a fire occurs. This Back to Basics article addresses the basics of fire prevention and the steps that can be taken to prevent fires from occurring. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Motorcycle crashes potentially preventable by three crash avoidance technologies on passenger vehicles.

Science.gov (United States)

Teoh, Eric R

2018-07-04

The objective of this study was to identify and quantify the motorcycle crash population that would be potential beneficiaries of 3 crash avoidance technologies recently available on passenger vehicles. Two-vehicle crashes between a motorcycle and a passenger vehicle that occurred in the United States during 2011-2015 were classified by type, with consideration of the functionality of 3 classes of passenger vehicle crash avoidance technologies: frontal crash prevention, lane maintenance, and blind spot detection. Results were expressed as the percentage of crashes potentially preventable by each type of technology, based on all known types of 2-vehicle crashes and based on all crashes involving motorcycles. Frontal crash prevention had the largest potential to prevent 2-vehicle motorcycle crashes with passenger vehicles. The 3 technologies in sum had the potential to prevent 10% of fatal 2-vehicle crashes and 23% of police-reported crashes. However, because 2-vehicle crashes with a passenger vehicle represent fewer than half of all motorcycle crashes, these technologies represent a potential to avoid 4% of all fatal motorcycle crashes and 10% of all police-reported motorcycle crashes. Refining the ability of passenger vehicle crash avoidance systems to detect motorcycles represents an opportunity to improve motorcycle safety. Expanding the capabilities of these technologies represents an even greater opportunity. However, even fully realizing these opportunities can affect only a minority of motorcycle crashes and does not change the need for other motorcycle safety countermeasures such as helmets, universal helmet laws, and antilock braking systems.

Physical activity in the prevention and rehabilitation of cardiovascular risk

Directory of Open Access Journals (Sweden)

Jovović Veselin

2015-01-01

Full Text Available Cardiovascular diseases (CVD are more widespread today, whereby they take dimensions of global epidemic. They are the leading cause of diseases in the world, of inability to work, of absenteeism and premature mortality up to 65 years of age. Modern lifestyle in which there is not enough physical activity is recognized as one of the major risk factors for health and emergence of CVD. Physical inactivity is responsible for poor health quality, unnecessary illnesses and premature death. The aim of this work is to point out the basic risk factors and importance and the role of physical exercise in the prevention and rehabilitation of CVD. In the analysis of the data, the methods of speculation and introspection are used. Numerous studies have shown that properly practiced physical activity is a powerful and beneficial effect in the prevention, treatment and rehabilitation of cardiovascular diseases (Scrutino et al. 2005; Secco et al. 2000; Jovović, 2008; Šuščević et al. 2011. Physical activity belongs to the concept of numerous factors, which along with the reduction of risk factors, lifestyle changes and medical therapy leads to the reduction of risk for cardiovascular diseases. To achieve the desired effect, a combination of aerobic, interval and isotonic muscle activity of moderate intensity at least four times a week for 45 minutes is recommended. During the secondary prevention and rehabilitation, physical activity adapts to health status, level of individual risk and the estimated functional abilities of patients. Transformational processes can only be achieved through regular exercise. The risk of emergence of complications during physical exercise is negligible, especially if the walking is practiced as a form of physical exercise.

Preventive maintenance - An important element in the `risk management` philosophy

Energy Technology Data Exchange (ETDEWEB)

Gullev, Lars [VEKS (Denmark)

1996-11-01

The contents of the paper is a presentation of the company VEKS with particular focus on the connection between preventive maintenance and the `Risk Management` philosophy. Implementation of Risk Management was preferred instead of an ISO-9000 certification of the company. The experience is that the responsibility in the organisation has been increased. (au)

Trauma center maturity measured by an analysis of preventable and potentially preventable deaths: there is always something to be learned….

Science.gov (United States)

Matsumoto, Shokei; Jung, Kyoungwon; Smith, Alan; Coimbra, Raul

2018-06-23

To establish the preventable and potentially preventable death rates in a mature trauma center and to identify the causes of death and highlight the lessons learned from these cases. We analyzed data from a Level-1 Trauma Center Registry, collected over a 15-year period. Data on demographics, timing of death, and potential errors were collected. Deaths were judged as preventable (PD), potentially preventable (PPD), or non-preventable (NPD), following a strict external peer-review process. During the 15-year period, there were 874 deaths, 15 (1.7%) and 6 (0.7%) of which were considered PPDs and PDs, respectively. Patients in the PD and PPD groups were not sicker and had less severe head injury than those in the NPD group. The time-death distribution differed according to preventability. We identified 21 errors in the PD and PPD groups, but only 61 (7.3%) errors in the NPD group (n = 853). Errors in judgement accounted for the majority and for 90.5% of the PD and PPD group errors. Although the numbers of PDs and PPDs were low, denoting maturity of our trauma center, there are important lessons to be learned about how errors in judgment led to deaths that could have been prevented.

Preventative Therapeutics: A Study of Risk and Prevention in Australian Mental Health

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Andrew McLachlan

2014-10-01

Full Text Available his study investigates the preventative therapeutics of two major Australian mental health organisations - beyondblue and The Black Dog Institute. The aim of this study is to examine how the resilience-based programs of both organisations reconfigure clinical and preventative expertise into new forms of ‘anticipatory action' (Anderson 2010. First, this article situates beyondblue and the Black Dog Institute within their historical contexts to consider how issues of risk and protection have become essential to mental health care today. Second, it examines the institutional practices of beyondblue and the Black Dog Institute and the role of clinical and preventative expertise as enacted forms of authority. Finally, this study investigates the intellectual and biokeeping technologies promoted through both organisations“ resilience-based pedagogies. The view taken in this study is that such technologies actively participate in the making of new therapeutic cultures and practices. Moreover, as biomarkers continue to act as indicators of future states of ‘unhealth' (Dumit 2012: 112, biokeeping technologies will continue to act as essential elements in the governmentality of mental health and wellbeing.

Personalized Genetic Risk Counseling to Motivate Diabetes Prevention: A randomized trial

OpenAIRE

Grant, Richard W.; O’Brien, Kelsey E.; Waxler, Jessica L.; Vassy, Jason L.; Delahanty, Linda M.; Bissett, Laurie G.; Green, Robert C.; Stember, Katherine G.; Guiducci, Candace; Park, Elyse R.; Florez, Jose C.; Meigs, James B.

2013-01-01

OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top an...

Using risk-informed asset management for feedwater system preventative maintenance optimization

International Nuclear Information System (INIS)

Kee, Ernest; Sun, Alice; Richards, Andrew; Grantom, Rick; Liming, James; Salter, James

2004-01-01

The initial development of a South Texas Project Nuclear Operating Company process for supporting preventative maintenance optimization by applying the Balance-Of-Plant model and Risk-Informed Asset Management alpha-level software applications is presented. Preventative maintenance activities are evaluated in the South Texas Project Risk-Informed Asset Management software while the plant maintains or improves upon high levels of nuclear safety. In the Balance-Of-Plant availability application, the level of detail in the feedwater system is enhanced to support plant decision-making at the component failure mode and human error mode level of indenture by elaborating on the current model at the super-component level of indenture. The enhanced model and modeling techniques are presented. Results of case studies in feedwater system preventative maintenance optimization sing plant-specific data are also presented. (author)

A questionnaire study of associations between potential risk factors and salmonella status in Swedish dairy herds.

Science.gov (United States)

Ågren, Estelle C C; Frössling, Jenny; Wahlström, Helene; Emanuelson, Ulf; Sternberg Lewerin, Susanna

2017-08-01

In this study associations between potential risk factors and salmonella status in Swedish dairy herds were investigated. A case-control study design was used, including existing as well as new cases. Herds were assigned a salmonella status on the basis of antibody analysis of bulk milk samples. Information on potential risk factors was collected from registry data and from farmers via a questionnaire. Univariable and multivariable logistic regression analyses were used to investigate associations between salmonella status and potential risk factors. In addition, multivariate analysis with Additive Bayesian Network (ABN) modelling was performed to improve understanding of the complex relationship between all the variables. Because of the difficulty in identifying associations between potential risk factors and infections with low prevalence and a large regional variation, exposure of potential risk factors in the high-prevalence region (Öland) were compared to exposure in other regions in Sweden. In total 483 of 996 (48%) farmers responded to the questionnaire, 69 herds had test-positive bulk milk samples. The strongest association with salmonella status was 'presence of salmonella test-positive herds pastures and providing protective clothing for visitors. The latter is probably a reflection of increased disease awareness in Öland. The ABN model showed associations between herd size and housing as well as several management procedures. This provides an explanation why herd size frequently has been identified as a risk factor for salmonella by other studies. The study confirms the importance of local transmission routes for salmonella, but does not identify specific components in this local spread. Therefore, it supports the use of a broad biosecurity approach in the prevention of salmonella. In Öland, some potential risk factors are more common than in other parts of Sweden. Theoretically these could contribute to the spread of salmonella, but this was not

Prevention of hepatocellular carcinoma: potential targets, experimental models, and clinical challenges

Science.gov (United States)

Hoshida, Yujin; Fuchs, Bryan C.; Tanabe, Kenneth K.

2013-01-01

Chronic fibrotic liver diseases such as viral hepatitis eventually develop liver cirrhosis, which causes occurrence of hepatocellular carcinoma (HCC). Given the limited therapeutic efficacy in advanced HCC, prevention of HCC development could be an effective strategy for improving patient prognosis. However, there is still no established therapy to meet the goal. Studies have elucidated a wide variety of molecular mechanisms and signaling pathways involved in HCC development. Genetically-engineered or chemically-treated experimental models of cirrhosis and HCC have been developed and shown their potential value in investigating molecular therapeutic targets and diagnostic biomarkers for HCC prevention. In this review, we overview potential targets of prevention and currently available experimental models, and discuss strategies to translate the findings into clinical practice. PMID:22873223

[Chronic migraine and work: occupational risks and prevention].

Science.gov (United States)

Vicente-Herrero, M T; Ramírez Iñiguez de la Torre, M V; Capdevila García, L M; López-González, Á A; Terradillos García, M J

2013-09-01

Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Risk assessment and cost-benefit techniques as management tools for oil spill prevention

International Nuclear Information System (INIS)

Diller, S.

1998-01-01

In the last 15 years, and especially after remarkable large technological accidents like Bhopal, San Juanico, Tacoa, Piper Alpha, Exxon Valdez, Sea Empress, etc, the risk assessment tools have become a must for design engineers and also have been growing popular since more reliable oil spill accident analysis data has been gathered in the last ten years. On the other hand the large investments that have been necessary to execute in order to adequate and improve old facilities, equipment, etc., and the total loss control enhancements in new projects, have created some concern on how safe is safe and how much money is it necessary to spend in order to be sufficiently preventative without getting into financial trouble and being technologically sound according to the growing global concern about environmental issues. Concepts are presented in risk prevention and oil spill risk assessment, and examples are developed in order to understand the link between different oil spill risk prevention options and the management finance decision making process. (author)

Risk prevention and management in cooperatives: An instrument to eliminate it or reduce it

Directory of Open Access Journals (Sweden)

María de Jesús Ribet-Cuadot

2015-06-01

Full Text Available The article exposes a methodological proposal that covers aspects to consider in the process of managing and preventing risks, which must be developed in any business or business association, for it constitutes an indispensable instrument for risk elimination or reduction that will further aid to achieve the desired goals.  This methodology comes from an investigation that had a precise question as starting point: How to contribute to the risk management and prevention in cooperatives? This was its fundamental problem. The idea comes, of course, from the sudden awakening and ever –growing use of this type of association in a difficult economical and financial context. Its general goal is to expose a methodology for risk management and prevention in cooperatives. The methodology has the necessary flexibility to be adjusted to the peculiarities of each cooperative. Its main advantage consists of assuring a systematic approach to management and prevention that begins with a diagnostic and later elaboration of a map of risks in each area, which will all ease into constant check up and reviewing. Furthermore, it allows to assess the positive impact regarding economics, society and ecology.

Cultural Effects on Cancer Prevention Behaviors: Fatalistic Cancer Beliefs and Risk Optimism Among Asians in Singapore.

Science.gov (United States)

Kim, Hye Kyung; Lwin, May O

2017-10-01

Although culture is acknowledged as an important factor that influences health, little is known about cultural differences pertaining to cancer-related beliefs and prevention behaviors. This study examines two culturally influenced beliefs-fatalistic beliefs about cancer prevention, and optimistic beliefs about cancer risk-to identify reasons for cultural disparity in the engagement of cancer prevention behaviors. We utilized data from national surveys of European Americans in the United States (Health Information National Trends Survey 4, Cycle3; N = 1,139) and Asians in Singapore (N = 1,200) to make cultural comparisons. The odds of an Asian adhering to prevention recommendations were less than half the odds of a European American, with the exception of smoking avoidance. Compared to European Americans, Asians were more optimistic about their cancer risk both in an absolute and a comparative sense, and held stronger fatalistic beliefs about cancer prevention. Mediation analyses revealed that fatalistic beliefs and absolute risk optimism among Asians partially explain their lower engagement in prevention behaviors, whereas comparative risk optimism increases their likelihood of adhering to prevention behaviors. Our findings underscore the need for developing culturally targeted interventions in communicating cancer causes and prevention.

Child maltreatment and risk patterns among participants in a child abuse prevention program.

Science.gov (United States)

Duffy, Jennifer Y; Hughes, Marcia; Asnes, Andrea G; Leventhal, John M

2015-06-01

The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR=6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR=8.47, 95% CI [2.96, 24.39]), paternal DV (OR=11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR=4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR=2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Risks, consequences, and prevention of falls of older people in oral healthcare centers.

Science.gov (United States)

de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

2017-03-01

One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Carbon nano-tubes - what risks, what prevention?

International Nuclear Information System (INIS)

Ricaud, Myriam; Lafon, Dominique; Roos, Frederique

2007-01-01

Carbon nano-tubes are arousing considerable interest in both the research world and industry because of their exceptional intrinsic properties and dimensional characteristics. Health risks of nano-tubes have been little studied, although the general public is already aware of their existence on account of their numerous promising applications. Existing, sometimes extremely brief, publications only reveal insufficient data for assessing risks sustained due to carbon nano-tube exposure. Yet, the great interest aroused by these new chemicals would indicate strongly that the number of exposed workers will increase over the coming years. It therefore appears essential to review not only the characteristics and applications of carbon nano-tubes, but also the prevention means to be implemented during their handling. We recommend application of the principle of precaution and measures to keep the exposure level as low as possible until the significance of occupational exposure and the corresponding human health risks are better known and have been assessed. (authors)

Finding the High-Risk Patient in Primary Prevention Is Not as Easy as a Conventional Risk Score!

Science.gov (United States)

Ambrose, John A; Acharya, Tushar; Roberts, Micah J

2016-12-01

Patients with coronary artery disease or its equivalent are an appropriate target for guideline-directed therapy. However, finding and treating the individuals at risk for myocardial infarction or sudden death in primary prevention has been problematic. Most initial cardiovascular events are acute syndromes, and only a minority of these occurs in those deemed high risk by contemporary algorithms. Even newer noninvasive modalities cannot detect a majority of those at risk. Furthermore, accurate and early detection of high risk/vulnerability does not guarantee event prevention. Until new tools can be identified, one should consider a few simplistic solutions. In addition to a greater emphasis on lifestyle, earlier use of statins than currently recommended and a direct assault on tobacco could go a long way in reducing acute syndromes and cardiovascular mortality. To achieve the tobacco goal, the medical community would have to be directly and communally engaged. Copyright © 2016 Elsevier Inc. All rights reserved.

Medication Errors: New EU Good Practice Guide on Risk Minimisation and Error Prevention.

Science.gov (United States)

Goedecke, Thomas; Ord, Kathryn; Newbould, Victoria; Brosch, Sabine; Arlett, Peter

2016-06-01

A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. Reducing the risk of medication errors is a shared responsibility between patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. In 2015, the EU regulatory network released a two-part good practice guide on medication errors to support both the pharmaceutical industry and regulators in the implementation of the changes introduced with the EU pharmacovigilance legislation. These changes included a modification of the 'adverse reaction' definition to include events associated with medication errors, and the requirement for national competent authorities responsible for pharmacovigilance in EU Member States to collaborate and exchange information on medication errors resulting in harm with national patient safety organisations. To facilitate reporting and learning from medication errors, a clear distinction has been made in the guidance between medication errors resulting in adverse reactions, medication errors without harm, intercepted medication errors and potential errors. This distinction is supported by an enhanced MedDRA(®) terminology that allows for coding all stages of the medication use process where the error occurred in addition to any clinical consequences. To better understand the causes and contributing factors, individual case safety reports involving an error should be followed-up with the primary reporter to gather information relevant for the conduct of root cause analysis where this may be appropriate. Such reports should also be summarised in periodic safety update reports and addressed in risk management plans. Any risk minimisation and prevention strategy for medication errors should consider all stages of a medicinal product's life-cycle, particularly the main sources and types of medication errors during product development. This article

Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians – A population with the highest risk of premature coronary artery disease & diabetes

Science.gov (United States)

Enas, Enas A.; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C.S.; Mohan, Viswanathan

2013-01-01

Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians. PMID:24434254

Pencegahan primer pada anak yang berisiko karies tinggi (Primary prevention in children with high caries risk

Directory of Open Access Journals (Sweden)

Ami Angela

2005-09-01

Full Text Available Oral and dental health has got improvement tremendously over the last century but the prevalence of dental caries in children has remained a significant clinical problem. Caries risk varies between individuals according to each subject’s balance between factors exposing to and protecting from caries attack. It is important to assess the risk of caries for all patients on a routine basis. Caries risk is divided into three levels: high, moderate, and low. Thereby, the dental professional is better to make a specific prevention and treatment recommendations to reduce a child risk and improve overall oral health. The goal of caries-risk assessment and preventive treatment is to eliminate caries or at least to reduce the high-caries occurrence down to the level of the remaining part of the age group. Preventive treatment is divided into three parts: primary, secondary, and tertiary prevention. This paper describes the primary prevention in children with high caries risk by behavior modification and tooth protection. Behavior modification is about dental health education, oral hygiene, diet and sugar consumption, sugar-free chewing gum and sugar-free medicines. Tooth protection is about sealant, usage of flouride and chlorhexidine.

Parents' perceptions on offspring risk and prevention of anxiety and depression: a qualitative study.

Science.gov (United States)

Festen, Helma; Schipper, Karen; de Vries, Sybolt O; Reichart, Catrien G; Abma, Tineke A; Nauta, Maaike H

2014-01-01

Offspring of patients with anxiety or depression are at high risk for developing anxiety or depression. Despite the positive findings regarding effectiveness of prevention programs, recruitment for prevention activities and trials is notoriously difficult. Our randomized controlled prevention trial was terminated due to lack of patient inclusion. Research on mentally-ill parents' perceptions of offspring's risk and need for preventive intervention may shed light on this issue, and may enhance family participation in prevention activities and trials. Qualitative data were collected through semi-structured interviews with 24 parents (patients with anxiety or depression, or their partners). An inductive content analysis of the data was performed. Five research questions were investigated regarding parents' perceptions of anxiety, depression, and offspring risk; anxiety, depression, and parenting; the need for offspring intervention and prevention; and barriers to and experiences with participation in preventive research. Parental perceptions of the impact of parental anxiety and depression on offspring greatly differed. Parents articulated concerns about children's symptomatology, however, most parents did not perceive a direct link between parent symptoms and offspring quality of life. They experienced an influence of parental symptoms on family quality of life, but chose not to discuss that with their children in order to protect them. Parents were not well aware of the possibilities regarding professional help for offspring and preferred parent-focused rather than offspring-focused interventions such as parent psycho-education. Important barriers to participation in preventive research included parental overburden, shame and stigma, and perceived lack of necessity for intervention. This study highlights the importance of educating parents in adult health care. Providing psycho-education regarding offspring risk, communication in the family, and parenting in order

RISK LEVEL ANALYSIS ON THE PREVENTIVE EROSION CAPACITY OF BRIDGES

Institute of Scientific and Technical Information of China (English)

无

2002-01-01

Deficiency of the Preventive Erosion Capacity (PEC) of a bridge pier is the main factor leading to bridge failures. In this paper, the PEC of bridge piers was analyzed using the stochastic analysis method. The definitions of the reliability and risk level of a bridge pier subjected to water erosion were proposed and a computational model for erosion depth and risk level in was suggested.

The Role of Mental Health Disease in Potentially Preventable Hospitalizations: Findings From a Large State.

Science.gov (United States)

Medford-Davis, Laura N; Shah, Rohan; Kennedy, Danielle; Becker, Emilie

2018-01-01

Preventable hospitalizations are markers of potentially low-value care. Addressing the problem requires understanding their contributing factors. The objective of this study is to determine the correlation between specific mental health diseases and each potentially preventable hospitalization as defined by the Agency for Healthcare Research and Quality. The Texas Inpatient Public Use Data File, an administrative database of all Texas hospital admissions, identified 7,351,476 adult acute care hospitalizations between 2005 and 2008. A hierarchical multivariable logistic regression model clustered by admitting hospital adjusted for patient and hospital factors and admission date. A total of 945,280 (12.9%) hospitalizations were potentially preventable, generating $6.3 billion in charges and 1.2 million hospital days per year. Mental health diseases [odds ratio (OR), 1.25; 95% confidence interval (CI), 1.22-1.27] and substance use disorders (OR, 1.13; 95% CI, 1.12-1.13) both increased odds that a hospitalization was potentially preventable. However, each mental health disease varied from increasing or decreasing the odds of potentially preventable hospitalization depending on which of the 12 preventable hospitalization diagnoses were examined. Older age (OR, 3.69; 95% CI, 3.66-3.72 for age above 75 years compared with 18-44 y), black race (OR 1.44; 95% CI, 1.43-1.45 compared to white), being uninsured (OR 1.52; 95% CI, 1.51-1.54) or dual-eligible for both Medicare and Medicaid (OR, 1.23; 95% CI, 1.22-1.24) compared with privately insured, and living in a low-income area (OR, 1.20; 95% CI, 1.17-1.23 for lowest income quartile compared with highest) were other patient factors associated with potentially preventable hospitalizations. Better coordination of preventative care for mental health disease may decrease potentially preventable hospitalizations.

Prevention messages and AIDS risk behavior in Kampala, Uganda.

Science.gov (United States)

Hearst, Norman; Kajubi, Phoebe; Hudes, Esther Sid; Maganda, Albert K; Green, Edward C

2012-01-01

Uganda was one of the first countries to substantially reduce HIV rates through behavior change, but these gains have not continued in recent years. Little is known about what messages Ugandans are currently hearing about AIDS prevention, what they themselves believe to be important prevention strategies, and how these beliefs are associated with behavior. We interviewed men and women aged between 20 and 39 in two poor peri-urban areas of Kampala, using a random sample, cross-sectional household survey design. Respondents provided detailed reports of sexual behavior over the past six months, the main prevention message they are currently hearing about AIDS, and their own ranking of the importance of prevention strategies. Condom use was the main AIDS prevention message that respondents reported hearing, followed by getting tested. These were also what respondents themselves considered most important, followed closely by faithfulness. Abstinence was the lowest ranked strategy, but a higher ranking for this prevention strategy was the only one consistently associated with less risky behavior. A higher ranking for condoms was associated with higher levels of risk behavior, while the ranking of testing made no difference in any behavior. These results present challenges for AIDS prevention strategies that rely primarily on promoting condoms and testing. HIV prevention programs need to assess their impact on behavior.

Clinician-patient risk discussion for atherosclerotic cardiovascular disease prevention: importance to implementation of the 2013 ACC/AHA Guidelines.

Science.gov (United States)

Martin, Seth S; Sperling, Laurence S; Blaha, Michael J; Wilson, Peter W F; Gluckman, Ty J; Blumenthal, Roger S; Stone, Neil J

2015-04-07

Successful implementation of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines hinges on a clear understanding of the clinician-patient risk discussion (CPRD). This is a dialogue between the clinician and patient about potential for atherosclerotic cardiovascular disease risk reduction benefits, adverse effects, drug-drug interactions, and patient preferences. Designed especially for primary prevention patients, this process of shared decision making establishes the appropriateness of a statin for a specific patient. CPRD respects the autonomy of an individual striving to make an informed choice aligned with personal values and preferences. Dedicating sufficient time to high-quality CPRD offers an opportunity to strengthen clinician-patient relationships, patient engagement, and medication adherence. We review the guideline-recommended CPRD, the general concept of shared decision making and decision aids, the American College of Cardiology/American Heart Association Risk Estimator application as an implementation tool, and address potential barriers to implementation. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The roles of exercise and fall risk reduction in the prevention of osteoporosis.

Science.gov (United States)

Henderson, N K; White, C P; Eisman, J A

1998-06-01

In summary, the optimal model for the prevention of osteoporotic fractures includes maximization and maintenance of bone strength and minimization of trauma. Numerous determinants of each have been identified, but further work to develop preventative strategies based on these determinants remains to be undertaken. Physical activity is a determinant of peak BMD. There also is evidence that activity during growth modulates the external geometry and trabecular architecture, potentially enhancing skeletal strength, while during the adult years activity may reduce age-related bone loss. The magnitude of the effect of a 7% to 8% increase in peak BMD, if maintained through the adult years, could translate to a 1.5-fold reduction in fracture risk. Moreover, in the older population, appropriate forms of exercise could reduce the risk of falling and, thus, further reduce fracture risk. These data must be considered as preliminary in view of the paucity of long-term fracture outcome data from randomized clinical trials. However, current information suggests that the optimal form of exercise to achieve these objectives may vary through life. Vigorous physical activity (including weight-bearing, resistance, and impact components) during childhood may maximize peak BMD. This type of activity seems optimal through the young adult years, but as inevitable age-related degeneration occurs, activity modification to limit the impact component of exercise may become necessary. In the elderly, progressive strength training has been demonstrated to be a safe and effective form of exercise that reduces risk factors for falling and may also enhance BMD. In the frail elderly, activity to improve balance and confidence also may be valuable. Group activities such as Tai Chi may be cost-effective. Precise prescriptions must await the outcome of well-designed, controlled longitudinal studies that include fracture as an outcome. However, increased physical activity seems to be a sensible

Satisfying Product Features of a Fall Prevention Smartphone App and Potential Users’ Willingness to Pay: Web-Based Survey Among Older Adults

Science.gov (United States)

Mertens, Alexander; Brandl, Christopher; Liu, Shan; Buecking, Benjamin; Bliemel, Christopher; Horst, Klemens; Weber, Christian David; Lichte, Philipp; Knobe, Matthias

2018-01-01

Background Prohibiting falls and fall-related injuries is a major challenge for health care systems worldwide, as a substantial proportion of falls occur in older adults who are previously known to be either frail or at high risk for falls. Hence, preventive measures are needed to educate and minimize the risk for falls rather than just minimize older adults’ fall risk. Health apps have the potential to address this problem, as they enable users to self-assess their individual fall risk. Objective The objective of this study was to identify product features of a fall prevention smartphone app, which increase or decrease users’ satisfaction. In addition, willingness to pay (WTP) was assessed to explore how much revenue such an app could generate. Methods A total of 96 participants completed an open self-selected Web-based survey. Participants answered various questions regarding health status, subjective and objective fall risk, and technical readiness. Seventeen predefined product features of a fall prevention smartphone app were evaluated twice: first, according to a functional (product feature is implemented in the app), and subsequently by a dysfunctional (product feature is not implemented in the app) question. On the basis of the combination of answers from these 2 questions, the product feature was assigned to a certain category (must-be, attractive, one-dimensional, indifferent, or questionable product feature). This method is widely used in user-oriented product development and captures users’ expectations of a product and how their satisfaction is influenced by the availability of individual product features. Results Five product features were identified to increase users’ acceptance, including (1) a checklist of typical tripping hazards, (2) an emergency guideline in case of a fall, (3) description of exercises and integrated workout plans that decrease the risk of falling, (4) inclusion of a continuous workout program, and (5) cost coverage by

The Neighborhood Environment: Perceived Fall Risk, Resources, and Strategies for Fall Prevention.

