WorldWideScience

Sample records for preventative concurrent management

  1. Managing Asynchronous Data in ATLAS's Concurrent Framework

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00100895; The ATLAS collaboration; Baines, John; Bold, Tomasz; Calafiura, Paolo; Cranshaw, Jack; Dotti, Andrea; Farrell, Steven; Malon, David; Stewart, Graeme; Snyder, Scott; van Gemmeren, Peter; Tsulaia, Vakhtang; Wynne, Benjamin

    2016-01-01

    In order to be able to make effective use of emerging hardware, where the amount of memory available to any CPU is rapidly decreasing as the core count continues to rise, ATLAS has begun a migration to a concurrent, multi-threaded software framework, known as AthenaMT. Significant progress has been made in implementing AthenaMT - we can currently run realistic Geant4 simulations on massively concurrent machines. the migration of realistic prototypes of reconstruction workflows is more difficult, given the large amounts of legacy code and the complexity and challenges of reconstruction software. These types of workflows, however, are the types that will most benefit from the memory reduction features of a multi-threaded framework. One of the challenges that we will report on in this paper is the re-design and implementation of several key asynchronous technologies whose behaviour is radically different in a concurrent environment than in a serial one, namely the management of Conditions data and the Detector D...

  2. Rain VM: Portable Concurrency through Managing Code

    OpenAIRE

    Brown, Neil C.C.

    2006-01-01

    A long-running recent trend in computer programming is the growth in popularity of virtual machines. However, few have included good support for concurrency - a natural mechanism in the Rain programming language. This paper details the design and implementation of a secure virtual machine with support for concurrency, which enables portability of concurrent programs. Possible implementation ideas of many-to-many threading models for the virtual machine kernel are discussed, and initial benchm...

  3. Verified compilation of Concurrent Managed Languages

    Science.gov (United States)

    2017-11-01

    drawings, specifications, or other data does not license the holder or any other person or corporation ; or convey any rights or permission to... explore new proof techniques and methodologies that would enable scalable and modular verification of modern concurrent programming languages like Java...I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2 Proof strategy

  4. Concurrent engineering design and management knowledge capture

    Science.gov (United States)

    1990-01-01

    The topics are presented in viewgraph form and include the following: real-time management, personnel management, project management, conceptual design and decision making; the SITRF design problem; and the electronic-design notebook.

  5. Distributed Management of Concurrent Web Service Transactions

    DEFF Research Database (Denmark)

    Alrifai, Mohammad; Dolog, Peter; Balke, Wolf-Tilo

    2009-01-01

    in the open and dynamic environment of Web services, where interleaving business transactions enter and exit the system independently, remains an open issue. In this paper, we address this problem and propose an architecture that supports concurrency control on the Web services level. An extension......Business processes involve dynamic compositions of interleaved tasks. Therefore, ensuring reliable transactional processing of Web services is crucial for the success of Web service-based B2B and B2C applications. But the inherent autonomy and heterogeneity of Web services render the applicability...... of conventional ACID transaction models for Web services far from being straightforward. Current Web service transaction models relax the isolation property and rely on compensation mechanisms to ensure atomicity of business transactions in the presence of service failures. However, ensuring consistency...

  6. Concurrent sexual partnerships among married Zimbabweans – implications for HIV prevention

    Directory of Open Access Journals (Sweden)

    Mugweni E

    2015-09-01

    Full Text Available Esther Mugweni,1 Stephen Pearson,2 Mayeh Omar2 1UCL Department of Infection and Population Health, University College London, London, 2The Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK Background: Concurrent sexual partnerships play a key role in sustaining the HIV epidemic in Zimbabwe. Married couples are at an increased risk of contracting HIV from sexual networks produced by concurrent sexual partnerships. Addressing these partnerships is an international HIV prevention priority. Methods: Our qualitative study presents the socioeconomic factors that contribute to the occurrence of concurrent sexual partnerships among married people in Zimbabwe. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008 to understand the organizations of concurrent sexual partnerships. Data were analyzed using framework analysis. Results: Our study indicates that relationship dissatisfaction played a key role in the engagement of concurrent sexual partnerships. Depending on the source of the dissatisfaction, there were four possible types of concurrent sexual relationships that were formed: sex worker, casual partner, regular girlfriend or informal polygyny which was referred to as “small house”. These relationships had different levels of intimacy, which had a bearing on practicing safer sex. Participants described three characteristics of hegemonic masculinity that contributed to the sources of dissatisfaction leading to concurrent sexual activity. Similarly, various aspects of emphasized femininity were described as creating opportunities for the occurrence of concurrent sexual relationships. Economic status was also listed as a factor that contributed to the occurrence of concurrent sexual partnerships. Conclusion: Marital dissatisfaction was indicated as a contributing factor to the occurrence of concurrent sexual relationships. There were several

  7. Space Station Freedom - Configuration management approach to supporting concurrent engineering and total quality management. [for NASA Space Station Freedom Program

    Science.gov (United States)

    Gavert, Raymond B.

    1990-01-01

    Some experiences of NASA configuration management in providing concurrent engineering support to the Space Station Freedom program for the achievement of life cycle benefits and total quality are discussed. Three change decision experiences involving tracing requirements and automated information systems of the electrical power system are described. The potential benefits of concurrent engineering and total quality management include improved operational effectiveness, reduced logistics and support requirements, prevention of schedule slippages, and life cycle cost savings. It is shown how configuration management can influence the benefits attained through disciplined approaches and innovations that compel consideration of all the technical elements of engineering and quality factors that apply to the program development, transition to operations and in operations. Configuration management experiences involving the Space Station program's tiered management structure, the work package contractors, international partners, and the participating NASA centers are discussed.

  8. Knowledge Management tools integration within DLR's concurrent engineering facility

    Science.gov (United States)

    Lopez, R. P.; Soragavi, G.; Deshmukh, M.; Ludtke, D.

    The complexity of space endeavors has increased the need for Knowledge Management (KM) tools. The concept of KM involves not only the electronic storage of knowledge, but also the process of making this knowledge available, reusable and traceable. Establishing a KM concept within the Concurrent Engineering Facility (CEF) has been a research topic of the German Aerospace Centre (DLR). This paper presents the current KM tools of the CEF: the Software Platform for Organizing and Capturing Knowledge (S.P.O.C.K.), the data model Virtual Satellite (VirSat), and the Simulation Model Library (SimMoLib), and how their usage improved the Concurrent Engineering (CE) process. This paper also exposes the lessons learned from the introduction of KM practices into the CEF and elaborates a roadmap for the further development of KM in CE activities at DLR. The results of the application of the Knowledge Management tools have shown the potential of merging the three software platforms with their functionalities, as the next step towards the fully integration of KM practices into the CE process. VirSat will stay as the main software platform used within a CE study, and S.P.O.C.K. and SimMoLib will be integrated into VirSat. These tools will support the data model as a reference and documentation source, and as an access to simulation and calculation models. The use of KM tools in the CEF aims to become a basic practice during the CE process. The settlement of this practice will result in a much more extended knowledge and experience exchange within the Concurrent Engineering environment and, consequently, the outcome of the studies will comprise higher quality in the design of space systems.

  9. Creatine supplementation prevents acute strength loss induced by concurrent exercise.

    Science.gov (United States)

    de Salles Painelli, Vítor; Alves, Victor Tavares; Ugrinowitsch, Carlos; Benatti, Fabiana Braga; Artioli, Guilherme Giannini; Lancha, Antonio Herbert; Gualano, Bruno; Roschel, Hamilton

    2014-08-01

    To investigate the effect of creatine (CR) supplementation on the acute interference induced by aerobic exercise on subsequent maximum dynamic strength (1RM) and strength endurance (SE, total number of repetitions) performance. Thirty-two recreationally strength-trained men were submitted to a graded exercise test to determine maximal oxygen consumption (VO2max: 41.56 ± 5.24 ml kg(-1) min(-1)), anaerobic threshold velocity (ATv: 8.3 ± 1.18 km h(-1)), and baseline performance (control) on the 1RM and SE (4 × 80 % 1RM to failure) tests. After the control tests, participants were randomly assigned to either a CR (20 g day(-1) for 7 days followed by 5 g day(-1) throughout the study) or a placebo (PL-dextrose) group, and then completed 4 experimental sessions, consisting of a 5-km run on a treadmill either continuously (90 % ATv) or intermittently (1:1 min at vVO2max) followed by either a leg- or bench-press SE/1RM test. CR was able to maintain the leg-press SE performance after the intermittent aerobic exercise when compared with C (p > 0.05). On the other hand, the PL group showed a significant decrease in leg-press SE (p ≤ 0.05). CR supplementation significantly increased bench-press SE after both aerobic exercise modes, while the bench-press SE was not affected by either mode of aerobic exercise in the PL group. Although small increases in 1RM were observed after either continuous (bench press and leg press) or intermittent (bench press) aerobic exercise in the CR group, they were within the range of variability of the measurement. The PL group only maintained their 1RM. In conclusion, the acute interference effect on strength performance observed in concurrent exercise may be counteracted by CR supplementation.

  10. Resource Management and Contingencies in Aerospace Concurrent Engineering

    Science.gov (United States)

    Karpati, Gabe; Hyde, Tupper; Peabody, Hume; Garrison, Matthew

    2012-01-01

    significant concern in designing complex systems implementing new technologies is that while knowledge about the system is acquired incrementally, substantial financial commitments, even make-or-break decisions, must be made upfront, essentially in the unknown. One practice that helps in dealing with this dichotomy is the smart embedding of contingencies and margins in the design to serve as buffers against surprises. This issue presents itself in full force in the aerospace industry, where unprecedented systems are formulated and committed to as a matter of routine. As more and more aerospace mission concepts are generated by concurrent design laboratories, it is imperative that such laboratories apply well thought-out contingency and margin structures to their designs. The first part of this publication provides an overview of resource management techniques and standards used in the aerospace industry. That is followed by a thought provoking treatise on margin policies. The expose presents the actual flight telemetry data recorded by the thermal discipline during several recent NASA Goddard Space Flight Center missions. The margins actually achieved in flight are compared against pre-flight predictions, and the appropriateness and the ramifications of having designed with rigid margins to bounding stacked worst case conditions are assessed. The second half of the paper examines the particular issues associated with the application of contingencies and margins in the concurrent engineering environment. In closure, a discipline-by-discipline disclosure of the contingency and margin policies in use at the Integrated Design Center at NASA s Goddard Space Flight Center is made.

  11. The HSE Management Standards Indicator Tool: concurrent and construct validity.

    Science.gov (United States)

    Marcatto, F; Colautti, L; Larese Filon, F; Luis, O; Ferrante, D

    2014-07-01

    The Health & Safety Executive Management Standards Indicator Tool (HSE-MS IT) is a questionnaire commonly used to assess work-related stress risks at an organizational level. A critical factor in determining whether this instrument is actually useful is that higher levels of stress risk in the work-design domains should predict higher levels of stress and stress-related outcomes in workers. Only a few studies, however, have addressed this issue. To test both the concurrent and construct validity of the HSE-MS IT, by relating it with another widely used instrument, the Job Content Questionnaire (JCQ), and by examining its relationships with a set of work-related stress outcomes. An anonymous cross-sectional questionnaire was administered to a sample of employees in an Italian municipality. The questionnaire included the HSE-MS IT, self-reported measures of job satisfaction, job motivation and stress at work, the Satisfaction with Life Scale and the reduced form of the JCQ. A total of 760 out of 779 employees completed the questionnaire. Results showed moderate to strong correlation among the corresponding HSE-MS IT and JCQ scales. Hierarchical regression highlighted the specific contribution of each of the HSE-MS IT scales in predicting three relevant work-related stress outcomes (self-reported stress, job satisfaction and job motivation), after controlling for gender, age and life satisfaction. Our findings consolidated the HSE-MS IT validity and showed the specific sensitivity of its scales to assess different aspects of work-related distress, including self-perception of stress at work. These results can have practical implications for the occupational well-being of employees. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Cholera - management and prevention.

    Science.gov (United States)

    Davies, Hannah G; Bowman, Conor; Luby, Stephen P

    2017-06-01

    Cholera is an acute secretory diarrhoeal infection caused by the bacterium Vibrio cholerae. It is likely to have originated in the Indian sub-continent; however, it spread to cause six worldwide pandemics between 1817-1923. The ongoing seventh worldwide pandemic of cholera began in 1961. The intensity, duration and severity of cholera epidemics have been increasing, signaling the need for more effective control and prevention measures. The response to the cholera pandemics of the 19th century led to the development of safe and effective sanitation and water systems which have effectively removed the risk of cholera in many settings. However, such systems are not in place to protect billions of people worldwide. Although some progress has been made in expanding access to water in recent years, achieving optimal infrastructure will, in the most optimistic scenario, take decades. Climate change, extreme weather events and rapid urbanisation suggests that alternatives to the current paradigm of providing large centralised water and sanitation systems should be considered, including smaller decentralised systems. The aim of this review paper is to provide an overview of current knowledge regarding management of cholera with a focus on prevention measures including vaccination and water and sanitation interventions. © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  13. Management and Surgical Outcomes of Concurrent Tuberculosis and Lung Cancer.

    Science.gov (United States)

    Evman, Serdar; Baysungur, Volkan; Alpay, Levent; Uskul, Bahadir; Misirlioglu, Aysun Kosif; Kanbur, Serda; Dogruyol, Talha

    2017-10-01

    Background  Concurrent pulmonary tuberculosis (TB) and lung cancer are rarely encountered in Western countries; however, it is more common in developing countries. We aim to share the diagnostic and treatment approaches in this study. Materials and Methods  Clinical files of all patients undergoing lung resection for non-small cell carcinoma with concurrent pulmonary TB between February 2006 and December 2012 were investigated retrospectively in terms of patient characteristics, operation methods, definite pathology and stage of tumor, postoperative treatment schemes, and associated complications. Results  TB was detected in 17 (1.3%) of 1,266 operated carcinoma patients. Eleven had squamous cell carcinoma and six had adenocarcinoma. Mean age was 54.9 years. Two patients received anti-TB treatment preoperatively. Fifteen patients were given anti-TB treatment postoperatively, as soon as definite microbiological confirmation was obtained, and concurrently given adjuvant therapy after 3 weeks of sole four-drug TB treatment. Pneumonectomy was performed in four (23.5%), sleeve lobectomy in three (17.6%), lobectomy in eight (47%), and bilobectomy in two (11.7%) patients. Postoperative complications occurred in four (23.5%) patients, with bronchopleural fistula being seen in only one pneumonectomy patient. No postoperative mortality or reactivation of TB was seen. Mean survival time was 32 ± 2 months. Conclusion  Resection following a 3-week anti-TB treatment or concurrent anti-TB and postoperative adjuvant chemotherapy does not constitute an additional postoperative risk for patients with concomitant lung malignancy and pulmonary TB. The determination of optimum treatment for these patients presents a challenge in developing countries, where TB is still a common disease. Georg Thieme Verlag KG Stuttgart · New York.

  14. Concurrent Transient Activation of Wnt/β-Catenin Pathway Prevents Radiation Damage to Salivary Glands

    International Nuclear Information System (INIS)

    Hai Bo; Yang Zhenhua; Shangguan Lei; Zhao Yanqiu; Boyer, Arthur; Liu, Fei

    2012-01-01

    Purpose: Many head and neck cancer survivors treated with radiotherapy suffer from permanent impairment of their salivary gland function, for which few effective prevention or treatment options are available. This study explored the potential of transient activation of Wnt/β-catenin signaling in preventing radiation damage to salivary glands in a preclinical model. Methods and Materials: Wnt reporter transgenic mice were exposed to 15 Gy single-dose radiation in the head and neck area to evaluate the effects of radiation on Wnt activity in salivary glands. Transient Wnt1 overexpression in basal epithelia was induced in inducible Wnt1 transgenic mice before together with, after, or without local radiation, and then saliva flow rate, histology, apoptosis, proliferation, stem cell activity, and mRNA expression were evaluated. Results: Radiation damage did not significantly affect activity of Wnt/β-catenin pathway as physical damage did. Transient expression of Wnt1 in basal epithelia significantly activated the Wnt/β-catenin pathway in submandibular glands of male mice but not in those of females. Concurrent transient activation of the Wnt pathway prevented chronic salivary gland dysfunction following radiation by suppressing apoptosis and preserving functional salivary stem/progenitor cells. In contrast, Wnt activation 3 days before or after irradiation did not show significant beneficial effects, mainly due to failure to inhibit acute apoptosis after radiation. Excessive Wnt activation before radiation failed to inhibit apoptosis, likely due to extensive induction of mitosis and up-regulation of proapoptosis gene PUMA while that after radiation might miss the critical treatment window. Conclusion: These results suggest that concurrent transient activation of the Wnt/β-catenin pathway could prevent radiation-induced salivary gland dysfunction.