Science.gov (United States)

Chippendale, Tracy; Boltz, Marie

2015-08-01

To explore the experience of older adults in their neighborhood in relation to perceived fall risk, fear of falling (FOF), and resources/strategies for fall prevention. Fourteen older adults, 65 years of age and older from 3 urban senior centers, participated in this qualitative study. The semistructured interview guidelines and background questionnaire were developed by the researchers based on the literature and an existing measure of walkability. Both tools were refined based on pilot interviews with seniors. Collaizzi's phenomenological method was used for data analysis. Five themes emerged from the data: (a) The built environment contributes to perceived fall risk and FOF, (b) personal strategies used to adapt to perceived neighborhood fall risks-behavioral approaches, (c) resources for physical activity and safety, (d) barriers to physical activity and exercise, and (e) neighborhood features as a motivator. Urban-dwelling seniors perceive that neighborhood features contribute to or mitigate fall risk and FOF. Behavioral strategies are used by seniors to prevent outdoor falls. The findings can help clinicians develop targeted fall prevention interventions for well elders and help urban planners to design and retrofit urban environments to reduce fall risk. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease

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Tuso, Phillip

2014-01-01

More than 100 million Americans have prediabetes or diabetes. Prediabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes. People with prediabetes have an increased risk of Type 2 diabetes. An estimated 34% of adults have prediabetes. Prediabetes is now recognized as a reversible condition that increases an individual’s risk for development of diabetes. Lifestyle risk factors for prediabetes include overweight and physical inactivity. Increasing awareness and risk stratification of individuals with prediabetes may help physicians understand potential interventions that may help decrease the percentage of patients in their panels in whom diabetes develops. If untreated, 37% of the individuals with prediabetes may have diabetes in 4 years. Lifestyle intervention may decrease the percentage of prediabetic patients in whom diabetes develops to 20%. Long-term data also suggest that lifestyle intervention may decrease the risk of prediabetes progressing to diabetes for as long as 10 years. To prevent 1 case of diabetes during a 3-year period, 6.9 persons would have to participate in the lifestyle intervention program. In addition, recent data suggest that the difference in direct and indirect costs to care for a patient with prediabetes vs a patient with diabetes may be as much as $7000 per year. Investment in a diabetes prevention program now may have a substantial return on investment in the future and help prevent a preventable disease. PMID:25102521

Risk factors and effectiveness of preventive measures against influenza in the community

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Castilla, Jesús; Godoy, Pere; Domínguez, Ángela; Martín, Vicente; Delgado‐Rodríguez, Miguel; Martínez‐Baz, Iván; Baricot, Maretva; Soldevila, Nuria; Mayoral, José M.; Astray, Jenaro; Quintana, José M.; Cantón, Rafael; Castro, Ady; González‐Candelas, Fernando; Alonso, Jordi; Saez, Marc; Tamames, Sonia; Pumarola, Tomás

2012-01-01

Please cite this paper as: Castilla et al. (2013) Risk factors and effectiveness of preventive measures against influenza in the community. Influenza and Other Respiratory Viruses 7(2) 177–183. Background  The role of different risk exposures and preventive measures against influenza has not been well established. Objective  The aim of this study was to evaluate risk factors and measures to prevent influenza infection in the community. Methods  We conducted a multicenter case–control study. Cases were 481 outpatients aged 18 years or older with laboratory‐confirmed influenza A(H1N1)09 in the 2009–2010 season in Spain. A control was selected for each case from outpatients from the same area matched by age and date of consultation. Information on risk situations, preventive measures and other variables was obtained by interview and review of the medical record. Results  In the multivariate conditional logistic regression analysis, the risk of a diagnosis of influenza increased with the number of cohabitants (compared with <3 cohabitants, three cohabitants had an OR = 1·80, 95% CI 1·12–2·89, and ≥5 cohabitants had an OR = 2·66, 95% CI 1·31–5·41) and for health care workers (OR = 2·94, 95% CI 1·53–5·66). The use of metropolitan public transport was associated with a lower frequency of a diagnosis of influenza (OR = 0·45, 95% CI 0·30–0·68) but not the use of taxis or long‐distance transport. The influenza A(H1N1)09 vaccine had a protective effect (OR = 0·13, 95% CI 0·04–0·48), unlike hand washing after touching contaminated surfaces or the use of alcohol‐based hand sanitizers. Conclusion  The home environment appears to play an important role in the spread of influenza in adults, but not the use of public transport. Health care workers have a higher risk of contracting influenza. Vaccination was the most effective preventive measure. PMID:22458533

Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review

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Suzanne A Ligthart

2010-08-01

Full Text Available Suzanne A Ligthart1, Eric P Moll van Charante1, Willem A Van Gool2, Edo Richard21Department of General Practice, 2Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsBackground: Over the last decade, evidence has accumulated that vascular risk factors increase the risk of Alzheimer disease (AD. So far, few randomized controlled trials have focused on lowering the vascular risk profile to prevent or postpone cognitive decline or dementia.Objective: To systematically perform a review of randomized controlled trials (RCTs evaluating drug treatment effects for cardiovascular risk factors on the incidence of dementia or cognitive decline.Selection criteria: RCTs studying the effect of treating hypertension, dyslipidemia, ­hyperhomocysteinemia, obesity, or diabetes mellitus (DM on cognitive decline or dementia, with a minimum follow-up of 1 year in elderly populations.Outcome measure: Cognitive decline or incident dementia.Main results: In the identified studies, dementia was never the primary outcome. Statins (2 studies and intensified control of type II DM (1 study appear to have no effect on prevention of cognitive decline. Studies on treatment of obesity are lacking, and the results of lowering homocysteine (6 studies are inconclusive. There is some evidence of a preventive effect of antihypertensive medication (6 studies, but results are inconsistent.Conclusion: The evidence of a preventive treatment effect aimed at vascular risk factors on cognitive decline and dementia in later life is scarce and mostly based on secondary outcome parameters. Several important sources of bias such as differential dropout may importantly affect interpretation of trial results.Keywords: cardiovascular risk factors, cognitive decline, dementia, prevention

Proactive prevention in occupational safety and health: how to identify tomorrow's prevention priorities and preventive measures.

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Hauke, Angelika; Flaspöler, Eva; Reinert, Dietmar

2018-04-17

Global trends such as digitalisation, globalisation and demographic change are changing workplaces, and accordingly occupational safety and health (OSH) needs. To better prepare for the future and to foster proactive prevention, the German Social Accident Insurance (DGUV) established an OSH risk observatory (RO OSH). The RO OSH relies on an online survey and calls upon the expertise of labour inspectors. 398 labour inspectors participated in the first RO OSH enquiry. They rated developments with regard to their sector-specific relevance for OSH in the near future. The RO OSH also provides ideas for preventive measures that can be implemented by the German Social Accident Insurance Institutions. Work intensity, demographic aspects, and digitalisation play a major role for most or all sectors. However, familiar OSH issues such as musculoskeletal strain and noise also continue to be of major importance and require further consideration and specific solutions in prevention. For the DGUV, training and consulting bear great potential for proactive prevention in the above priority areas, e.g. by fostering a prevention culture and supporting companies in (psychosocial) risk assessment (also for mobile work). For instance, concepts for increasing physical activity at sedentary workplaces, and data security require continued research.

Mosquito-borne illnesses in travelers: a review of risk and prevention.

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Mirzaian, Edith; Durham, Melissa J; Hess, Karl; Goad, Jeffery A

2010-10-01

In 2008, residents of the United States made 12 million visits to developing countries in Asia, South America, Central America, Oceania, the Middle East, and Africa. Due to the presence of Anopheles, Aedes, and Culex mosquitoes, travel to these destinations poses a risk for diseases such as malaria, yellow fever, and Japanese encephalitis that cause significant morbidity and mortality. To gain a better understanding of the major emerging and established travel-related infectious diseases transmitted principally by mosquitoes and the measures for their prevention in U.S. residents who travel to these developing countries, we performed a literature search of the PubMed and MEDLINE databases (January 1950-February 2010). Information from the Centers for Disease Control and Prevention and the World Health Organization and relevant references from the publications identified were also reviewed. Vaccines for the prevention of Japanese encephalitis and yellow fever are commercially available to U.S. travelers and should be administered when indicated. However, the prevention of malaria, dengue fever, chikungunya, and West Nile virus relies on personal insect protection measures and chemoprophylaxis for malaria. As the rate of international travel continues to rise, individuals traveling overseas should be made aware of the risk of various infectious diseases and the importance of prevention. Physicians, pharmacists, nurses, and other practitioners can play a vital role in disease education and prevention, including the administration of vaccines and provision of chemoprophylactic drugs.

Predicting Cancer-Prevention Behavior: Disentangling the Effects of Risk Aversion and Risk Perceptions.

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Riddel, Mary; Hales, David

2018-05-16

Experimental and survey research spanning the last two decades concludes that people who are more risk tolerant are more likely to engage in risky health activities such as smoking and heavy alcohol consumption, and are more likely to be obese. Subjective perceptions of the risk associated with different activities have also been found to be associated with health behaviors. While there are numerous studies that link risk perceptions with risky behavior, it is notable that none of these controls for risk aversion. Similarly, studies that control for risk aversion fail to control for risk misperceptions. We use a survey of 474 men and women to investigate the influence of risk aversion, risk misperceptions, and cognitive ability on the choice to engage in behaviors that either increase or mitigate cancer risk. We measure optimism in two dimensions: baseline optimists are those who inaccurately believe their cancer risk to be below its expert-assessed level, while control optimists are those who believe they can reduce their risk of cancer (by changing their lifestyle choices) to a greater extent than is actually the case. Our results indicate that baseline optimism is significantly and negatively correlated with subjects' tendencies to engage in cancer-risk-reducing behaviors, and positively correlated with risky behaviors. Subjects' control misperceptions also appear to play a role in their tendency to engage in risky and prevention behaviors. When controlling for both of these types of risk misperception, risk aversion plays a much smaller role in determining health behaviors than found in past studies. © 2018 Society for Risk Analysis.

Primary Prevention of Food Allergy.

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Greenhawt, Matthew J; Fleischer, David M

2017-04-01

Food allergy is estimated to affect approximately 8% of children in the USA. This is a disease without any known treatment or cure and, for some, a disease that can be quite severe, even life-threatening. While recent advances in potential treatment have made remarkable strides, with two food-targeted immunotherapy products now in phase III trials, perhaps the biggest gains in the field have come in the advent of potential preventative strategies to avoid the development of food allergy in high-risk individuals. There have been multiple, randomized, controlled trials (RCTs) performed in the past 5 years that have demonstrated significant risk reduction from early allergen introduction. These include two trials for early peanut introduction and five trials for early egg introduction in the first year of life. The results indicate that primary prevention of food allergy through early allergen introduction may represent a strategy that could potentially avert tens of thousands of children from becoming food allergic. In support of the data for peanut, the National Institute of Allergy and Infectious Diseases recently sponsored an addendum to the 2010 food allergy guidelines, specifically recommending peanut be introduced in both high- and standard-risk infants to reduce the risk of developing peanut allergy. To date, no formal recommendations have been made for egg, however. This review will focus on the latest evidence supporting early introduction as a strategy to prevent food allergy, as well as on practical aspects for its successful implementation.

75 FR 40845 - Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at Structure Fires

Science.gov (United States)

2010-07-14

... NIOSH 141-A] Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... publication entitled ``Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... fires in unoccupied structures to using established risk management principles at all structure fires...

Postoperative persistent chronic pain: what do we know about prevention, risk factors, and treatment

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Durval Campos Kraychete

Full Text Available Abstract Background and objectives: Postoperative persistent chronic pain (POCP is a serious health problem, disabling, undermining the quality of life of affected patients. Although more studies and research have addressed the possible mechanisms of the evolution from acute pain to chronic postoperatively, there are still no consistent data about the risk factors and prevention. This article aims to bring what is in the panorama of the current literature available. Content: This review describes the definition, risk factors, and mechanisms of POCD, its prevention and treatment. The main drugs and techniques are exposed comprehensively. Conclusion: Postoperative persistent chronic pain is a complex and still unclear etiology entity, which interferes heavily in the life of the subject. Neuropathic pain resulting from surgical trauma is still the most common expression of this entity. Techniques to prevent nerve injury are recommended and should be used whenever possible. Despite efforts to understand and select risk patients, the management and prevention of this syndrome remain challenging and inappropriate.

Mitigating construction safety risks using prevention through design.

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Gangolells, Marta; Casals, Miquel; Forcada, Núria; Roca, Xavier; Fuertes, Alba

2010-04-01

Research and practice have demonstrated that decisions made prior to work at construction sites can influence construction worker safety. However, it has also been argued that most architects and design engineers possess neither the knowledge of construction safety nor the knowledge of construction processes necessary to effectively perform Construction Hazards Prevention through Design (CHPtD). This paper introduces a quantitative methodology that supports designers by providing a way to evaluate the safety-related performance of residential construction designs using a risk analysis-based approach. The methodology compares the overall safety risk level of various construction designs and ranks the significance of the various safety risks of each of these designs. The methodology also compares the absolute importance of a particular safety risk in various construction designs. Because the methodology identifies the relevance of each safety risk at a particular site prior to the construction stage, significant risks are highlighted in advance. Thus, a range of measures for mitigating safety risks can then be implemented during on-site construction. The methodology is specially worthwhile for designers, who can compare construction techniques and systems during the design phase and determine the corresponding level of safety risk without their creative talents being restricted. By using this methodology, construction companies can improve their on-site safety performance. Copyright 2010 Elsevier Ltd. All rights reserved.

Risk and direct protective factors for youth violence: results from the Centers for Disease Control and Prevention's Multisite Violence Prevention Project.

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Henry, David B; Tolan, Patrick H; Gorman-Smith, Deborah; Schoeny, Michael E

2012-08-01

This study was conducted as part of a multisite effort to examine risk and direct protective factors for youth violence. The goal was to identify those factors in the lives of young people that increase or decrease the risk of violence. These analyses fill an important gap in the literature, as few studies have examined risk and direct protective factors for youth violence across multiple studies. Data on 4432 middle-school youth, from the CDC Multisite Violence Prevention Project were used. Evaluations were made of effects of variables coded as risk and direct protective factors in the fall of 6th grade on violence measured in spring of 7th and 8th grades. Factors tested included depression, delinquency, alcohol and drug involvement, involvement in family activities, academic achievement, attitudes toward school, truancy, and peer deviance. Most variables were coded with two sets of dummy variables indicating risk and protective directions of effects. Results showed that higher teacher-rated study skills were associated with lower subsequent violence across genders and ethnic groups. Affiliation with deviant peers was significantly associated with increased subsequent violence among youth reporting their race/ethnicity as white or other, marginally associated with increased violence among African-American youth, and unrelated among Latino youth. This study identified some factors than should be areas of interest for effective prevention programs. Some ethnic differences also should be considered in planning of prevention. The CDC Multisite Violence Prevention Project completed enrollment prior to July 2005. Copyright © 2012. Published by Elsevier Inc.

Deep Vein Thrombosis: Risk Factors and Prevention in Surgical ...

African Journals Online (AJOL)

BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously by many ...

Families Matter! Presexual Risk Prevention Intervention

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Lasswell, Sarah M.; Riley, Drewallyn B.; Poulsen, Melissa N.

2013-01-01

Parent-based HIV prevention programming may play an important role in reaching youths early to help establish lifelong patterns of safe and healthy sexual behaviors. Families Matter! is a 5-session, evidence-based behavioral intervention designed for primary caregivers of children aged 9 to 12 years to promote positive parenting and effective parent–child communication about sexuality and sexual risk reduction. The program’s 5-step capacity-building model was implemented with local government, community, and faith-based partners in 8 sub-Saharan African countries with good intervention fidelity and high levels of participant retention. Families Matter! may be useful in other resource-constrained settings. PMID:24028229

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis

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Freya M Shearer, BSc

2018-03-01

Full Text Available Summary: Background: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies. Methods: We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa. We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide. Findings: Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the

Contemporary Primary Prevention Aspirin Use by Cardiovascular Disease Risk: Impact of US Preventive Services Task Force Recommendations, 2007-2015: A Serial, Cross-sectional Study.

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Van't Hof, Jeremy R; Duval, Sue; Walts, Adrienne; Kopecky, Stephen L; Luepker, Russell V; Hirsch, Alan T

2017-10-03

No previous study has evaluated the impact of past US Preventive Services Task Force statements on primary prevention (PP) aspirin use in a primary care setting. The aim of this study was to evaluate temporal changes in PP aspirin use in a primary care population, stratifying patients by their 10-year global cardiovascular disease risk, in response to the 2009 statement. This study estimated biannual aspirin use prevalence using electronic health record data from primary care clinics within the Fairview Health System (Minnesota) from 2007 to 2015. A total of 94 270 patient encounters had complete data to estimate a 10-year cardiovascular disease risk score using the 2013 American College of Cardiology/American Heart Association global risk estimator. Patients were stratified into low- (aspirin use averaged 43%. When stratified by low, intermediate and high risk, average PP aspirin use was 41%, 63%, and 73%, respectively. Average PP aspirin use decreased after the publication of the 2009 US Preventive Services Task Force recommendation statement: from 45% to 40% in the low-risk group; from 66% to 62% in the intermediate-risk group; and from 76% to 73% in the high-risk group, before and after the guideline. Publication of the 2009 US Preventive Services Task Force recommendation was not associated with an increase in aspirin use. High risk PP patients utilized aspirin at high rates. Patients at intermediate risk were less intensively treated, and patients at low risk used aspirin at relatively high rates. These data may inform future aspirin guideline dissemination. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Potential risk of regional disease spread in West Africa through cross-border cattle trade.

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Anna S Dean

Full Text Available Transboundary animal movements facilitate the spread of pathogens across large distances. Cross-border cattle trade is of economic and cultural importance in West Africa. This study explores the potential disease risk resulting from large-scale, cross-border cattle trade between Togo, Burkina Faso, Ghana, Benin, and Nigeria for the first time.A questionnaire-based survey of livestock movements of 226 cattle traders was conducted in the 9 biggest cattle markets of northern Togo in February-March 2012. More than half of the traders (53.5% operated in at least one other country. Animal flows were stochastically simulated based on reported movements and the risk of regional disease spread assessed. More than three quarters (79.2%, range: 78.1-80.0% of cattle flowing into the market system originated from other countries. Through the cattle market system of northern Togo, non-neighbouring countries were connected via potential routes for disease spread. Even for diseases with low transmissibility and low prevalence in a given country, there was a high risk of disease introduction into other countries.By stochastically simulating data collected by interviewing cattle traders in northern Togo, this study identifies potential risks for regional disease spread in West Africa through cross-border cattle trade. The findings highlight that surveillance for emerging infectious diseases as well as control activities targeting endemic diseases in West Africa are likely to be ineffective if only conducted at a national level. A regional approach to disease surveillance, prevention and control is essential.

Potential Risk of Regional Disease Spread in West Africa through Cross-Border Cattle Trade

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Dean, Anna S.; Fournié, Guillaume; Kulo, Abalo E.; Boukaya, G. Aboudou; Schelling, Esther; Bonfoh, Bassirou

2013-01-01

Background Transboundary animal movements facilitate the spread of pathogens across large distances. Cross-border cattle trade is of economic and cultural importance in West Africa. This study explores the potential disease risk resulting from large-scale, cross-border cattle trade between Togo, Burkina Faso, Ghana, Benin, and Nigeria for the first time. Methods and Principal Findings A questionnaire-based survey of livestock movements of 226 cattle traders was conducted in the 9 biggest cattle markets of northern Togo in February-March 2012. More than half of the traders (53.5%) operated in at least one other country. Animal flows were stochastically simulated based on reported movements and the risk of regional disease spread assessed. More than three quarters (79.2%, range: 78.1–80.0%) of cattle flowing into the market system originated from other countries. Through the cattle market system of northern Togo, non-neighbouring countries were connected via potential routes for disease spread. Even for diseases with low transmissibility and low prevalence in a given country, there was a high risk of disease introduction into other countries. Conclusions By stochastically simulating data collected by interviewing cattle traders in northern Togo, this study identifies potential risks for regional disease spread in West Africa through cross-border cattle trade. The findings highlight that surveillance for emerging infectious diseases as well as control activities targeting endemic diseases in West Africa are likely to be ineffective if only conducted at a national level. A regional approach to disease surveillance, prevention and control is essential. PMID:24130721

HIV in Indian prisons: risk behaviour, prevalence, prevention & treatment.

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Dolan, Kate; Larney, Sarah

2010-12-01

HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided.

Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

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Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

2013-12-31

While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

The Importance of Damage Potential for Avalanche Risk Assessments

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Keiler, M.; Fuchs, S.

2003-04-01

Risk is normally expressed as a function of recurrence probability of a process and its related damage potential. Various physical and empirical models describing the process aspect of the risk formula exist in the field of avalanche risk management while studies on damage potential are rare. Due to the changes of the socio-economic structures in mountain regions (urban sprawl, population growth, increased mobility and tourism) these studies are mandatory. This study focuses on different possibilities to obtain obligatory input parameters for multitemporal studies in settlement areas. A conceptual method that records the damage potential (probability of presence, evaluation of buildings) was developed and applied in Tyrol, Austria. A second approach, working with real-time insurance values for buildings and population growth, was tested in Grison, Switzerland. The different developments of the damage potential in the two alpine study areas are highlighted; their influences on the risk formula are discussed. The results of both studies show the advantages and disadvantages of each method, such as precision, amount of time needed and possibilities of implementing in a GIS. The results serve to improve risk determination and point out an unnoticed increase of damage potential and risk in apparently safe settlement areas.

Established and potential risk factors for clostridum difficile infection

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Vaishnavi C

2009-01-01

Full Text Available Clostridium difficile is the aetiological agent for almost all cases of pseudo membranous colitis and 15-25% of antibiotic associated diarrhoea. In recent years, C. difficile associated disease (CDAD has been increasing in frequency and severity due to the emergence of virulent strains. Severe cases of toxic mega colon may be associated with mortality rates of 24-38%. The prevalence of CDAD is global and the incidence varies considerably from place to place. In the initial stages of its discovery, C. difficile infection was regarded mainly as an outcome of antibiotic intake and not as a life threatening disease. Intervention by man has produced conditions making C. difficile a significant cause of morbidity and mortality. The recent outbreak of CDAD in Quebec has sent the alarm bells ringing. Apart from a threefold increase in the incidence of CDAD, clinicians have also reported a higher number of cases involving toxic mega colon, colectomy or death. Among all the risk factors, inclusive of the host and the environmental factors, antibiotics are the most important ones. Surgical patients comprise 55-75% of all patients with CDAD due to the fact that perioperative prophylaxis requires the use of antibiotics. However, other drugs such as immunosuppressants and proton pump inhibitors are also important risk factors. Thus CDAD is a growing nosocomial and public health challenge. Additionally, the recognition of community acquired CDAD signals the presence of several risk factors. In this review, the established and potential risk factors of CDAD, along with the epidemiology, diagnostic modalities, management and preventive measures of the disease have been elaborated.

Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes.

Science.gov (United States)

Carlo Hojilla, J; Koester, Kimberly A; Cohen, Stephanie E; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y

2016-07-01

Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP demonstration project to assess how men who have sex with men used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was 'seasonal' and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts.

An ounce of prevention or a pound of cure: bioeconomic risk analysis of invasive species.

Science.gov (United States)

Leung, Brian; Lodge, David M; Finnoff, David; Shogren, Jason F; Lewis, Mark A; Lamberti, Gary

2002-12-07

Numbers of non-indigenous species--species introduced from elsewhere - are increasing rapidly worldwide, causing both environmental and economic damage. Rigorous quantitative risk-analysis frameworks, however, for invasive species are lacking. We need to evaluate the risks posed by invasive species and quantify the relative merits of different management strategies (e.g. allocation of resources between prevention and control). We present a quantitative bioeconomic modelling framework to analyse risks from non-indigenous species to economic activity and the environment. The model identifies the optimal allocation of resources to prevention versus control, acceptable invasion risks and consequences of invasion to optimal investments (e.g. labour and capital). We apply the model to zebra mussels (Dreissena polymorpha), and show that society could benefit by spending up to US$324 000 year(-1) to prevent invasions into a single lake with a power plant. By contrast, the US Fish and Wildlife Service spent US$825 000 in 2001 to manage all aquatic invaders in all US lakes. Thus, greater investment in prevention is warranted.

Predictors of sexual-risk behaviour and HIV-preventive practices ...

African Journals Online (AJOL)

A cross-sectional study design was used to assess sexual-risk behaviour and HIV-preventive practices among students at Hawassa University, Ethiopia, in 2009. Among 1 220 students eligible for the study, approximately 29% reported experience of sex (36.3% of the males and 9.3% of the females). Of the total sexually ...

Parents-CARE: a suicide prevention program for parents of at-risk youth.

Science.gov (United States)

Hooven, Carole

2013-02-01

Families play an important role in youth suicide prevention, as both a source of protection and a source of risk, and thus are an important target for adolescent suicide prevention programs. This article describes in detail Parents-CARE, a brief youth suicide prevention program for parents, for which effectiveness has been demonstrated. Engaging parents in preventive intervention can be challenging; therefore, the feasibility, acceptability, and relevance of the program to parents are examined. A total of 289 households participated in Parents-CARE. Parent attendance data and parent and interventionist process data are utilized to demonstrate the positive response by parents to the program. The Parents-CARE program was highly attended, and ratings demonstrate that parents were engaged in the program. Ratings show parents found the program both acceptable and relevant. Hence, the program described is promising for clinicians working with at-risk youth as they seek brief, accessible, and effective interventions that include parents in order to amplify the effects of an individual intervention approach. © 2013 Wiley Periodicals, Inc.

Does prevention for Alzheimer's disease exist?

Directory of Open Access Journals (Sweden)

Sonia Maria Dozzi Brucki

Full Text Available Abstract The prevention of Alzheimer's disease is a growing public health concern amidst an ageing population. Meanwhile, there is no effective or curative treatment available where prevention could greatly reduce health costs. This review was based on reports of potential preventive factors, including modifiable lifestyle factors, as well as preventive pharmacological strategies. Although the present review was not systematic, the reports selected from PubMed using "Alzheimer's disease" and "prevention" as key-words, allow us to affirm that pursuing a healthy lifestyle; physical, cognitive, leisure activities; good social engagement; a high consumption of fish, low consumption of dietary fat and moderate consumption of wine, and control of vascular risk factors appear to be potential factors for delaying dementia.

Potential Risk Assessment of Mountain Torrent Disasters on Sloping Fields in China

Science.gov (United States)

GAO, X.

2017-12-01

China's sloping fields have the problems of low production and serious soil erosion, and mountain torrent disasters will bring more serious soil and water loss to traditional extensive exploitation of sloping field resources. In this paper, China's sloping fields were classified into three grades, such as slightly steep, steep and very steep grade. According to the geological hazards prevention and control regulation, the historical data of China's mountain torrent disasters were spatially interpolated and divided into five classes, such as extremely low, low, middle, high and extremely high level. And the risk level map of mountain torrents was finished in ArcGIS. By using overlaying analysis on sloping fields and risk level map, the potential risk regionalization map of sloping fields in various slope grades was obtained finally. The results shows that the very steep and steep sloping fields are mainly distributed in the first or second stage terraces in China. With the increase of hazard risk level, the area of sloping fields decreases rapidly and the sloping fields in extremely low and low risk levels of mountain torrents reach 98.9%. With the increase of slope grade, the area of sloping fields in various risk levels also declines sharply. The sloping fields take up approximately 60 65% and 26 30% in slightly steep and steep grade areas separately at different risk level. The risk regionalization map can provide effective information for returning farmland to forests or grassland and reducing water and soil erosion of sloping fields in the future.

AN EFFECTIVE RISK-PREVENTIVE MODEL PROPOSAL FOR OCCUPATIONAL ACCIDENTS AT SHIPYARDS

Directory of Open Access Journals (Sweden)

Ozge Acuner

2016-03-01

Full Text Available According to the statistics of occupational accidents, it is observed that the number of accidents occurred in shipbuilding industry is high and the rate of deaths and serious injuries among these accidents is higher than in other industries. However, the number of the studies to prevent these accidents in both industrial and scientific practices is considerably low. Therefore, the objective of this study is to develop an efficient risk preventive model in accordance with occupational health and safety regulations for industrial organizations. The approach proposed in this study differs from those described in the literature, because it is based on fuzzy set theory in order to cope with uncertainties on probability and severity definitions in terms of occupational health and safety. Furthermore, in this paper, risk severity is considered in terms of harm to worker, harm to environment, and harm to hardware, whereas in the literature, risk severity is generally considered solely in terms of only harm to worker. Then, risk magnitude is obtained by utilizing fuzzy inference system. The proposed approach is applied to a shipyard located in the Marmara Region in order to illustrate the applicability of the model.

Potentials and limitations of hazard indices for the determination of risk potentials of disposed toxic wastes

International Nuclear Information System (INIS)

Kirchner, Gerald

1989-01-01

Hazard indices are often used for the determination of risk potentials arising from the geological disposal of toxic wastes. They are based on simplified models for the calculation of potential health effects caused by the wastes. The attractiveness of hazard indices lies in their simplicity which nevertheless results in reliable data on necessary isolation times and the most toxic nuclides of a waste. They also make possible comparisons of the potential risks of different wastes. After a discussion of the processes that control the behavior of toxic wastes in the environment after a failure of the geological barriers, a new hazard index is presented. Originally developed for nuclear wastes, it is the first which involves the joint consideration of the composition of a waste, the probability for transport of waste nuclides to man, their toxicity, and the time-dependent changes of the risk potentials which are caused by radioactive buildup and decay processes after the waste has entered the biosphere. The new hazard index makes possible the calculation of risk potentials at a given time of release and time period of concern thereafter. Sample calculations for different nuclear wastes show the importance of the model improvements on resulting time-dependent risk potentials. Applicability of the new hazard index to non-nuclear wastes is described. Potentials and limitations of comparative risk assessments using hazard indices are discussed. (author)

Risk of atherosclerosis in general Czech population is very high - preventive examinations

Czech Academy of Sciences Publication Activity Database

Tomečková, Marie; Grünfeldová, H.; Peleška, Jan; Hanuš, P.; Martinková, Patrícia

2007-01-01

Roč. 14, suppl 1 (2007), S66-S66 ISSN 1741-8267. [EuroPrevent Congress. 19.04.2007-21.04.2007, Madrid] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : risk of atherosclerosis * preventive examinations * general population Subject RIV: BB - Applied Statistics, Operational Research

Satisfying Product Features of a Fall Prevention Smartphone App and Potential Users' Willingness to Pay: Web-Based Survey Among Older Adults.

Science.gov (United States)

Rasche, Peter; Mertens, Alexander; Brandl, Christopher; Liu, Shan; Buecking, Benjamin; Bliemel, Christopher; Horst, Klemens; Weber, Christian David; Lichte, Philipp; Knobe, Matthias

2018-03-27

Prohibiting falls and fall-related injuries is a major challenge for health care systems worldwide, as a substantial proportion of falls occur in older adults who are previously known to be either frail or at high risk for falls. Hence, preventive measures are needed to educate and minimize the risk for falls rather than just minimize older adults' fall risk. Health apps have the potential to address this problem, as they enable users to self-assess their individual fall risk. The objective of this study was to identify product features of a fall prevention smartphone app, which increase or decrease users' satisfaction. In addition, willingness to pay (WTP) was assessed to explore how much revenue such an app could generate. A total of 96 participants completed an open self-selected Web-based survey. Participants answered various questions regarding health status, subjective and objective fall risk, and technical readiness. Seventeen predefined product features of a fall prevention smartphone app were evaluated twice: first, according to a functional (product feature is implemented in the app), and subsequently by a dysfunctional (product feature is not implemented in the app) question. On the basis of the combination of answers from these 2 questions, the product feature was assigned to a certain category (must-be, attractive, one-dimensional, indifferent, or questionable product feature). This method is widely used in user-oriented product development and captures users' expectations of a product and how their satisfaction is influenced by the availability of individual product features. Five product features were identified to increase users' acceptance, including (1) a checklist of typical tripping hazards, (2) an emergency guideline in case of a fall, (3) description of exercises and integrated workout plans that decrease the risk of falling, (4) inclusion of a continuous workout program, and (5) cost coverage by health insurer. Participants' WTP was assessed

Bicycling to Work and Primordial Prevention of Cardiovascular Risk

DEFF Research Database (Denmark)

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

2016-01-01

of incident obesity, hypertension, hypertriglyceridemia, and impaired glucose tolerance, comparing individuals who commuted to work by bicycle with those who used passive modes of transportation. We also examined the relationship of change in commuting mode with incidence of these clinical risk factors......% CI 0.74-0.91) compared with participants not cycling to work at both times points or who switched from cycling to other modes of transport during follow-up. CONCLUSIONS: These data suggest that commuting by bicycle to work is an important strategy for primordial prevention of clinical cardiovascular...... risk factors among middle-aged men and women....

Culturally Sensitive Risk Behavior Prevention Programs for African American Adolescents: A Systematic Analysis

Science.gov (United States)

Metzger, Isha; Cooper, Shauna M.; Zarrett, Nicole; Flory, Kate

2013-01-01

The current review conducted a systematic assessment of culturally sensitive risk prevention programs for African American adolescents. Prevention programs meeting the inclusion and exclusion criteria were evaluated across several domains: (1) theoretical orientation and foundation; (2) methodological rigor; (3) level of cultural integration; (4)…

Training Needs Assessment in Occupational Risk Prevention into Schools

Science.gov (United States)

Burgos-Garcia, Antonio; Alonso-Morillejo, Enrique; Pozo-Munoz, Carmen

2011-01-01

The assessment of needs plays a relevant role in the training for preventing of risks at work into school, as it is a scientific procedure to identify and prioritise problems existing within an educative context. This type of assessment is the starting point for a subsequent planning of the educative interventions that will enable pupils and…

Towards prevention of ovarian cancer.

Science.gov (United States)

Ali, Aus Tariq

2018-01-01

Ovarian cancer is the leading cause of death of all gynaecological cancers. To date, there is no reliable, specific screening procedure for detecting ovarian cancer. The risk factors of ovarian cancer include modifiable and non-modifiable factors. The main goal of the ovarian cancer prevention program is to significantly reduce the risk of development of ovarian cancer and other cancers such as breast and/or peritoneal cancer. The application of non-surgical preventive approaches such as oral contraceptives, parity and breastfeeding has been shown to be highly protective against ovarian cancer development. Targeting inflammation has been also reported to be associated with a protective trend against ovarian cancer and can be achieved through either non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or lifestyle modifications or both. Lifestyle modification that includes regular exercise, healthy diet supplemented with anti-oxidants and anti-inflammatory elements reduces the risk of the disease even further. Surgical protective approaches include; tubal ligation, hysterectomy and prophylactic bilateral salpingo-oophorectomy and the former is the most effective approach to protect against ovarian cancer. A better understanding of the risk factors of ovarian cancer and the current approaches to prevent it may increase the awareness and help to decrease the incidence of ovarian cancer, increase the five-year survival rate and decrease the mortality rate significantly in the general population especially among those at high risk for ovarian cancer. This review is an attempt to outline a potential program of ovarian cancer prevention and the potential challenges. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Risk Prediction Models in Psychiatry: Toward a New Frontier for the Prevention of Mental Illnesses.

Science.gov (United States)

Bernardini, Francesco; Attademo, Luigi; Cleary, Sean D; Luther, Charles; Shim, Ruth S; Quartesan, Roberto; Compton, Michael T

2017-05-01

-scale, longitudinal studies pertaining to depression, bipolar disorder, anxiety disorders, and other psychiatric illnesses; (2) replicating and carrying out external validations of proposed models; (3) further testing potential selective and indicated preventive interventions; and (4) evaluating effectiveness of such interventions in the context of risk stratification using risk prediction models. © Copyright 2017 Physicians Postgraduate Press, Inc.

Carotenoids as potential antioxidant agents in stroke prevention: A systematic review

Directory of Open Access Journals (Sweden)

Ahmad Bahonar

2017-01-01

Full Text Available Stroke and other cerebrovascular diseases are among the most common causes of death worldwide. Prevention of modifiable risk factors is a cost-effective approach to decrease the risk of stroke. Oxidative stress is regarded as the major flexible operative agent in ischemic brain damage. This review presents recent scientific advances in understanding the role of carotenoids as antioxidants in lowering stroke risk based on observational studies. We searched Medline using the following terms: (Carotenoids [MeSH] OR Carotenes [tiab] OR Carotene [tiab] OR “lycopene [Supplementary Concept]” [MeSH] OR lycopene [tiab] OR beta-Carotene [tiab] AND (stroke [MeSH] OR stroke [tiab] OR “Cerebrovascular Accident” [tiab] OR “Cerebrovascular Apoplexy” [tiab] OR “Brain Vascular Accident” [tiab] OR “Cerebrovascular Stroke” [tiab] AND (“oxidative stress” [MeSH] OR “oxidative stress”[tiab]. This search considered papers that had been published between 2000 and 2017. Recent studies indicated that high dietary intake of six main carotenoids (i.e., lycopene, <- and ®-carotene, lutein, zeaxanthin, and astaxanthin was associated with reduced risk of stroke and other cardiovascular outcomes. However, the main mechanism of the action of these nutrients was not identified, and multiple mechanisms except antioxidant activity were suggested to be involved in the observed beneficial effects. The dietary intake of six major carotenoids should be promoted as this may have a substantial positive effect on stroke prevention and stroke mortality reduction.

Psychosocial risks in university education teachers: Diagnosis and prevention

Directory of Open Access Journals (Sweden)

María Matilde García

2016-12-01

Full Text Available The aim of this study is to assess the psychosocial risks of university teachers and identify enhancement areas for a healthy organization in a sample of 621 teachers from the University of A Coruña, Spain. To achieve this aim, the Copenhagen Psychosocial Questionnaire (CoPsoQ adapted to the Spanish population (ISTAS21 Method was applied. The results showed an unfavorable situation for psychosocial health in five dimensions: high psychological demands, low esteem, high double presence, low social support, and high job insecurity. In contrast, a favorable situation for health is the dimension active work and development opportunities. It was also found that there is not a single profile of university teacher in psychosocial risk. To conclude, a diagnosis of psychosocial risks of university teachers is made and, in that scenario, some risk prevention strategies at university level are proposed.

Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated Infections

Directory of Open Access Journals (Sweden)

Andrea L. Lorden

2017-08-01

Full Text Available Background: An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs and accounted for $9.8 (USD billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events. Aims: To estimate the period occurrences and likelihood of acquiring an HAI for the PPH population. Methods: Retrospective, cross-sectional study using logistic regression analysis of 2011 Texas Inpatient Discharge Public Use Data File including 2.6 million admissions from 576 acute care hospitals. Agency for Healthcare Research and Quality Prevention Quality Indicator software identified PPH, and existing administrative data identification methodologies were refined for Clostridium difficile infection, central line–associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia. Odds of acquiring HAIs when admitted with PPH were adjusted for demographic, health status, hospital, and community characteristics. Findings: We identified 272 923 PPH, 14 219 HAI, and 986 admissions with PPH and HAI. Odds of acquiring an HAI for diabetic patients admitted for lower extremity amputation demonstrated significantly increased odds ratio of 2.9 (95% confidence interval: 2.16-3.91 for Clostridium difficile infection. Other PPH patients had lower odds of acquiring HAI compared to non-PPH patients, and results were frequently significant. Conclusions: Clinical implications include increased risk of HAI among diabetic patients admitted for lower extremity amputation. Methodological implications include identification of rare events for inpatient subpopulations and the need for improved codification of HAIs to improve cost and policy analyses regarding allocation of resources toward clinical improvements.

The association of hospital prevention processes and patient risk factors with the risk of Clostridium difficile infection: a population-based cohort study.

Science.gov (United States)

Daneman, N; Guttmann, A; Wang, X; Ma, X; Gibson, D; Stukel, T A

2015-07-01

Clostridium difficile is the most common cause of healthcare-acquired infection; the real-world impacts of some proposed C. difficile prevention processes are unknown. We conducted a population-based retrospective cohort study of all patients admitted to acute care hospitals between April 2011 and March 2012 in Ontario, Canada. Hospital prevention practices were determined by survey of infection control programmes; responses were linked to patient-level risk factors and C. difficile outcomes in Ontario administrative databases. Multivariable generalised estimating equation (GEE) regression models were used to assess the impact of selected understudied hospital prevention processes on the patient-level risk of C. difficile infection, accounting for patient risk factors, baseline C. difficile rates and structural hospital characteristics. C. difficile infections complicated 2341 of 653 896 admissions (3.6 per 1000 admissions). Implementation of the selected C. difficile prevention practices was variable across the 159 hospitals with isolation of all patients at onset of diarrhoea reported by 43 (27%), auditing of antibiotic stewardship compliance by 26 (16%), auditing of cleaning practices by 115 (72%), on-site diagnostic testing by 74 (47%), vancomycin as first-line treatment by 24 (15%) and reporting rates to senior leadership by 52 (33%). None of these processes were associated with a significantly reduced risk of C. difficile after adjustment for baseline C. difficile rates, structural hospital characteristics and patient-level factors. Patient-level factors were strongly associated with C. difficile risk, including age, comorbidities, non-elective and medical admissions. In the largest study to date, selected hospital prevention strategies were not associated with a statistically significant reduction in patients' risk of C. difficile infection. These prevention strategies have either limited effectiveness or were ineffectively implemented during the study

Risk factors for nutritional status determination and indications for preventive nutrition therapy in hospitalized gastroenterological patients

Directory of Open Access Journals (Sweden)

Roganović Branka

2007-01-01

Full Text Available Background/Aim. Risk factors for the intrahospital nutritional status worsening (NSW have not been precisely defined in the literature. The objective was defining thoese factors among gastroenterological patients and defining the risk patients requiring a preventive nutritional therapy. Methods. In 650 gastroenterological patients, NSW was evaluated on the basis of reducing of the six parameters: body weight, body mass index (BMI, triceps skinfold thickness (TSF, midupper arm muscle circumference (MAMC, serum albumin level (ALB, and lymphocyte count (LYM. The influence on NSW was tested for 13 factors concerning characteristics of the patient, disease, and diagnostic procedures. Among the factors influencing significantly the NSW, primary and secondary risk factors were selected. After scoring of risk factors had been performed, the risk-score for NSW (RSNSW was defined. The critical value of RSNSW which required preventive nutritional therapy was also calculated. Results. The incidence of NSW was in the range 29.2%−57.9%. The presence of general complications and severe disease activity were considered as primary risk factors, whereas malignant disease, age above 71, hepato-billiary tract involvement, hospitalization longer than 14 days, and mobility worsening were considered as secondary risk factors. The best predictive value for the NSW was proved for the RSNSW ≥ 6. Because of that, preventive nutritional therapy should be indicated in patients presenting with both primary risk factors or in patients presenting with one primary factor combined with three secondary risk factors at least. Conclusion. There are 7 risk factors for NSW in gastroenterological patients, but they are not of the same importance - two primary and five secondary risk factors can be differentiated. Preventive nutritional therapy is indicated only in patients having both primary risk factors or in those presenting with one primary risk factor combined with three

School-Based Drug Prevention among At-Risk Adolescents: Effects of ALERT Plus

Science.gov (United States)

Longshore, Douglas; Ellickson, Phyllis L.; McCaffrey, Daniel F.; St. Clair, Patricia A.

2007-01-01

In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth…

Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness analysis.

Science.gov (United States)

Manchanda, Ranjit; Legood, Rosa; Antoniou, Antonis C; Gordeev, Vladimir S; Menon, Usha

2016-09-01

Risk-reducing salpingo-oophorectomy (RRSO) is the most effective intervention to prevent ovarian cancer (OC). It is only available to high-risk women with >10% lifetime OC risk. This threshold has not been formally tested for cost-effectiveness. To specify the OC risk thresholds for RRSO being cost-effective for preventing OC in premenopausal women. The costs as well as effects of surgical prevention ('RRSO') were compared over a lifetime with 'no RRSO' using a decision analysis model. RRSO was undertaken in premenopausal women >40 years. The model was evaluated at lifetime OC risk levels: 2%, 4%, 5%, 6%, 8% and 10%. Costs and outcomes are discounted at 3.5%. Uncertainty in the model was assessed using both deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA). Outcomes included in the analyses were OC, breast cancer (BC) and additional deaths from coronary heart disease. Total costs and effects were estimated in terms of quality-adjusted life-years (QALYs); incidence of OC and BC; as well as incremental cost-effectiveness ratio (ICER). Published literature, Nurses Health Study, British National Formulary, Cancer Research UK, National Institute for Health and Care Excellence guidelines and National Health Service reference costs. The time horizon is lifetime and perspective: payer. Premenopausal RRSO is cost-effective at 4% OC risk (life expectancy gained=42.7 days, ICER=£19 536/QALY) with benefits largely driven by reduction in BC risk. RRSO remains cost-effective at >8.2% OC risk without hormone replacement therapy (ICER=£29 071/QALY, life expectancy gained=21.8 days) or 6%if BC risk reduction=0 (ICER=£27 212/QALY, life expectancy gained=35.3 days). Sensitivity analysis indicated results are not impacted much by costs of surgical prevention or treatment of OC/ BC or cardiovascular disease. However, results were sensitive to RRSO utility scores. Additionally, 37%, 61%, 74%, 84%, 96% and 99.5% simulations on PSA are cost

Prevention of thromboembolism during radiosynoviorthesis?

International Nuclear Information System (INIS)

Fischer, M.; Ritter, B.

2006-01-01

The question of pharmacological prevention of thromboembolic disease during radiosynoviorthesis with concomitant immobilization of the treated joint is discussed by means of a recent case report. The possible advantages must be balanced against the potential risks of hemorrhage and heparine-induced thrombocytopenia in every patient. The intraarticular radionuclide therapy might be ranked as ''low risk'', comparable to small or medium interventions with minor trauma according to surgical and perioperative classifications, provided that there are no individual risk factors. With respect to the possible side effects, a general thromboembolic prophylaxis is not recommended in these patients. After radiosynoviorthesis of the knee and an additional joint of the same limb which requires an immobilization spanning both joints, a ''medium risk'' of thromboembolic disease must be assumed. In these cases, as well as with two or more predisposing risk factors, a pharmacological prevention of thromboembolism is mandatory. Ready-to-use syringes containing low-molecular-weight heparine are available for this purpose. Although serious side effects from LMW heparine are rare, monitoring of the thrombocyte counts prior to and 1-2 times during heparine application are advisable. Pharmacological prophylaxis of thromboembolic disease is strictly contraindicated in patients with acute bleeding, cerebral aneurysms and known aortic dissections. In case of concomitant treatment with NSAIDs, antagonists of platelet aggregation or valproic acid, the indication for heparine treatment should be discussed very seriously. Both the verbal and written information of each patient must be complete and precise with respect to possible advantages and potential risks of pharmacological prevention of thromboembolic disease. (orig.)

Supporting families in a high-risk setting: proximal effects of the SAFEChildren preventive intervention.

Science.gov (United States)

Tolan, Patrick; Gorman-Smith, Deborah; Henry, David

2004-10-01

Four hundred twenty-four families who resided in inner-city neighborhoods and had a child entering 1st grade were randomly assigned to a control condition or to a family-focused preventive intervention combined with academic tutoring. SAFEChildren, which was developed from a developmental-ecological perspective, emphasizes developmental tasks and community factors in understanding risk and prevention. Tracking of linear-growth trends through 6 months after intervention indicated an overall effect of increased academic performance and better parental involvement in school. High-risk families had additional benefits for parental monitoring, child-problem behaviors, and children's social competence. High-risk youth showed improvement in problem behaviors and social competence. Results support a family-focused intervention that addresses risk in low-income communities as managing abnormal challenges.

Falls in older people: risk factors and strategies for prevention

National Research Council Canada - National Science Library

Lord, Stephen R. (Stephen Ronald)

2007-01-01

... on visual, neuropsychological and medical risk factors. The book also reviews the numerous new randomized controlled trials that have examined the effects of exercise, visual, cardiovascular and environmental interventions in preventing falls. The new edition will be an invaluable update for medical practitioners, physiotherapists, occupational therap...

Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia.

Science.gov (United States)

Stone, Cosby A; McEvoy, Cindy T; Aschner, Judy L; Kirk, Ashudee; Rosas-Salazar, Christian; Cook-Mills, Joan M; Moore, Paul E; Walsh, William F; Hartert, Tina V

2018-03-07

Vitamin E is obtained only through the diet and has a number of important biological activities, including functioning as an antioxidant. Evidence that free radicals may contribute to pathological processes such as bronchopulmonary dysplasia (BPD), a disease of prematurity associated with increased lung injury, inflammation and oxidative stress, led to trials of the antioxidant vitamin E (α-tocopherol) to prevent BPD with variable results. These trials were all conducted at supraphysiologic doses and 2 of these trials utilized a formulation containing a potentially harmful excipient. Since 1991, when the last of these trials was conducted, both neonatal management strategies for minimizing oxygen and ventilator-related lung injury and our understanding of vitamin E isoforms in respiratory health have advanced substantially. It is now known that there are differences between the effects of vitamin E isoforms α-tocopherol and γ-tocopherol on the development of respiratory morbidity and inflammation. What is not known is whether improvements in physiologic concentrations of individual or combinations of vitamin E isoforms during pregnancy or following preterm birth might prevent or reduce BPD development. The answers to these questions require adequately powered studies targeting pregnant women at risk of preterm birth or their premature infants immediately following birth, especially in certain subgroups that are at increased risk of vitamin E deficiency (e.g., smokers). The objective of this review is to compile, update, and interpret what is known about vitamin E isoforms and BPD since these first studies were conducted, and suggest future research directions. © 2018 S. Karger AG, Basel.

Prevention of risks and dangers as a subject of the law relating to nuclear safety

International Nuclear Information System (INIS)

Bender, B.

1979-01-01

In the light of the decision of the Federal Constitutional Court in the Kalkar case, the author discusses the requirement laid down in sec. 7 of the German Atomic Energy Act, to take every precaution necessary to prevent damage resulting from the erection and operation of nuclear installations. This concept of prevention of damage is dealt with in great detail by the author, defining two main aspects of the overall concept, namely prevention of danger (i.e. risks that can be assessed on the basis of current scientific knowledge and technology), and prevention of risks (i.e. risks that cannot be clearly defined). According to the author, the 'remaining risk' which, following the decision of the Federal Constitutional Court, is accepted by the Atomic Energy Act, can only be grouped among those that cannot be assessed in detail due to lack of knowledge. The author further states that Sec. 7 of the Atomic Energy Act, aiming at guaranteeing the rights of third parties, can be interpreted to grant a 'right' to individual persons to bring action in accordance with administrative jurisdiction. (HSCH) 891 HP/HSCH 892 CKA [de

WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

Science.gov (United States)

Afuakwah, Charles; Welbury, Richard

2015-11-01

Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

Environmental and risk screening for prioritizing pollution prevention opportunities in the U.S. printed wiring board manufacturing industry.

Science.gov (United States)

Lam, Carl W; Lim, Seong-Rin; Schoenung, Julie M

2011-05-15

Modern manufacturing of printed wiring boards (PWBs) involves extensive use of various hazardous chemicals in different manufacturing steps such as board preparation, circuit design transfer, etching and plating processes. Two complementary environmental screening methods developed by the U.S. EPA, namely: (i) the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) and (ii) Risk-Screening Environmental Indicators (RSEI), are used to quantify geographic and chemical environmental impacts in the U.S. PWB manufacturing industry based on Toxics Release Inventory (TRI) data. Although the release weight percentages of industrial chemicals such as methanol, glycol ethers and dimethylformamide comprise the larger fraction of reported air and water emissions, results indicate that lead, copper and their compounds' releases correspond to the highest environmental impact from toxicity potentials and risk-screening scores. Combining these results with further knowledge of PWB manufacturing, select alternative chemical processes and materials for pollution prevention are discussed. Examples of effective pollution prevention options in the PWB industry include spent etchant recovery technologies, and process and material substitutions. In addition, geographic assessment of environmental burden highlights states where promotion of pollution prevention strategies and emissions regulations can have the greatest effect to curb the PWB industry's toxic release impacts. Copyright © 2011 Elsevier B.V. All rights reserved.

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis.

Science.gov (United States)

Shearer, Freya M; Longbottom, Joshua; Browne, Annie J; Pigott, David M; Brady, Oliver J; Kraemer, Moritz U G; Marinho, Fatima; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Fullman, Nancy; Ray, Sarah E; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S; Reiner, Robert C; Moyes, Catherine L; Hay, Simon I; Golding, Nick

2018-03-01

Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies. We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa). We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide. Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the Congo, and South Sudan, where vaccination coverage in 2016

Causes of conflict and their potential prevention in a rehabilitation hospital

OpenAIRE

Darbutienė, Rita

2010-01-01

Management of public health CAUSES OF CONFLICT AND THEIR POTENTIAL PREVENTION IN A REHABILITATION HOSPITAL Rita Darbutiene Supervisor – doc. dr. Junona Almonaitene Kaunas University of Medicine, Faculty of Public Health, Department of Health Management. Kaunas 2010. 79 p. Aim of study: to determine the attidute of the staff to conflicts occurring in the hospital, to work out a conflict prevention scheme. Goals of study: 1. To establish the most common causes of conflict ...