  15. Concurrent Transient Activation of Wnt/{beta}-Catenin Pathway Prevents Radiation Damage to Salivary Glands

    Energy Technology Data Exchange (ETDEWEB)

    Hai Bo; Yang Zhenhua; Shangguan Lei; Zhao Yanqiu [Institute for Regenerative Medicine, Scott and White Hospital, Molecular and Cellular Medicine Department, Texas A and M Health Science Center, Temple, Texas (United States); Boyer, Arthur [Department of Radiology, Scott and White Hospital, Temple, Texas (United States); Liu, Fei, E-mail: fliu@medicine.tamhsc.edu [Institute for Regenerative Medicine, Scott and White Hospital, Molecular and Cellular Medicine Department, Texas A and M Health Science Center, Temple, Texas (United States)

    2012-05-01

    Purpose: Many head and neck cancer survivors treated with radiotherapy suffer from permanent impairment of their salivary gland function, for which few effective prevention or treatment options are available. This study explored the potential of transient activation of Wnt/{beta}-catenin signaling in preventing radiation damage to salivary glands in a preclinical model. Methods and Materials: Wnt reporter transgenic mice were exposed to 15 Gy single-dose radiation in the head and neck area to evaluate the effects of radiation on Wnt activity in salivary glands. Transient Wnt1 overexpression in basal epithelia was induced in inducible Wnt1 transgenic mice before together with, after, or without local radiation, and then saliva flow rate, histology, apoptosis, proliferation, stem cell activity, and mRNA expression were evaluated. Results: Radiation damage did not significantly affect activity of Wnt/{beta}-catenin pathway as physical damage did. Transient expression of Wnt1 in basal epithelia significantly activated the Wnt/{beta}-catenin pathway in submandibular glands of male mice but not in those of females. Concurrent transient activation of the Wnt pathway prevented chronic salivary gland dysfunction following radiation by suppressing apoptosis and preserving functional salivary stem/progenitor cells. In contrast, Wnt activation 3 days before or after irradiation did not show significant beneficial effects, mainly due to failure to inhibit acute apoptosis after radiation. Excessive Wnt activation before radiation failed to inhibit apoptosis, likely due to extensive induction of mitosis and up-regulation of proapoptosis gene PUMA while that after radiation might miss the critical treatment window. Conclusion: These results suggest that concurrent transient activation of the Wnt/{beta}-catenin pathway could prevent radiation-induced salivary gland dysfunction.

  16. [Dementia: management and prevention].

    Science.gov (United States)

    Daher, Oscar; Nguyen, Sylvain; Smith, Cindi; Büla, Christophe; Démonet, Jean-François

    2016-04-20

    Dementia represents a great challenge for health care providers. Detection of cognitive impairment is critical for early diagnosis of dementia. Early diagnosis allows to initiate individualized management that focuses on maintaining patient's autonomy and supporting their caregivers. Proposed multimodal interventions include physical activity, cognitive training, mediterranean diet, and management of cardiovascular risk factors. Before the initiation of pro-cognitive therapy, medication review is essential to evaluate current treament and determine specific therapeutic objectives, based on patient's overall health and preferences. Overall risk reduction for dementia revolves around similar measures that target physical activity, cognition, diet and management of cardiovascular risk factors.

  17. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services

    Science.gov (United States)

    Riza, Anca Lelia; Pearson, Fiona; Ugarte-Gil, Cesar; Alisjahbana, Bachti; van de Vijver, Steven; Panduru, Nicolae M; Hill, Philip C; Ruslami, Rovina; Moore, David; Aarnoutse, Rob; Critchley, Julia A; van Crevel, Reinout

    2016-01-01

    Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management of patients with both diseases can be difficult. Tuberculosis patients with diabetes have a lower concentration of tuberculosis drugs and a higher risk of drug toxicity than tuberculosis patients without diabetes. Good glycaemic control, which reduces long-term diabetes complications and could also improve tuberculosis treatment outcomes, is hampered by chronic inflammation, drug-drug interactions, suboptimum adherence to drug treatments, and other factors. Besides drug treatments for tuberculosis and diabetes, other interventions, such as education, intensive monitoring, and lifestyle interventions, might be needed, especially for patients with newly diagnosed diabetes or those who need insulin. From a health systems point of view, delivery of optimum care and integration of services for tuberculosis and diabetes is a huge challenge in many countries. Experience from the combined tuberculosis and HIV/AIDS epidemic could serve as an example, but more studies are needed that include economic assessments of recommended screening and systems to manage concurrent tuberculosis and diabetes. PMID:25194887

  18. UPDATE MANAGEMENT CONCURRENT INFECTION BETWEEN DENGUE VIRAL AND SALMONELLA

    Directory of Open Access Journals (Sweden)

    Dyah Wikanesthi

    2014-09-01

    Full Text Available Since Januari 2013, Soerya Hospital has found many cases with positive result of IgM Salmonella along with NS1 or IgM & IgG Dengue. The clinical manifestations mostly are high fever, headache, vomiting, malaise and plasma leakage. Some of them with convulsion and unconsciousness. Therefore in order to get well of care management, this clinical phenomena should be studied carefully. The aim of this research is to get update management concurent Dengue Viral and Salmonella infection. Observational study had been done, since Januari 2013 until Juli 2013. Purposive sampling in 30 case of concurent Dengue Viral and Salmonella infection compared with 30 case of Dengue Viral infection alone. Diagnosis has published based on WHO 2011 criteria. By using anti vomiting drug, anti pyretic, anti convulsion and antibiotic for Salmonella infection and rehidration using Ringer Acetate, combining Ringer Asetat and Dextrose 5% or combining Ringer Asetat Saline 0,225% or solution of Dextrose 5% and Saline 0,45 during 4–5 days hospitalization. The result show that all cases were recovered and got well. There is no significant different between concurent Dengue Viral and Salmonella infection compared with Dengue Viral infection alone. Some cases showed that length time to stay in hospital become 1–2 days longer. It was due to delayed getting antibiotic for Salmonella infection. All cases had got first drugs accurately in a clinical manifestation that has been daily showed. It was as a problem solving for saving all the cases.

  19. Employee engagement and management standards: a concurrent evaluation.

    Science.gov (United States)

    Ravalier, J M; Dandil, Y; Limehouse, H

    2015-08-01

    The UK Health & Safety Executive's Management Standards Indicator Tool (MSIT) has been used to assess areas of work design, which may act as psychosocial hazards leading to burnout. These have not been assessed as predictors of employee engagement. To determine the utility of the MSIT in evaluating employee engagement as measured by the Utrecht Work Engagement Scale (UWES). A cross-sectional survey of employees from two sales organizations in London was performed using the MSIT and UWES. MSIT scores were analysed stratifying medium-high versus low engagement. Multivariate linear regression evaluated the association of all MSIT scores with UWES factors. Control, managerial support, peer support and employee role differed by engagement level. Demands, peer support and role exceeded MSIT benchmark guidance that would warrant urgent improvement. Role ambiguity was the only factor significantly associated with all subdomains of engagement. Role appears to play a major part in determining employee engagement. Assessment of the relationship between factors measured by the MSIT and UWES requires further investigation in wider organizational settings, particularly the influence of employee role on positive psychological outcomes. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Pressure ulcer prevention and management.

    Science.gov (United States)

    Lyder, Courtney H

    2002-01-01

    This chapter reviews 218 published and unpublished research reports of pressure ulcer prevention and management by nurse researchers and researchers from other disciplines. The electronic databases MEDLINE (1966-July 2001), CINAHL (1982-June 2001), AMED (1985-July 2001), and EI Compedex Plus (1980-June 2001) were selected for the searches because of their focus on health and applied research. Moreover, evaluations of previous review articles and seminal studies that were published before 1966 are also included. Research conducted worldwide and published in English between 1930 and 2001 was included for review. Studies using descriptive, correlational, longitudinal, and randomized control trials were included. This review found that numerous gaps remain in our understanding of effective pressure ulcer prevention and management. Moreover, the majority of pressure ulcer care is derived from expert opinion rather than empirical evidence. Thus, additional research is needed to investigate pressure ulcer risk factors of ethnic minorities. Further studies are needed that examine the impact of specific preventive interventions (e.g., turning intervals based on risk stratification) and the cost-effectiveness of comprehensive prevention programs to prevent pressure ulcers. Finally, an evaluation is needed of various aspects of pressure ulcer management (e.g., use of support surfaces, use of adjunctive therapies) and healing of pressure ulcers.

  1. Automation through the PIP [Program Implementation Plan] concurrence system improves information sharing among DOE [Dept. of Energy] managers

    International Nuclear Information System (INIS)

    Imholz, R.M.; Berube, D.S.; Peterson, J.L.

    1990-01-01

    The Program Implementation Plan (PIP) Concurrence System is designed to improve information sharing within the U.S. Department of Energy (DOE) and between DOE and the Field. Effectively sharing information enables DOE managers to make more informed, effective decisions. The PIP Concurrence System improved information sharing among DOE managers by defining the automated process for concurring on a DOE document, thus reducing the time required to concur on the document by 75%. The first step in defining an automated process is to structure the process for concurring on a document. Only those DOE managers with approved access could review certain parts of a document on a concurrence system. Remember that the concurrence process is a sign off procedure unlike a commentary process in which comments may not be restricted to certain people. The commentary process is the beginning of the concurrence process. The commentary process builds a document; the concurrence process approves it. 6 refs., 7 figs

  2. Radiation therapy and concurrent cisplatin in management of locoregionally advanced nasopharyngeal carcinomas

    International Nuclear Information System (INIS)

    Serin, M.; Erkal, H.S.; Cakmak, A.

    1999-01-01

    Radiation therapy in combination with chemotherapy in the management of locoregionally advanced nasopharyngeal carcinomas is evaluated in an attempt to improve locoregional response, reduce locoregional failure and reduce systemic failure. The current study was designed to investigate radiation therapy and concurrent cisplatin in this context. From 1992 through 1997, 70 patients with locoregionally advanced nasopharyngeal carcinomas were treated with radiation therapy and concurrent cisplatin. External beam radiation dose was 60 Gy for T1, T2 and T3 tumors, 70 Gy for T4 tumors and 70 Gy for metastatic cervical lymph nodes. An intracavitary brachytherapy boost (10 Gy) was applied for T1, T2 and T3 tumors. Cisplatin (30 mg/m 2 ) was administered weekly during external beam radiation therapy. Locoregional complete response was achieved in 63 patients, locoregional failure was observed in 4 patients and systemic failure was observed in 15. N-stage predicted systemic failure. Overall survival, locoregional failure-free survival and systemic failure-free survival were 63%, 79% and 75%, respectively, at three years. Grade 3 acute skin toxicity was observed in 2 patients, Grade 3 acute mucous membrane toxicity was observed in 6 and Grad 3 acute hematological toxicity was observed in 2 patients. Despite improved locoregional response, reduced locoregional failure and improved survival with radiation therapy and concurrent cisplatin, systemic failure remains prevalent for locoregionally advanced nasopharyngeal carcinomas. (orig.)

  3. Crisis management and crisis prevention

    International Nuclear Information System (INIS)

    Wallensteen, P.

    1988-01-01

    This paper reports that many proposals have come forth to ease the tension between East and West. Some focus on arms developments, others take up diplomatic issues. In addition, some have raised the question of crisis management and crisis prevention. Can crises be prevented even before they have taken place? The Palme Commission on Disarmament and Security suggested, in its 1982 report, ways of restraining superpower involvement in Third World conflicts. Such conflicts, it was argued, could escalate and ultimately result in nuclear confrontation between the United States and the Soviet Union. Certainly, the commission also paid attention to conflicts over issues in Europe and to problems in Eastern or in Western Europe. However, the commission raised a question that lately has received increasing attention: the dangers of superpower confrontation over Third World issues. In his statement to the United Nations on 24 October 1985, President Regan pointed to the need for settling regional conflicts as they play a large role in building suspicions and tensions. Regan's initiative explicitly concerned Afghanistan, Cambodia, Ethiopia, Angola and Nicaragua. It included negotiations with the Soviet Union over Afghanistan, and, at a later stage, also over other issues. The goal, he the, was not to force a settlement on the parties. The initiative concerned issues that have for the American public, justified armaments and reduced Soviet credibility

  4. Prevention and management of gastroesophageal varices.

    Science.gov (United States)

    Seo, Yeon Seok

    2018-03-01

    Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published. The present article reviews published articles and practice guidelines to present the most optimal management of patients with gastroesophageal varices.

  5. A novel approach to wound management and prosthetic use with concurrent vacuum-assisted closure therapy.

    Science.gov (United States)

    Fuller, Matthew; Luff, Robin; Van Den Boom, Monique

    2011-06-01

    Stump healing is critical to post amputation management. When healing is not optimal, immobility is prolonged and patients risk hospital acquired deconditioning. Two clinical cases with unhealed trans-femoral stump wounds are described. Vacuum assisted closure (VAC) dressing with concurrent prosthetic utilisation was undertaken successfully in both cases. Fitting of the prosthetic socket included space for VAC dressing with modifications to allow the suction piping to exit the prosthesis. With VAC application, timely rehabilitation and mobility was enabled despite incomplete wound healing. The two clinical cases described made excellent progress. Discharge home was expedited with the provision of portable VAC pumps. Wounds healed fully without infection. Both patients were able to mobilise sooner than if they had to wait for complete wound closure and, importantly, the consequences of prolonged immobility were minimised. No extra costs were incurred using this novel therapy. Guidance for early mobilisation of trans-femoral amputees with open wounds is limited. These cases provide examples utilising VAC dressings with concurrent prosthetic rehabilitation, facilitating prompt ambulatory retraining, minimising deconditioning and optimising outcomes.

  6. Pressure ulcers: prevention and management.

    Science.gov (United States)

    Dib, Mansour

    2008-01-01

    Pressure ulcers are a significant medical problem that greatly affects the geriatric population. We reviewed pertinent published data in the literature concerning the prevention and treatment of pressure ulcers. The development of pressure ulcers is associated with well known risk factors including unrelieved pressure, skin maceration, shear forces, malnutrition and immobility. Risk factor modification is an important aspect in prevention and treatment. When a pressure ulcer develops, various specialized support surfaces and wound care products exist to accelerate wound healing. Alternative therapeutic modalities such as ultrasonic mist and wound vacuum therapy are increasingly being used with success for such ulcers. Pressure ulcers are typically the consequence of underlying medical conditions that should be treated appropriately in order for the wound to heal.

  7. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services

    OpenAIRE

    Riza, Anca Lelia; Pearson, Fiona; Ugarte-Gil, Cesar; Alisjahbana, Bachti; van de Vijver, Steven; Panduru, Nicolae M; Hill, Philip C; Ruslami, Rovina; Moore, David; Aarnoutse, Rob; Critchley, Julia A; van Crevel, Reinout

    2014-01-01

    Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management o...

  8. Prevention and management of outpatient pediatric burns.

    Science.gov (United States)

    O'Brien, Shannon P; Billmire, David A

    2008-07-01

    Burns are common injuries in the pediatric population, with an estimated 250,000 pediatric burn patients seeking medical care annually. A relative few require inpatient management. This article discusses suggestions for burn prevention, as well as acute burn care and long-term management of small burns.

  9. Prenatal stress-induced increases in hippocampal von Willebrand factor expression are prevented by concurrent prenatal escitalopram.