Parents’ perceptions on offspring risk and prevention of anxiety and depression: a qualitative study

NARCIS (Netherlands)

Festen, Helma; Schipper, Karen; Vries, Sybolt O; Reichart, Catrien G.; Abma, Tineke A.; Nauta, Maaike H.

2014-01-01

Background Offspring of patients with anxiety or depression are at high risk for developing anxiety or depression. Despite the positive findings regarding effectiveness of prevention programs, recruitment for prevention activities and trials is notoriously difficult. Our randomized controlled

Pressure ulcer prevention in high-risk postoperative cardiovascular patients.

Science.gov (United States)

Jackson, Melissa; McKenney, Teresa; Drumm, Jennifer; Merrick, Brian; LeMaster, Tamara; VanGilder, Catherine

2011-08-01

Little has been published about how to prevent pressure ulcers in severely debilitated, immobile patients in intensive care units. To present a possible prevention strategy for postoperative cardiovascular surgery patients at high risk for development of pressure ulcers. Staff chose to implement air fluidized therapy beds, which provide maximal immersion and envelopment as a measure for preventing pressure ulcers in patients who (1) required vasopressors for at least 24 hours and (2) required mechanical ventilation for at least 24 hours postoperatively. Only 1 of 27 patients had a pressure ulcer develop while on the air fluidized therapy bed (February 2008 through August 2008), and that ulcer was only a stage I ulcer, compared with 40 ulcers in 25 patients before the intervention. Patients spent a mean of 7.9 days on the mattress, and the cost of bed rental was approximately $18000, which was similar to the cost of treatment of 1 pressure ulcer in stage III or IV (about $40000) and was considered cost-effective.

Wearable technology and ECG processing for fall risk assessment, prevention and detection.

Science.gov (United States)

Melillo, Paolo; Castaldo, Rossana; Sannino, Giovanna; Orrico, Ada; de Pietro, Giuseppe; Pecchia, Leandro

2015-01-01

Falls represent one of the most common causes of injury-related morbidity and mortality in later life. Subjects with cardiovascular disorders (e.g., related to autonomic dysfunctions and postural hypotension) are at higher risk of falling. Autonomic dysfunctions increasing the risk of falling in the short and mid-term could be assessed by Heart Rate Variability (HRV) extracted by electrocardiograph (ECG). We developed three trials for assessing the usefulness of ECG monitoring using wearable devices for: risk assessment of falling in the next few weeks; prevention of imminent falls due to standing hypotension; and fall detection. Statistical and data-mining methods are adopted to develop classification and regression models, validated with the cross-validation approach. The first classifier based on HRV features enabled to identify future fallers among hypertensive patients with an accuracy of 72% (sensitivity: 51.1%, specificity: 80.2%). The regression model to predict falls due to orthostatic dropdown from HRV recorded before standing achieved an overall accuracy of 80% (sensitivity: 92%, specificity: 90%). Finally, the classifier to detect simulated falls using ECG achieved an accuracy of 77.3% (sensitivity: 81.8%, specificity: 72.7%). The evidence from these three studies showed that ECG monitoring and processing could achieve satisfactory performances compared to other system for risk assessment, fall prevention and detection. This is interesting as differently from other technologies actually employed to prevent falls, ECG is recommended for many other pathologies of later life and is more accepted by senior citizens.

A quantitative risk assessment model to evaluate effective border control measures for rabies prevention

Science.gov (United States)

Weng, Hsin-Yi; Wu, Pei-I; Yang, Ping-Cheng; Tsai, Yi-Lun; Chang, Chao-Chin

2009-01-01

Border control is the primary method to prevent rabies emergence. This study developed a quantitative risk model incorporating stochastic processes to evaluate whether border control measures could efficiently prevent rabies introduction through importation of cats and dogs using Taiwan as an example. Both legal importation and illegal smuggling were investigated. The impacts of reduced quarantine and/or waiting period on the risk of rabies introduction were also evaluated. The results showed that Taiwan’s current animal importation policy could effectively prevent rabies introduction through legal importation of cats and dogs. The median risk of a rabid animal to penetrate current border control measures and enter Taiwan was 5.33 × 10−8 (95th percentile: 3.20 × 10−7). However, illegal smuggling may pose Taiwan to the great risk of rabies emergence. Reduction of quarantine and/or waiting period would affect the risk differently, depending on the applied assumptions, such as increased vaccination coverage, enforced custom checking, and/or change in number of legal importations. Although the changes in the estimated risk under the assumed alternatives were not substantial except for completely abolishing quarantine, the consequences of rabies introduction may yet be considered to be significant in a rabies-free area. Therefore, a comprehensive benefit-cost analysis needs to be conducted before recommending these alternative measures. PMID:19822125

Male Labor Migrants in Russia: HIV Risk Behavior Levels, Contextual Factors, and Prevention Needs

Science.gov (United States)

Amirkhanian, Yuri A.; Kuznetsova, Anna V.; Kelly, Jeffrey A.; DiFranceisco, Wayne J; Musatov, Vladimir B.; Avsukevich, Natalya A.; Chaika, Nikolay A.; McAuliffe, Timothy L.

2015-01-01

Background Although the dire life circumstances of labor migrants working in Russia are well-known, their HIV risk vulnerability and prevention needs are understudied. Low socioeconomic status, lack of access to services, separation from family, and limited risk awareness all contribute to migrants’ HIV vulnerability. Methods Male labor migrants in St. Petersburg (n=499) were administered assessments of their sexual behavior practices, substance use, and psychosocial characteristics related to risk and well-being. Results Thirty percent of migrants reported multiple female partners in the past 3 months. Condom use was low, ranging from 35% with permanent to 52% with casual partners. Central Asian migrants had very low AIDS knowledge, low levels of substance use, moderate sexual risk, high depression, and poor social supports. Eastern European migrants had higher AIDS knowledge, alcohol and drug use, and sexual risk. Discussion Improved HIV prevention efforts are needed to reduce the risk vulnerability of migrants who relocate to high disease prevalence areas. PMID:20690041

Potential pollution prevention and waste minimization for Department of Energy operations

International Nuclear Information System (INIS)

Griffin, J.; Ischay, C.; Kennicott, M.; Pemberton, S.; Tull, D.

1995-10-01

With the tightening of budgets and limited resources, it is important to ensure operations are carried out in a cost-effective and productive manner. Implementing an effective Pollution Prevention strategy can help to reduce the costs of waste management and prevent harmful releases to the environment. This document provides an estimate of the Department of Energy's waste reduction potential from the implementation of Pollution Prevention opportunities. A team of Waste Minimization and Pollution Prevention professionals was formed to collect the data and make the estimates. The report includes a list of specific reduction opportunities for various waste generating operations and waste types. A generic set of recommendations to achieve these reduction opportunities is also provided as well as a general discussion of the approach and assumptions made for each waste generating operation

Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (The LOOP study)

DEFF Research Database (Denmark)

Diederichsen, Søren Zöga; Haugan, Ketil Jørgen; Køber, Lars

2017-01-01

years or older and previously diagnosed as having at least one of the following conditions: hypertension, diabetes mellitus, heart failure, or previous stroke. Exclusion criteria include history of AF and current oral anticoagulation treatment. When an AF episode lasting ≥6minutes is detected, oral...... anticoagulation will be initiated according to guidelines. Expected follow-up is 4years. The primary end point is time to stroke or systemic embolism, whereas secondary end points include time to AF diagnosis and death. CONCLUSION: The LOOP study will evaluate health benefits and cost-effectiveness of ILR...... as a screening tool for AF to prevent stroke in patients at risk. Secondary objectives include identification of risk factors for the development of AF and characterization of arrhythmias in the population. The trial holds the potential to influence the future of stroke prevention....

Identification of cancer risk and associated behaviour: implications for social marketing campaigns for cancer prevention.

Science.gov (United States)

Kippen, Rebecca; James, Erica; Ward, Bernadette; Buykx, Penny; Shamsullah, Ardel; Watson, Wendy; Chapman, Kathy

2017-08-17

Community misconception of what causes cancer is an important consideration when devising communication strategies around cancer prevention, while those initiating social marketing campaigns must decide whether to target the general population or to tailor messages for different audiences. This paper investigates the relationships between demographic characteristics, identification of selected cancer risk factors, and associated protective behaviours, to inform audience segmentation for cancer prevention social marketing. Data for this cross-sectional study (n = 3301) are derived from Cancer Council New South Wales' 2013 Cancer Prevention Survey. Descriptive statistics and logistic regression models were used to investigate the relationship between respondent demographic characteristics and identification of each of seven cancer risk factors; demographic characteristics and practice of the seven 'protective' behaviours associated with the seven cancer risk factors; and identification of cancer risk factors and practising the associated protective behaviours, controlling for demographic characteristics. More than 90% of respondents across demographic groups identified sun exposure and smoking cigarettes as moderate or large cancer risk factors. Around 80% identified passive smoking as a moderate/large risk factor, and 40-60% identified being overweight or obese, drinking alcohol, not eating enough vegetables and not eating enough fruit. Women and older respondents were more likely to identify most cancer risk factors as moderate/large, and to practise associated protective behaviours. Education was correlated with identification of smoking as a moderate/large cancer risk factor, and with four of the seven protective behaviours. Location (metropolitan/regional) and country of birth (Australia/other) were weak predictors of identification and of protective behaviours. Identification of a cancer risk factor as moderate/large was a significant predictor for five out

Risk Profiles for Falls among Older Adults: New Directions for Prevention

Directory of Open Access Journals (Sweden)

William A. Satariano

2017-08-01

Full Text Available ObjectiveTo address whether neighborhood factors, together with older adults’ levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM analysis to conduct this descriptive analysis.MethodThis is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC. Interviews focused on neighborhood characteristics, physical and cognitive function, walking, and falls and injuries. Four risk profiles (higher order interactions of individual and neighborhood factors were derived from GoM analysis.ResultsProfiles 1 and 2 reflect previous results showing that frail older adults are likely to fall indoors (Profile 1; healthy older adults are likely to fall outdoors (Profile 2. Profile 3 identifies the falls risk for older with mild cognitive impairment living in moderately walkable neighborhoods. Profile 4 identifies the risk found for healthy older adults living in neighborhoods with low walkability.DiscussionNeighborhood walkability, in combination with levels of health and functioning, is associated with both indoor and outdoor falls. Descriptive results suggest possible research hypotheses and new directions for prevention, based on individual and neighborhood factors.

The potential for oxytocin (OT) to prevent breast cancer: a hypothesis.

Science.gov (United States)

Murrell, T G

1995-08-01

This hypothesis proposes that carcinogens in the breast are generated by the action of superoxide free radicals released when acinal gland distension, under the influence of unopposed prolactin, causes microvessel ischaemia. Inadequate nipple care in the at-risk years leads to ductal obstruction preventing the elimination of carcinogens from the breast. The regular production of oxytocin (OT) from nipple stimulation would cause contraction of the myoepithelial cells, relieving acinal gland distension and aiding the active elimination of carcinogenic fluid from the breast. Mechanical breast pump stimulation causes an increase in plasma OT levels in the luteal but not in the follicular phase of the menstrual cycle. OT production upon nipple stimulation in the luteal phase of premenopausal, non-lactating women may be protective against the high rates of mitotic breast cell division noted at this time via the potential to block the effect of oestrogen. The epidemiology of breast cancer suggests that lengthy lactation time is beneficial. Sexual activity in nulliparous women also protects and OT levels have been shown to rise with orgasm in women and in men. OT systems in the brain are intricately linked to oestrogen and progesterone levels, and it is possible that these hormones may modify the OT secretory response both centrally and through an effect on the sensitivity of the breast. OT production with nipple care and in sex and lactation, and the reduction in cycling ovarian hormones that occurs with pregnancy, may all be important preventative factors in the development of breast cancer both pre- and post-menopausally.

Fisetin: A bioactive phytochemical with potential for cancer prevention and pharmacotherapy.

Science.gov (United States)

Kashyap, Dharambir; Sharma, Ajay; Sak, Katrin; Tuli, Hardeep Singh; Buttar, Harpal Singh; Bishayee, Anupam

2018-02-01

A wide variety of chronic diseases, such as neurodegenerative and cardiovascular disorders, diabetes mellitus, osteoarthtitis, obesity and various cancers, are now being treated with cost effective phytomedicines. Since synthetic medicines are very expensive, concerted efforts are being made in developing and poor countries to discover cost effective medicines for the treatment of non-communicable diseases (NCDs). Understanding the underlying mechanisms of bioactive medicines from natural sources would not only open incipient avenues for the scientific community and pharmaceutical industry to discover new drug molecules for the therapy of NCDs, but also help to garner knowledge for alternative therapeutic approaches for the management of chronic diseases. Fisetin is a polyphenolic molecule of flavonoids class, and belongs to the bioactive phytochemicals that have potential to block multiple signaling pathways associated with NCDs such as cell division, angiogenesis, metastasis, oxidative stress, and inflammation. The emerging evidence suggests that fisetin may be useful for the prevention and management of several types of human malignancies. Efforts are being made to enhance the bioavailability of fisetin after oral administration to prevent and/or treat cancer of the liver, breast, ovary and other organs. The intent of this review is to highlight the in vitro and in vivo activities of fisetin and to provide up-to-date information about the molecular interactions of fisetin with its cellular targets involved in cancer initiation, promotion and progression as well as to focus on strategies underway to increase the bioavailability and reduce the risk of deleterious effects, if any, associated with fisetin administration. Copyright © 2017 Elsevier Inc. All rights reserved.

Nocebo and the potential harm of 'high risk' labelling: a scoping review.

Science.gov (United States)

Symon, Andrew; Williams, Brian; Adelasoye, Qadir A; Cheyne, Helen

2015-07-01

A discussion of the existence, prevalence and characteristics of the nocebo effect in health care. There is increasing but inconsistent evidence for nocebo effects (the opposite of placebo). Causal mechanisms are believed to be similar to placebo (negative effects result from suggestions of negative clinical outcomes). Risk screening in health care may produce this unintended effect through labelling some patients as high risk. Given health care's almost universal coverage this potentially affects many people. Discussion paper following a scoping review of the existence and frequency of nocebo. Literature databases (PsycINFO, MEDLINE, CCTR, CINAHL and EMBASE) searched from inception dates to 2013. Significant empirical evidence indicates that negative beliefs may impact on health outcomes (incidence estimates range from 3-27%). The nocebo effect, rooted in the complex interplay between physiological functioning and social factors, appears significantly more common among women and where prior negative knowledge or expectations exist. Pre-existing psychological characteristics (anxiety, neuroses, panic disorder or pessimism) exacerbate it. While the placebo effect is well documented, there has been no systematic attempt to synthesize primary empirical research on the role of nocebo. It is possible that nocebo outcomes may be preventable through careful consideration of information provision and the prior identification of potentially high risk individuals. This paper summarizes the scale and importance of the nocebo effect, its distribution according to a range of social and clinical variables and its known relation to psychological precursors. It identifies important gaps in the research literature. © 2015 John Wiley & Sons Ltd.

Exploring the potential of a conditional cash transfer intervention to reduce HIV risk among young women in Iringa, Tanzania.

Science.gov (United States)

Kennedy, Caitlin E; Brahmbhatt, Heena; Likindikoki, Samuel; Beckham, Sarah W; Mbwambo, Jessie K; Kerrigan, Deanna

2014-01-01

Cash transfer programs seek to alter structural determinants of HIV risk such as poverty and gender inequality. We sought to explore the feasibility and potential effectiveness of a cash transfer intervention for young women as part of combination HIV prevention in Iringa, Tanzania. Qualitative, in-depth interviews were conducted with 116 stakeholders and residents from the region, including key informants, service delivery users, and members of key populations. Most respondents felt a cash transfer program would assist young women in Iringa to have more control over sexual decision-making and reduce poverty-driven transactional sex. Respondents were divided on who should receive funds: young women themselves, their parents/guardians, or community leaders. Cash amounts and suggested target groups varied, and several respondents suggested providing microcredit or small business capital instead of cash. Potential concerns included jealousy, dependency, and corruption. However, most respondents felt that some intervention was needed to address underlying poverty driving some sexual risk behavior. A cash transfer program could fill this role, ultimately reducing HIV, sexually transmitted infections, and unintended pregnancies. As increased attention is given to economic and structural interventions for HIV prevention, local input and knowledge should be considered in a program design.

Emerging Risk Factors and Prevention of Perioperative Pulmonary Complications

Directory of Open Access Journals (Sweden)

Priyanka Bhateja

2014-01-01

Full Text Available Modern surgery is faced with the emergence of newer “risk factors” and the challenges associated with identifying and managing these risks in the perioperative period. Obstructive sleep apnea and obesity hypoventilation syndrome pose unique challenges in the perioperative setting. Recent studies have identified some of the specific risks arising from caring for such patients in the surgical setting. While all possible postoperative complications are not yet fully established or understood, the prevention and management of these complications pose even greater challenges. Pulmonary hypertension with its changing epidemiology and novel management strategies is another new disease for the surgeon and the anesthesiologist in the noncardiac surgical setting. Traditionally most such patients were not considered surgical candidates for any required elective surgery. Our review discusses these disease entities which are often undiagnosed before elective noncardiac surgery.

Dutch monitor on stress and physical load : risk factors, consequences, and preventive action

NARCIS (Netherlands)

Houtman, I.L.D.; Goudswaard, A.; Dhondt, S.; Grinten, M.P. van der; Hildebrandt, V.H.; Poel, E.G.T. van der

1998-01-01

Objectives - Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks,

Gatekeeper Training in Campus Suicide Prevention

Science.gov (United States)

Wallack, Cory; Servaty-Seib, Heather L.; Taub, Deborah J.

2013-01-01

Gatekeeper training is one of the most commonly employed methods for identifying and intervening with at-risk students (Davidson and Locke, 2010). Within the context of campus suicide prevention, a gatekeeper is broadly defined as any individual who has the potential to come into contact with at-risk students (Davidson and Locke, 2010). Although…

Risk perception is not associated with attendance at a preventive intervention for type 2 diabetes mellitus among South Asians at risk of diabetes.

Science.gov (United States)

Vlaar, Everlina M A; Nierkens, Vera; Nicolaou, Mary; Middelkoop, Barend J C; Stronks, Karien; van Valkengoed, Irene G M

2015-04-01

To evaluate the association between risk perception and attendance in a diabetes prevention programme among South Asians with a high risk for diabetes. An observational study. We measured risk perception during the baseline interview with causal beliefs, perceived susceptibility and perceived controllability. We used logistic regression to examine the relationship between risk perception and attendance. We adjusted for relevant sociodemographic factors, screening results and psychosocial factors. The Hague, the Netherlands. Five hundred and thirty-five Hindustani Surinamese (South Asians) aged 18-60 years from a lifestyle-versus-control intervention for the prevention of diabetes. In total, 68·2% attended the lifestyle or control intervention. Participants perceived lifestyle and heredity to increase the risk of diabetes and perceived increasing physical activity to decrease it. Only 44·2% of the participants perceived themselves as susceptible to diabetes and only those who perceived a family history of diabetes as a cause of diabetes appeared to be more inclined to attend. However, after adjustment for confounding, the association was not statistically significant. Risk perception was not significantly associated with attendance. The results suggest that increasing the risk perception alone in this South Asian population is unlikely to increase the attendance at a diabetes prevention programme.

Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

Science.gov (United States)

Collier, Crystal

2013-01-01

The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

Zika Virus Prevention: U.S. Travelers' Knowledge, Risk Perceptions, and Behavioral Intentions-A National Survey.

Science.gov (United States)

Squiers, Linda; Herrington, James; Kelly, Bridget; Bann, Carla; Becker-Dreps, Sylvia; Stamm, Lola; Johnson, Mihaela; McCormack, Lauren

2018-06-01

Limited data exist about U.S. travelers' knowledge, risk perceptions, and behaviors related to the Zika virus (ZIKV). Using an internet research panel, in March 2017, we surveyed 1,202 Americans in the continental United States and Puerto Rico who planned to travel to a ZIKV-affected country, state, or U.S. territory in 2017. We compared levels of knowledge and perceived risk of ZIKV, and intentions to practice ZIKV prevention behaviors across respondents from three regions: Puerto Rico, at-risk states, and other states. More than 80% of respondents correctly understood that a person could acquire ZIKV through a bite from an infected mosquito, and over 64% of respondents knew that a pregnant woman could pass the virus to her fetus. Less than half of the respondents from at-risk states and other states knew that ZIKV could be transmitted sexually, as compared with three-quarters of respondents from Puerto Rico. Compared with respondents from at-risk and other states, respondents from Puerto Rico were the most knowledgeable for almost all types of knowledge assessed. Knowledge about post-travel precautions was low across all three regions. Differences in perceived risk and intentions to practice specific prevention behaviors also varied among regions. Significant gaps exist in U.S. travelers' knowledge about how to prevent ZIKV transmission both during and after travel. Input and collaboration from the travel industry, health care providers, and the media are needed to help educate travelers about how to prevent ZIKV infection and transmission.

How health risks prevention shapes collective identities: a micro-sociological approach

NARCIS (Netherlands)

Weenink, D.; Bröer, C.; Boersma, J.

2015-01-01

Sociological theories of health risks in late modernity emphasise the individualisation and increasing anxiety that results from prevention policies, while bio-sociality theories point to the creation of new, biologically or medically based social identities. In this article, we outline an

Carpal tunnel syndrome. Risk factors and preventive strategies for the dental hygienist.

Science.gov (United States)

Gerwatowski, L J; McFall, D B; Stach, D J

1992-02-01

Carpal tunnel syndrome (CTS) is well recognized as an occupational risk for dental hygienists. The contributing risk factors fall primarily into two categories: medical and occupational. The purposes of this paper are to examine the factors that predispose one to CTS in order to increase awareness among dental hygienists, and to offer preventive strategies that can be incorporated into daily practice.

Perceptions of risk from workers in high risk industries with work related musculoskeletal disorders.

Science.gov (United States)

Hunter, D; Silverstein, B

2014-01-01

Work-related musculoskeletal disorders (WMSDs) remain a major occupational health problem, despite decades of research, outreach, and intervention. The aim of this study is to promote early identification and prevention of WMSDs by developing education and outreach materials grounded in interview data collected from workers that have recently filed for workers compensation (WC) for WMSDs. We conducted semi-structured telephone interviews with WC claimants (n=66) from high risk industries identified through the use of a Prevention Index (PI) in Washington state with WMSDs of the back, shoulder, hand/wrist, or knee. Perceptions regarding the degree of exposure to WMSD risk factors, the social construction of pain, and the potential to implement injury-prevention measures varied widely. Many workers dismissed their injuries as the result of "fluke" or "freak" occurrences and framed their exposure to risk factors for WMSDs as either inevitable or "just part of the job." Workers in high-risk industries for WMSDs described their work conditions in ways that suggested: (1) a lack of awareness of the potential for developing a WMSD, (2) a view of work-related pain as normal, and/or (3) a pattern of self-blame for WMSD onset. A paradigm that either asserts the inevitability of WMSDs or dismisses potential control measures presents both a significant barrier to injury prevention efforts as well as a major opportunity for future occupational health research.

Noise and Vibration Risk Prevention Virtual Web for Ubiquitous Training

Science.gov (United States)

Redel-Macías, María Dolores; Cubero-Atienza, Antonio J.; Martínez-Valle, José Miguel; Pedrós-Pérez, Gerardo; del Pilar Martínez-Jiménez, María

2015-01-01

This paper describes a new Web portal offering experimental labs for ubiquitous training of university engineering students in work-related risk prevention. The Web-accessible computer program simulates the noise and machine vibrations met in the work environment, in a series of virtual laboratories that mimic an actual laboratory and provide the…

Social media and suicide prevention: findings from a stakeholder survey

Science.gov (United States)

ROBINSON, Jo; RODRIGUES, Maria; FISHER, Steve; BAILEY, Eleanor; HERRMAN, Helen

2015-01-01

Background Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community’s overall suicide prevention strategy remains a matter of debate. Aim Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. Methods A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. Results Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one’s feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. Conclusions Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be

Social media and suicide prevention: findings from a stakeholder survey.

Science.gov (United States)

Robinson, Jo; Rodrigues, Maria; Fisher, Steve; Bailey, Eleanor; Herrman, Helen

2015-02-25

Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community's overall suicide prevention strategy remains a matter of debate. Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one's feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be developed and implemented.

Primary Prevention of Cardiovascular Disease

Directory of Open Access Journals (Sweden)

Danny J. Eapen, MD

2016-09-01

Full Text Available Cardiovascular disease (CVD is the leading cause of death worldwide. This article focuses on current guidelines for the primary prevention of CVD and addresses management of key risk factors. Dietary modification, weight loss, exercise, and tobacco use cessation are specific areas where focused efforts can successfully reduce CVD risk on both an individual and a societal level. Specific areas requiring management include dyslipidemia, hypertension, physical activity, diabetes, aspirin use, and alcohol intake. These preventive efforts have major public health implications. As the global population continues to grow, health care expenditures will also rise, with the potential to eventually overwhelm the health care system. Therefore it is imperative to apply our collective efforts on CVD prevention to improve the cardiovascular health of individuals, communities, and nations.

Convergence of nanotechnology and cancer prevention: are we there yet?

Science.gov (United States)

Menter, David G; Patterson, Sherri L; Logsdon, Craig D; Kopetz, Scott; Sood, Anil K; Hawk, Ernest T

2014-10-01

Nanotechnology is emerging as a promising modality for cancer treatment; however, in the realm of cancer prevention, its full utility has yet to be determined. Here, we discuss the potential of integrating nanotechnology in cancer prevention to augment early diagnosis, precision targeting, and controlled release of chemopreventive agents, reduced toxicity, risk/response assessment, and personalized point-of-care monitoring. Cancer is a multistep, progressive disease; the functional and acquired characteristics of the early precancer phenotype are intrinsically different from those of a more advanced anaplastic or invasive malignancy. Therefore, applying nanotechnology to precancers is likely to be far more challenging than applying it to established disease. Frank cancers are more readily identifiable through imaging and biomarker and histopathologic assessment than their precancerous precursors. In addition, prevention subjects routinely have more rigorous intervention criteria than therapy subjects. Any nanopreventive agent developed to prevent sporadic cancers found in the general population must exhibit a very low risk of serious side effects. In contrast, a greater risk of side effects might be more acceptable in subjects at high risk for cancer. Using nanotechnology to prevent cancer is an aspirational goal, but clearly identifying the intermediate objectives and potential barriers is an essential first step in this exciting journey. ©2014 American Association for Cancer Research.

Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention

DEFF Research Database (Denmark)

Andersen, Kenneth Geving; Kehlet, Henrik

2011-01-01

for prevention and treatment. However, nerve damage and radiotherapy appear to be significant risk factors for chronic pain. A proposal for the design of future prospective studies is presented. PERSPECTIVE: A comprehensive and systematic approach to research in chronic pain after breast cancer treatment......Chronic pain after breast cancer treatment is a major clinical problem, affecting 25 to 60% of patients. Development of chronic pain after breast cancer treatment, as well as other surgical procedures, involves a complex pathophysiology that involves pre-, intra- and post-operative factors....... This review is a systematic analysis on methodology and evidence in research into persistent pain after breast cancer treatment during the period 1995 to 2010, in order to clarify the significance and relative role of potential risk factors. Literature was identified by a search in PubMed and OVID, as well...

Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease. Potential benefits and underlying mechanisms: A mini review

Directory of Open Access Journals (Sweden)

Kim E Innes

2014-04-01

Full Text Available Alzheimer's disease (AD is a chronic, progressive, brain disorder that affects at least 5.3 million Americans at an estimated cost of $148 billion, figures that are expected to rise steeply in coming years. Despite decades of research, there is still no cure for AD, and effective therapies for preventing or slowing progression of cognitive decline in at-risk populations remain elusive. While the etiology of AD remains uncertain, chronic stress, sleep deficits, and mood disturbance, conditions common in those with cognitive impairment, have been prospectively linked to the development and progression of both chronic illness and memory loss and are significant predictors of AD. Therapies such as meditation that specifically target these risk factors may thus hold promise for slowing and possibly preventing cognitive decline in those at risk. In this paper, we briefly review the existing evidence regarding the potential utility of meditation as a therapeutic intervention for those with and at risk for AD, discuss possible mechanisms underlying the observed benefits of meditation, and outline directions for future research.

Physical inactivity: the "Cinderella" risk factor for noncommunicable disease prevention.

Science.gov (United States)

Bull, Fiona C; Bauman, Adrian E

2011-08-01

There is strong evidence demonstrating the direct and indirect pathways by which physical activity prevents many of the major noncommunicable diseases (NCD) responsible for premature death and disability. Physical inactivity was identified as the 4th leading risk factor for the prevention of NCD, preceded only by tobacco use, hypertension, and high blood glucose levels, and accounting for more than 3 million preventable deaths globally in 2010. Physical inactivity is a global public health priority but, in most countries, this has not yet resulted in widespread recognition nor specific physical activity-related policy action at the necessary scale. Instead, physical inactivity could be described as the Cinderella of NCD risk factors, defined as "poverty of policy attention and resourcing proportionate to its importance." The pressing question is "Why is this so?" The authors identify and discuss 8 possible explanations and the need for more effective communication on the importance of physical activity in the NCD prevention context. Although not all of the issues identified will be relevant for any 1 country, it is likely that at different times and in different combinations these 8 problems continue to delay national-level progress on addressing physical inactivity in many countries. The authors confirm that there is sufficient evidence to act, and that much better use of well-planned, coherent communication strategies are needed in most countries and at the international level. Significant opportunities exist. The Toronto Charter on Physical Activity and the Seven Investments that Work are 2 useful tools to support increased advocacy on physical activity within and beyond the context of the crucial 2011 UN High-Level Meeting on NCDs.

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.

Risk Factors and Prevention Strategies for Suicide among the Elderly

Science.gov (United States)

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

2012-01-01

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

New horizons in fall prevention.

Science.gov (United States)

Lord, Stephen R; Close, Jacqueline C T

2018-04-25

Falls pose a major threat to the well-being and quality of life of older people. Falls can result in fractures and other injuries, disability and fear and can trigger a decline in physical function and loss of autonomy. This article synthesises recent published findings on fall risk and mobility assessments and fall prevention interventions and considers how this field of research may evolve in the future. Fall risk topics include the utility of remote monitoring using wearable sensors and recent work investigating brain activation and gait adaptability. New approaches for exercise for fall prevention including dual-task training, cognitive-motor training with exergames and reactive step training are discussed. Additional fall prevention strategies considered include the prevention of falls in older people with dementia and Parkinson's disease, drugs for fall prevention and safe flooring for preventing fall-related injuries. The review discusses how these new initiatives and technologies have potential for effective fall prevention and improved quality of life. It concludes by emphasising the need for a continued focus on translation of evidence into practice including robust effectiveness evaluations of so that resources can be appropriately targeted into the future.

Role of the American Institute for Pollution Prevention in reducing environmental risk

International Nuclear Information System (INIS)

Hauser, T.R.

1991-01-01

The EPA Science Advisory Board recommended that in the decade of the 1990's, EPA strategy should focus on the long-term goal of preventing and reducing environmental risk and should shift from end-of-pipe controls to preventing the generation of pollution. To assist EPA in developing and implementing this philosophy, the American Institute for Pollution Prevention (AIPP) was founded jointly by EPA and the University of Cincinnati in June, 1989. The mission of the Institute is to generate broad support from private and public sectors and to assist EPA in achieving widespread and expeditious adoption of pollution prevention concepts. AIPP will provide a novel communication bridge between EPA and industry. AIPP will provide and promote liasion between professionals in the field of pollution and those who need to employ new and improved pollution prevention techniques

The Importance of Behavioral Risk Factors for Prevention of Chronic Diseases

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Mahmut Kilic

2011-12-01

Full Text Available In 2005, the cause for almost 60.0% of the deaths in the world is chronic diseases. In the word each year, due to die 5.1 million people from tobacco use, 3.2 million people from physical inactivity, 2.8 million people from overweight or obesity, and 2.7 million people from inadequate intake of fruit and vegetables. The relationships between environmental, socio-economic, cultural and individual characteristics of the risk factors were multi-dimensional and complex. Today, socio-economic burden of disease and risk factors they bring to society are calculated and determined according to this policy. According to World Health Organization (WHO Global Health Risks report, tobacco use, being overweight or obese, insufficient physical activity, alcohol consumption and inadequate fruit and vegetable consumption were responsible one-third of deaths (34.4%, and 19.3% (excluded inadequate e fruits and vegetables consumption of the burden of DALYs in middle-income countries. According to Turkey the National Burden of Disease (NBD and WHO is preparing the Global Burden of Disease 2005, which is fundamental in the prevention of chronic diseases is life style risks that can be prevented, controlled, and changed. According to the NBD 2004 study, 79% of deaths were due to non-communicable diseases in our country. The primary risk factor for DALY is high blood pressure, and following 6 risk factors were related to behavior in our country. Smoking, being overweight or obese, alcohol consumption, insufficient fruits and vegetables consumption, inactive life, and high dietary fat and salt intake which are considered to be significant risk factors for chronic diseases are lifestyle behaviors. When adults visited to health facilities for any reason, their risky behavior can be evaluated. [TAF Prev Med Bull 2011; 10(6.000: 735-740

Alendronate for fracture prevention in postmenopause.

Science.gov (United States)

Holder, Kathryn K; Kerley, Sara Shelton

2008-09-01

, 0.26 to 0.85) and a 1 percent absolute risk reduction. The only significance found for wrist fractures was in secondary prevention, with a 50 percent relative risk reduction (RR = 0.50; 95% CI, 0.34 to 0.73) and a 2 percent absolute risk reduction. For adverse events, the authors found no statistically significant difference in any included study. However, observational data raise concerns about potential risk for upper gastrointestinal injury and, less commonly, osteonecrosis of the jaw. At 10 mg of alendronate per day, clinically important and statistically significant reductions in vertebral, nonvertebral, hip, and wrist fractures were observed for secondary prevention. The authors found no statistically significant results for primary prevention, with the exception of vertebral fractures, for which the reduction was clinically important.

Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies.

Science.gov (United States)

Pillemer, Karl; Burnes, David; Riffin, Catherine; Lachs, Mark S

2016-04-01

Elder mistreatment is now recognized internationally as a pervasive and growing problem, urgently requiring the attention of health care systems, social welfare agencies, policymakers, and the general public. In this article, we provide an overview of global issues in the field of elder abuse, with a focus on prevention. This article provides a scoping review of key issues in the field from an international perspective. By drawing primarily on population-based studies, this scoping review provided a more valid and reliable synthesis of current knowledge about prevalence and risk factors than has been available. Despite the lack of scientifically rigorous intervention research on elder abuse, the review also identified 5 promising strategies for prevention. The findings highlight a growing consensus across studies regarding the extent and causes of elder mistreatment, as well as the urgent need for efforts to make elder mistreatment prevention programs more effective and evidence based. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Preventive care delivered within Public Dental Service after caries risk assessment of young adults

DEFF Research Database (Denmark)

Hänsel Petersson, G; Ericson, E; Twetman, S

2016-01-01

OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

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

Science.gov (United States)

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

2013-01-01

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

Associations Between Fathers' and Sons' Sexual Risk in Rural Kenya: The Potential for Intergenerational Transmission.

Science.gov (United States)

Giusto, Ali M; Green, Eric P; Puffer, Eve S

2017-08-01

Despite high rates of HIV in areas of Sub-Saharan Africa and men's role in driving the epidemic, little is known about whether or how sexual risk-both behaviors and beliefs-may be passed down through generations of males. This study examined associations between sexual risk behaviors and sex-related beliefs of adolescent males and those of their male caregivers in Kenya, as well as the potential moderating effects of parenting characteristics and father-son relationship quality. Cross-sectional linear regression analysis was applied to baseline data from a trial of a family- and church-based intervention for families in rural Kenya that followed a stepped-wedge cluster randomized design. Our subsample consisted of 79 male caregiver and son (aged 10-16 years) dyads. Results demonstrated a direct relationship between fathers' and sons' sex-related beliefs that was not moderated by parenting or quality of father-son relationship. Parenting/relationship characteristics did moderate the relationship between fathers' and sons' sexual behavior; if fathers did not engage in high-risk sex and exhibited more positive parenting/higher relationship quality, their sons were less likely to be sexually active. Among fathers having high-risk sex, parenting was unrelated to sons' behavior except at very high levels of positive parenting/relationship quality; at these levels, sons were actually more likely to have had sex. Findings support recommendations to include male caregivers in youth HIV prevention efforts, potentially by targeting fathers' parenting strategies and their individual risk. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Adult mortality attributable to preventable risk factors for non-communicable diseases and injuries in Japan: a comparative risk assessment.

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Nayu Ikeda

2012-01-01

Full Text Available BACKGROUND: The population of Japan has achieved the longest life expectancy in the world. To further improve population health, consistent and comparative evidence on mortality attributable to preventable risk factors is necessary for setting priorities for health policies and programs. Although several past studies have quantified the impact of individual risk factors in Japan, to our knowledge no study has assessed and compared the effects of multiple modifiable risk factors for non-communicable diseases and injuries using a standard framework. We estimated the effects of 16 risk factors on cause-specific deaths and life expectancy in Japan. METHODS AND FINDINGS: We obtained data on risk factor exposures from the National Health and Nutrition Survey and epidemiological studies, data on the number of cause-specific deaths from vital records adjusted for ill-defined codes, and data on relative risks from epidemiological studies and meta-analyses. We applied a comparative risk assessment framework to estimate effects of excess risks on deaths and life expectancy at age 40 y. In 2007, tobacco smoking and high blood pressure accounted for 129,000 deaths (95% CI: 115,000-154,000 and 104,000 deaths (95% CI: 86,000-119,000, respectively, followed by physical inactivity (52,000 deaths, 95% CI: 47,000-58,000, high blood glucose (34,000 deaths, 95% CI: 26,000-43,000, high dietary salt intake (34,000 deaths, 95% CI: 27,000-39,000, and alcohol use (31,000 deaths, 95% CI: 28,000-35,000. In recent decades, cancer mortality attributable to tobacco smoking has increased in the elderly, while stroke mortality attributable to high blood pressure has declined. Life expectancy at age 40 y in 2007 would have been extended by 1.4 y for both sexes (men, 95% CI: 1.3-1.6; women, 95% CI: 1.2-1.7 if exposures to multiple cardiovascular risk factors had been reduced to their optimal levels as determined by a theoretical-minimum-risk exposure distribution. CONCLUSIONS

Vertigo and dizziness in adolescents: Risk factors and their population attributable risk.

Science.gov (United States)

Filippopulos, Filipp M; Albers, Lucia; Straube, Andreas; Gerstl, Lucia; Blum, Bernhard; Langhagen, Thyra; Jahn, Klaus; Heinen, Florian; von Kries, Rüdiger; Landgraf, Mirjam N

2017-01-01

To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.

The potential carcinogenic risk of tanning beds: clinical guidelines and patient safety advice

International Nuclear Information System (INIS)

Mogensen, Mette; Jemec, Gregor BE

2010-01-01

In 2009, the WHO listed ultraviolet (UV) radiation as a group 1 carcinogen. In spite of this, each year, millions of people tan indoor in Western countries. The aim of this review is to summarize evidence of tanning bed carcinogenesis and to present guidelines for use of tanning beds and patient safety advice. A narrative review of the literature was conducted based on both PubMed and Medline searches and on literature review of the retrieved papers. Use of indoor tanning beds represents a significant and avoidable risk factor for the development of both melanoma and nonmelanoma skin cancers. Frequent tanners are more often adolescent females. Tanning beds have additional potential adverse effects such as burns, solar skin damage, infection, and possibly also addictive behavior. The effort in preventing UV light-induced carcinogenesis should currently be aimed at developing new strategies for public health information. Tanning beds are one preventable source of UV radiation. In the majority of people solar UV radiation continues to be the major factor and therefore anti-tanning campaigns must always include sunbathers

Emergency Department Catheter-Associated Urinary Tract Infection Prevention: Multisite Qualitative Study of Perceived Risks and Implemented Strategies.

Science.gov (United States)

Carter, Eileen J; Pallin, Daniel J; Mandel, Leslie; Sinnette, Corine; Schuur, Jeremiah D

2016-02-01

Existing knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs. In this qualitative comparative case study, we enrolled early-adopting EDs, that is, those using criteria for urinary catheter placement and tracking the frequency of catheters placed in the ED. At 6 diverse facilities, we conducted 52 semistructured interviews and 9 focus groups with hospital and ED participants. All ED CAUTI programs originated from a hospitalwide focus on CAUTI prevention. Staff were motivated to address CAUTI because they believed program compliance improved patient care. ED CAUTI prevention was perceived to differ from CAUTI prevention in the inpatient setting. To identify areas of ED CAUTI prevention focus, programs examined ED workflow and identified 4 CAUTI risks: (1) inappropriate reasons for urinary catheter placement; (2) physicians' limited involvement in placement decisions; (3) patterns of urinary catheter overuse; and (4) poor insertion technique. Programs redesigned workflow to address risks by (1) requiring staff to specify the medical reason for catheter at the point of order entry and placement; (2) making physicians responsible for determining catheter use; (3) using catheter alternatives to address patterns of overuse; and (4) modifying urinary catheter insertion practices to ensure proper placement. Early-adopting EDs redesigned workflow to minimize catheter use and ensure proper insertion technique. Assessment of ED workflow is necessary to identify and modify local practices that may increase CAUTI risk.

Individual resources for the pupil′s addictive behavior prevention

Directory of Open Access Journals (Sweden)

Florova N.B.

2015-03-01

Full Text Available The expanding knowledge about psychology of addictive adolescents allows to develop innovative strategies and to set new accents in prevention activity among students. Now it is reinforcing the trend of individual preventive work, which is differentiated for ages and stages of the educational process. Such work is most relevant to group of risk for involvement –namely, for students, changing living environment, - who are at the first semester of college. Here is an overview of science concepts of individual preventive engagement, primarily in alcoholism, based on recovery of the spiritual realm, psychological well-being, spiritual potential of any age. On the example of concepts about cognitive behavioral strategies and risks of failure it is shown their potential effectiveness for the monitoring of chemical dependence among adolescents.

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

NARCIS (Netherlands)

Steenkiste, B.C. van; Grol, R.P.T.M.; Weijden, G.D.E.M. van der

2008-01-01

BACKGROUND: Cardiovascular disease prevention is guided by so-called risk tables for calculating individual's risk numbers. However, they are not widely used in routine practice and it is important to understand the conditions for their use. OBJECTIVES: Systematic review of the literature on

Multiple regression as a preventive tool for determining the risk of Legionella spp.

Directory of Open Access Journals (Sweden)

Enrique Gea-Izquierdo

2012-04-01

Full Text Available To determine the interrelationship between health & hygiene conditions for prevention of legionellosis, the compositionof materials used in water distribution systems, the water origin and Legionella pneumophila risk. Material and methods. Include adescriptive study and multiple regression analysis on a sample of golf course sprinkler irrigation systems (n=31 pertaining to hotelslocated on the Costa del Sol (Malaga, Spain. The study was carried out in 2009. Results. Presented a significant lineal relation, withall the independent variables contributing significantly (p<0.05 to the model’s fit. The relationship between water type and the risk ofLegionella, as well as the material composition and the latter, is lineal and positive. In contrast, the relationship between health-hygieneconditions and Legionella risk is lineal and negative. Conclusion. The characterization of Legionella pneumophila concentration, asdefined by the risk in water and through use of the predictive method, can contribute to the consideration of new influence variables inthe development of the agent, resulting in improved control and prevention of the disease.

Holistic risk assessment and risk prevention approach to the mechanized NDT and the inspection procedure

International Nuclear Information System (INIS)

Bertovic, Marija; Mueller, Christina; Fahlbruch, Babette; Ronneteg, Ulf; Pitkaenen, Jorma

2013-01-01

The difficulty to deal with human factors in non-destructive testing (NDT) stems from their diversity and complexity - no single human or organizational factor is responsible for the entire fluctuations in the NDT performance. The typical approach to decrease the variability in the inspection results had been found in replacing manual NDT with mechanized methods. However, even though some human errors can be avoided by automating the process, there are new risks that can arise from its application and need to be further investigated. To address this problem, a combination of theoretical and practical approaches should be applied, where the source of error is not seen only in the inspector, but also in his interaction with social and technical systems, as well as the organization. An analysis of potential risks in the use of mechanized inspections methods for spent fuel canisters has shown potential for human error in acquisition, as well as in the evaluation of the gathered results. Assessed causes of those errors lay in the inspector, but also in the organization and in shortcomings of the inspection procedure. The aim of the analysis was to provide with preventive measures and optimization recommendations. Those include further automation of the process, application of human redundancy, improvements of the inspection procedure, hardware and software improvements etc. Before improvements can be made, there is a need to understand the resulting processes and the influence of their interaction on the inspection results. The results have shown that when working with an automated system, one must avoid over relying on its proper functioning and form appropriate trust towards automation. Furthermore, human redundancy should be applied only in cases where the redundant inspectors are completely unaware of each other, in order to avoid the effects of social loafing and shirking. The inspection procedure is one of the most important tools in the application of NDT. On an

Holistic risk assessment and risk prevention approach to the mechanized NDT and the inspection procedure

Energy Technology Data Exchange (ETDEWEB)

Bertovic, Marija; Mueller, Christina [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany); Fahlbruch, Babette [TUEV NORD Systems GmbH und Co. KG, Berlin (Germany); Ronneteg, Ulf [SKB Swedish Nuclear Fuel and Waste Management Co., Oskarshamn (Sweden); Pitkaenen, Jorma [Posiva Oy, Eurajoki (Finland)

2013-07-01

The difficulty to deal with human factors in non-destructive testing (NDT) stems from their diversity and complexity - no single human or organizational factor is responsible for the entire fluctuations in the NDT performance. The typical approach to decrease the variability in the inspection results had been found in replacing manual NDT with mechanized methods. However, even though some human errors can be avoided by automating the process, there are new risks that can arise from its application and need to be further investigated. To address this problem, a combination of theoretical and practical approaches should be applied, where the source of error is not seen only in the inspector, but also in his interaction with social and technical systems, as well as the organization. An analysis of potential risks in the use of mechanized inspections methods for spent fuel canisters has shown potential for human error in acquisition, as well as in the evaluation of the gathered results. Assessed causes of those errors lay in the inspector, but also in the organization and in shortcomings of the inspection procedure. The aim of the analysis was to provide with preventive measures and optimization recommendations. Those include further automation of the process, application of human redundancy, improvements of the inspection procedure, hardware and software improvements etc. Before improvements can be made, there is a need to understand the resulting processes and the influence of their interaction on the inspection results. The results have shown that when working with an automated system, one must avoid over relying on its proper functioning and form appropriate trust towards automation. Furthermore, human redundancy should be applied only in cases where the redundant inspectors are completely unaware of each other, in order to avoid the effects of social loafing and shirking. The inspection procedure is one of the most important tools in the application of NDT. On an

[Screening for the risk of allergy and prevention in French maternity units: A survey].

Science.gov (United States)

Chouraqui, J-P; Simeoni, U; Tohier, C; Nguyen, F; Kempf, C; Beck, L; Lachambre, E

2015-09-01

Allergy has been on the rise for half a century and concerns nearly 30% of children; it has now become a real public health problem. The guidelines on prevention of allergy set up by the French Society of Paediatrics (SFP) and the European Society of Paediatric Allergology and Clinical Immunology (ESPACI) are based on screening children at risk through a systematic search of the family history and recommend, for children at risk, exclusive breastfeeding whenever possible or otherwise utilization of hypoallergenic infant formula, which has demonstrated efficacy. The AllerNaiss practice survey assessed the modes of screening and prevention of allergy in French maternity units in 2012. The SFP guidelines are known by 82% of the maternity units that took part in the survey, and the ESPACI guidelines by 55% of them. A screening strategy is in place in 59% of the participating maternity wards, based on local consensus for 36% of them, 13% of the units having a written screening procedure. Screening is based on the search for a history of allergy in first-degree relatives (99%) during pregnancy (51%), in the delivery room (50%), and after delivery (89%). A mode of prevention of the risk of allergy exists in 62% of the maternity units, most often in writing (49%). A hypoallergenic infant formula is prescribed for non-breastfed children in 90% of the units. The survey shows that there is a real need for formalization of allergy risk screening and prevention of allergy in newborns in French maternity units. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

'With the best of reasons': cervical cancer prevention policy and the suppression of sexual risk factor information.

Science.gov (United States)

Braun, V; Gavey, N

1999-05-01

Cervical cancer is a very common but largely preventable cancer. Despite considerable medical knowledge of risk and even causal factors, possible social-behavioural strategies for the primary prevention of cervical cancer have rarely been explored as a viable addition to cervical screening. We examine key policy documents and interview 18 key informants on cervical cancer prevention in New Zealand. Using a discourse analytic approach we identify and discuss two discourses (which we have labelled 'protectionism' and 'right to know') which inform positions on whether or not women should be provided with information regarding sexual risk factors for cervical cancer. Cervical cancer prevention policy in New Zealand, which largely reflects a protectionist discourse, suppresses sexual risk factor information and focuses exclusively on cervical screening. The right to know discourse informs an alternative position, which contends that women have a right to be informed about risk factors. We discuss these positions in relation to questions about women's rights, the principle of informed choice, and attempts to judge what is in women's 'best interests.'

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

Science.gov (United States)

Yazdani, Amin; Wells, Richard

2012-01-01

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

Estimating lung cancer risks of indoor radon: applications for prevention

International Nuclear Information System (INIS)

Klotz, J.B.

1986-01-01

The epidemiologic evidence for a serious lung cancer hazard from radon exposure is very strong, and cumulative exposures accrued in residences may frequently overlap those accrued in underground miners. However, many uncertainties exist in extrapolating from mining to indoor risks because of differences in the populations, in radon exposure variables, and in other exposures. Risks are also considered for indoor radon exposures outside the home. There is already suggestive evidence of an association of lung cancer with radon levels in community settings, and several large-scale investigations are in progress. Some important questions regarding quantifying risk may not be approached, however; some further research needs are outlined including development of techniques for preventing or postponing lung cancer in individuals previously exposed to high radon levels. 31 references, 2 tables

Worldwide application of prevention science in adolescent health

Science.gov (United States)

Catalano, Richard F; Fagan, Abigail A; Gavin, Loretta E; Greenberg, Mark T; Irwin, Charles E; Ross, David A; Shek, Daniel T L

2015-01-01

The burden of morbidity and mortality from non-communicable disease has risen worldwide and is accelerating in low-income and middle-income countries, whereas the burden from infectious diseases has declined. Since this transition, the prevention of non-communicable disease as well as communicable disease causes of adolescent mortality has risen in importance. Problem behaviours that increase the short-term or long-term likelihood of morbidity and mortality, including alcohol, tobacco, and other drug misuse, mental health problems, unsafe sex, risky and unsafe driving, and violence are largely preventable. In the past 30 years new discoveries have led to prevention science being established as a discipline designed to mitigate these problem behaviours. Longitudinal studies have provided an understanding of risk and protective factors across the life course for many of these problem behaviours. Risks cluster across development to produce early accumulation of risk in childhood and more pervasive risk in adolescence. This understanding has led to the construction of developmentally appropriate prevention policies and programmes that have shown short-term and long-term reductions in these adolescent problem behaviours. We describe the principles of prevention science, provide examples of efficacious preventive interventions, describe challenges and potential solutions to take efficacious prevention policies and programmes to scale, and conclude with recommendations to reduce the burden of adolescent mortality and morbidity worldwide through preventive intervention. PMID:22538180

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

Directory of Open Access Journals (Sweden)

Jiménez Francisco

2010-06-01

Full Text Available Abstract Background The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice. Methods/Design Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers. Discussion Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336.

Re-evaluating the Rose approach: comparative benefits of the population and high-risk preventive strategies

DEFF Research Database (Denmark)

Cooney, Marie-Therese; Dudina, Alexandra; Whincup, Peter

2009-01-01

BACKGROUND: Options for the prevention of cardiovascular disease, the greatest global cause of death, include population preventive measures (the Rose approach), or specifically seeking out and managing high-risk cases. However, the likely benefit of a population approach has been recently...

Re-evaluating the Rose approach: comparative benefits of the population and high-risk preventive strategies.

LENUS (Irish Health Repository)

Cooney, Marie-Therese

2009-10-01

Options for the prevention of cardiovascular disease, the greatest global cause of death, include population preventive measures (the Rose approach), or specifically seeking out and managing high-risk cases. However, the likely benefit of a population approach has been recently questioned.

A quality control circle process to improve implementation effect of prevention measures for high-risk patients.