    Science.gov (United States)

    Neigh, Gretchen N; Nemeth, Christina L; Kelly, Sean D; Hardy, Emily E; Bourke, Chase; Stowe, Zachary N; Owens, Michael J

    2017-04-01

    Prenatal stress has been linked to deficits in neurological function including deficient social behavior, alterations in learning and memory, impaired stress regulation, and susceptibility to adult disease. In addition, prenatal environment is known to alter cardiovascular health; however, limited information is available regarding the cerebrovascular consequences of prenatal stress exposure. Vascular disturbances late in life may lead to cerebral hypoperfusion which is linked to a variety of neurodegenerative and psychiatric diseases. The known impact of cerebrovascular compromise on neuronal function and behavior highlights the importance of characterizing the impact of stress on not just neurons and glia, but also cerebrovasculature. Von Willebrand factor has previously been shown to be impacted by prenatal stress and is predictive of cerebrovascular health. Here we assess the impact of prenatal stress on von Willebrand factor and related angiogenic factors. Furthermore, we assess the potential protective effects of concurrent anti-depressant treatment during in utero stress exposure on the assessed cerebrovascular endpoints. Prenatal stress augmented expression of von Willebrand factor which was prevented by concurrent in utero escitalopram treatment. The functional implications of this increase in von Willebrand factor remain elusive, but the presented data demonstrate that although prenatal stress did not independently impact total vascularization, exposure to chronic stress in adulthood decreased blood vessel length. In addition, the current study demonstrates that production of reactive oxygen species in the hippocampus is decreased by prenatal exposure to escitalopram. Collectively, these findings demonstrate that the prenatal experience can cause complex changes in adult cerebral vascular structure and function. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Multi-disciplinary Concurrent Management of Recurrent Hepatocellular Therapy is Superior to Sequential Therapy.

    Science.gov (United States)

    Fields, Tyler D; Philips, Prejesh; Scoggins, Charles R; Tatum, Cliff; Kelly, Lawrence; McMasters, Kelly M; Martin, Robert C G

    2017-05-01

    Recurrent hepatocellular carcinoma after a patient's initial therapy, whether it is transplantation, resection, or ablation, remains a challenging clinical problem. Since recurrence occurs in 70% of all initially treated disease within 5 years, optimal management to treat this recurrence is needed. Currently, a bias exists toward mono-therapy (i.e., ablation alone, hepatic arterial therapy alone, or sorafenib therapy alone) instead of concurrent sequential therapy-as is common in other primary and metastatic disease to the liver. Thus, the aim of our study was to evaluate the overall survival of recurrent HCC based on either mono-therapy or multimodality therapy. A review of our prospective 2245 patient hepato-pancreatico-biliary database was performed for all patients who underwent treatment with curative intent for hepatocellular carcinoma and had complete recurrence treatment data from June 2002 to May 2015. Mono-therapy was defined as initiation of a solitary therapy until disease progression or intolerance. Multimodality therapy was defined as at least 2 therapies that occurred simultaneously or within 4 weeks of each therapy. A total of 281 patients underwent treatment with curative intent for hepatocellular carcinoma, in which 192 experienced recurrence. These patients were treated with either thermal ablation or liver resection (LR) (N = 51), transarterial chemoembolization (TACE) or radiation (N = 68), systemic therapy (N = 26), or multimodality therapy (N = 47). The extent of the first recurrence was similar in regard to the number of tumors (median 1), the type of radiologic HCC, gender, BMI, and percentage of liver involvement. They differed in regard to size (MMT largest, median 5.6 cm, p = 0.02), and MMT had higher Hepatitis C involvement (37% of patients, p = 0.001). In evaluation of first recurrence treatment, after a median follow-up of 24 months, multimodality therapy has a significant improvement in overall survival (median 40

  11. Juvenile Diabetes Mellitus and Concurrent Exocrine Pancreatic Insufficiency in a Labrador Retriever: Long-Term Management.

    Science.gov (United States)

    Alvarez, Maria Saiz; Herrería-Bustillo, Vicente; Utset, Artur Font; Martínez, Jorge

    2015-01-01

    A 3 mo old, female, entire Labrador retriever presented with vomiting, diarrhea, polyuria, polydipsia, polyphagia, and stunted growth. Diagnostics revealed the presence of juvenile diabetes mellitus and concurrent exocrine pancreatic insufficiency. Pancreatic histopathology showed severe pancreatic atrophy. Successful treatment was achieved with a combination of insulin and pancreatic enzymes. This report describes successful long-term treatment of juvenile diabetes mellitus and concurrent exocrine pancreatic insufficiency in a dog.

  12. Are chronic low back pain outcomes improved with co-management of concurrent depression?

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2005-06-01

    Full Text Available Abstract Objective To discuss the role of depression in chronic lower back pain and comment on appropriate methods of screening and co-management. Data Sources The current scientific literature was investigated using the online web databases CINAHL, Medline/PUBMED, Proquest, Meditext and from manual library searches. Data Extraction Databases were searched from 1980 to the present (2005. Articles were searched with the key words "depression" and "low back pain". Over three hundred articles were sourced and articles were then selected on their relevance to the chronic spinal pain states that present to manual therapy practitioners. Data synthesis Pain is a subjective awareness of peripheral nociceptive stimulation, projected from the thalamus to the cerebral cortex with each individual's pain experience being mediated by his or her psychological state. Thus a psychological component will often be associated with any painful experience. A number of studies suggest (among other things that the incidence of depression predicts chronicity in lower back pain syndromes but that chronic lower back pain does not have the reciprocal action to predict depression. Conclusion The aetiology of chronic pain is multifactorial. There is sufficient evidence in the literature to demonstrate a requirement to draw treatment options from many sources in order to achieve a favourable pain relief outcome. The treatment should be multimodal, including mental and emotional support, counseling and herbal advice. While a strong correlation between depression and chronic low back pain can be demonstrated, an apparent paucity of literature that specifically addresses the patient response to chiropractic treatment and concurrent psychotherapy identifies the need for prospective studies of this nature to be undertaken. It is likely that multimodal/multidisciplinary treatment approaches should be encouraged to deal with these chronic lower back pain syndromes.

  13. Diagnosing, managing, and preventing cracked tooth syndrome.

    Science.gov (United States)

    Wright, Edward F; Bartoloni, Joseph A

    2012-01-01

    Cracked tooth syndrome (CTS) can be a perplexing disorder to diagnose and manage. Many practitioners wonder whether the latest dental materials and adhesives can or should be used when restoring these teeth. The authors reviewed the literature and developed recommendations for how to diagnose and manage CTS and prevent it in susceptible teeth. As the population continues to age and people retain their teeth longer, it is anticipated that patients will present even more frequently with symptoms of CTS.

  14. SAGES Guidelines: Prevention and management of gastro ...

    African Journals Online (AJOL)

    SAGES Guidelines: Prevention and management of gastro-oesophageal varices and variceal haemorrhage in cirrhosis. J F Botha. Abstract. No Abstract South African Gastroenterology Review Vol. 6 (1) 2008: pp. 23-25. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  15. Diagnosis, Prevention and Management of Postoperative ...

    African Journals Online (AJOL)

    Diagnosis, Prevention and Management of Postoperative Pulmonary Edema. ... period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post.extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure.

  16. How Do Chinese Speakers of English Manage Rapport in Extended Concurrent Speech?

    Science.gov (United States)

    Zhu, Weihua

    2017-01-01

    Little research has focused on extended concurrent speech, unexpected floor taking, or topic switching, since it has been deemed rare (Schegloff 2000. "Overlapping talk and the organization of turn-taking for conversation." "Language in Society" 29(1). 1-63.) or inappropriate (Goldberg 1990." Interrupting the discourse on…

  17. Preventing and managing awareness during general anesthesia

    Directory of Open Access Journals (Sweden)

    Jelena Berger

    2014-03-01

    Full Text Available Background: General anesthesia is a reversible state of a temporary loss of consciousness, analgesia, muscle paralysis, blunted autonomic responses and amnesia. To achieve this, an adequate depth of anesthesia should be maintained throughout the surgery. Awareness is a serious complication of general anesthesia, which occurs when the depth of anesthesia is not appropriate due to various causes.In this paper the underlying neurobiology of intraoperative awareness is presented, as well as risk factors for awareness and methods for assessing the depth of anesthesia. Possible psychological consequences of awareness and their management are also discussed. At the end, the recommendations for preventing intraoperative awareness are given.Conclusions: Awareness during general anesthesia may have adverse psychological sequelae in individual patients, therefore guidelines for preventing and managing of intraoperative awareness need to be adopted. In case of a possible awareness, the recommendations for offering a psychological support should also be followed.

  18. Clinical management of stage I pinkeye with concurrent pneumonic pasteurellosis in a goat: A case report

    OpenAIRE

    Faez Firdaus Abdullah Jesse; Eric Lim Teik Chung; Yusuf Abba; Asinamai Athliamai Bitrus; Idris Umar Hambali; Mohd Azmi Mohd Lila; Abd Wahid Haron

    2017-01-01

    Objective: This clinical case reports the occurrence of stage I pinkeye with concurrent pneumonic pasteurellosis in a goat. Materials and methods: A 2-year-old Jamnapari goat weighing 25 Kg was presented to the Universiti Veterinary Hospital, Universiti Putra Malaysia with primary complain of eye problem and inappetence. Results: Upon clinical examination, the most prominent abnormality observed was corneal opacity of the right eye with presence of ulceration on the corneal surface a...

  19. Positive Relational Management for healthy organizations: psychometric properties of a new scale for prevention for workers

    Directory of Open Access Journals (Sweden)

    Annamaria Di Fabio

    2016-10-01

    Full Text Available This contribution aims at evaluating the psychometric properties of the Positive Relational Management Scale (PRMS in a sample of two hundred and fifty-one Italian workers. The dimensionality, reliability, and concurrent validity of the scale were investigated. Confirmatory factor analysis supported a correlated three-dimensional version of the scale, comprising Respect, Caring, and Connectedness. Latent correlations among the dimensions were moderate-to-strong (.44 - .57, but suggestive of the multidimensionality of the scores. In addition, good internal consistency was confirmed. The concurrent validity is good as the Pearson’s correlations between PRMS and measure for social support, life satisfaction, life meaningfulness, and flourishing range from .39 to .52. The results indicate that the PRMS is a valid instrument for measuring positive relational management at work in the Italian context within a positive preventive perspective.

  20. Positive Relational Management for Healthy Organizations: Psychometric Properties of a New Scale for Prevention for Workers.

    Science.gov (United States)

    Di Fabio, Annamaria

    2016-01-01

    This contribution aims at evaluating the psychometric properties of the Positive Relational Management Scale (PRMS) in a sample of 251 Italian workers. The dimensionality, reliability, and concurrent validity of the scale were investigated. Confirmatory factor analysis supported a correlated three-dimensional version of the scale, comprising Respect, Caring, and Connectedness. Latent correlations among the dimensions were moderate-to-strong (0.44-0.57), but suggestive of the multidimensionality of the scores. In addition, good internal consistency was confirmed. The concurrent validity is good as the Pearson's correlations between PRMS and measure for social support, life satisfaction, life meaningfulness, and flourishing range from 0.39 to 0.52. The results indicate that the PRMS is a valid instrument for measuring positive relational management at work in the Italian context within a positive preventive perspective.

  1. Clinical management of stage I pinkeye with concurrent pneumonic pasteurellosis in a goat: A case report

    Directory of Open Access Journals (Sweden)

    Faez Firdaus Abdullah Jesse

    2017-12-01

    Full Text Available Objective: This clinical case reports the occurrence of stage I pinkeye with concurrent pneumonic pasteurellosis in a goat. Materials and methods: A 2-year-old Jamnapari goat weighing 25 Kg was presented to the Universiti Veterinary Hospital, Universiti Putra Malaysia with primary complain of eye problem and inappetence. Results: Upon clinical examination, the most prominent abnormality observed was corneal opacity of the right eye with presence of ulceration on the corneal surface and chemosis of the right conjunctiva with excessive lacrimation. On auscultation, there was the presence of crackle lung sounds with bilateral mucopurulent nasal discharges. Samples from the ocular swab yielded a positive growth for Mycoplasma spp., while the nasal swab yielded a positive growth for Mannheimia haemolytica. The goat was diagnosed with stage I pinkeye with concurrent pneumonic pasteurellosis infection. Treatment was instituted with 400 mL of 0.9% NaCl administered intravenously once for rehydration. Flunixin meglumine 2.2 mg/kg bwt was given intramuscularly twice daily for three days as anti-inflammatory and analgesic. Oxytetracycline 20 mg/kg bwt was injected once intramuscularly as long acting broad spectrum antibiotic for treatment of pinkeye and pasteurellosis infections. Furthermore, terramycin eye ointment containing oxytetracycline HCl was also administered intraocularly twice daily for seven days as treatment for the Mycoplasma spp. Conclusion: The prognosis for this case was good as the goat were treated promptly and effectively. [J Adv Vet Anim Res 2017; 4(4.000: 390-393

  2. Concurrent Complementary and Alternative Medicine CAM and Conventional Rehabilitation Therapy in the Management of Children with Developmental Disorders

    Directory of Open Access Journals (Sweden)

    Soo Yeon Kim

    2013-01-01

    Full Text Available Background. We investigated the concurrent use of conventional rehabilitations and complementary and alternative medicine (CAM therapies for the long-term management of children with developmental disorders (DDs. Methods. The parents or caregivers of 533 children with DDs (age range, 1–19 years who visited the rehabilitation centers were surveyed using in depth face-to-face interviews. Results. Of the 533 patients enrolled, 520 completed the questionnaire (97% response rate. A total of 292 (56% children were receiving multiple therapies, more than two conventional rehabilitations and CAM, at the time of the interview. A total of 249 (48% children reported lifetime CAM use, 23% used CAM at the time of the interview, and 62% of the patients planned to use CAM therapy in the future. Conventional rehabilitation therapies used at the time of the interview included physical therapy (30%, speech therapy (28%, and occupational therapy (19%, and the CAM therapies included herbal medicine (5% and acupuncture or moxibustion (3%. The respondents indicated that in the future they planned to use acupuncture or moxibustion (57%, occupational therapy (18%, cognitive behavioral therapy (16%, speech therapy (10%, and physical therapy (8%. Conclusion. Concurrent management as conventional rehabilitations and CAM therapies is widely used by children with DDs.

  3. Prevention and Management of Childhood Obesity.

    Science.gov (United States)

    Dabas, Aashima; Seth, Anju

    2018-02-19

    Childhood obesity has been recognized as a global pandemic. Preventive strategies have proven to be the most effective public health intervention in curbing this pandemic. A multi-component approach involving dietary modification and advocacy for a healthy lifestyle comprising of regular physical activity, minimizing screen time and behavioral interventions have been found beneficial in preventing obesity. A life-cycle approach has been recommended where preventive interventions go as far back as affecting maternal, fetal and early childhood nutrition and lifestyle. Family, school and community involvement is important for long term results, so is the involvement of government in developing policies that help create an environment and opportunities for healthy diet and physical activity. Management of childhood obesity is challenging. It involves following a structured weight reduction programme individualized for every child, along with adoption of a healthy diet and life style. Anti-obesity drugs have a limited role in childhood years and are not recommended in younger children. Bariatric surgery is reserved for morbidly obese older adolescents but its long term safety data is limited in this age group.

  4. Primary prevention of periodontitis: managing gingivitis.

    Science.gov (United States)

    Chapple, Iain L C; Van der Weijden, Fridus; Doerfer, Christof; Herrera, David; Shapira, Lior; Polak, David; Madianos, Phoebus; Louropoulou, Anna; Machtei, Eli; Donos, Nikos; Greenwell, Henry; Van Winkelhoff, Ari J; Eren Kuru, Bahar; Arweiler, Nicole; Teughels, Wim; Aimetti, Mario; Molina, Ana; Montero, Eduardo; Graziani, Filippo

    2015-04-01

    Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal

  5. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    Directory of Open Access Journals (Sweden)

    Andrew Reich

    2008-08-01

    Full Text Available Ciguatera Fish Poisoning (CFP is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol, the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

  6. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    Science.gov (United States)

    Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

    2008-01-01

    Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. PMID:19005579

  7. Complications of Blepharoplasty: Prevention and Management

    Directory of Open Access Journals (Sweden)

    James Oestreicher

    2012-01-01

    Full Text Available Blepharoplasty is an operation to modify the contour and configuration of the eyelids in order to restore a more youthful appearance. The surgery involves removing redundant skin, fat, and muscle. In addition, supporting structures such as canthal tendons are tightened. Other conditions such as ptosis, brow ptosis, entropion, ectropion, or eyelid retraction may also need to be corrected at the time a blepharoplasty is performed to ensure the best functional and aesthetic result. Due to the complexity and intricate nature of eyelid anatomy, complications do exist. In addition to a thorough pre operative assessment and meticulous surgical planning, understanding the etiology of complications is key to prevention. Finally, management of complications is just as important as surgical technique.

  8. Complications of blepharoplasty: prevention and management.

    Science.gov (United States)

    Oestreicher, James; Mehta, Sonul

    2012-01-01

    Blepharoplasty is an operation to modify the contour and configuration of the eyelids in order to restore a more youthful appearance. The surgery involves removing redundant skin, fat, and muscle. In addition, supporting structures such as canthal tendons are tightened. Other conditions such as ptosis, brow ptosis, entropion, ectropion, or eyelid retraction may also need to be corrected at the time a blepharoplasty is performed to ensure the best functional and aesthetic result. Due to the complexity and intricate nature of eyelid anatomy, complications do exist. In addition to a thorough pre operative assessment and meticulous surgical planning, understanding the etiology of complications is key to prevention. Finally, management of complications is just as important as surgical technique.

  9. [Prediction, prevention and management of shoulder dystocia].

    Science.gov (United States)

    Csorba, Roland

    2012-05-20

    Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2-0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4-16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia.

  10. The TRIDEC System-of-Systems; Choreography of large-scale concurrent tasks in Natural Crisis Management

    Science.gov (United States)

    Häner, R.; Wächter, J.

    2012-04-01

    The project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC), co-funded by the European Commission in its Seventh Framework Programme aims at establishing a network of dedicated, autonomous legacy systems for large-scale concurrent management of natural crises utilising heterogeneous information resources. TRIDEC's architecture reflects the System-of- Systems (SoS) approach which is based on task-oriented systems, cooperatively interacting as a collective in a common environment. The design of the TRIDEC-SoS follows the principles of service-oriented and event-driven architectures (SOA & EDA) exceedingly focusing on a loose coupling of the systems. The SoS approach in combination with SOA and EDA has the distinction of being able to provide novel and coherent behaviours and features resulting from a process of dynamic self-organisation. Self-organisation is a process without the need for a central or external coordinator controlling it through orchestration. It is the result of enacted concurrent tasks in a collaborative environment of geographically distributed systems. Although the individual systems act completely autonomously, their interactions expose emergent structures of evolving nature. Particularly, the fact is important that SoS are inherently able to evolve on all facets of intelligent information management. This includes adaptive properties, e.g. seamless integration of new resource types or the adoption of new fields in natural crisis management. In the case of TRIDEC with various heterogeneous participants involved, concurrent information processing is of fundamental importance because of the achievable improvements regarding cooperative decision making. Collaboration within TRIDEC will be implemented with choreographies and conversations. Choreographies specify the expected behaviour between two or more participants; conversations describe the message exchange between all participants emphasising their logical

  11. [Prevention and management of postresectional bronchopleural fistula].

    Science.gov (United States)

    Ishikawa, Shigemi

    2008-07-01

    Bronchopleural fistula (BPF) is still a life-threatening complication after pulmonary resection. Several factors were identified to contribute BPF. Meticulous surgical technique and the liberal use of prophylactic, pedicled flaps are important for prevention. Although these patients often present compromised and moribund, evaluation and management should proceed in a logical, stepwise fashion. In high-risk surgical patients, bronchoscopic procedures using different glues and sealants may serve as a temporary bridge until the patient's recovery or as a permanent resolution. However persistent conservative therapy may deteriorate patient's condition. Immediate creation of open window thoracotomy has been shown to be a significant predictor of wound closure afterwards. Pedicled muscle or omental flaps are useful to close bronchial stump and to fill the residual space in the thorax after pulmonary resection. Once fistula closed, the pleural space is filled with an antibiotic solution and then the open window thoracotomy closed in layers as Clagett procedure. The transternal transpericardial approach to recalcitrant postpneumonectomy BPF can be considered when patients have failed prior closure attempt. To conclude, survival and excellent result of BPF depends on early diagnosis, and aggressive surgical intervention.

  12. Routine management of locally advanced cervical cancer with concurrent radiation and cisplatin. Five-year results

    Directory of Open Access Journals (Sweden)

    Candelaria Myrna

    2006-02-01

    Full Text Available Abstract Background Globally, cervical cancer primarily affects socially disadvantaged women. Five randomized trials were the foundation for adopting cisplatin-based chemotherapy during radiation as the standard of care for high-risk patients after primary radical hysterectomy who require adjuvant radiation and for locally advanced patients treated with definitive radiation. These results were obtained in clinical trials performed in carefully prepared academic centers; hence, we sought to determine whether these results could be reproduced when patients were treated on an out-of-protocol basis. Methods We reviewed the files of 294 patients with locally advanced cervical cancer who received radiation plus weekly cisplatin as routine management between 1999 to 2003, and analyzed treatment compliance, response rate, toxicity, and survival. Results A total of 294 patients who received radiation and cisplatin were analyzed. Mean age was 43.8 years (range, 26–68 years. The majority of cases were squamous cell carcinoma (87.8%, and distribution according to International Federation of Gynecology and Obstetrics (FIGO stage was as follows: IB2-IIA, 23%; IIB, 53.3%, and IIIB, 23%; there were only two IVA cases. Overall, 96% of patients completed external beam, and intracavitary therapy. The majority of patients (67% received the planned six courses of weekly cisplatin. Complete responses were achieved in 243 (83% patients, whereas 51 (17% had either persistent (32 patients, 10.8% or progressive (19 patients, 6.4% disease. At median follow-up (28 months; range, 2–68 months, 36 patients (12.2% have relapsed (locally 30.5, and systemically, 69.5%. The most common toxicities were hematologic and gastrointestinal, in the majority of cases considered mild-moderate. At median follow-up (28 months; range, 2–68 months, overall and progression-free survival are 76.5 and 67%, respectively. Conclusion Our results support use of chemoradiation with six weekly

  13. Apple-CORE: Microgrids of SVP cores: flexible, general-purpose, fine-grained hardware concurrency management

    NARCIS (Netherlands)

    Poss, R.; Lankamp, M.; Yang, Q.; Fu, J.; van Tol, M.W.; Jesshope, C.; Nair, S.

    2012-01-01

    To harness the potential of CMPs for scalable, energy-efficient performance in general-purpose computers, the Apple-CORE project has co-designed a general machine model and concurrency control interface with dedicated hardware support for concurrency control across multiple cores. Its SVP interface

  14. Severe accident management. Prevention and Mitigation

    International Nuclear Information System (INIS)

    1992-01-01

    Effective planning for the management of severe accidents at nuclear power plants can produce both a reduction in the frequency of such accidents as well as the ability to mitigate their consequences if and when they should occur. This report provides an overview of accident management activities in OECD countries. It also presents the conclusions of a group of international experts regarding the development of accident management methods, the integration of accident management planning into reactor operations, and the benefits of accident management

  15. Preventing Stress in Organizations How to Develop Positive Managers

    CERN Document Server

    Donaldson-Feilder, Emma; Yarker, Joanna

    2011-01-01

    Preventing Stress in Organizations:How to Develop Positive Managersoffers an innovative, evidence-based approach to help managers prevent and reduce workplace stress in their staff.Provides information on the critical skills managers must develop in order to prevent stress in their staff, and the key ongoing behaviours that promote a healthy work environmentShows practitioners in occupational psychology, HR, Health and Safety and related professions how positive management can be integrated into an organization???s existing practices and processesServes as an essential guide for managers thems

  16. Concurrent Collections

    OpenAIRE

    Budimlić, Zoran; Burke, Michael; Cavé, Vincent; Knobe, Kathleen; Lowney, Geoff; Newton, Ryan; Palsberg, Jens; Peixotto, David; Sarkar, Vivek; Schlimbach, Frank; Taşırlar, Sağnak

    2010-01-01

    We introduce the Concurrent Collections (CnC) programming model. CnC supports flexible combinations of task and data parallelism while retaining determinism. CnC is implicitly parallel, with the user providing high-level operations along with semantic ordering constraints that together form a CnC graph. We formally describe the execution semantics of CnC and prove that the model guarantees deterministic computation. We evaluate the performance of CnC implementations on several applications an...

  17. Indirubin-3-Oxime Prevents H2O2-Induced Neuronal Apoptosis via Concurrently Inhibiting GSK3β and the ERK Pathway.

    Science.gov (United States)

    Yu, Jie; Zheng, Jiacheng; Lin, Jiajia; Jin, Linlu; Yu, Rui; Mak, Shinghung; Hu, Shengquan; Sun, Hongya; Wu, Xiang; Zhang, Zaijun; Lee, Mingyuen; Tsim, Wahkeung; Su, Wei; Zhou, Wenhua; Cui, Wei; Han, Yifan; Wang, Qinwen

    2017-05-01

    Oxidative stress-induced neuronal apoptosis plays an important role in many neurodegenerative disorders. In this study, we have shown that indirubin-3-oxime, a derivative of indirubin originally designed for leukemia therapy, could prevent hydrogen peroxide (H 2 O 2 )-induced apoptosis in both SH-SY5Y cells and primary cerebellar granule neurons. H 2 O 2 exposure led to the increased activities of glycogen synthase kinase 3β (GSK3β) and extracellular signal-regulated kinase (ERK) in SH-SY5Y cells. Indirubin-3-oxime treatment significantly reversed the altered activity of both the PI3-K/Akt/GSK3β cascade and the ERK pathway induced by H 2 O 2 . In addition, both GSK3β and mitogen-activated protein kinase inhibitors significantly prevented H 2 O 2 -induced neuronal apoptosis. Moreover, specific inhibitors of the phosphoinositide 3-kinase (PI3-K) abolished the neuroprotective effects of indirubin-3-oxime against H 2 O 2 -induced neuronal apoptosis. These results strongly suggest that indirubin-3-oxime prevents H 2 O 2 -induced apoptosis via concurrent inhibiting GSK3β and the ERK pathway in SH-SY5Y cells, providing support for the use of indirubin-3-oxime to treat neurodegenerative disorders caused or exacerbated by oxidative stress.

  18. Stroke Prevention: Managing Modifiable Risk Factors

    Directory of Open Access Journals (Sweden)

    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.

  19. Integrated concurrent utilization quality review, Part one.

    Science.gov (United States)

    Caterinicchio, R P

    1987-01-01

    This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

  20. Concurrent Collections

    Directory of Open Access Journals (Sweden)

    Zoran Budimlić

    2010-01-01

    Full Text Available We introduce the Concurrent Collections (CnC programming model. CnC supports flexible combinations of task and data parallelism while retaining determinism. CnC is implicitly parallel, with the user providing high-level operations along with semantic ordering constraints that together form a CnC graph. We formally describe the execution semantics of CnC and prove that the model guarantees deterministic computation. We evaluate the performance of CnC implementations on several applications and show that CnC offers performance and scalability equivalent to or better than that offered by lower-level parallel programming models.

  1. [Pulmonary rehabilitation as an effective method for optimizing therapeutic and preventive measures in patients with chronic obstructive pulmonary disease concurrent with metabolic syndrome].

    Science.gov (United States)

    Budnevsky, A V; Isaeva, Ya V; Malysh, E Yu; Kozhevnikova, S A

    to evaluate the impact of a pulmonary rehabilitation (PR) cycle based on patient education, smoking cessation, physical exercises, and balanced nutrition in addition to standard therapy for chronic obstructive pulmonary disease COPD in patients with this condition. 70 patients (27 (38.6%) women and 43 (61.4%) men) aged 18 to 60 years (mean age, 48.31±0.64 years) with moderate COPD in remission concurrent with MS were examined. The comprehensive examination of the patients encompassed assessment of clinical, instrumental, and laboratory findings at baseline and 12 months. The patients were randomized into two groups: 1) 35 patients who underwent a RH cycle in addition to standard therapy for COPD; 2) 35 patients who received standard COPD treatment only. Group 1 was found to have significant differences in reducing the number of patients with COPD exacerbations, emergency calls, hospitalizations, severity of clinical symptoms of COPD and their impact on the physical activity and health of the patients, as well as better quality of life and exercise tolerance. The therapeutic and preventive measures for patients with COPD and MS should involve educational programs and physical trainings, which are developed, by taking into account of a comorbidity in order to optimize therapeutic and preventive measures and to improve quality of life in this category of patients.

  2. Phase III trial of low-level laser therapy to prevent oral mucositis in head and neck cancer patients treated with concurrent chemoradiation

    International Nuclear Information System (INIS)

    Antunes, Heliton S.; Herchenhorn, Daniel; Small, Isabele A.; Araújo, Carlos M.M.; Viégas, Celia Maria Pais; Cabral, Elida; Rampini, Mariana P.; Rodrigues, Pedro C.; Silva, Tereza G.P.; Ferreira, Elza M.S.; Dias, Fernando L.; Ferreira, Carlos G.

    2013-01-01

    Background: Oral mucositis (OM) is a complication of chemoradiotherapy treatment of head and neck squamous cell carcinoma (HNSCC) patients with no effective therapy. This study was designed to assess the efficacy of preventive low-level laser therapy (LLLT) in reducing the incidence of grade 3–4 OM. Material and methods: From June 2007 to December 2010, 94 HNSCC patients entered a prospective, randomized, double-blind, placebo-controlled phase III trial. Chemoradiotherapy consisted of conventional radiotherapy plus concurrent cisplatin every 3 weeks. A diode InGaAlP (660 nm–100 mW–1 J–4 J/cm 2 ) was used. OM evaluation was performed by WHO and OMAS scales and quality of life by EORTC questionnaires (QLQ). Results: A six-fold decrease in the incidence of grades 3–4 OM was detected in the LLLT group compared to the placebo; (6.4% versus 40.5%). LLLT impacted the incidence of grades 3–4 OM to a relative risk ratio of 0.158 (CI 95% 0.050–0.498). After treatment QLQ-C30 showed, differences favoring LLLT in physical, emotional functioning, fatigue, and pain; while the QLQ-H and N35 showed improvements in LLLT arm for pain, swallowing, and trouble with social eating. Conclusion: Preventive LLLT in HNSCC patients receiving chemoradiotherapy is an effective tool for reducing the incidence of grade 3–4 OM. Efficacy data were corroborated by improvements seen in quality of life

  3. Spontaneous preterm birth : prevention, management and outcome

    NARCIS (Netherlands)

    Vermeulen, Gustaaf Michiel

    1999-01-01

    Preterm birth (birth before 37 completed weeks of pregnancy) is a major cause of perinatal morbidity and mortality. Strategies to prevent and adequately treat preterm labour, in order to postpone birth and to identify risk factors for neonatal damage due to preterm birth, have to be developed by

  4. Attitudes to malaria, prevention, treatment and management ...

    African Journals Online (AJOL)

    SERVER

    2007-11-05

    Nov 5, 2007 ... to clean environment, and most of times have no means of acquiring better mosquito-bite preventive measures and no access to modern treatment. Some of these conditions may greatly influence their knowledge and attitudes towards handling of malaria episode. Hence, it is the cardinal objective of this ...

  5. Program manager perspectives on the service system to meet the needs of youth with concurrent disorders: findings from a Canadian national survey.