Science.gov (United States)

Feng, Haixia; Li, Guohong; Xu, Cuirong; Ju, Changping; Suo, Peiheng

2017-12-01

The aim of the study was to analyse the influence of prevention measures on pressure injuries for high-risk patients and to establish the most appropriate methods of implementation. Nurses assessed patients using a checklist and factors influencing the prevention of a pressure injury determined by brain storming. A specific series of measures was drawn up and an estimate of risk of pressure injury determined using the Braden Scale, analysis of nursing documents, implementation of prevention measures for pressure sores and awareness of the system both before and after carrying out a quality control circle (QCC) process. The overall scores of implementation of prevention measures ranged from 74.86 ± 14.24 to 87.06 ± 17.04, a result that was statistically significant (P prevention measure scores ranged from 11.48 ± 4.18 to 13.96 ± 3.92. Differences in all of the above results are statistically significant (P prevention measures for patients who are vulnerable to pressure sores and is of practical importance to their prevention and control. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Occupational injuries and illnesses in rubber factory: Profile, Potential Hazards and possible prevention

Directory of Open Access Journals (Sweden)

Tri Hari Irfani

2015-12-01

Full Text Available Rubber is one of the important commodities in the world. Globally, workers are facing so many problems of hazards that produce by rubber process. In Indonesia, there are several data of occupational problems such as respiratory diseases, muscle and skeletal diseases, gastrointestinal diseases, diseases of the teeth and oral cavity, skin diseases and skin tissue. In Iranian rubber factory, Iran, workers had suffered from some kind of musculoskeletal symptoms. Stomach and liver cancers in workers are having in Shanghai tire factory. In addition, Germany has cancer problem of their workers who work in rubber factory. Most of the rubber process in the factory can cause some hazards of the workers. In unloading area and area that operator is taking the dirt manually, workers are facing ergonomic problems. The possible control is reduce weight of load, team lift the object with two or more workers and Use mechanical assist. Machine safeguarding is essential for protecting from Cutting process that can make workers amputation organs such as hands, and fingers. In bale process, the workers need to cut raw rubber into bale in bale cutting. Furthermore, workers are facing with amputation problem. To manage that, It must be designed as a standard which has interlocking guards to prevent access to the cutting area. When wrapped using plastic, workers use a heated iron and sticked in plastic so that it blends neatly. The risks are fingers can cut accidently and then the workers also get contamination from polyvinyl chloride (PVC. The possible preventions are use an automatic plastic wrapping machine with palletized product sitting on a turntable and respirator. Another problem is contact dermatitis that has been reported frequently among rubber workers. The prevention for that problem is using Gloves. The aim of researcher is to provide the profile of occupational injuries and illnesses, potential hazards in rubber factory to prevent the workers.

Fall prevention in central coast community pharmacies.

Science.gov (United States)

Stuart, Gina M; Kale, Helen L

2018-04-19

Fall injuries among people aged 65 years and over (older people) cause substantial health decline and cost to the health system. In 2009 in New South Wales, 25.6% of older people fell in the previous year, and 10.7% (32 000) were hospitalised. Pharmacists are trusted professionals, who interact extensively with older people and have potential to augment fall prevention in pharmacies. This brief report describes how professional development improved pharmacist's knowledge and confidence in fall prevention, encouraged implementation of fall prevention plans and facilitated the provision of brief fall prevention interventions for older clients, after identification of fall risk. In 2014, pharmacists from all Central Coast pharmacies (n = 76) were invited to free, continuing professional development (CPD) in fall prevention. It provided education and resources to identify clients' fall risk, conduct brief fall prevention interventions and implement fall prevention health promotion plans (FPHPP). Pharmacists completed written: Baseline and post-workshop questionnaires to assess changes in pharmacist's knowledge and confidence, and existing fall prevention in pharmacies. Logs of client fall risk and brief fall prevention interventions offered to clients. Four-month follow-up questionnaires to assess implementation of FPHPPs and pharmacy practice changes. Pharmacists representing 36% of pharmacies participated. At four-month follow-up, 67% had implemented FPHPPs, and 62% delivered brief interventions determined by client fall risk. Fall prevention in pharmacies can be augmented through locally provided CPD tailored for pharmacists. SO WHAT?: This model could increase fall prevention reach. It is transferable to settings where health professionals provide services to older adults and require reregistration through professional development. © 2018 Australian Health Promotion Association.

[Fall prevention counselling for patients with hearing and balance disorders].

Science.gov (United States)

Ptok, M; Ptok, A; Jungheim, M; Kühn, D; Miller, S

2014-09-01

Otolaryngologists caring for patients with hearing and balance disorders are also responsible for advising patients about their increased risk of falling and informing them of fall prevention measures. This review will give a brief overview of appropriate programs. This systematic review is based on a selective literature search. Intrinsic and extrinsic fall risk factors can be distinguished. The former include not only hearing and balance disorders, but also increasing age, nocturia, dementia, limited mobility and poor nutritional status. Extrinsic factors include, for example, unfixed carpet edges, poor lighting and poor footwear. Fall prevention can be achieved through appropriate counselling about risk factors and fall prevention courses. The frequency of falls--with potentially very adverse consequences--increases continuously beyond the age of 60 years. Furthermore, the risk of falling is significantly increased in patients with hearing and balance disorders. Otolaryngologists caring for this patient group should inform them about their fall risk and advise appropriate countermeasures during counselling. A basal knowledge of fall prevention measures is therefore helpful.

Evaluating an In-School Drug Prevention Program for At-Risk Youth.

Science.gov (United States)

DeWit, David J.; Steep, Barbara; Silverman, Gloria; Stevens-Lavigne, Andrea; Ellis, Kathy; Smythe, Cindy; Rye, Barbara J.; Braun, Kathy; Wood, Eileen

2000-01-01

A drug prevention program involving 167 at-risk students in grades 8-10 at 9 Ontario schools resulted in reduced use of and less supportive attitudes toward alcohol, cannabis, tobacco, and tranquilizers. Program success is attributed to high attendance and retention, community health professionals' participation, comprehensive approach, strong…

Adolescent transformations of behavioral and neural processes as potential targets for prevention.

Science.gov (United States)

Eldreth, Dana; Hardin, Michael G; Pavletic, Nevia; Ernst, Monique

2013-06-01

Adolescence is a transitional period in development that is marked by a distinct, typical behavioral profile of high rates of exploration, novelty-seeking, and emotional lability. While these behaviors generally assist the adolescent transition to independence, they can also confer vulnerability for excessive risk-taking and psychopathology, particularly in the context of specific environmental or genetic influences. As prevention research depends on the identification of targets of vulnerability, the following review will discuss the interplay among motivational systems including reward-related, avoidance-related, and regulatory processes in typical and atypical adolescent development. Each set of processes will be discussed in relation to their underlying neural correlates and distinct developmental trajectories. Evidence suggests that typical adolescent behavior and the risk for atypical development are mediated by heightened adolescent responsiveness of reward-related and avoidance-related systems under specific conditions, concurrent with poor modulation by immature regulatory processes. Finally, we will propose strategies to exploit heightened reward processing to reinforce inhibitory control, which is an essential component of regulatory processes in prevention interventions.

Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

Science.gov (United States)

Sullivan, Helen W.; Beckjord, Ellen Burke; Finney Rutten, Lila J.; Hesse, Bradford W.

2008-01-01

This study tested whether the risk perception attitude framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey were analyzed to assess respondents' reported likelihood of developing cancer (risk) and perceptions of whether they could lower their…

Impact of preventive therapy on the risk of breast cancer among women with benign breast disease.

Science.gov (United States)

Cuzick, Jack; Sestak, Ivana; Thorat, Mangesh A

2015-11-01

There are three main ways in which women can be identified as being at high risk of breast cancer i) family history of breast and/or ovarian cancer, which includes genetic factors ii) mammographically identified high breast density, and iii) certain types of benign breast disease. The last category is the least common, but in some ways the easiest one for which treatment can be offered, because these women have already entered into the treatment system. The highest risk is seen in women with lobular carcinoma in situ (LCIS), but this is very rare. More common is atypical hyperplasia (AH), which carries a 4-5-fold risk of breast cancer as compared to general population. Even more common is hyperplasia of the usual type and carries a roughly two-fold increased risk. Women with aspirated cysts are also at increased risk of subsequent breast cancer. Tamoxifen has been shown to be particularly effective in preventing subsequent breast cancer in women with AH, with a more than 70% reduction in the P1 trial and a 60% reduction in IBIS-I. The aromatase inhibitors (AIs) also are highly effective for AH and LCIS. There are no published data on the effectiveness of tamoxifen or the AIs for breast cancer prevention in women with hyperplasia of the usual type, or for women with aspirated cysts. Improving diagnostic consistency, breast cancer risk prediction and education of physicians and patients regarding therapeutic prevention in women with benign breast disease may strengthen breast cancer prevention efforts. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impact of Fall Prevention on Nurses and Care of Fall Risk Patients.

Science.gov (United States)

King, Barbara; Pecanac, Kristen; Krupp, Anna; Liebzeit, Daniel; Mahoney, Jane

2018-03-19

Falls are common events for hospitalized older adults, resulting in negative outcomes both for patients and hospitals. The Center for Medicare and Medicaid (CMS) has placed pressure on hospital administrators by identifying falls as a "never event", resulting in a zero falls goal for many hospitals. Staff nurses are responsible for providing direct care to patients and for meeting the hospital no falls goal. Little is known about the impact of "zero falls" on nurses, patients and the organization. A qualitative study, using Grounded Dimensional Analysis (GDA) was conducted to explore nurses' experiences with fall prevention in hospital settings and the impact of those experiences on how nurses provide care to fall risk patients. Twenty-seven registered nurses and certified nursing assistants participated in in-depth interviews. Open, axial and selective coding was used to analyze data. A conceptual model which illustrates the impact of intense messaging from nursing administration to prevent patient falls on nurses, actions nurses take to address the message and the consequences to nurses, older adult patients and to the organization was developed. Intense messaging from hospital administration to achieve zero falls resulted in nurses developing a fear of falls, protecting self and unit, and restricting fall risk patients as a way to stop messages and meet the hospital goal. Results of this study identify unintended consequences of fall prevention message on nurses and older adult patients. Further research is needed understand how nurse care for fall risk patients.

Diabetes prevention among American Indians: the role of self-efficacy, risk perception, numeracy and cultural identity.

Science.gov (United States)

Simonds, Vanessa W; Omidpanah, Adam; Buchwald, Dedra

2017-10-02

According to the Risk Perception Attitude (RPA) framework, classifying people according to their perceptions of disease risk and their self-efficacy beliefs allows us to predict their likelihood for engaging in preventive behaviors. Health interventions can then be targeted according to RPA group. We applied the framework to type 2 diabetes prevention behaviors among American Indians and expanded it to include culture and numeracy. Using a cross-sectional study design, we surveyed a sample of Northern Plains American Indians in a reservation community setting on self-reported perceptions of diabetes risk, objective diabetes risk, self-efficacy, engagement in healthy behaviors, knowledge of diabetes risk factors, and covariates including demographics, numeracy, and cultural identity. We used the RPA framework to classify participants into four groups based on their perceptions of risk and self-efficacy. Analyses of variance and covariance estimated inter-group differences in behaviors associated with type 2 diabetes prevention. Among 128 participants, our only finding consistent with the RPA framework was that self-efficacy and risk perception predicted knowledge about diabetes risk factors. We found limited evidence for the influence of cultural identity within the RPA framework. Overall, participants had lower numeracy skills which tended to be associated with inaccurate perceptions of higher levels of risk. The theoretical framework may benefit from inclusion of further contextual factors that influence these behaviors. Attention to numeracy skills stands out in our study as an important influence on the RPA framework, highlighting the importance of attending to numeracy when targeting and tailoring risk information to participants segmented by the RPA framework.

Potential risks of nuclear ships

International Nuclear Information System (INIS)

Oelgaard, P.L.

1994-07-01

This report represents an attempt to evaluate the potential risks of nuclear ships. Firstly reasons are given why nuclear ship accidents will not lead to accidents of the magnitude of the Chernobyl accident. This is due to much lower content of radioactive material and to different reactor designs. Next a review is given of the types of accidents which have actually occurred. Of these the reactor accidents which may lead to serious consequences for the crew and the environment are considered further. These are reactivity accidents and loss of coolant accidents. In addition the long term risks of sunken nuclear ships and sea disposed reactor compartments etc. are also discussed. Based on available accident data an attempt is made to estimate the probability of serious nuclear ship accidents. (au)

[Screening for atherosclerosis to prevent cardiovascular risk : a pro-contra debate].

Science.gov (United States)

Nanchen, David; Genest, Jacques

2018-02-28

Detecting atherosclerosis using imaging techniques is the subject of intense debate in the scientific community. Among the arguments in favor of screening, a better identification or better stratification of cardiovascular risk is mentioned, compared to cardiovascular risk scores based solely on traditional risk factors, such as blood pressure or cholesterol levels. Imaging techniques are also used to monitor the progression of atherosclerosis among patients using lipid-lowering or antihypertensive drugs in primary prevention. However, several experts in recent years have challenged the clinical utility of these imaging techniques in asymptomatic adults. This article proposes a debate « for or against » to describe the main arguments for or against the use of imaging for screening for atherosclerosis.

Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention.

Science.gov (United States)

Miovský, Michal; Vonkova, Hana; Čablová, Lenka; Gabrhelík, Roman

2015-11-01

To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles. A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups. The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children. We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research. Copyright © 2015 Elsevier Ltd. All rights reserved.

CSN competence in the new regulations on risk prevention at work

International Nuclear Information System (INIS)

Mendez, V. E.

1999-01-01

This article gives a summary of the paper as submitted by the authoress at the seminar organized by the Spanish Radiological Protection Society for analyzing the implications of the regulations on risk prevention at work in medical surveillance and radiological protection of radiation workers occupationally exposed to ionizing radiations. (Author)

Checklist Usage as a Guidance on Read-Back Reducing the Potential Risk of Medication Error

Directory of Open Access Journals (Sweden)

Ida Bagus N. Maharjana

2014-06-01

Full Text Available Hospital as a last line of health services shall provide quality service and oriented on patient safety, one responsibility in preventing medication errors. Effective collaboration and communication between the profession needed to achieve patient safety. Read-back is one way of doing effective communication. Before-after study with PDCA TQM approach. The samples were on the medication chart patient medical rd rd records in the 3 week of May (before and the 3 week in July (after 2013. Treatment using the check list, asked for time 2 minutes to read-back by the doctors and nurses after the visit together. Obtained 57 samples (before and 64 samples (after. Before charging 45.54% incomplete medication chart on patient medical records that have the potential risk of medication error to 10.17% after treatment with a read back check list for 10 weeks, with 77.78% based on the achievement of the PDCA TQM approach. Checklist usage as a guidance on Read-back as an effective communication can reduce charging incompleteness drug records on medical records that have the potential risk of medication errors, 45.54% to 10.17%.

The Green, Amber, Red Delineation of Risk and Need (GARDIAN) management system: a pragmatic approach to optimizing heart health from primary prevention to chronic disease management.

Science.gov (United States)

Carrington, Melinda J; Kok, Simone; Jansen, Kiki; Stewart, Simon

2013-08-01

A sustained epidemic of cardiovascular disease and related risk factors is a global phenomenon contributing significantly to premature deaths and costly morbidity. Preventative strategies across the full continuum of life, from a population to individual perspective, are not optimally applied. This paper describes a simple and adaptable 'traffic-light' system we have developed to systematically perform individual risk and need delineation in order to 'titrate' the intensity and frequency of healthcare intervention in a cost-effective manner. The GARDIAN (Green Amber Red Delineation of Risk and Need) system is an individual assessment of risk and need that modulates the frequency and intensity of future healthcare intervention. Individual assessment of risk and need for ongoing intervention and support is determined with reference to three domains: (1) clinical stability, (2) gold-standard management, and (3) a broader, holistic assessment of individual circumstance. This can be applied from a primary prevention, secondary prevention, or chronic disease management perspective. Our experience with applying and validating GARDIAN to titrate healthcare resources according to need has been extensive to date, with >5000 individuals profiled in a host of clinical settings. A series of clinical randomized trials will determine the impact of the GARDIAN system on important indices of healthcare utilization and health status. The GARDIAN model to delineating risk and need for varied intensity of management shows strong potential to cost effectively improve health outcomes for both individuals at risk of heart disease and those with established heart disease.

Optimizing prevention of hospital-acquired venous thromboembolism (VTE): prospective validation of a VTE risk assessment model.

Science.gov (United States)

Maynard, Gregory A; Morris, Timothy A; Jenkins, Ian H; Stone, Sarah; Lee, Joshua; Renvall, Marian; Fink, Ed; Schoenhaus, Robert

2010-01-01

Hospital-acquired (HA) venous thromboembolism (VTE) is a common source of morbidity/mortality. Prophylactic measures are underutilized. Available risk assessment models/protocols are not prospectively validated. Improve VTE prophylaxis, reduce HA VTE, and prospectively validate a VTE risk-assessment model. Observational design. Academic medical center. Adult inpatients on medical/surgical services. A simple VTE risk assessment linked to a menu of preferred VTE prophylaxis methods, embedded in order sets. Education, audit/feedback, and concurrent identification of nonadherence. Randomly sampled inpatient audits determined the percent of patients with "adequate" VTE prevention. HA VTE cases were identified concurrently via digital imaging system. Interobserver agreement for VTE risk level and judgment of adequate prophylaxis were calculated from 150 random audits. Interobserver agreement with 5 observers was high (kappa score for VTE risk level = 0.81, and for judgment of "adequate" prophylaxis = 0.90). The percent of patients on adequate prophylaxis improved each of the 3 years (58%, 78%, and 93%; P risk of HA VTE (risk ratio [RR] = 0.69; 95% confidence interval [CI] = 0.47-0.79) and preventable HA VTE (RR = 0.14; 95% CI = 0.06-0.31) occurred. We detected no increase in heparin-induced thrombocytopenia (HIT) or prophylaxis-related bleeding using administrative data/chart review. We prospectively validated a VTE risk-assessment/prevention protocol by demonstrating ease of use, good interobserver agreement, and effectiveness. Improved VTE prophylaxis resulted in a substantial reduction in HA VTE. (c) 2010 Society of Hospital Medicine.

Procedure for identifying and prevent risks in in vitro sugarcane plantlets marketing

Directory of Open Access Journals (Sweden)

Ana Rosa Hernández Freire

2014-10-01

Full Text Available Seed Banks and agricultural farms benefit greatly from plant in vitro Culture techniques, for their rapid propagation processes and the production of desease-free plantlets. However, the production and commercialization process can fail and it is not as successful l as it was supposed to. The objective of this study is to identify potential failure modes at the acclimatiztion stage of plantlets to ex vitro conditions at Estación Territorial de Investigaciones de la Caña de Azúcar de Villa Clara (ETICA. A methodology of Failure Mode and Effects Analysis (FMEA was applied. A value of 80 or higher was determined to be the Risk Priority Number (RPN and the more relevant failure modes were defined a t the acclimatization and commercialization stages and ground rules and assumptions were established in order to prevent and control failure modes of the process. The study and implementation of the methodology to other processes at ETICA is strongly recommended.

Risk management

International Nuclear Information System (INIS)

Magne, L.

1999-01-01

There is always a risk of an accident occurring at a nuclear power plant, however small. The problem lies in estimating the probability of it occurring. The method of probabilistic safety assessment provides this estimate, and by identifying the sources of potential risk, makes it possible to prevent them from occurring. It is not, however, a substitute for other decision-making processes. (author)

Vertigo and dizziness in adolescents: Risk factors and their population attributable risk.

Directory of Open Access Journals (Sweden)

Filipp M Filippopulos

Full Text Available To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies.The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking.Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively.Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.

Evaluation of the Prostate Cancer Prevention Trial Risk Calculator in a High-Risk Screening Population

Science.gov (United States)

Kaplan, David J.; Boorjian, Stephen A.; Ruth, Karen; Egleston, Brian L.; Chen, David Y.T.; Viterbo, Rosalia; Uzzo, Robert G.; Buyyounouski, Mark K.; Raysor, Susan; Giri, Veda N.

2009-01-01

Introduction Clinical factors in addition to PSA have been evaluated to improve risk assessment for prostate cancer. The Prostate Cancer Prevention Trial (PCPT) risk calculator provides an assessment of prostate cancer risk based on age, PSA, race, prior biopsy, and family history. This study evaluated the risk calculator in a screening cohort of young, racially diverse, high-risk men with a low baseline PSA enrolled in the Prostate Cancer Risk Assessment Program. Patients and Methods Eligibility for PRAP include men ages 35-69 who are African-American, have a family history of prostate cancer, or have a known BRCA1/2 mutation. PCPT risk scores were determined for PRAP participants, and were compared to observed prostate cancer rates. Results 624 participants were evaluated, including 382 (61.2%) African-American men and 375 (60%) men with a family history of prostate cancer. Median age was 49.0 years (range 34.0-69.0), and median PSA was 0.9 (range 0.1-27.2). PCPT risk score correlated with prostate cancer diagnosis, as the median baseline risk score in patients diagnosed with prostate cancer was 31.3%, versus 14.2% in patients not diagnosed with prostate cancer (p<0.0001). The PCPT calculator similarly stratified the risk of diagnosis of Gleason score ≥7 disease, as the median risk score was 36.2% in patients diagnosed with Gleason ≥7 prostate cancer versus 15.2% in all other participants (p<0.0001). Conclusion PCPT risk calculator score was found to stratify prostate cancer risk in a cohort of young, primarily African-American men with a low baseline PSA. These results support further evaluation of this predictive tool for prostate cancer risk assessment in high-risk men. PMID:19709072

Risk Prevention for Nuclear Materials and Radioactive Sources

International Nuclear Information System (INIS)

Badawy, I.

2008-01-01

The present paper investigates the parameters which may have effects on the safety of nuclear materials and other radioactive sources used in peaceful applications of atomic energy. The emergency response planning in such situations are also indicated. In synergy with nuclear safety measures, an approach is developed in this study for risk prevention. It takes into consideration the collective implementation of measures of nuclear material accounting and control, physical protection and monitoring of such strategic and dangerous materials in an integrated and coordinated real-time mode at a nuclear or radiation facility and in any time

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

Science.gov (United States)

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

2017-07-01

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

Ventilator associated pneumonia: risk factors and preventive measures.

Science.gov (United States)

Vincent, J L; Lobo, S; Struelens, M

2001-11-01

Ventilator-associated pneumonia (VAP) is a common nosocomial infection associated with considerable morbidity and mortality. Various risk factors for VAP have been identified and include the duration of ICU stay and of mechanical ventilation, a diagnosis of trauma, and severity of illness. Knowledge of these factors can promote early diagnosis and hence treatment. In addition to simple, but very effective, basic hygiene, different preventative strategies have been suggested, and can be divided into those that aim to limit airway colonization, and those that improve host defense mechanisms. Of the former, non-invasive ventilation is effective but not always applicable or available, nursing the patient in the semi-recumbent position is also associated with a reduced incidence of VAP but carries its own problems, stress ulcer prophylaxis remains controversial, and selective digestive decontamination is probably only relevant to certain subgroups of patients. Methods to improve host defense include early nutrition. Immunostimulatory therapies, such as interferon and granulocyte colony stimulating factor, require further research to confirm their place in the prevention or management of VAP.

Prevention Of Stroke

Directory of Open Access Journals (Sweden)

Nagaraja D

2005-01-01

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

From risk analysis to risk control in land transport of dangerous materials. Contribution of quantitative evaluation

International Nuclear Information System (INIS)

Hubert, Ph.; Pages, P.

1985-03-01

The different approaches of risks and risk management system are described: statistics, potential risk, prevention, information and intervention. Quantitative evaluation is developed: data collection, purposes and methods. Two examples of application are given on risks associated to road transport of propane and of uranium hexafluoride. In conclusion level of risk and practical use of studies on risks are examined. 41 refs [fr

Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors.

Science.gov (United States)

Alentorn-Geli, Eduard; Myer, Gregory D; Silvers, Holly J; Samitier, Gonzalo; Romero, Daniel; Lázaro-Haro, Cristina; Cugat, Ramón

2009-07-01

Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players by 2006. Inherent to this sport is the higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes the most time lost from competition in soccer which has influenced a strong research focus to determine the risk factors for injury. This research emphasis has afforded a rapid influx of literature defining potential modifiable and non-modifiable risk factors that increase the risk of injury. The purpose of the current review is to sequence the most recent literature that reports potential mechanisms and risk factors for non-contact ACL injury in soccer players. Most ACL tears in soccer players are non-contact in nature. Common playing situations precluding a non-contact ACL injury include: change of direction or cutting maneuvers combined with deceleration, landing from a jump in or near full extension, and pivoting with knee near full extension and a planted foot. The most common non-contact ACL injury mechanism include a deceleration task with high knee internal extension torque (with or without perturbation) combined with dynamic valgus rotation with the body weight shifted over the injured leg and the plantar surface of the foot fixed flat on the playing surface. Potential extrinsic non-contact ACL injury risk factors include: dry weather and surface, and artificial surface instead of natural grass. Commonly purported intrinsic risk factors include: generalized and specific knee joint laxity, small and narrow intercondylar notch width (ratio of notch width to the diameter and cross sectional area of the ACL), pre-ovulatory phase of menstrual cycle in females not using oral contraceptives, decreased relative (to quadriceps) hamstring strength and recruitment, muscular fatigue by altering neuromuscular control, decreased "core" strength and proprioception, low trunk, hip, and knee flexion angles, and high

Family as a factor of risk prevention and victim behaviour

Directory of Open Access Journals (Sweden)

Artur A. Rean

2015-03-01

Full Text Available The paper examines psychological factors victim behaviour. The definition of victim behaviour is given and it is emphasized that such conduct is not necessarily passivebehaviour of the victim. Victimization and behaviour can be active and aggressive. It is shown that antisocial, deviant behaviour of children and adolescents seriously increases the risk of victimization. Family as the most important institution of socialization is considered both as a preventing factor and risk factor of victim behaviour. The role of the family in shaping the victim behaviour is revealed in the following issues: aggressive, conflict behaviour is personal inclination or absence of the “proper” skills; interdependence of the severity of punishment and child aggression; punishment for child aggression (between siblings: what is the result?; ignoring aggression – is it the best solution?; victims of sexual violence and causes of victim behaviour; demonstrative accentuation as a risk factor in rape victim behaviour; happy family – can it be a risk factor for victim behaviour? For a long time, social deviant personality development has been believed to deal with structural deformation of the family, which is defined as a single-parent family, i.e. absence of one parent (usually the father. It is now proved that the major factor of family negative impact on personal development is not structural but psychosocial family deformation. A really happy family, psychologically happy family is the cornerstone of preventing victim behaviour. The victim behaviour being mainly determined by personal qualities does not negate this conclusion, but only strengthens it, as the qualities mentioned above are shaped in many respects within family socialization, are determined by family upbringing styles and features of interpersonal relationships inside the family.

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

Science.gov (United States)

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

2014-05-02

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

Risk Prevention of Spreading Emerging Infectious Diseases Using a HybridCrowdsensing Paradigm, Optical Sensors, and Smartphone.

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Edoh, Thierry

2018-04-10

The risk of spreading diseases within (ad-hoc)crowds and the need to pervasively screen asymptomatic individuals to protect the population against emerging infectious diseases, request permanentcrowd surveillance., particularly in high-risk regions. Thecase of Ebola epidemic in West Africa in recent years has shown the need for pervasive screening. The trend today in diseases surveillance is consisting of epidemiological data collection about emerging infectious diseases using social media, wearable sensors systems, or mobile applications and data analysis. This approach presents various limitations. This paper proposes a novel approach for diseases monitoring and risk prevention of spreading infectious diseases. The proposed approach, aiming at overcoming the limitation of existing disease surveillance approaches, combines the hybrid crowdsensing paradigm with sensing individuals' bio-signals using optical sensors for monitoring any risks of spreading emerging infectious diseases in any (ad-hoc) crowds. A proof-of-concept has been performed using a drone armed with a cat s60 smartphone featuring a Forward Looking Infra-Red (FLIR) camera. According to the results of the conducted experiment, the concept has the potential to improve the conventional epidemiological data collection. The measurement is reliable, and the recorded data are valid. The measurement error rates are about 8%.