    Science.gov (United States)

    Henderson, Joanna L; Chaim, Gloria; Luca, Stephanie; Brownlie, E B; Rosenkranz, Susan; Skilling, Tracey A; Beitchman, Joseph H

    2015-09-18

    Concurrent mental health and substance use issues are a serious problem for adolescents and transition-aged youth. Service providers across sectors must be involved in informing system change to meet youth needs. This study examines stakeholder perspectives on services for youth with concurrent disorders including 1) clinical issues in youth services; 2) priority system issues; and 3) optimal knowledge translation strategies to enhance researcher-stakeholder communication. A database of youth clinical services across Canada was developed. Program managers (n = 481) at cross-sectoral (mental health, addictions, justice, child welfare, advocacy, and outreach) youth-serving (aged 12-24) programs were invited to complete an online survey; 232 responded. Survey questions concerned youth needs, program characteristics, priorities for service system enhancement; and usual and preferred knowledge translation methods. Across service sectors, the mean estimated proportion of youth using services with concurrent mental health and substance use problems was 55%. Program managers reported routine screening for mental health and substance use concerns (66%), referring to other agencies to meet the concurrent disorder needs of youth (54%), offering specific programming for concurrent disorders (42%), and program evaluation (48%). Notably, mental health programs were significantly less likely to offer concurrent disorders services than addictions programs. Where services do exist, most are targeted at youth aged 12-18 years, with fewer services available for transition-aged youth. Endorsement of various system change goals exceeded 80%, with a particular emphasis on improving access to services (49%), ensuring a continuum of services for varying levels of severity (37%), and improved integration across sectors (36%). Preferred knowledge exchange methods were workshops and websites for receiving information; and focus groups or surveys, rather than intensive participation on

  6. Oral Mucositis Prevention By Low-Level Laser Therapy in Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy: A Phase III Randomized Study

    Energy Technology Data Exchange (ETDEWEB)

    Gouvea de Lima, Aline [Departamento de Radiologia, Disciplina de Oncologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Villar, Rosangela Correa [Instituto de Radiologia, Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Castro, Gilberto de, E-mail: gilberto.castro@usp.br [Department of Clinical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, SP (Brazil); Antequera, Reynaldo [Divisao de Odontologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Gil, Erlon; Rosalmeida, Mauro Cabral [Instituto de Radiologia, Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Federico, Miriam Hatsue Honda; Snitcovsky, Igor Moises Longo [Departamento de Radiologia, Disciplina de Oncologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil)

    2012-01-01

    Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm{sup 2} or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60-70 Gy (range, 1.8-2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy, p = .03). During CRT, the number of patients diagnosed with Grade 3 or 4 oral mucositis treated with LLL vs. placebo was 4 vs. 5 (Week 2, p = 1.0), 4 vs. 12 (Week 4, p = .08), and 8 vs. 9 (Week 6, p = 1.0), respectively. More of the patients treated with placebo had RT interruptions because of mucositis (6 vs. 0, p = .02). No difference was detected between the treatment arms in the incidence of severe pain. Conclusions: LLL therapy was not effective in reducing severe oral mucositis, although a marginal benefit could not be excluded. It reduced RT interruptions in these head-and-neck cancer patients, which might

  7. Oral Mucositis Prevention By Low-Level Laser Therapy in Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy: A Phase III Randomized Study

    International Nuclear Information System (INIS)

    Gouvêa de Lima, Aline; Villar, Rosângela Correa; Castro, Gilberto de; Antequera, Reynaldo; Gil, Erlon; Rosalmeida, Mauro Cabral; Federico, Miriam Hatsue Honda; Snitcovsky, Igor Moisés Longo

    2012-01-01

    Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm 2 or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60–70 Gy (range, 1.8–2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy, p = .03). During CRT, the number of patients diagnosed with Grade 3 or 4 oral mucositis treated with LLL vs. placebo was 4 vs. 5 (Week 2, p = 1.0), 4 vs. 12 (Week 4, p = .08), and 8 vs. 9 (Week 6, p = 1.0), respectively. More of the patients treated with placebo had RT interruptions because of mucositis (6 vs. 0, p = .02). No difference was detected between the treatment arms in the incidence of severe pain. Conclusions: LLL therapy was not effective in reducing severe oral mucositis, although a marginal benefit could not be excluded. It reduced RT interruptions in these head-and-neck cancer patients, which might

  8. Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

    Science.gov (United States)

    Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

    2008-06-01

    This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented.

  9. Prevention and management of radiation-induced dermatitis, mucositis, and xerostomia.

    Science.gov (United States)

    Radvansky, Lauren J; Pace, Makala B; Siddiqui, Asif

    2013-06-15

    Current strategies for preventing and managing radiation-induced dermatitis, mucositis, and xerostomia are reviewed, with an emphasis on pharmacologic interventions. Nearly two thirds of all patients with cancer receive radiation therapy during the course of treatment, frequently resulting in acute skin and mucosal toxicities. The severity of radiotherapy-associated toxicities varies according to multiple treatment- and patient-related factors (e.g., total radiation dose and dose fractionation schedule, volume of organ or tissue irradiated, use of concurrent versus sequential chemotherapy, comorbid conditions, functional performance status). Three major radiation toxicities encountered in clinical practice are (1) radiation dermatitis, typically managed with a variety of topical agents such as water-based moisturizing creams or lotions, topical steroids, antiinflammatory emulsions, and wound dressings, (2) radiation-induced oral mucositis, which can be managed through proper basic oral care practices, appropriate pain management, and the use of medicated mouthwashes and oral rinses and gels, and (3) radiation-induced xerostomia, which can be alleviated with saliva substitutes, moistening agents, and sialagogues. Pharmacists involved in the care of patients receiving radiotherapy can play an important role in optimizing symptom control, educating patients on self-care strategies, and adverse effect monitoring and reporting. Radiation-induced dermatitis, mucositis, and xerostomia can cause significant morbidity and diminished quality of life. Pharmacologic interventions for the prevention and treatment of these toxicities include topical agents for dermatitis; oral products, analgesics, and palifermin for mucositis; and amifostine, saliva substitutes, and pilocarpine for xerostomia.

  10. [Interdisciplinary quality management in preventive medicine institutions].

    Science.gov (United States)

    Fischer, Robert

    2004-12-01

    Like all health care institutions, preventive medicine institutions, too, need a quality assurance structure. An integrated system consisting of "balanced score card", "finite-elements-model" and "interdisciplinary quality circles" is presented. This organisational structure allows the implementation of quality assurance in complex institutions as well, such as health care organisations. In addition, this concept guarantees broad acceptance by all team members, not least due to complexity reduction.

  11. Management of Diverticulitis and Prevention of Recurrence

    Directory of Open Access Journals (Sweden)

    Paolo Andreozzi

    2015-12-01

    Full Text Available Acute diverticulitis is an acute inflammation of colonic diverticulae that is associated with an episode of severe, prolonged, lower abdominal pain (usually on the left side, changes in bowel movements, low-grade fever, and leukocytosis. Acute diverticulitis is a significant burden in industrialised societies, accounting for 313,000 hospitalisations in the USA alone, and a trend of rising incidence has been observed. Despite the high prevalence, the management of diverticulitis and post-diverticulitis is largely based on consensus more than evidence derived from randomised clinical trials. In this review we will focus on the diagnosis and management strategies for diverticulitis and post-diverticulitis.

  12. Managed care, consumerism, preventive medicine: does a causal connection exist?

    Science.gov (United States)

    Rizzo, John A; Xie, Yang

    2006-07-01

    Managed care plans, and HMOs in particular, have long touted that their emphasis is on preventive care, to avoid expensive illness later in life. However, few articles in the contemporary literature adequately address this claim. The available evidence seems to support that HMOs do, in fact, provide greater access to preventive services, but the limitations of this research are substantial. This article discusses the scientific evidence on the relationships between managed care arrangements and the implications for preventive care in the current era, emphasizing consumer choices and less-restrictive plan structures.

  13. An Ounce of Prevention: Child Management.

    Science.gov (United States)

    Merrill, Barbara, Ed.

    This training manual on child management consists of eight workshops for day care center staff. Workshops focus on (1) communications skills useful in working with children; (2) the nature of discipline; (3) positive approaches to guiding children's behavior; (4) natural and logical consequences; (5) ways of dealing with problem behavior; (6) the…

  14. Prevention and management of cesarean wound infection.

    Science.gov (United States)

    Fitzwater, Joseph L; Tita, Alan T N

    2014-12-01

    Cesarean wound infections represent a significant health and economic burden. Several modifiable risk factors have been identified for their development. Understanding these risks and techniques to manage cesarean wounds is essential for providers. In this article, these factors and prophylactic and therapeutic interventions are reviewed. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Development of preventative streamside landslide buffers on managed timberlands

    Science.gov (United States)

    Jason S. Woodward; Matthew R. House; David W. Lamphear

    2017-01-01

    Shallow streamside landslides are a principle source of sediment on managed timberlands in northern California. Using an adaptive management process, LiDAR, and a detailed field-based landslide inventory, Green Diamond Resource Company (GDRCo) has redefined the interim preventative landslide tree-retention buffers it applies to steep streamside slopes along...

  16. 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)

  17. AEGIS: a wildfire prevention and management information system

    Science.gov (United States)

    Kostas Kalabokidis; Alan Ager; Mark Finney; Nikos Athanasis; Palaiologos Palaiologou; Christos Vasilakos

    2016-01-01

    We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to...

  18. Knowledge management: an application to wildfire prevention planning

    Science.gov (United States)

    Daniel L Schmoldt

    1989-01-01

    Residential encroachment into wildland areas places an additional burden on fire management activities. Prevention programs, fuel management efforts, and suppression strategies, previously employed in wildland areas, require modification for protection of increased values at risk in this interface area. Knowledge-based computer systems are being investigated as...

  19. The prevention and management of pressure ulcers.

    Science.gov (United States)

    Goode, P S; Allman, R M

    1989-11-01

    Pressure ulcers are a common problem for older persons. Complications associated with pressure ulcers include infection and even death for some patients. Pressure is the primary pathogenic factor, but shearing forces, friction, and moisture are also important. Immobility, nutritional status, and age-related factors seem to be significant risk factors. Preventive care includes use of assessment tools to identify high risk patients, frequent repositioning, air or foam mattresses that reduce pressure over bony prominences, as well as careful attention to optimizing the overall patient condition. When pressure ulcers do develop, the treatment plan should include adequate nutrition including protein, vitamin C, and zinc supplements as indicated; systemic antibiotics for sepsis, cellulitis, osteomyelitis, or the prevention of bacterial endocarditis; and local wound care that eliminates necrotic tissue, decreases bacterial load, and provides a physiologic, pressure-free environment allowing the wound to heal. Specialized beds may be considered in some patients, particularly those with larger ulcers. Surgery is an option in older persons who are operative candidates. For some patients with pressure ulcers, appropriate treatment goals may focus on providing comfort rather than curing the ulcer.

  20. To manage is human, to prevent is divine

    International Nuclear Information System (INIS)

    Nye, J.S. Jr.

    1985-01-01

    There is no simple solution to the political problem of proliferation. But political wisdom begins with efforts to maintain the existing regime and the presumption against proliferation. In this regard, the Reagan administration has hewed to the previous main lines of American policy. Some critics find it fashionable to talk about ''managing proliferation.'' But proliferation management requires a strategy for prevention - a plan for dealing with the steps before, not just after, a nuclear explosion. Without some prevention, the task of management may become untenable. An effective nonproliferation policy is not easy to design or implement, but one must exist

  1. Management of Diverticulitis and Prevention of Recurrence

    OpenAIRE

    Paolo Andreozzi; Francesco Paolo Zito; Giovanni Sarnelli; Rosario Cuomo

    2015-01-01

    Acute diverticulitis is an acute inflammation of colonic diverticulae that is associated with an episode of severe, prolonged, lower abdominal pain (usually on the left side), changes in bowel movements, low-grade fever, and leukocytosis. Acute diverticulitis is a significant burden in industrialised societies, accounting for 313,000 hospitalisations in the USA alone, and a trend of rising incidence has been observed. Despite the high prevalence, the management of diverticulitis and post-dive...

  2. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

    Science.gov (United States)

    Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

    2015-11-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

  3. Workplace managed care: collaboration for substance abuse prevention.

    Science.gov (United States)

    Galvin, D M

    2000-05-01

    This article describes the history, purpose, and overall methodology of the Workplace Managed Care (WMC) study sponsored by the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention (CSAP). This study was initiated to discern best practices for workplaces and managed care organizations integrating their substance abuse prevention and early intervention programs, strategies, and activities for employees and their families. CSAP funded nine WMC grants to study their retrospective and prospective data. Results of the WMC study suggested the addition of substance abuse prevention material to existing workplace health promotion offerings that resulted in improved substance abuse attitudes without jeopardizing existing health promotion programs. Stress management programming was successful at improving substance abuse attitudes indirectly. This study provides a platform for multidisciplinary research in workplace and managed care settings.

  4. The prevention research centers' managing epilepsy well network.

    Science.gov (United States)

    DiIorio, Colleen K; Bamps, Yvan A; Edwards, Ariele L; Escoffery, Cam; Thompson, Nancy J; Begley, Charles E; Shegog, Ross; Clark, Noreen M; Selwa, Linda; Stoll, Shelley C; Fraser, Robert T; Ciechanowski, Paul; Johnson, Erica K; Kobau, Rosemarie; Price, Patricia H

    2010-11-01

    The Managing Epilepsy Well (MEW) Network was created in 2007 by the Centers for Disease Control and Prevention's (CDC) Prevention Research Centers and Epilepsy Program to promote epilepsy self-management research and to improve the quality of life for people with epilepsy. MEW Network membership comprises four collaborating centers (Emory University, University of Texas Health Science Center at Houston, University of Michigan, and University of Washington), representatives from CDC, affiliate members, and community stakeholders. This article describes the MEW Network's background, mission statement, research agenda, and structure. Exploratory and intervention studies conducted by individual collaborating centers are described, as are Network collaborative projects, including a multisite depression prevention intervention and the development of a standard measure of epilepsy self-management. Communication strategies and examples of research translation programs are discussed. The conclusion outlines the Network's role in the future development and dissemination of evidence-based epilepsy self-management programs. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. "Hepatitis" - Prevention and management in dental practice.

    Science.gov (United States)

    Dahiya, Parveen; Kamal, Reet; Sharma, Varun; Kaur, Saravpreet

    2015-01-01

    Today, viral hepatitis has become a silent epidemic worldwide. It is the major cause of liver cirrhosis and liver carcinoma. In a dental office, infections can be expedited through several routes, including direct or indirect contact with blood, oral fluids, droplet splatter, aerosols, etc. The aim of the present review is to increase the awareness among dental practitioners, so as to reduce the burden of hepatitis in their community. Electronic databases like PubMed, Medline, ProQuest, etc. were searched using the keywords hepatitis, dentist, liver disease, and infection control. Manual search of various journals and books was also carried out. Only highly relevant articles from English literature were considered for the present review. The results revealed that the dentists were among the high-risk groups for hepatitis, and they have little information on the factors associated with adherence to hepatitis B vaccination. A dentist can play a major role in the prevention of hepatitis by considering each and every patient as a potential carrier of hepatitis. Proper infection control, sterilization, and prophylactic vaccination protocols should be followed in order to reduce the risk of hepatitis.

  6. Hypoparathyroidism after thyroidectomy: prevention, assessment and management.

    Science.gov (United States)

    Dedivitis, Rogerio A; Aires, Felipe T; Cernea, Claudio R

    2017-04-01

    Permanent hypoparathyroidism is the most common long-term complication after total thyroidectomy and it can cause significant morbidity and increased costs. Its incidence varies from 30% to 60%. The surgical technique and the extent of thyroidectomy are related to parathyroid injury and hypoparathyroidism. The glands should be identified in situ, carefully manipulated and preserved, as well as their vascularization. In case of incidental removal, routine autotransplantation is advocated. Low calcium levels, identification of fewer than two parathyroid glands at surgery, reoperation for bleeding, Graves disease and heavier thyroid specimens were considered independent predictors of permanent hypocalcemia. Intraoperative parathyroid hormone (PTH) measurements allows the early detection of hypocalcemia. Treatment is recommended for patients with symptoms of hypocalcemia or corrected serum calcium Hypoparathyroidism is the most common long-term complication after total thyroidectomy. Adequate recognition and management decrease its morbidity and costs.

  7. TERMAL BALANCE MANAGEMENT FOR INTRADIALYSIS HYPOTENSION PREVENTION

    Directory of Open Access Journals (Sweden)

    A. G. Strokov

    2012-01-01

    Full Text Available Intradialytic hypotension (IDH remains an important cause of morbidity and mortality in chronic hemodialysis (HD patients and can be ameliorated by low temperature HD. Biofeed-back temperature-control device BTM® (Fresenius Medical Care, Germany was used for precision temperature measurement and to deliver isothermic (ITD or thermoneutral (TND dialysis. At stage one 24 stable dialysis patients were studied in terms of inlet blood temperature (IBT variation during sessions with normal (36,5 °С-ND and cold dialysate (35 °С-CD. IBT was increasing in both cases however the increase was significantly lower in CD. At stage two, 18 patients underwent programmed cooling during two ITD and two TND sessions. In TND high correlation (r = 0.66; р < 0.05 was observed between IBT increase and ultrafiltration rate. Keeping IBT stable during ITD required cons- tant decrease of dialysate temperature to 34.9 ± 0.2 °С at the end of session. At stage three, 19 IDH-prone patients were displaced from regular dialysis program to ITD. As a result,the decrease overall rate of IDH from 36.2 ± 1.1% to 11.3 ± 4,6% was observed. Conclusions: 1. The main mechanism of body temperature raise during HD is heat retention secondary to the compensatory response to loss of plasma volume, resulting in increase of the total peripheral resistance. 2. CD is effective for IDH prevention. 3. ITD is the optimal version of CD. 

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

    OpenAIRE

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

    2017-01-01

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

  9. Community perspectives on parental influence on engagement in multiple concurrent sexual partnerships among youth in Tanzania: implications for HIV prevention programming.

    Science.gov (United States)

    Fehringer, Jessica A; Babalola, Stella; Kennedy, Caitlin E; Kajula, Lusajo J; Mbwambo, Jessie K; Kerrigan, Deanna

    2013-01-01

    Although concurrent sexual partnerships (CPs) have been hypothesized to be an important risk factor for HIV in sub-Saharan Africa, the social and cultural factors that encourage CPs are not well understood. This study explored the community's perspectives on the role that parents can play in influencing their children's decision to engage in CPs. We conducted 16 in-depth interviews, 32 focus group discussions, and 16 key informant interviews with 280 adult participants in Tanzania. Data were coded; findings and conclusions were developed based on themes that emerged from coding. Three parental influences on CPs emerged: parent-child communication about sex, both silent and explicit encouragement of CPs, and parental behavior modeling. Parents are typically either too busy or too "embarrassed" to talk with their children about sex and CPs. The information parents do give is often confusing, fear-based, inadequate, and/or only focused on daughters. Parents themselves also encourage CPs through complicity of silence when their daughters come home with extra cash or consumer goods. In some cases, parents overtly encourage their children, particularly daughters, to practice CPs due to the promise of money from wealthy partners. Finally, when parents engage in CPs, the children themselves learn to behave similarly. These results suggest that parents can influence their children's decision to engage in CPs. HIV prevention interventions should address this by promoting parent-child communication about sexuality; associated disease risks and gender-equitable relationships; promoting positive parental role modeling; and educating parents on the implications of encouragement of CPs in their children.

  10. When science meets culture: the prevention and management of ...

    African Journals Online (AJOL)

    2013-05-13

    May 13, 2013 ... Review Article: When science meets culture: the prevention and management of erectile dysfunction in the 21st century. 2014;27(1). S Afr J Clin Nutr. Introduction. It is now well recognised ..... Traditional Asian folklore medicines in sexual health. Indian J Urol. 2006;22(3):241-245. 3. Lim PH, Moorthy P, Tan ...

  11. Pattern Of Occurrence, Management And Prevention Of Trauma In ...

    African Journals Online (AJOL)

    OBJECTIVE: The purpose of this paper is to review the occurrence, management and prevention of trauma in industry in Nigeria with particular reference to the oil industry. The type of injuries, their causes and relative frequency in the Nigerian oil industry has been discussed. First aid facilities, evacuation procedures and ...

  12. Modality planning for preventing tunnel vision in crisis management

    NARCIS (Netherlands)

    Cao, Y.; Nijholt, Antinus; Theune, Mariët; van der Sluis, Ielka; Bachvarova, Yulia; Andre, Elisabeth

    2008-01-01

    Crisis management is a time-critical task with high uncertainty and high risk. Stress and cognitive overload often result in a set of bias in crisis manager’s situation understanding and information confirming processes, known as 'tunnel vision'. Aiming at preventing tunnel vision, we propose an

  13. Risk assessment and management to prevent preterm birth

    NARCIS (Netherlands)

    Koullali, B.; Oudijk, M. A.; Nijman, T. A. J.; Mol, B. W. J.; Pajkrt, E.

    2016-01-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history

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

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

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

  15. Prevention and management of ventilator-associated pneumonia ...

    African Journals Online (AJOL)

    The Care Bundle approach offers an interventional tool to implement strategies specifically directed to the prevention of VAP and the facilitation of a team approach to improving its clinical management. The evidence available presents a strong argument to consider a team approach to reducing the incidence of VAP in our ...

  16. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

    Science.gov (United States)

    Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

    2016-02-01

    Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

  17. Geophysical Hazards and Preventive Disaster Management of Extreme Natural Events

    Science.gov (United States)

    Ismail-Zadeh, A.; Takeuchi, K.

    2007-12-01

    Geophysical hazard is potentially damaging natural event and/or phenomenon, which may cause the loss of life or injury, property damage, social and economic disruption, or environmental degradation. Extreme natural hazards are a key manifestation of the complex hierarchical nonlinear Earth system. An understanding, accurate modeling and forecasting of the extreme hazards are most important scientific challenges. Several recent extreme natural events (e.g., 2004 Great Indian Ocean Earthquake and Tsunami and the 2005 violent Katrina hurricane) demonstrated strong coupling between solid Earth and ocean, and ocean and atmosphere. These events resulted in great humanitarian tragedies because of a weak preventive disaster management. The less often natural events occur (and the extreme events are rare by definition), the more often the disaster managers postpone the preparedness to the events. The tendency to reduce the funding for preventive disaster management of natural catastrophes is seldom follows the rules of responsible stewardship for future generations neither in developing countries nor in highly developed economies where it must be considered next to malfeasance. Protecting human life and property against earthquake disasters requires an uninterrupted chain of tasks: from (i) understanding of physics of the events, analysis and monitoring, through (ii) interpretation, modeling, hazard assessment, and prediction, to (iii) public awareness, preparedness, and preventive disaster management.

  18. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

    NARCIS (Netherlands)

    Kraaijenga, S.A.C.; van der Molen, L.; Jacobi, I.; Hamming-Vrieze, O.; Hilgers, F.J.M.; van den Brekel, M.W.M.

    2015-01-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in

  19. Is Case Management Effective for Long-Lasting Suicide Prevention?

    Science.gov (United States)

    Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken

    2015-01-01

    Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

  20. Computer technologies for industrial risk prevention and emergency management

    International Nuclear Information System (INIS)

    Balduccelli, C.; Bologna, S.; Di Costanzo, G.; Vicoli, G.

    1996-07-01

    This document provides an overview about problems related to the engineering of computer based systems for industrial risk prevention and emergency management. Such systems are rather complex and subject to precise reliability and safety requirements. With the evolution of informatic technologies, such systems are becoming to be the means for building protective barriers for reduction of risk associated with plant operations. For giving more generality to this document, and for not concentrating on only a specific plant, the emergency management systems will be dealt with more details than ones for accident prevention. The document is organized in six chapters. Chapter one is an introduction to the problem and to its state of art, with particular emphasis to the aspects of safety requirements definition. Chapter two is an introduction to the problems related to the emergency management and to the training of operators in charge of this task. Chapter three deals in details the topic of the Training Support Systems, in particular about MUSTER (multi-user system for training and evaluation of environmental emergency response) system. Chapter four deals in details the topic of decision support systems, in particular about ISEM (information technology support for emergency management) system. Chapter five illustrates an application of support to the operators of Civil Protection Department for the management of emergencies in the fields of industrial chemical. Chapter six is about a synthesis of the state of art and the future possibilities, identifying some research and development activities more promising for the future

  1. Improving Obesity Prevention and Management in Primary Care in Canada.

    Science.gov (United States)

    Campbell-Scherer, Denise; Sharma, Arya Mitra

    2016-09-01

    Obesity is a major risk factor for chronic diseases with significant morbidity, mortality and health care cost. There is concern due to the dramatic increase in overweight and obesity in Canada in the last 20 years. The causes of obesity are multifactorial, with underestimation by patients and healthcare providers of the long-term nature of the condition, and its complexity. Solutions related to prevention and management will require multifaceted strategies involving education, health policy, public health and health systems across the care continuum. We believe that to support such strategies we need to have a strong primary care workforce equipped with appropriate knowledge, skills and attitudes to support persons at risk for, or with, obesity. To achieve this end, significant skills building is required to improve primary care obesity prevention and management efforts. This review will first examine the current state, and then will outline how we can improve.

  2. Major accident prevention through applying safety knowledge management approach.

    Science.gov (United States)

    Kalatpour, Omid

    2016-01-01

    Many scattered resources of knowledge are available to use for chemical accident prevention purposes. The common approach to management process safety, including using databases and referring to the available knowledge has some drawbacks. The main goal of this article was to devise a new emerged knowledge base (KB) for the chemical accident prevention domain. The scattered sources of safety knowledge were identified and scanned. Then, the collected knowledge was formalized through a computerized program. The Protégé software was used to formalize and represent the stored safety knowledge. The domain knowledge retrieved as well as data and information. This optimized approach improved safety and health knowledge management (KM) process and resolved some typical problems in the KM process. Upgrading the traditional resources of safety databases into the KBs can improve the interaction between the users and knowledge repository.

  3. Preventive distribution and plans of iodine tablets stocks management

    International Nuclear Information System (INIS)

    2002-01-01

    This official note includes two parts: one concerns the new preventive distribution of iodine tablets on the areas defined by the Particular Intervention Plans (P.P.I.) around nuclear facilities and the other one the setting up of iodine tablets stocks beyond the P.P.I. areas. In annexe is a guide for the elaboration of stocks management plans for steady iodine tablets. (N.C.)

  4. Prevention and management of maternal obesity in pregnancy

    OpenAIRE

    E. Alexopoulou; N. Giannousi; I. K. Thanasas

    2017-01-01

    Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal dev...

  5. Unruptured intracranial aneurysms: development, rupture and preventive management.

    Science.gov (United States)

    Etminan, Nima; Rinkel, Gabriel J

    2016-12-01

    Saccular unruptured intracranial aneurysms (UIAs) have a prevalence of 3% in the adult population, and are being increasingly detected because of improved quality and higher frequency of cranial imaging. Large amounts of data, providing varying levels of evidence, have been published on aneurysm development, progression and rupture, but less information is available on the risks and efficacy of preventive treatment. When deciding how to best manage UIAs, clinicians must consider the age and life expectancy of the patient, the estimated risk of rupture, the risk of complications attributed to preventive treatment, and the level of anxiety caused by the awareness of having an aneurysm. This Review highlights the latest human data on the formation, progression and rupture of intracranial aneurysms, as well as risks associated with preventive treatment. Considering these we discuss the implication for clinical management. Furthermore, we highlight pivotal questions arising from current data on intracranial aneurysms and the implications the data have for future experimental or clinical research. We also discuss data on novel radiological surrogates for rupture for those aneurysms that do not require preventive occlusion. Finally, we provide guidance for clinicians who are confronted with patients with incidentally detected UIAs.

  6. Ozone therapy in the management and prevention of caries

    Directory of Open Access Journals (Sweden)

    Merve Erkmen Almaz

    2015-01-01

    Full Text Available The purpose of this article was to assess the effectiveness of ozone therapy in the management and prevention of caries, reviewing clinical and in vitro studies. Ozone has proven to be effective against gram-negative and gram-positive bacteria, viruses, and fungi. In dentistry, most of the published articles are based on ozone's antimicrobial effects and the treatment of caries. Most of the clinical studies reported ozone to be a promising alternative to conventional methods for caries management. However, a few studies have shown ozone to be insufficient for preventing caries and reducing microorganisms in open occlusal carious lesions. Ozone might be a useful tool to reduce and control oral infectious microorganisms in dental plaque and dental cavity. However, the results of in vitro studies are controversial; while some researchers reported that ozone therapy had a minimal or no effect on the viability of microorganisms, others suggested ozone to be highly effective in killing both gram-positive and gram-negative oral microorganisms. Therefore, more evidence is required before ozone can be accepted as an alternative to present methods for the management and prevention of caries.

  7. [INTERVENTIONS FOR PREVENTION AND MANAGEMENT OF CHILD AND YOUTH OBESITY].

    Science.gov (United States)

    Pérez Morente, Ma Angeles; Sánchez Ocón, Ma Teresa; Mingorance Ruiz, Ma Visitación; Pérez Robles, Angustias; Munoz de la Fuente, José Manuel; Sánchez De Arias, Celia

    2015-02-01

    To determine the current epidemiological situation, prevention and management of child and youth obesity based on the best scientific evidence available. Literature search in PubMed, Cochrane, Science Direct, ENFISPO, Lilacs and SciELO, selecting articles about child and youth obesity, its prevention and treatment. Child and youth obesity is a multifactorial chronic disease that it has been increasing, tending to stay in adolescence and adulthood with greater intensity than more early starts. The data vary from country to country, although most articles are governed by body mass index (BMI). Pediatric overweight is defined by a BMI percentiles located between 91-98 and obesity by a percentile equal or greater than 99. Its prevalence varies according to time, geography, age, gender and race. The prevalence rates of obesity in Spain are one of the highest around the world. The overweight prevalence is lower slightly and there is no difference in gender. Its implications include the metabolic syndrome and diabetes mellitus II. Unanimously, the combination of interventions on life and dietary habits and physical activity is important for the management of obesity and overweight. Currently, the obesity management requires a generalized approach, with changes in lifestyle, diet and physical activity. The best solution for reducing this epidemic lies in prevention rather than treatment.

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

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2013-01-01

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

  9. Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management.

    Science.gov (United States)

    Alkhatib, Ahmad; Tsang, Catherine; Tiss, Ali; Bahorun, Theeshan; Arefanian, Hossein; Barake, Roula; Khadir, Abdelkrim; Tuomilehto, Jaakko

    2017-12-01

    Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic diseases, such as type 2 diabetes mellitus (T2DM). A regular consumption of functional foods may be associated with enhanced anti-oxidant, anti-inflammatory, insulin sensitivity, and anti-cholesterol functions, which are considered integral to prevent and manage T2DM. Components of the Mediterranean diet (MD)-such as fruits, vegetables, oily fish, olive oil, and tree nuts-serve as a model for functional foods based on their natural contents of nutraceuticals, including polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids. Polyphenols within MD and polyphenol-rich herbs-such as coffee, green tea, black tea, and yerba maté-have shown clinically-meaningful benefits on metabolic and microvascular activities, cholesterol and fasting glucose lowering, and anti-inflammation and anti-oxidation in high-risk and T2DM patients. However, combining exercise with functional food consumption can trigger and augment several metabolic and cardiovascular protective benefits, but it is under-investigated in people with T2DM and bariatric surgery patients. Detecting functional food benefits can now rely on an "omics" biological profiling of individuals' molecular, genetics, transcriptomics, proteomics, and metabolomics, but is under-investigated in multi-component interventions. A personalized approach for preventing and managing T2DM should consider biological and behavioral models, and embed nutrition education as part of lifestyle diabetes prevention studies. Functional foods may provide additional benefits in such an approach.