Prevalence of Blood-Borne Viruses in Health Care Workers of a Northern District in Pakistan: Risk Factors and Preventive Behaviors

Directory of Open Access Journals (Sweden)

Muhammad Zuhaib Khan

2016-01-01

Full Text Available Background. Blood-borne viral infections like viral hepatitis are highly prevalent in Pakistan. There is also a potential threat of human immunodeficiency virus (HIV spread in the country. Health care workers (HCWs are a high risk population for acquiring such viral infections and potential spread to the patients. This study aimed to determine the frequency of three blood-borne viruses: HCV, HBV, and HIV in HCWs of district Malakand in northern Khyber Pakhtunkhwa (KPK province of Pakistan. Moreover, risk factors and preventive behaviors among HCWs were investigated in detail. Materials and Methods. Prevalence was investigated using serological assays followed by real time polymerase chain reaction (RT-PCR based characterization. A total of 626 health care workers working at 17 different health care units, belonging to 6 different job categories, were included in this study. Results. HIV was not detected in the HCWs while rate of prevalence of HCV and HBV was far less (0.8 % and 0.64 %, resp. as compared to general population (4.7%–38%. The majority of HCWs were aware of the mode of spread of these viruses and associated risk factors. Needle stick injury was found to be the most important risk factor for possible acquisition of these infections.

Attributable risks for childhood overweight: evidence for limited effectiveness of prevention.

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Plachta-Danielzik, Sandra; Kehden, Britta; Landsberg, Beate; Schaffrath Rosario, Angelika; Kurth, Bärbel-Maria; Arnold, Christiane; Graf, Christine; Hense, Sabrina; Ahrens, Wolfgang; Müller, Manfred James

2012-10-01

Calculation of attributable risks (ARs) of childhood overweight to estimate effectiveness of prevention strategies. We used pooled data of 4 population-based German studies including 34240 children and adolescents aged 3 to 18 years to calculate the impact of familial, social, "early life", and lifestyle factors on overweight. ARs (joint for all determinants as well as partial risks) were calculated. The prevalence of childhood overweight was 13.4%. Successfully tackling all determinants can reduce overweight by 77.7% (ie, from 13.4% to 3.0%; = joint AR) with partial effects of treating parental overweight (42.5%); improving social status (14.3%); reducing media time to lifestyle) the effect is 9.2%. Media time has the strongest effect. The determinants identified explained 78% of the prevalence of overweight. Taking into account the partial ARs, the effectiveness of lifestyle interventions to prevent overweight in children is limited. Our data argue in favor of interventions aimed at families and social environments, with a major focus on promoting a lower screen time and computer use in children.

Primary prevention of stroke and cardiovascular disease in the community (PREVENTS): Methodology of a health wellness coaching intervention to reduce stroke and cardiovascular disease risk, a randomized clinical trial.

Science.gov (United States)

Mahon, Susan; Krishnamurthi, Rita; Vandal, Alain; Witt, Emma; Barker-Collo, Suzanne; Parmar, Priya; Theadom, Alice; Barber, Alan; Arroll, Bruce; Rush, Elaine; Elder, Hinemoa; Dyer, Jesse; Feigin, Valery

2018-02-01

Rationale Stroke is a major cause of death and disability worldwide, yet 80% of strokes can be prevented through modifications of risk factors and lifestyle and by medication. While management strategies for primary stroke prevention in high cardiovascular disease risk individuals are well established, they are underutilized and existing practice of primary stroke prevention are inadequate. Behavioral interventions are emerging as highly promising strategies to improve cardiovascular disease risk factor management. Health Wellness Coaching is an innovative, patient-focused and cost-effective, multidimensional psychological intervention designed to motivate participants to adhere to recommended medication and lifestyle changes and has been shown to improve health and enhance well-being. Aims and/or hypothesis To determine the effectiveness of Health Wellness Coaching for primary stroke prevention in an ethnically diverse sample including Māori, Pacific Island, New Zealand European and Asian participants. Design A parallel, prospective, randomized, open-treatment, single-blinded end-point trial. Participants include 320 adults with absolute five-year cardiovascular disease risk ≥ 10%, calculated using the PREDICT web-based clinical tool. Randomization will be to Health Wellness Coaching or usual care groups. Participants randomized to Health Wellness Coaching will receive 15 coaching sessions over nine months. Study outcomes A substantial relative risk reduction of five-year cardiovascular disease risk at nine months post-randomization, which is defined as 10% relative risk reduction among those at moderate five-year cardiovascular disease risk (10-15%) and 25% among those at high risk (>15%). Discussion This clinical trial will determine whether Health Wellness Coaching is an effective intervention for reducing modifiable risk factors, and hence decrease the risk of stroke and cardiovascular disease.

The concept of attributes and preventions of the variables that influence the pipeline risk in the Muhlbauer Method

Energy Technology Data Exchange (ETDEWEB)

Schafer, Alexandro G. [Universidade Federal do Pampa (UNIPAMPA), Bage, RS (Brazil)

2009-07-01

There are several methods for the risk assessment and risk management applied to pipelines, among them the Muhlbauer's Method. Muhlbauer is an internationally recognized authority on pipeline risk management. The purpose of this model is to evaluate the public exposure to the risk and identify ways for management that risk in fact. The assessment is made by the attribution of quantitative values to the several items that influences in the pipeline risk. Because the ultimate goal of the risk assessment is to provide a means of risk management, it is sometimes useful to make a distinction between two types of risk variables. The risk evaluator can categorize each index risk variable as either an attribute or a prevention. This paper approaches the subject of the definition of attributes and preventions in the Muhlbauer basic model of risk assessment and also presents a classification of the variables that influence the risk in agreement with those two categories. (author)

Global Potential Distribution of Bactrocera carambolae and the Risks for Fruit Production in Brazil.

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Marchioro, Cesar A

2016-01-01

The carambola fruit fly, Bactrocera carambolae, is a tephritid native to Asia that has invaded South America through small-scale trade of fruits from Indonesia. The economic losses associated with biological invasions of other fruit flies around the world and the polyphagous behaviour of B. carambolae have prompted much concern among government agencies and farmers with the potential spread of this pest. Here, ecological niche models were employed to identify suitable environments available to B. carambolae in a global scale and assess the extent of the fruit acreage that may be at risk of attack in Brazil. Overall, 30 MaxEnt models built with different combinations of environmental predictors and settings were evaluated for predicting the potential distribution of the carambola fruit fly. The best model was selected based on threshold-independent and threshold-dependent metrics. Climatically suitable areas were identified in tropical and subtropical regions of Central and South America, Sub-Saharan Africa, west and east coast of India and northern Australia. The suitability map of B. carambola was intersected against maps of fruit acreage in Brazil. The acreage under potential risk of attack varied widely among fruit species, which is expected because the production areas are concentrated in different regions of the country. The production of cashew is the one that is at higher risk, with almost 90% of its acreage within the suitable range of B. carambolae, followed by papaya (78%), tangerine (51%), guava (38%), lemon (30%), orange (29%), mango (24%) and avocado (20%). This study provides an important contribution to the knowledge of the ecology of B. carambolae, and the information generated here can be used by government agencies as a decision-making tool to prevent the carambola fruit fly spread across the world.

Global Potential Distribution of Bactrocera carambolae and the Risks for Fruit Production in Brazil.

Directory of Open Access Journals (Sweden)

Cesar A Marchioro

Full Text Available The carambola fruit fly, Bactrocera carambolae, is a tephritid native to Asia that has invaded South America through small-scale trade of fruits from Indonesia. The economic losses associated with biological invasions of other fruit flies around the world and the polyphagous behaviour of B. carambolae have prompted much concern among government agencies and farmers with the potential spread of this pest. Here, ecological niche models were employed to identify suitable environments available to B. carambolae in a global scale and assess the extent of the fruit acreage that may be at risk of attack in Brazil. Overall, 30 MaxEnt models built with different combinations of environmental predictors and settings were evaluated for predicting the potential distribution of the carambola fruit fly. The best model was selected based on threshold-independent and threshold-dependent metrics. Climatically suitable areas were identified in tropical and subtropical regions of Central and South America, Sub-Saharan Africa, west and east coast of India and northern Australia. The suitability map of B. carambola was intersected against maps of fruit acreage in Brazil. The acreage under potential risk of attack varied widely among fruit species, which is expected because the production areas are concentrated in different regions of the country. The production of cashew is the one that is at higher risk, with almost 90% of its acreage within the suitable range of B. carambolae, followed by papaya (78%, tangerine (51%, guava (38%, lemon (30%, orange (29%, mango (24% and avocado (20%. This study provides an important contribution to the knowledge of the ecology of B. carambolae, and the information generated here can be used by government agencies as a decision-making tool to prevent the carambola fruit fly spread across the world.

Risk communication concerning welding fumes for the primary preventive care of welding apprentices in southern Brazil.

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Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; Vaz, Joana Cezar

2015-01-19

This study's aim was to assess the perceptions of welding apprentices concerning welding fumes being associated with respiratory and cardiovascular disorders and assess the implementation of risk communication as a primary prevention tool in the welding training process. This quasi-experimental, non-randomized study with before-and-after design was conducted with 84 welding apprentices in Southern Brazil. Poisson Regression analysis was used. Relative Risk was the measure used with a 95% confidence interval and 5% (p ≤ 0.05) significance level. Significant association was found between perceptions of worsened symptoms of respiratory disorders caused by welding fumes and educational level (p = 0.049), the use of goggles to protect against ultraviolet rays (p = 0.023), and access to services in private health facilities without insurance coverage (p = 0.001). Apprentices younger than 25 years old were 4.9 times more likely to perceive worsened cardiovascular symptoms caused by welding fumes after risk communication (RR = 4.91; CI 95%: 1.09 to 22.2). The conclusion is that risk communication as a primary preventive measure in continuing education processes implemented among apprentices, who are future welders, was efficacious. Thus, this study confirms that risk communication can be implemented as a primary prevention tool in welding apprenticeships.

Managing industrial risk--having a tested and proven system to prevent and assess risk.

Science.gov (United States)

Heller, Stephen

2006-03-17

Some relatively easy techniques exist to improve the risk picture/profile to aid in preventing losses. Today with the advent of computer system resources, focusing on specific aspects of risk through systematic scoring and comparison, the risk analysis can be relatively easy to achieve. Techniques like these demonstrate how working experience and common sense can be combined mathematically into a flexible risk management tool or risk model for analyzing risk. The risk assessment methodology provided by companies today is no longer the ideas and practices of one group or even one company. It is reflective of the practice of many companies, as well as the ideas and expertise of academia and government regulators. The use of multi-criteria decision making (MCDM) techniques for making critical decisions has been recognized for many years for a variety of purposes. In today's computer age, the easy accessing and user-friendly nature for using these techniques, makes them a favorable choice for use in the risk assessment environment. The new user of these methodologies should find many ideas directly applicable to his or her needs when approaching risk decision making. The user should find their ideas readily adapted, with slight modification, to accurately reflect a specific situation using MCDM techniques. This makes them an attractive feature for use in assessment and risk modeling. The main advantage of decision making techniques, such as MCDM, is that in the early stages of a risk assessment, accurate data on industrial risk, and failures are lacking. In most cases, it is still insufficient to perform a thorough risk assessment using purely statistical concepts. The practical advantages towards deviating from strict data-driven protocol seem to outweigh the drawbacks. Industry failure data often comes at a high cost when a loss occurs. We can benefit from this unfortunate acquisition of data through the continuous refining of our decisions by incorporating this new

Radiological risk in case of potential exposures

International Nuclear Information System (INIS)

Chiossi, C.E.

1998-01-01

This paper presents basic theoretical aspects about the probabilistic conception of radiological risk in case of potential exposure associated with practices concerning installations such as nuclear power plants, research reactors or repositories for final disposal of radioactive waste. It is here shown how such conception helps in the decision-making process concerning people protection in the frame of the above mentioned situations. The question of risk is first analysed in a general sense- be it radiological risk or not- showing common concepts among the different technical definitions of risk. The subjects of individual risk an societal risk are then considered, as well as that of risk perception. Finally, some probabilistic safety criteria are described- corresponding to different schools which study radioactive and nuclear installations safety- putting emphasis in the way how such criteria are used in the decision-making process in order to accept or reject an installation from the point of view of safety. The criteria referred to are the 'Farmer Limit-Line', the 'Single-Dual Failure Criterion' and the 'Argentine Acceptation Criterion', in particular this last one is carefully detailed showing its origin as well as its practical application. (author)

[Use of hypertext as information and training tools in the prevention of occupational risk].

Science.gov (United States)

Franco, G

1998-01-01

Modern medical education is based on a variety of teaching techniques, by means of which individuals learn most effectively. The availability of the new technologies together with the diffusion of personal computers is favouring the spreading of the use of hypertexts through the World Wide Web. This contribution describes 2 hypertexts ("Human Activities and Health Risk"; "Occupation, Risk and Disease. A Problem-Oriented Hypertext-Tool to Learn Occupational Medicine") and the prototype "Virtual Hospital". Assuming that prevention of health risks is based upon their knowledge, they have been created with the aim of providing users with problem-oriented tools, whose retorical aspects (content, information organization, user interface) are analysed. The "Human Activities and Health Risk" deals with the description of working activities and allows user to recognize health risks. The "Occupation, Risk and Disease. A Problem-Oriented Hypertext-Tool to Learn Occupational Medicine" embodies a case report containing the clustered information about the patient and the library including educational material (risk factors, symptoms and signs, organ system diseases, jobs, occupational risk factors, environment related diseases. The "Virtual Hospital" has been conceived assuming that an appropriate information can change workers' behaviour in hospital, where health risks can be often underevaluated. It consists of a variety of structured and unstructured information, which can be browsed by users, allowing the discovery of links and providing the awareness of the semantic relationship between related information elements (including environment, instruments, drugs, job analysis, situations at risk for health, preventive means). The "Virtual Hospital" aims making the understanding of the working situations at risk easier and more interesting, stimulating the awareness of the relationship between jobs and risks.

Complications of thoracentesis: incidence, risk factors, and strategies for prevention.

Science.gov (United States)

Cantey, Eric P; Walter, James M; Corbridge, Thomas; Barsuk, Jeffrey H

2016-07-01

Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax. Although coagulopathy or thrombocytopenia and the use of anticoagulant or antiplatelet medications have traditionally been viewed as contraindications to thoracentesis, new evidence suggests that patients may be able to safely undergo thoracentesis without treating their bleeding risk. Re-expansion pulmonary edema, a rare complication of thoracentesis, is felt to result in part from the generation of excessively negative pleural pressure. When and how to monitor changes in pleural pressure during thoracentesis remains a focus of ongoing study. Major complications of thoracentesis are uncommon. Clinician awareness of risk factors for procedural complications and familiarity with strategies that improve outcomes are essential components for safely performing thoracentesis.

Clinicians' preventive strategies for children and adolescents identified as at high risk of developing caries.

Science.gov (United States)

Sarmadi, Roxana; Gahnberg, Lars; Gabre, Pia

2011-05-01

Clinicians handle diagnosis and treatment planning of caries in different ways, and the underlying factors leading to management of risk and choice of treatment strategies are poorly understood. The aim of this study was to investigate dentists' and dental hygienists' choices of preventive strategies for children and adolescents identified as at high risk of developing caries. A sample of dental records from 432 of a total of 3372 children in a Swedish county identified as at high risk of developing caries, aged 3-19 years, was randomly selected for analysis in the study. Information of importance for the therapists' choice of caries management strategies were obtained from the dental records. The results showed that therapists considered tooth brushing instruction and fluoride treatment at the clinic to be of primary importance as treatment given in 60% of the cases, respectively. Fluoride treatment at home and diet counselling were both chosen in half of the cases. Fissure sealant therapy was used in 21% of the cases, and 15% of the patients did not receive any preventive treatment at all. The results also showed that girls more often received fluoride treatment, tooth brushing instruction and oral hygiene information than boys. In the majority of the children and adolescents, several preventive measures were given. The more background factors included in the risk assessment, the more preventive measures were given. The differences between the treatments given to girls and the boys need to be further investigated. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Slip and fall risk on ice and snow:identification, evaluation and prevention

OpenAIRE

Gao, Chuansi

2004-01-01

Slip and fall accidents and associated injuries on ice and snow are prevalent among outdoor workers and the general public in winter in many regions of the world. To understand and tackle this multi-factorial problem, a multidisciplinary approach was used to identify and evaluate slip and fall risks, and to propose recommendations for prevention of slips and falls on icy and snowy surfaces. Objectives were to present a systems perspective of slip and fall accidents and related risk factors; t...

Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

Science.gov (United States)

Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

2018-01-01

Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

Child Sexual Abuse Prevention Opportunities: Parenting, Programs, and the Reduction of Risk.

Science.gov (United States)

Rudolph, Julia; Zimmer-Gembeck, Melanie J; Shanley, Dianne C; Hawkins, Russell

2018-02-01

To date, child sexual abuse (CSA) prevention has relied largely on child-focused education, teaching children how to identify, avoid, and disclose sexual abuse. The purpose of this article is to explore how prevention opportunities can include parents in new and innovative ways. We propose that parents can play a significant role as protectors of their children via two pathways: (i) directly, through the strong external barriers afforded by parent supervision, monitoring, and involvement; and (ii) indirectly, by promoting their children's self-efficacy, competence, well-being, and self-esteem, which the balance of evidence suggests will help them become less likely targets for abuse and more able to respond appropriately and disclose abuse if it occurs. In this article, we first describe why teaching young children about CSA protective behaviors might not be sufficient for prevention. We then narratively review the existing research on parents and prevention and the parenting and family circumstances that may increase a child's risk of experiencing sexual abuse. Finally, we make a number of recommendations for future approaches to prevention that may better inform and involve parents and other adult protectors in preventing CSA.

Iatrogenic possibilities of orthodontic treatment and modalities of prevention

Science.gov (United States)

Meeran, Nazeer Ahmed

2013-01-01

The benefits of orthodontic treatment are numerous and in most cases, the benefits outweigh the possible disadvantages. Orthodontic treatment can play an important role in enhancing esthetics, function, and self-esteem in patients. However, it carries with it the risks of enamel demineralization, tissue damage, root resorption, open gingival embrasures in the form of triangular spaces, allergic reactions to nickel, and treatment failure in the form of relapse. These potential complications are easily avoidable by undertaking certain precautions and timely interventions by both the orthodontist and the patient. The orthodontist must ensure that the patient is aware of the associated risks and stress the importance of the patient's role in preventing these untoward outcomes. The decision whether to proceed with the orthodontic treatment is essentially a risk-benefit analysis, where the perceived benefits of commencing treatment outweigh the potential risks. This article provides an overview of the iatrogenic possibilities of orthodontic treatment and the role of the patient as well as the orthodontist in preventing the associated risks. PMID:24987646

Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes.

Science.gov (United States)

Maseroli, Elisa; Scavello, Irene; Vignozzi, Linda

2018-05-02

Erectile dysfunction is recognized as an opportunity for preventing cardiovascular (CV) events, and assessing the impairment of penile vascular flow by Doppler ultrasound is an important tool to ascertain CV risk. Conversely, the role of genital vascular impairment in the pathophysiology of female sexual dysfunction (FSD) remains contentious. To focus on the current scientific support for an association between CV risk factors and female sexual health in the 1st part of a 2-part review. A thorough literature search of peer-reviewed publications on the associations between CV risk factors and FSD and their underlying mechanisms was performed using the PubMed database. We present a summary of the evidence from clinical studies and discuss the possible mechanisms providing the pathophysiologic bases of vasculogenic FSD syndromes. The peripheral sexual response in women is a vascular-dependent event, and evidence suggests that cardiometabolic-related perturbations in endothelial function can determine vascular insufficiency in female genital tissues. Although epidemiologic and observational studies demonstrate that the prevalence of FSD is higher in women with diabetes mellitus, a cause-effect relation between these clinical conditions cannot be assumed. Evidence on the effect of obesity, metabolic syndrome, and polycystic ovary syndrome on sexual function in women is controversial. Data on the associations of dyslipidemia and hypertension with FSD are limited. Common cardiometabolic alterations could affect vascular function in the female genital tract. Based on limited data, there is an association between CV risk factors and female sexual health in women; however, this association appears milder than in men. Maseroli E, Scavello I, Vignozzi L. Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes. Sex Med Rev 2018;X:XXX-XXX. Copyright © 2018 International

Single and combined metal contamination in coastal environments in China: current status and potential ecological risk evaluation.

Science.gov (United States)

Manzoor, Romana; Zhang, Tingwan; Zhang, Xuejiao; Wang, Min; Pan, Jin-Fen; Wang, Zhumei; Zhang, Bo

2018-01-01

With the development of industrialization and urbanization, metal and metalloid pollution is one of the most serious environmental problems in China. Current contamination status of metals and metalloid and their potential ecological risks along China's coasts were reviewed in the present paper by a comprehensive study on metal contents in marine waters and sediments in the past few decades. The priority metals/metalloid cadmium (Cd), mercury (Hg), chromium (Cr), lead (Pb), and arsenic (As), which were the target elements of the designated project "Comprehensive Prevention and Control of Heavy Metal Pollution" issued by the Chinese government in 2011, were selected considering their high toxicity, persistence, and prevalent existence in coastal environment. Commonly used environmental quality evaluation methods for single and combined metals were compared, and we accordingly suggest the comprehensive approach of joint utilization of the Enrichment Factor and Effect Range Median combined with Pollution Load Index and Mean Effect Range Median Quotient (EEPME); this battery of guidelines may provide consistent, internationally comparable, and accurate understanding of the environment pollution status of combined metals/metalloid and their potential ecological risk.

Toward Primary Prevention of Asthma. Reviewing the Evidence for Early-Life Respiratory Viral Infections as Modifiable Risk Factors to Prevent Childhood Asthma

Science.gov (United States)

Feldman, Amy S.; He, Yuan; Moore, Martin L.; Hershenson, Marc B.

2015-01-01

A first step in primary disease prevention is identifying common, modifiable risk factors that contribute to a significant proportion of disease development. Infant respiratory viral infection and childhood asthma are the most common acute and chronic diseases of childhood, respectively. Common clinical features and links between these diseases have long been recognized, with early-life respiratory syncytial virus (RSV) and rhinovirus (RV) lower respiratory tract infections (LRTIs) being strongly associated with increased asthma risk. However, there has long been debate over the role of these respiratory viruses in asthma inception. In this article, we systematically review the evidence linking early-life RSV and RV LRTIs with asthma inception and whether they could therefore be targets for primary prevention efforts. PMID:25369458

Cash transfers for HIV prevention: considering their potential.

Science.gov (United States)

Heise, Lori; Lutz, Brian; Ranganathan, Meghna; Watts, Charlotte

2013-08-23

Cash payments to vulnerable households and/or individuals have increasingly garnered attention as a means to reduce poverty, improve health and achieve other development-related outcomes. Recent evidence from Malawi and Tanzania suggests that cash transfers can impact HIV-related behaviours and outcomes and, therefore, could serve as an important addition to HIV prevention efforts. This article reviews the current evidence on cash transfers for HIV prevention and suggests unresolved questions for further research. Gaps include (1) understanding more about the mechanisms and pathways through which cash transfers affect HIV-related outcomes; (2) addressing key operational questions, including the potential feasibility and the costs and benefits of different models of transfers and conditionality; and (3) evaluating and enhancing the wider impacts of cash transfers on health and development. Ongoing and future studies should build on current findings to unpack unresolved questions and to collect additional evidence on the multiple impacts of transfers in different settings. Furthermore, in order to address questions on sustainability, cash transfer programmes need to be integrated with other sectors and programmes that address structural factors such as education and programming to promote gender equality and address HIV.

Pro-Active Fall-Risk Management is Mandatory to Sustain in Hospital-Fall Prevention in Older Patients--Validation of the LUCAS Fall-Risk Screening in 2,337 Patients.

Science.gov (United States)

Hoffmann, V S; Neumann, L; Golgert, S; von Renteln-Kruse, W

2015-12-01

Prevention of in-hospital falls contributes to improvement of patient safety. However, the identification of high-risk patients remains a challenge despite knowledge of fall-risk factors. Hence, objective was to prospectively validate the performance of the LUCAS (Longitudinal Urban Cohort Ageing Study) fall-risk screening, based on routine data (fall history, mobility, mental status) and applied by nurses. Observational study comparing two groups of patients who underwent different fall-risk screenings; the LUCAS screening (2010 - 2011) and the STRATIFY (St. Thomas's Risk Assessment Tool In Falling Elderly Inpatients) (2004 - 2006). Urban teaching hospital. Consecutively hospitalized patients (≥ 65 years old) were screened on admission; LUCAS n = 2,337, STRATIFY n = 4,735. The proportions of fallers were compared between the STRATIFY and the LUCAS time periods. The number of fallers expected was compared to that observed in the LUCAS time period. Standardized fall-incidence recording included case-note checks for unreported falls. Plausibility checks of fall-risk factors and logistic regression analysis for variable fall-risk factors were performed. The proportions of fallers during the two time periods were LUCAS n = 291/2,337 (12.5%) vs. STRATIFY n = 508/4,735 (10.7%). After adjustment for risk-factor prevalence, the proportion of fallers expected was 14.5% (334/2,337), the proportion observed was 12.5% (291/2,337) (p = 0.038). In-hospital fall prevention including systematic use of the LUCAS fall-risk screening reduced the proportion of fallers compared to that expected from the patients' fall-risk profile. Raw proportions of fallers are not suitable to evaluate fall prevention in hospital because of variable prevalence of patients' fall-risk factors over time. Continuous communication, education and training is needed to sustain in-hospital falls prevention.

Biomarkers Associated with Cognitive Impairment in Treated Cancer Patients: Potential Predisposition and Risk Factors

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Castel, Hélène; Denouel, Angeline; Lange, Marie; Tonon, Marie-Christine; Dubois, Martine; Joly, Florence

2017-01-01

Purpose: Cognitive impairment in cancer patients induced, at least in part, by treatment are frequently observed and likely have negative impacts on patient quality of life. Such cognitive dysfunctions can affect attention, executive functions, and memory and processing speed, can persist after treatment, and their exact causes remain unclear. The aim of this review was to create an inventory and analysis of clinical studies evaluating biological markers and risk factors for cognitive decline in cancer patients before, during, or after therapy. The ultimate objectives were to identify robust markers and to determine what further research is required to develop original biological markers to enable prevention or adapted treatment management of patients at risk. Method: This review was guided by the PRISMA statement and included a search strategy focused on three components: “cognition disorders,” “predictive factors”/“biological markers,” and “neoplasms,” searched in PubMed since 2005, with exclusion criteria concerning brain tumors, brain therapy, and imaging or animal studies. Results: Twenty-three studies meeting the criteria were analyzed. Potential associations/correlations were identified between cognitive impairments and specific circulating factors, cerebral spinal fluid constituents, and genetic polymorphisms at baseline, during, and at the end of treatment in cancer populations. The most significant results were associations between cognitive dysfunctions and genetic polymorphisms, including APOE-4 and COMT-Val; increased plasma levels of the pro-inflammatory cytokine, IL-6; anemia; and hemoglobin levels during chemotherapy. Plasma levels of specific hormones of the hypothalamo-pituitary-adrenal axis are also modified by treatment. Discussion: It is recognized in the field of cancer cognition that cancer and comorbidities, as well as chemotherapy and hormone therapy, can cause persistent cognitive dysfunction. A number of biological

[Prevention of shoulder dystocia risk factors before delivery].