  10. Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management

    Directory of Open Access Journals (Sweden)

    Ahmad Alkhatib

    2017-12-01

    Full Text Available Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic diseases, such as type 2 diabetes mellitus (T2DM. A regular consumption of functional foods may be associated with enhanced anti-oxidant, anti-inflammatory, insulin sensitivity, and anti-cholesterol functions, which are considered integral to prevent and manage T2DM. Components of the Mediterranean diet (MD—such as fruits, vegetables, oily fish, olive oil, and tree nuts—serve as a model for functional foods based on their natural contents of nutraceuticals, including polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids. Polyphenols within MD and polyphenol-rich herbs—such as coffee, green tea, black tea, and yerba maté—have shown clinically-meaningful benefits on metabolic and microvascular activities, cholesterol and fasting glucose lowering, and anti-inflammation and anti-oxidation in high-risk and T2DM patients. However, combining exercise with functional food consumption can trigger and augment several metabolic and cardiovascular protective benefits, but it is under-investigated in people with T2DM and bariatric surgery patients. Detecting functional food benefits can now rely on an “omics” biological profiling of individuals’ molecular, genetics, transcriptomics, proteomics, and metabolomics, but is under-investigated in multi-component interventions. A personalized approach for preventing and managing T2DM should consider biological and behavioral models, and embed nutrition education as part of lifestyle diabetes prevention studies. Functional foods may provide additional benefits in such an approach.

  11. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

    Science.gov (United States)

    Munns, Craig F.; Shaw, Nick; Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M.; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary

    2016-01-01

    Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. PMID:26745253

  12. A concurrent diagnosis of microbiological food safety output and food safety management system performance: Cases from meat processing industries

    NARCIS (Netherlands)

    Luning, P.A.; Jacxsens, L.; Rovira, J.; Oses Gomez, S.; Uyttendaele, M.; Marcelis, W.J.

    2011-01-01

    Stakeholder requirements force companies to analyse their food safety management system (FSMS) performance to improve food safety. Performance is commonly analysed by checking compliance against preset requirements via audits/inspections, or actual food safety (FS) output is analysed by

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

    Directory of Open Access Journals (Sweden)

    Abdelwahad Biad

    1997-09-01

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

  14. Basic Concurrency Theory

    DEFF Research Database (Denmark)

    Løvengreen, Hans Henrik

    2002-01-01

    In this set of notes, we present some of the basic theory underlying the discipline of programming with concurrent processes/threads. The notes are intended to supplement a standard textbook on concurrent programming.......In this set of notes, we present some of the basic theory underlying the discipline of programming with concurrent processes/threads. The notes are intended to supplement a standard textbook on concurrent programming....

  15. Disability prevention and management in leprosy: A field experience

    Directory of Open Access Journals (Sweden)

    Ganapati R

    2003-11-01

    Full Text Available Bombay Leprosy Project has conducted operational research into cost effective ways of using therapeutic management for prevention of disabilities (POD. The goal of achieving this are broadly divided as 1 prevention of impairments and disabilities [POID] and 2 prevention of worsening of disabilities [POWD]. About 33-56% of newly registered leprosy patients already have clinically detectable nerve function impairment [NFI], often no longer amenable to MDT. An analysis of 892 leprosy cases treated with WHO-MDT stresses the need to focus attention on leprosy patients having > 5 skin lesions and multiple nerve thickening. Assessment of 454 disabled leprosy patients after 4 years indicated that the compliance for the services offered was good and it helped to improve the disability status in more than 50% of patients. In terms of effectiveness of the services, it was found to be effective in preventing worsening of deformities in hands and healing of trophic ulcers in feet. The methodology adopted has also helped us to develop an operational research model about the necessity to systematize the assistance and support to be given if the services can be routed through a public health facility. Because of the large numbers of leprosy patients with disability living in this region and the limited resources available, the services have to be targeted towards those who are most in need. The major advantage of such community based program is an attempt to eliminate the social stigma in the patients′ families and the education of the community.

  16. [Postoperative Chylotholax;Intraoperative Prevention and Postoperative Management].

    Science.gov (United States)

    Saito, Tomohito; Kariya, Shuji; Murakawa, Tomohiro

    2017-07-01

    Postoperative chylothorax is a relatively rare but potentially fatal complication caused by iatrogenic injury to thoracic duct system, with an incidence ranging from 2 to 4% after major lung surgery or esophagectomy. The pathophysiologic features of chylothorax include dehydration, loss of nutrients and immunological components. Intraopreative prevention is the first step for the management, and treatment options include conservative therapy, percutaneous intervention, and redo-operation. Although the treatment algorithm has not been standardized, chylothorax which is refractory to conservative treatment, or that with high output greater than 1,000 ml/day should be treated aggressively with thoracic duct embolization or redo-operation in a timely fashion. We herein review the anatomy and physiology of thoracic duct system and describe the overview of prevention and each theapeutic options of postoperative chylothorax.

  17. Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention

    Science.gov (United States)

    Pass, Robert F.; Arav-Boger, Ravit

    2018-01-01

    Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection. PMID:29560263

  18. Clinical management of parasitic gastroenteritis (PGE concurrent with moderate pneumonia in a goat: a clinical veterinary case report

    Directory of Open Access Journals (Sweden)

    Faez Firdaus Abdullah Jesse

    2017-09-01

    Materials and methods: The Jamnapari cross goat aged two years and weighing 40 Kg was presented to the Universiti Veterinary Hospital, Universiti Putra Malaysia with the history of diarrhea and depression. The goat was examined physically. Blood and fecal samples were collected for complete blood count, serum biochemistry analysis and parasitological examination. Standard treatment plan was applied for the correction of the the problem. Results: Physical examination findings revealed the goat was in poor body condition, dull and depressed. Wet and dry fecal traces were observed around the groin region. The temperature was slightly elevated (39.5°C, the heart rate was increased (160 b/min while other parameters were within normal range. Upon auscultation of the thoracic region, moderate crackle lung sound was determined. Visual observation of the nasal cavity indicated a bilateral mucopurulent nasal discharge. The hemogram result revealed evidence of a normocytic normochromic anemia, leukocytosis, neutrophilia with left shift and monocytosis. Serum biochemistry revealed increases in gamma-glutamyl transferase (GGT, sodium, chloride, creatine kinase (CK, and hyperglobulinemia. Fecal examination revealed increased in Strongyle egg count of about 2,700 eggs per gram of feces using the Modified Mcmaster technique. From the history, physical examination and laboratory findings the goat was diagnosed with clinical parasitic gastroenteritis (PGE concurrent with moderate pneumonia infection. The therapeutic plan for this case were 45 mL of kaolin-pectin (30 mL/Kg body weight orally SID for 3 days as anti-diarrhea, 12 mL Levamisole (12 mg/Kg bwt was administered orally once as anthelminthic, fluid therapy was instituted using 1.5 L of Lactated Ringers’ solution once via intravenously. Trimethoprim-Sulfamethoxazole (1 mL/16 Kg bwt was administered intramuscularly SID for 3 days. Conclusion: Follow up examination of the goat a week post treatment indicated a good prognosis

  19. Diagnosis, prevention, and management of canine hip dysplasia: a review

    Directory of Open Access Journals (Sweden)

    Schachner ER

    2015-05-01

    Full Text Available Emma R Schachner, Mandi J Lopez Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA Abstract: Canine hip dysplasia (CHD is a polygenic and multifactorial developmental disorder characterized by coxofemoral (hip joint laxity, degeneration, and osteoarthritis (OA. Current diagnostic techniques are largely subjective measures of joint conformation performed at different stages of development. Recently, measures on three-dimensional images generated from computed tomography scans predicted the development of OA associated with CHD. Continued refinement of similar imaging methods may improve diagnostic imaging techniques to identify dogs predisposed to degenerative hip joint changes. By current consensus, joint changes consistent with CHD are influenced by genetic predisposition as well as environmental and biomechanical factors; however, despite decades of work, the relative contributions of each to the development and extent of CHD signs remain elusive. Similarly, despite considerable effort to decipher the genetic underpinnings of CHD for selective breeding programs, relevant genetic loci remain equivocal. As such, prevention of CHD within domestic canine populations is marginally successful. Conservative management is often employed to manage signs of CHD, with lifelong maintenance of body mass as one of the most promising methods. Surgical intervention is often employed to prevent joint changes or restore joint function, but there are no gold standards for either goal. To date, all CHD phenotypes are considered as a single entity in spite of recognized differences in expression and response to environmental conditions and treatment. Identification of distinct CHD phenotypes and targeting evidence-based conservative and invasive treatments for each may significantly advance prevention and management of a prevalent, debilitating condition in canine companions. Keywords: canine

  20. Takotsubo Cardiomyopathy in Intensive Care Unit: Prevention, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Hannah Masoud

    2016-01-01

    Full Text Available Accurate diagnosis of Takotsubo Cardiomyopathy has substantial prognostic implications in an intensive care unit, given its increased mortality risk and association with life-threatening complications. This report seeks to discuss diagnostic modalities that can be useful in accurately differentiating Takotsubo Cardiomyopathy from Acute Coronary Syndrome, and also briefly discuss prevention and management of this cardiomyopathy in an intensive care unit. For critically ill Takotsubo patients, intensive clinicians can consider establishment of diagnosis by specific electrocardiograph changes, distinctive marked release of cardiac enzymes, characteristic echocardiograph findings, as well as invasive coronary angiography or noninvasive cardiac magnetic imaging.

  1. Prevention, Recognition, and Management of Urologic Injuries During Gynecologic Surgery.

    Science.gov (United States)

    Sharp, Howard T; Adelman, Marisa R

    2016-06-01

    The urethra, bladder, and ureters are particularly susceptible to injury during gynecologic surgery. When preventive measures fail, prompt recognition and management of injury can avoid long-term sequelae such as fistula formation and loss of renal function. Intraoperative identification should be the primary goal when an injury occurs, although this is not always possible. Postoperative injury recognition requires a high level of suspicion and vigilance. In addition to history and physical examination, appropriate radiologic studies can be useful in localizing injury and planning management strategies. Some injuries may require Foley catheter drainage or ureteral stenting alone, whereas others will require operative intervention with ureteral resection and reanastomosis or reimplantation. Prompt restoration of urinary drainage or diversion will avoid further renal compromise.

  2. Measuring and modelling concurrency

    Science.gov (United States)

    Sawers, Larry

    2013-01-01

    This article explores three critical topics discussed in the recent debate over concurrency (overlapping sexual partnerships): measurement of the prevalence of concurrency, mathematical modelling of concurrency and HIV epidemic dynamics, and measuring the correlation between HIV and concurrency. The focus of the article is the concurrency hypothesis – the proposition that presumed high prevalence of concurrency explains sub-Saharan Africa's exceptionally high HIV prevalence. Recent surveys using improved questionnaire design show reported concurrency ranging from 0.8% to 7.6% in the region. Even after adjusting for plausible levels of reporting errors, appropriately parameterized sexual network models of HIV epidemics do not generate sustainable epidemic trajectories (avoid epidemic extinction) at levels of concurrency found in recent surveys in sub-Saharan Africa. Efforts to support the concurrency hypothesis with a statistical correlation between HIV incidence and concurrency prevalence are not yet successful. Two decades of efforts to find evidence in support of the concurrency hypothesis have failed to build a convincing case. PMID:23406964

  3. Constraints meet concurrency

    CERN Document Server

    Mauro, Jacopo

    2014-01-01

    This book describes the benefits that emerge when the fields of constraint programming and concurrency meet. On the one hand, constraints can be used in concurrency theory to increase the conciseness and the expressive power of concurrent languages from a pragmatic point of view. On the other hand, problems modeled by using constraints can be solved faster and more efficiently using a concurrent system. Both directions are explored providing two separate lines of development. Firstly the expressive power of a concurrent language is studied, namely Constraint Handling Rules, that supports constraints as a primitive construct. The features of this language which make it Turing powerful are shown. Then a framework is proposed to solve constraint problems that is intended to be deployed on a concurrent system. For the development of this framework the concurrent language Jolie following the Service Oriented paradigm is used. Based on this experience, an extension to Service Oriented Languages is also proposed in ...

  4. Anesthetic Management of Two Pediatric Patients With Concurrent Diagnoses of Mitochondrial Disease and Malignant Hyperthermia Susceptibility: A Case Report.

    Science.gov (United States)

    Nelson, Jonathon H; Kaplan, Richard F

    2017-10-01

    We report the case of 2 pediatric patients with coexisting diagnoses of malignant hyperthermia susceptibility and mitochondrial disease in 2 different surgical settings. Due to the rare occurrence of each disorder, and even more so together, we reviewed evidence-based anesthetic concerns and described our perioperative management, with the goal of aiding future practitioners in safely caring for these patients. Consent was obtained for both patients, as well as IRB approval before publication.

  5. Atrial fibrillation after cardiac surgery: Prevention and management: The Australasian experience.

    Science.gov (United States)

    Alawami, Mohammed; Chatfield, Andrew; Ghashi, Rajaie; Walker, Laurence

    2018-01-01

    Atrial fibrillation (AF) after cardiac surgery is a major health problem that is associated with a significant financial burden. This paper aims to highlight this problem and review the current guidelines in the prevention and management of AF after cardiac surgery, providing our experience in the Australasian centers. We conducted a literature review using mainly PubMed to compare the current practice with the available evidence. EMBASE and Cochrane library were also searched. We concurrently developed an online questionnaire to collect data from other Australasian centers regarding their approach to this problem. We identified 194 studies that were considered relevant to our research. We did not find any formal protocols published in the literature. From our Australasian experience; seven centers (58%) had a protocol for AF prophylaxis. The protocols included electrolytes replacement, use of amiodarone and/or β-blockers. Other strategies were occasionally used but were not part of a structured protocol. The development of an integrated medical and surgical protocol for the prophylaxis of AF after cardiac surgery is an important aspect for the care of postoperative cardiac patients. Considerations of prophylactic strategies other than those routinely used should be included in the protocol. This area should receive considerable attention in order to reduce the postoperative complications and health costs.

  6. Optimal diagnosis, prevention, and management of periprosthetic joint infection

    Directory of Open Access Journals (Sweden)

    Tafer N

    2015-01-01

    Full Text Available Nathalie Tafer,1 Wilson Belaieff,1 Céline Cuérel,1 Matthieu Zingg,1 Pierre Hoffmeyer,1 Ilker Uçkay1,2 1Orthopedic Surgery Department, 2Division of Infectious Diseases, University of Geneva Hospitals and Medical School, Geneva, Switzerland Abstract: The pace of the aging population is steadily rising worldwide with a parallel increase in the demand for joint replacement procedures. With the increasing number of patients undergoing arthroplasty, there is also an increased risk for arthroplasty infection that may lead to severe complications, poorer outcome, and substantial extra costs for health care systems. Current rates of prosthetic joint infection are not dramatically different from the 1960s or 1970s, but some general principles are now better defined, and their management has been studied extensively during the past decades, thus resulting in a change in clinical practice. The purpose of this review is to summarize important principles of prosthetic joint infection to guide the clinician and to contribute to the optimal diagnosis, prevention, and management of periprosthetic joint infections. Keywords: arthroplasty infection, antibiotic therapy, biofilm, surgery, prevention

  7. Pre-eclampsia part 2: prediction, prevention and management.

    Science.gov (United States)

    Chaiworapongsa, Tinnakorn; Chaemsaithong, Piya; Korzeniewski, Steven J; Yeo, Lami; Romero, Roberto

    2014-09-01

    An antiangiogenic state might constitute a terminal pathway for the multiple aetiologies of pre-eclampsia, especially those resulting from placental abnormalities. The levels of angiogenic and antiangiogenic proteins in maternal blood change prior to a diagnosis of pre-eclampsia, correlate with disease severity and have prognostic value in identifying women who will develop maternal and/or perinatal complications. Potential interventions exist to ameliorate the imbalance of angiogenesis and, hence, might provide opportunities to improve maternal and/or perinatal outcomes in pre-eclampsia. Current strategies for managing pre-eclampsia consist of controlling hypertension, preventing seizures and timely delivery of the fetus. Prediction of pre-eclampsia in the first trimester is of great interest, as early administration of aspirin might reduce the risk of pre-eclampsia, albeit modestly. Combinations of biomarkers typically predict pre-eclampsia better than single biomarkers; however, the encouraging initial results of biomarker studies require external validation in other populations before they can be used to facilitate intervention in patients identified as at increased risk. Angiogenic and antiangiogenic factors might also be useful in triage of symptomatic patients with suspected pre-eclampsia, differentiating pre-eclampsia from exacerbations of pre-existing medical conditions and performing risk assessment in asymptomatic women. This Review article discusses the performance of predictive and prognostic biomarkers for pre-eclampsia, current strategies for preventing and managing the condition and its long-term consequences.