Science.gov (United States)

Fuchs, F

2015-12-01

To determine whether it is possible to prevent the occurrence of risk factors for shoulder dystocia before or during pregnancy. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Studied measures were exercise before or during pregnancy, dietary management, and gestational diabetes management in obese and non-obese patients. No study has proven that the correction of these risk factors (except gestational diabetes) would reduce the risk of shoulder dystocia. In the general population, physical exercise is recommended either before or during pregnancy to reduce the risk of gestational diabetes (physical activity before pregnancy) (grade B), fetal macrosomia (grade C) or maternal weight gain during pregnancy (grade C). No dietary regimen is recommended to reduce these issues (grade B). In overweight or obese (body mass index [BMI]>25), physical activity coupled with dietary management is recommended (grade A) because it reduces fetal macrosomia (EL1). In addition, it allows a modest reduction in maternal weight gain during pregnancy (EL2), but did have an effect on the occurrence of gestational diabetes (EL1). In case of gestational diabetes, diabetes care is recommended (diabetic diet, glucose monitoring, insulin if needed) (grade A) as it reduces the risk of macrosomia and shoulder dystocia (EL1). The recommended weight gain during pregnancy is 11.5 kg to 16 kg for normal BMI patients (grade B). Obese patients should be aware of the importance of controlling their weight gain during pregnancy (professional consensus). It is recommended that patients regain their pre-conception weight, and ideally a BMI between 18 and 25 kg/m(2), 6 months postpartum (grade B) to reduce the risk of gestational diabetes and macrosomia in a subsequent pregnancy (EL2). Physical activity is recommended before and during pregnancy to reduce the occurrence of risk factors for shoulder dystocia

Tsunami prevention and mitigation necessities and options derived from tsunami risk assessment in Indonesia

Science.gov (United States)

Post, J.; Zosseder, K.; Wegscheider, S.; Steinmetz, T.; Mück, M.; Strunz, G.; Riedlinger, T.; Anwar, H. Z.; Birkmann, J.; Gebert, N.

2009-04-01

Risk and vulnerability assessment is an important component of an effective End-to-End Tsunami Early Warning System and therefore contributes significantly to disaster risk reduction. Risk assessment is a key strategy to implement and design adequate disaster prevention and mitigation measures. The knowledge about expected tsunami hazard impacts, exposed elements, their susceptibility, coping and adaptation mechanisms is a precondition for the development of people-centred warning structures, local specific response and recovery policy planning. The developed risk assessment and its components reflect the disaster management cycle (disaster time line) and cover the early warning as well as the emergency response phase. Consequently the components hazard assessment, exposure (e.g. how many people/ critical facilities are affected?), susceptibility (e.g. are the people able to receive a tsunami warning?), coping capacity (are the people able to evacuate in time?) and recovery (are the people able to restore their livelihoods?) are addressed and quantified. Thereby the risk assessment encompasses three steps: (i) identifying the nature, location, intensity and probability of potential tsunami threats (hazard assessment); (ii) determining the existence and degree of exposure and susceptibility to those threats; and (iii) identifying the coping capacities and resources available to address or manage these threats. The paper presents results of the research work, which is conducted in the framework of the GITEWS project and the Joint Indonesian-German Working Group on Risk Modelling and Vulnerability Assessment. The assessment methodology applied follows a people-centred approach to deliver relevant risk and vulnerability information for the purposes of early warning and disaster management. The analyses are considering the entire coastal areas of Sumatra, Java and Bali facing the Sunda trench. Selected results and products like risk maps, guidelines, decision support

[Prevention of the refeeding syndrome].

Science.gov (United States)

Martínez Núñez, Maria E; Hernández Muniesa, B

2010-01-01

The refeeding syndrome can be defined as the metabolic alterations developed by the rapid nutrition repletion (oral, enteral as well as parenteral feeding) of severaly malnourished patients. Refeeding syndrome is a potentially fatal clinical condition and it is often underdiagnosed on non-specialized nutrition units. The most important key for its prevention is to identify patients at high risk for developing refeeding syndrome, before nutrition repletion. The present case describes the steps to prevent the refeeding syndrome as well as the clinical recommendations to restart nutrition support.

Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

Science.gov (United States)

Conraths, Franz J; Probst, Carolina; Possenti, Alessia; Boufana, Belgees; Saulle, Rosella; La Torre, Giuseppe; Busani, Luca; Casulli, Adriano

2017-07-01

contributed to our current understanding of the epidemiology of human AE. The identification of potential risk factors may help researchers and decision makers improve surveillance and/or preventive measures that aim at decreasing human infection with E. multilocularis. More primary studies are needed to confirm potential risk factors and their role in the epidemiology of human AE.

Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Franz J Conraths

2017-07-01

years contributed to our current understanding of the epidemiology of human AE. The identification of potential risk factors may help researchers and decision makers improve surveillance and/or preventive measures that aim at decreasing human infection with E. multilocularis. More primary studies are needed to confirm potential risk factors and their role in the epidemiology of human AE.

Viability and Risk Assessment in Species Restoration: Planning Reintroductions for the Wild Boar, a Potential Disease Reservoir

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Néstor Fernández

2006-06-01

Full Text Available The reintroduction of large mammals is often considered a priority conservation action in highly industrialized countries in which many of these species have been depleted. However, species reintroduction after decades of absence may involve important risks for human activities and ecological communities, such as favoring the spread of diseases. An example of a potentially troublesome reintroduction is the wild boar, which may act as a reservoir of diseases, e.g., classical swine fever, and cause high economic losses, and has become a species of concern in several European countries for both ecological and recreational reasons. Failure to prevent the disease consequences of species restoration can negate its conservation benefits. Here we evaluated the probability of both successfully reintroducing wild boar into Denmark and limiting their contact with domestic pig farms to which they might spread disease. For this purpose, we developed a spatially explicit, individual-based population model that incorporates information on boar habitat and demography information from Central European populations. We then compared model predictions with the spatial distribution of farms to achieve a spatial assessment of the contact risk. The most restrictive model scenario predicted that nearly 6% of Denmark provides habitat conditions that would allow wild boar to reproduce. The best habitats for reintroduction were aggregated in seven different areas throughout the country in which the extinction probability was < 5%. However, the expected population expansion was very limited in most of these areas. Both the number of suitable areas and the potential for population expansion greatly increased when we relaxed our habitat assumptions about boar forest requirements; this provided a more conservative scenario for a cautious risk analysis. We additionally found that part of the risk of contact with piggeries was associated with the magnitude of the expansion

Risk and Protective Factors for Family Violence among Low-Income Fathers: Implications for Violence Prevention and Fatherhood Programs.

Science.gov (United States)

Hayward, R Anna; Honegger, Laura; Hammock, Amy Cristina

2018-01-01

Over the last decade there has been an increased focus on improving father engagement to improve child and family outcomes. Recent research suggests that child and family outcomes improve with increased fatherhood engagement. This exploratory study examined risk and protective factors associated with approval of family violence among a sample of low-income fathers (N = 686) enrolled in a responsible fatherhood program. The program goals include increasing father involvement and economic stability and encouraging healthy relationships-with a focus on preventing intimate partner violence. Toward these aims, this study explored factors associated with fathers' self-reported approval of family violence. Understanding the prevalence of risk and protective factors in this population and factors associated with fathers' potential for family violence is important in developing programs to address responsible fatherhood and healthy relationships. © 2017 National Association of Social Workers.

Potential hazards and risks associated with the aquaculture industry ...

African Journals Online (AJOL)

Aquaculture, the farming of aquatic organisms, is fraught with potential hazards and risks which are categorized into occupational, environmental, food safety and public health. This paper reviewed major hazards and risks associated with the aquaculture industry and proffered strategies for their management and control.

Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.

Science.gov (United States)

Blaha, Michael J; Silverman, Michael G; Budoff, Matthew J

2014-03-01

Although risk factors have proven to be useful therapeutic targets, they are poor predictors of risk. Traditional risk scores are moderately successful in predicting future CHD events and can be a starting place for general risk categorization. However, there is substantial heterogeneity between traditional risk and actual atherosclerosis burden, with event rates predominantly driven by burden of atherosclerosis. Serum biomarkers have yet to show any clinically significant incremental value to the FRS and even when combined cannot match the predictive value of atherosclerosis imaging. As clinicians, are we willing to base therapy decisions on risk models that lack optimum-achievable accuracy and limit personalization? The decision to treat a patient in primary prevention must be a careful one because the benefit of therapy in an asymptomatic patient must clearly outweigh the potential risk. CAC, in particular, provides a personalized assessment of risk and may identify patients who will be expected to derive the most, and the least, net absolute benefit from treatment. Emerging evidence hints that CAC may also promote long-term adherence to aspirin, exercise, diet, and statin therapy. When potentially lifelong treatment decisions are on the line, clinicians must arm their patients with the most accurate risk prediction tools, and subclinical atherosclerosis testing with CAC is, at the present time, superior to any combination of risk factors and serum biomarkers.

Public health economics of chlamydia and other STIs : aspects of risk, prevention and resources

OpenAIRE

Deogan, Charlotte

2013-01-01

The overall aim of this thesis was to increase the knowledge of the public health economic aspects of chlamydia and other STIs, in terms of risk, prevention and resources. In Study I, we examined the association between demographic, socioeconomic and lifestyle factors and the risk of self-reported chlamydial infection among young adults in the Stockholm public health cohort. We found that the risk of self-reported chlamydia infection among young adults in Sweden was associated with lowe...

Public health implications from COGS and potential for risk stratification and screening.

Science.gov (United States)

Burton, Hilary; Chowdhury, Susmita; Dent, Tom; Hall, Alison; Pashayan, Nora; Pharoah, Paul

2013-04-01

The PHG Foundation led a multidisciplinary program, which used results from COGS research identifying genetic variants associated with breast, ovarian and prostate cancers to model risk-stratified prevention for breast and prostate cancers. Implementing such strategies would require attention to the use and storage of genetic information, the development of risk assessment tools, new protocols for consent and programs of professional education and public engagement.

Comprehensive Sexuality Education as a Primary Prevention Strategy for Sexual Violence Perpetration.

Science.gov (United States)

Schneider, Madeline; Hirsch, Jennifer S

2018-01-01

Sexual violence (SV) represents a serious public health problem with high rates and numerous health consequences. Current primary prevention strategies to reduce SV perpetration have been shown to be largely ineffective-not surprisingly, since as others have pointed out current prevention largely fails to draw on existing knowledge about the characteristics of effective prevention. In this article, we examine the potential of K-12 comprehensive sexuality education (CSE), guided by the National Sexuality Education Standards (NSES), to be an effective strategy. Our discussion uses socioecological and feminist theories as a guide, examines the extent to which NSES-guided CSE could both meet the qualities of effective prevention programs and mitigate the risk factors that are most implicated in perpetration behavior, and considers the potential limitations of this approach. We suggest that sequential, K-12 program has potential to prevent the emergence of risk factors associated with SV perpetration by starting prevention early on in the life course. CSE has not yet been evaluated with SV perpetration behavior as an outcome, and this article synthesizes what is known about drivers of SV perpetration and the potential impacts of CSE to argue for the importance of future research in this area. The primary recommendation is for longitudinal research to examine the impact of CSE on SV perpetration as well as on other sexual and reproductive health outcomes.

Potentially preventable infant and child deaths identified at autopsy; findings and implications.

Science.gov (United States)

Bamber, Andrew R; Mifsud, William; Wolfe, Ingrid; Cass, Hilary; Pryce, Jeremy; Malone, Marian; Sebire, Neil J

2015-09-01

The purpose of the study was to determine the proportion of pediatric deaths investigated by HM Coronial autopsy which were potentially preventable deaths due to treatable natural disease, and what implications such findings may have for health policies to reduce their occurrence. A retrospective study of 1779 autopsies of individuals between 7 days and 14 years of age requested by HM Coroner, taking place in one specialist pediatric autopsy center, was undertaken. Cases were included if they involved a definite natural disease process in which appropriate recognition and treatment was likely to have affected their outcome. Strict criteria were used and cases were excluded where the individual had any longstanding condition which might have predisposed them to, or altered the recognition of, acute illness, or its response to therapy. Almost 8% (134/1779) of the study group were potentially preventable deaths as a result of natural disease, the majority occurring in children younger than 2 years of age. Most individuals reported between 1 and 7 days of symptoms before their death, and the majority had sought medical advice during this period, including from general practitioners within working hours, and hospital emergency departments. Of those who had sought medical attention, around one-third had done so more than once (28%, 15/53). Sepsis and pneumonia accounted for the majority of deaths (46 and 34% respectively), with all infections (sepsis, pneumonia and meningitis) accounting for 110/134 (82%). Around 10% of pediatric deaths referred to HM Coroner are potentially preventable, being the result of treatable natural acute illnesses. In many cases medical advice had been sought during the final illness. The results highlight how a review of autopsy data can identify significant findings with the potential to reduce mortality, and the importance of centralized investigation and reporting of pediatric deaths.

Diet and Pancreatic Cancer Prevention

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Ilaria Casari

2015-11-01

Full Text Available Pancreatic cancer is without any doubt the malignancy with the poorest prognosis and the lowest survival rate. This highly aggressive disease is rarely diagnosed at an early stage and difficult to treat due to its resistance to radiotherapy and chemotherapy. Therefore, there is an urgent need to clarify the causes responsible for pancreatic cancer and to identify preventive strategies to reduce its incidence in the population. Some circumstances, such as smoking habits, being overweight and diabetes, have been identified as potentially predisposing factors to pancreatic cancer, suggesting that diet might play a role. A diet low in fat and sugars, together with a healthy lifestyle, regular exercise, weight reduction and not smoking, may contribute to prevent pancreatic cancer and many other cancer types. In addition, increasing evidence suggests that some food may have chemo preventive properties. Indeed, a high dietary intake of fresh fruit and vegetables has been shown to reduce the risk of developing pancreatic cancer, and recent epidemiological studies have associated nut consumption with a protective effect against it. Therefore, diet could have an impact on the development of pancreatic cancer and further investigations are needed to assess the potential chemo preventive role of specific foods against this disease. This review summarizes the key evidence for the role of dietary habits and their effect on pancreatic cancer and focuses on possible mechanisms for the association between diet and risk of pancreatic cancer.

An Evaluation of Risk Factors and Preventive Techniques for Decubitus Ulcers in Selected Nigeria Hospitals

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Onigbinde A. Teslim

2012-08-01

Full Text Available AIM: The aim of this study was to determine if in-patients in some selected Nigeria hospitals are at risk of developing pressure sore and to determine the preventive techniques adopted by Health Care Professionals. METHOD: A questionnaire was used for this study and it was divided into two parts. The part A is a structured questionnaire that took care of socio-demographic data and preventive techniques while part B is the Braden Scale which was used to assess the risk of developing pressure ulcer. Three hundred and eighteen (318 In-patients in five Nigeria purposively selected hospitals in southwest Nigeria volunteered to participate in this study. The statistical method that was employed was descriptive statistics. RESULTS: The result of the study showed that In-patients in the selected hospitals are “at risk” of developing pressure ulcers. Also, General Practitioners (50.47% and nursing staff (49.52% mostly prescribed at least one of the preventive techniques while few (31.23% reported that physiotherapists prescribed at least one of the preventive techniques. However, a considerable number of the patients (35.02% were never informed by any of the health staff on preventive measures. CONCLUSION: It was concluded that In-patients in Nigeria hospitals are “at risk” of developing pressure ulcers and that health care providers in Nigeria are not prescribing adequate preventive techniques to prevent pressure ulcers. [TAF Prev Med Bull 2012; 11(4.000: 415-420

Symptom Awareness and Cancer Prevention: Exploratory Findings from an At-Risk Population

Science.gov (United States)

Eadie, Douglas; MacAskill, Susan

2008-01-01

Purpose: Secondary prevention programmes have traditionally employed mass screening approaches to assess for asymptomatic signs of cancer. It has been suggested that early detection strategies involving public education and self-referral may prove more cost-effective with low risk populations for cancers with symptomatic presentation. This study,…

Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients.

Science.gov (United States)

Lohman, Matthew C; Cotton, Brandi P; Zagaria, Alexandra B; Bao, Yuhua; Greenberg, Rebecca L; Fortuna, Karen L; Bruce, Martha L

2017-12-01

Hospitalizations and potentially inappropriate medication (PIM) use are significant and costly issues among older home health patients, yet little is known about the prevalence of PIM use in home health or the relationship between PIM use and hospitalization risk in this population. To describe the prevalence of PIM use and association with hospitalization among Medicare home health patients. Cross-sectional analysis using data from 132 home health agencies in the US. Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780). Prevalence of individual and aggregate PIM use at start of care, measured using the 2012 Beers criteria. Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use. In total, 30,168 (34.4%) patients were using at least one PIM, with 5969 (6.8%) taking at least two PIMs according to the Beers list. The most common types of PIMs were those affecting the brain or spinal cord, analgesics, and medications with anticholinergic properties. With the exception of nonsteroidal anti-inflammatory drugs (NSAIDs), PIM use across all classes was associated with elevated risk (10-33%) of hospitalization compared to non-use. Adjusting for demographic and clinical characteristics, patients using at least one PIM (excluding NSAIDs) had a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, while patients using at least two PIMs had 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30). Similar associations were found between PIMs and re-hospitalization risk among patients referred to home health from a hospital. Given the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes represent opportunities to substantially reduce PIM use among older adults and prevent adverse outcomes. Efforts to address medication use during home health episodes

Risk of potentially rabid animal exposure among foreign travelers in Southeast Asia.

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Watcharapong Piyaphanee

Full Text Available BACKGROUND: Each year millions of travelers visit Southeast Asia where rabies is still prevalent. This study aimed to assess the risk of rabies exposure, i.e., by being bitten or licked by an animal, among travelers in Southeast Asia. The secondary objective was to assess their attitudes and practices related to rabies. METHODOLOGY/PRINCIPAL FINDINGS: Foreign travelers departing to the destination outside Southeast Asia were invited to fill out the study questionnaire in the departure hall of Bangkok International Airport. They were asked about their demographic profile, travel characteristics, pre-travel health preparations, their possible exposure and their practices related to rabies during this trip. From June 2010 to February 2011, 7,681 completed questionnaires were collected. Sixty-two percent of the travelers were male, and the median age was 32 years. 34.0% of the participants were from Western/Central Europe, while 32.1% were from East Asia. Up to 59.3% had sought health information before this trip. Travel clinics were the source of information for 23.6% of travelers. Overall, only 11.6% of the participants had completed their rabies pre-exposure prophylaxis, and 15.3% had received only 1-2 shots, while 73.1% had not been vaccinated at all. In this study, the risk of being bitten was 1.11 per 100 travelers per month and the risk of being licked was 3.12 per 100 travelers per month. Among those who were bitten, only 37.1% went to the hospital to get post exposure treatment. Travelers with East Asian nationalities and longer duration of stay were significantly related to higher risk of animal exposure. Reason for travel was not related to the risk of animal exposure. CONCLUSIONS: Travelers were at risk of being exposed to potentially rabid animals while traveling in Southeast Asia. Many were inadequately informed and unprepared for this life-threatening risk. Rabies prevention advice should be included in every pre-travel visit.

STD patients’ preferences for HIV prevention strategies

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Castro JG

2014-12-01

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

PHYSIOTHERAPY METHODS IN PREVENTION OF FALLS IN ELDERLY PEOPLE

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MAŁGORZATA GAJOS

2016-06-01

Full Text Available The process of population ageing is observed not only in Poland but also in other European countries. Physiological processes of ageing reduces the functional capacity. In particular, associated diseases, progressive weakness and failure of the motor system increases the risk of collapse in seniors. Dangerous consequences of falls, inter alia, injuries, can often cause death, what justifies its classification as a so-called geriatric giant. Health and psychosocial consequences of falls should be noted. Therefore, there is a great need for induction of preventive measures. Many results of studies constantly show, that an effective intervention in preventing falls in seniors should include, first and foremost, multidirectional rehabilitation, which aims to improve balance and increase postural strength muscle. In addition, prevention should include: patient education, pharmacotherapy prescribed by a medical specialist, eyesight improvement, elimination of potential risks surrounding the patient. The introduction of multi-directional prevention of falls can reduce the risk of their occurrence up to 50%.

Developing global climate anomalies suggest potential disease risks for 2006-2007.

Science.gov (United States)

Anyamba, Assaf; Chretien, Jean-Paul; Small, Jennifer; Tucker, Compton J; Linthicum, Kenneth J

2006-12-28

risk for disease outbreaks: Indonesia, Malaysia, Thailand and most of the southeast Asia Islands for increased dengue fever transmission and increased respiratory illness; Coastal Peru, Ecuador, Venezuela, and Colombia for increased risk of malaria; Bangladesh and coastal India for elevated risk of cholera; East Africa for increased risk of a Rift Valley fever outbreak and elevated malaria; southwest USA for increased risk for hantavirus pulmonary syndrome and plague; southern California for increased West Nile virus transmission; and northeast Brazil for increased dengue fever and respiratory illness. The current development of El Niño conditions has significant implications for global public health. Extremes in climate events with above normal rainfall and flooding in some regions and extended drought periods in other regions will occur. Forecasting disease is critical for timely and efficient planning of operational control programs. In this paper we describe developing global climate anomalies that suggest potential disease risks that will give decision makers additional tools to make rational judgments concerning implementation of disease prevention and mitigation strategies.

HIV/AIDS-related sexual risk behaviors among rural residents in China: potential role of rural-to-urban migration

Science.gov (United States)

Li, Xiaoming; Zhang, Liying; Stanton, Bonita; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua

2007-01-01

The relationship between rural-to-urban migration and the spread of HIV is well described, although most studies focus on sexual risk behaviors among rural-to-urban migrants at the urban destination areas. Few studies have examined the sexual risk behaviors of migrants who have returned from urban areas to their rural homes (“return migrants”) in comparison with those of local rural residents who have never migrated to cities (“non-migrants”). This study examines the potential association between rural-to-urban migration and sexual risk behaviors by comparing sexual risk behaviors between 553 return migrants and 441 non-migrants from same rural communities in China. Findings reveal that, after controlling for sociodemographic characteristics, return migrants in rural areas had higher levels of sexual risk, including unprotected sex, than non-migrants. Among return migrants, sexual risk behaviors were associated with age, gender, marital status, and number of different jobs they had previously held in the cities. These findings underscore the importance for HIV/AIDS education and prevention efforts targeting the migrant population in urban destinations as well as the return migrant population in rural areas. PMID:17967110

Potential human health risk assessment of heavy metals intake via ...

African Journals Online (AJOL)

Potential human health risk assessment of heavy metals intake via consumption of some leafy vegetables obtained from four market in Lagos Metropolis, Nigeria. ... This result reflected the risk associated with exposure for the period of life expectancy considered, and the inhabitants are highly exposed to health risks ...

Potential Human Health Risks of Tannery Waste-contaminated Poultry Feed

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Mohammad Latiful Bari

2015-01-01

Conclusions. The estimated daily intake value, THQ, along with the aggregate hazard index value, indicated a potential risk to consumers through consumption of contaminated chicken. Therefore, the study results clearly demonstrate heavy metals accumulation in chicken due to feeding SCW-based feed. The contaminated chicken further transfers these heavy metals to humans through ingestion. Hence, there is a potential human health risk through consumption of contaminated chicken meat.

Environmental carcinogenic agents and cancer prevention. Risk assessment and management

International Nuclear Information System (INIS)

Tsugane, Shoichiro

2013-01-01

Many agents in our environment have been established as being carcinogenic, and in most cases, the carcinogenic properties of these agents were identified because of high-dose occupational or accidental exposure. Risk characterization, taking into account the dose-response relationship, and exposure assessment are essential for risk assessment and subsequent cancer prevention. Based on scientific risk assessment, risk management should be conducted practically by considering the economic, social, political, and other technical issues and by balancing the risks and benefits. Asbestos and environmental tobacco smoke are typical examples of established carcinogenic agents in the general environment, contributing to low-dose exposure. Further epidemiological studies are required to investigate the carcinogenicity of low-dose exposure to known carcinogenic agents such as arsenic and cadmium through dietary intake, radiation via medical and natural exposure, and air pollution due to diesel exhaust. In contrast, occupational chemical exposure to 1,2-dichloropropane and/or dichloromethane, whose carcinogenicity had not been established, was suggested to cause cholangiocarcinoma among workers involved in offset color proof-printing only after a rare situation of high-dose exposure was unveiled. Continuous monitoring of unusual cancer occurrences in target populations such as workers in occupational and regional settings as well as exposure reduction to suspected carcinogenic agents to levels as low as reasonably achievable is essential for reducing the risk of cancer due to environmental carcinogens. (author)

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia.

Science.gov (United States)

Heywood, Anita E; Zhang, Meng; MacIntyre, C Raina; Seale, Holly

2012-02-17

Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P students reported low risk perception of travel threats and a low corresponding concern for these threats. Our study highlights the need to educate students about the risk

Therapeutic interventions and success in risk factor control for secondary prevention of stroke.

Science.gov (United States)

Alvarez-Sabin, Jose; Quintana, Manuel; Hernandez-Presa, Miguel Angel; Alvarez, Carlos; Chaves, Jose; Ribo, Marc

2009-01-01

We sought to evaluate the success rates in achieving preventive therapeutic goals in patients who experienced an ischemic stroke (IS) and compare them with those achieved in patients with coronary artery disease (CAD). This was an observational multicenter case-control study (3 patients with IS and one control subject with CAD) performed in 1444 primary health centers in Spain. Preventive therapeutic objectives according to American Heart Association guidelines were predefined. Demographic data, vascular risk factors, and success/failure in achievement of objectives were recorded and compared between patients with IS and CAD. A total of 5458 patients were included, 4098 (75.1%) had IS and 1360 (24.9%) had CAD. Although more than 90% of patients with hypertension, diabetes, or dyslipidemia were under specific drug regimens, only about 25% achieved the recommended therapeutic objective for each risk factor. Success rate was especially low among patients with IS compared with CAD: hypertension (23.8% v 27.2%; P = .028); dyslipidemia (13.6% v 20.3%; P risk factors under control, compared with 5.6% of those with CAD (P = .006). For all patients, multivariate logistic regression model showed that independent predictors of full risk factor control were: presence of CAD as compared with IS (odds ratio [OR] 2.11; 95% confidence interval [CI] 1.35-3.29; P = .001), older age (OR 1.02; 95% CI 1.00-1.04; P = .028), and having less than 3 risk factors (OR 16.98; 95% CI 9.02-31.97; P risk factor control.

Prevention of Infection in Orthopedic Prosthetic Surgery.

Science.gov (United States)

Chirca, Ioana; Marculescu, Camelia

2017-06-01

Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection. Published by Elsevier Inc.

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

Science.gov (United States)

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

2015-06-06

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