  8. Colorectal cancer: prevention and management of metastatic disease.

    Science.gov (United States)

    Sugarbaker, Paul H

    2014-01-01

    This paper compared the similarities and differences of the two most common types of colorectal cancer metastases. The treatment of liver metastases by surgery combined with systemic chemotherapy was explained. The different natural history of liver metastases as compared to peritoneal metastases and the possibility for prevention of peritoneal metastases were emphasized. Perioperative cancer chemotherapy or second-look surgery must be considered as individualized treatments of selected patients who have small volume peritoneal metastases or who are known to be at risk for subsequent disease progression on peritoneal surfaces. However, the fact that peritoneal metastases, when diagnosed in the follow-up of colorectal cancer patients, can be cured with a combination of cytoreductive surgery and hyperthermic perioperative chemotherapy cannot be ignored. Careful follow-up and timely intervention in colorectal cancer patients with progressive disease are a necessary part of the management strategies recommended by the multidisciplinary team. After a critical evaluation of the data currently available, these strategies for prevention and management of colorectal metastases are presented as the author's recommendations for a high standard of care. As more information becomes available, modifications may be necessary.

  9. Knowledge on dental trauma management and caries prevention.

    Science.gov (United States)

    Frujeri, Maria de Lourdes V; Pinto, Adriana B Silveira; Bezerra, Ana C B; de Toledo, Orlando A; Cortes, Maria I de S; Pordeus, Isabela de A

    2015-01-01

    This study evaluated the knowledge of dental assistants (DA) and hygienists (DH) on dental trauma management and dental caries prevention. Secondarily, other aims were 2-fold: (1) to update the assistants/hygienists through courses supported on scientific evidence-based information and (2) to evaluate their job satisfaction. A cross-sectional study was conducted with 46 participants, DHs and Das, working in the Secretary of Education of the city of Brasilia (Federal District, Brazil). The information was gathered through 2 self-administered questionnaires during 2 training meetings. The first questionnaire was applied before the first meeting and the second questionnaire after the last meeting. All participants were women older than 38 years and with more than 15 years of experience. The participants demonstrated knowledge on dental trauma types but lack of knowledge on dental trauma first-aid approaches. Concerning to dental caries, the professional demonstrated knowledge on both etiology and prevention. Lectures, periodical training, and inclusion in multidisciplinary training groups aiming to caries prevention and dental trauma are necessary.

  10. Concurrent development of fault management hardware and software in the SSM/PMAD. [Space Station Module/Power Management And Distribution

    Science.gov (United States)

    Freeman, Kenneth A.; Walsh, Rick; Weeks, David J.

    1988-01-01

    Space Station issues in fault management are discussed. The system background is described with attention given to design guidelines and power hardware. A contractually developed fault management system, FRAMES, is integrated with the energy management functions, the control switchgear, and the scheduling and operations management functions. The constraints that shaped the FRAMES system and its implementation are considered.

  11. Endodontic Management of a Mandibular Incisor Exhibiting Concurrence of Fusion, Talon Cusp and Dens Invaginatus using CBCT as a Diagnostic Aid.

    Science.gov (United States)

    Juneja, Ruchi; Kumar, Varun

    2016-02-01

    Teeth with aberrant anatomy present a challenge to the endodontist. Advanced tools like cone beam computed tomography aid in exploring the details of endodontic architecture in such cases. The aim of this case report is to highlight the advantage of CBCT in endodontic management of teeth with multiple dental anomalies. A mandibular lateral incisor associated with an extraoral sinus tract revealed unusual clinical anatomy. A provisional diagnosis of type III dens in dente was made based on radiographic findings. Considering the complex anatomy, CBCT was advised to get a confirmatory diagnosis. The anatomic details revealed by CBCT differed significantly from the provisional diagnosis. A final diagnosis of concurrence of fusion with a supernumerary tooth, talon cusp and type II dens invaginatus was established and endodontic treatment of the concerned tooth was carried out. Non-surgical endodontic treatment resulted in successful resolution of the sinus tract and healing of the periapical lesion. CBCT, thus proves to be an excellent diagnostic tool for management of teeth with unusual anatomy, paving way for a conservative treatment free of endodontic mishaps.

  12. Patient web portals, disease management, and primary prevention

    Directory of Open Access Journals (Sweden)

    Coughlin SS

    2017-04-01

    Full Text Available Steven S Coughlin,1 Judith J Prochaska,2 Lovoria B Williams,3 Gina M Besenyi,1 Vahé Heboyan,1 D Stephen Goggans,4 Wonsuk Yoo,5 Gianluca De Leo1 1Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, 2Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA, 3Department of Biobehavioral Nursing, College of Nursing, Augusta University, 4Department of Public Health, East Central Health District, 5Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA Background: Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection.Methods: This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals.Results: Although findings have not been uniformly positive, several studies of the effectiveness of health care system patient portals in chronic disease management have shown promising results with regard to patient outcomes. Patient web portals have also shown promising results in increasing adherence with screening recommendations. Racial and ethnic minorities, younger persons, and patients who are less educated or have lower health literacy have been found to be less likely to use patient portals.Conclusion: Additional studies are needed of the utility and effectiveness of different elements of web portals for different patient populations. This should include additional diseases and health topics such as

  13. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits

    DEFF Research Database (Denmark)

    Brushøj, Christoffer; Larsen, Klaus; Albrecht-Beste, Elisabeth

    2008-01-01

    BACKGROUND: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. HYPOTHESIS: A preventive training program based...

  14. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load - A randomized controlled trial of 1020 army recruits

    DEFF Research Database (Denmark)

    Brushoj, C.; Larsen, K.; Albrecht-Beste, E.

    2008-01-01

    Background: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. Hypothesis: A preventive training program base...

  15. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load - A randomized controlled trial of 1020 army recruits

    DEFF Research Database (Denmark)

    Brushoj, C.; Larsen, K.; Albrecht-Beste, E.

    2008-01-01

    on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. Study Design: Randomized controlled trial; Level of evidence, 1. Methods......, flexibility, and coordination; the placebo program consisted of 5 exercises for the upper body. Results: During the observation period, 223 subjects sustained an injury, with 50 and 48 of these fulfilling the study criteria for overuse knee injuries or medial tibial stress syndrome, respectively. There were......). Conclusion: An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase...

  16. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits

    DEFF Research Database (Denmark)

    Brushøj, Christoffer; Larsen, Klaus; Albrecht-Beste, Elisabeth

    2008-01-01

    on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS......, flexibility, and coordination; the placebo program consisted of 5 exercises for the upper body. RESULTS: During the observation period, 223 subjects sustained an injury, with 50 and 48 of these fulfilling the study criteria for overuse knee injuries or medial tibial stress syndrome, respectively. There were......). CONCLUSION: An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase...

  17. Pollution prevention opportunity assessment: Foundation of pollution prevention for waste management

    International Nuclear Information System (INIS)

    Damewood, R.W.

    1994-01-01

    The objective of this paper is to promote the Pollution Prevention Opportunity Assessment (PPOA) technique as a fundamental of pollution prevention for waste management. All key elements of an effective PPOA program are presented. These key elements include impacts of environmental laws on pollution prevention, PPOA concepts and overview, waste minimization opportunities assessment, reporting and monitoring waste minimization progress, and PPOA program implementation. As environmental laws evolve the focus is shifting from end-of-pipe pollution control to front-end source reduction. Waste minimization was mistakenly interpreted to mean the reduction of hazardous waste after generation in the past. The Pollution Prevention Act of 1990 has clearly defined its requirement on resource reduction. Waste reduction can be viewed as a criterion to assess all industrial processes and operations. The fundamental approach of PPOA focuses on a mass balance concept. This concept deals with tracking of chemicals from the point of purchase, through storage, utilization in the process, and waste generation at the end of process. In other words, PPOA is a technique to analyze this input/output process. By applying PPOA techniques, the framework of applicable compliance requirements to the current operation process is established. Furthermore, documentation of PPOA itself can meet as documentation requirements for environmental compliance. In general, the PPOA process consists of two phases. The first phase involves input and output process description and waste characterization. The second phase is an opportunities assessment for waste minimization from input/output waste characterization. These two phases are explained in detail in the paper

  18. Silicone gel sheeting for the management and prevention of onychocryptosis.

    Science.gov (United States)

    Aksakal, A Burhan; Ozsoy, Esra; Gürer, Mehmet ali

    2003-03-01

    Onychocryptosis, commonly referred to as ingrown nails, has many therapeutic alternatives for its management. Although mild cases can be treated conservatively, in severe cases, surgical treatment is preferred. Silicone gel sheeting is found to be effective in the treatment of hypertrophic scars and keloids. To document the effectiveness of silicone gel sheeting in the management of patients with onychocryptosis and in the prevention of the recurrences by breaking the devil's circle, which usually took place after the surgical procedures used in the treatment of the onychocryptosis. Fourteen patients were enrolled in the study. Entry criteria required the presence of slight (2 patients), moderate (2 patients), or severe (10 patients) onychocryptosis. The simple technique used in the study was the excision of the one-quarter part of the lesional side of the nail plate without excising the granulation tissue. After 24 hours, the silicone was placed on the granulation tissue and the exposed nail bed. Silicone gel sheet was bandaged loosely without applying any pressure. Patients entering the study were given detailed instructions in applying and using the gel for 12 hours during the daytime. The study lasted for 14 months and was composed of a treatment period of 4 months and a follow-up period of 10 months. The patients were evaluated every 2 weeks in the first month and then monthly. The change in thickness of granulation tissue was evaluated by comparing them with the baseline photographs and those taken at each visit. The management and prevention of onychocryptosis were achieved in 12 of 14 patients (85.71%). The silicone gel sheeting treatment was well tolerated except for an occasional transient exudation, which was resolved when the treatment was withdrawn. The results show that the new method that we used for the treatment of onychocryptosis is successful in reducing the thickness of the hypertrophic nail fold and prevents the recurrence of the condition

  19. Temporal Concurrent Constraint Programming

    DEFF Research Database (Denmark)

    Nielsen, Mogens; Palamidessi, Catuscia; Valencia, Frank Dan

    2002-01-01

    The ntcc calculus is a model of non-deterministic temporal concurrent constraint programming. In this paper we study behavioral notions for this calculus. In the underlying computational model, concurrent constraint processes are executed in discrete time intervals. The behavioral notions studied...... reflect the reactive interactions between concurrent constraint processes and their environment, as well as internal interactions between individual processes. Relationships between the suggested notions are studied, and they are all proved to be decidable for a substantial fragment of the calculus...

  20. Domain Theory for Concurrency

    DEFF Research Database (Denmark)

    Nygaard, Mikkel

    Concurrent computation can be given an abstract mathematical treatment very similar to that provided for sequential computation by domain theory and denotational semantics of Scott and Strachey. A simple domain theory for concurrency is presented. Based on a categorical model of linear logic and ...... towards more expressive languages than HOPLA and Affine HOPLA—in particular concerning extensions to cover independence models. The thesis concludes with a discussion of related work towards a fully fledged domain theory for concurrency....

  1. ETHYLENE GLYCOL POISONING WITH CONCURRENT ETHANOL INGESTION

    Directory of Open Access Journals (Sweden)

    Mitja Lainščak

    2003-02-01

    Full Text Available Background. Ethylene glycol, usually ingested by coincidence, causes uncommon but serious poisoning which could have fatal consequences without prompt diagnosis and treatment. Ethylene glycol itself has a low toxicity but is rapidly degraded to toxic metabolites, that are responsible for typical clinical presentation. Metabolic acidosis, increased anion and osmolal gap are typical laboratory findings. Application of antidotes ethanol and fomepizol, hemodyalisis and correction of metabolic acidosis are mainstays of therapy.Patients and methods. A case of concurrent ethanol and ethylene glycol ingestion is presented. On admission diagnosis of ethylene glycol poisoning was supported by heteroanamnestic data, typical clinical presentation and laboratory findings and latter confirmed with body fluid analysis. Despite therapy with ethanol, sodium hydrogencarbonate and parenteral hydration patient developed acute renal failure which required hemodyalisis.Conclusions. Concurrent ingestion of spirit improved prognosis of ingestion of lethal ethylene glycol dose. Due to late arrival adequate and immediate in-hospital management could not prevent acute renal failure and subsequent hemodyalisis.

  2. RANAVIRUS EPIZOOTIC IN CAPTIVE EASTERN BOX TURTLES (TERRAPENE CAROLINA CAROLINA) WITH CONCURRENT HERPESVIRUS AND MYCOPLASMA INFECTION: MANAGEMENT AND MONITORING.

    Science.gov (United States)

    Sim, Richard R; Allender, Matthew C; Crawford, LaTasha K; Wack, Allison N; Murphy, Kevin J; Mankowski, Joseph L; Bronson, Ellen

    2016-03-01

    Frog virus 3 (FV3) and FV3-like viruses are members of the genus Ranavirus (family Iridoviridae) and are becoming recognized as significant pathogens of eastern box turtles (Terrapene carolina carolina) in North America. In July 2011, 5 turtles from a group of 27 in Maryland, USA, presented dead or lethargic with what was later diagnosed as fibrinonecrotic stomatitis and cloacitis. The presence of FV3-like virus and herpesvirus was detected by polymerase chain reaction (PCR) in the tested index cases. The remaining 22 animals were isolated, segregated by severity of clinical signs, and treated with nutritional support, fluid therapy, ambient temperature management, antibiotics, and antiviral therapy. Oral swabs were tested serially for FV3-like virus by quantitative real-time PCR (qPCR) and tested at day 0 for herpesvirus and Mycoplasma sp. by conventional PCR. With oral swabs, 77% of the 22 turtles were FV3-like virus positive; however, qPCR on tissues taken during necropsy revealed the true prevalence was 86%. FV3-like virus prevalence and the median number of viral copies being shed significantly declined during the outbreak. The prevalence of herpesvirus and Mycoplasma sp. by PCR of oral swabs at day 0 was 55% and 68%, respectively. The 58% survival rate was higher than previously reported in captive eastern box turtles for a ranavirus epizootic. All surviving turtles brumated normally and emerged the following year with no clinical signs during subsequent monitoring. The immediate initiation of treatment and intensive supportive care were considered the most important contributing factors to the successful outcome in this outbreak.

  3. Management and prevention of pertussis infection in neonates.

    Science.gov (United States)

    Berti, Elettra; Venturini, Elisabetta; Galli, Luisa; de Martino, Maurizio; Chiappini, Elena

    2014-12-01

    Despite the fact that universal immunization against pertussis led to a dramatic decrease in the incidence and mortality in high-income countries, it has left a window of vulnerability for newborns. Although specific guidelines concerning management of neonatal whooping cough have not yet been developed, the present review summarizes the main available recommendations on diagnostic work-up and treatment of neonatal pertussis. Additionally, new prevention strategies are explored, including the use of an additional booster dose of vaccine to adolescents and adults, vaccination of healthcare workers, immunization of household contacts and caregivers (cocooning strategy), vaccination of pregnant women and, finally, neonatal immunization with novel vaccines. These strategies are analyzed and discussed in terms of efficacy, safety and cost-effectiveness.

  4. Prevention and management of maternal obesity in pregnancy

    Directory of Open Access Journals (Sweden)

    E. Alexopoulou

    2017-03-01

    Full Text Available Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal development of pregnancy. Moreover every obese pregnant woman should be informed about the importance of calorie - intake regulation and weight reduction both before and after pregnancy. Additional therapeutic options are bariatric surgical procedures that a woman can have before pregnancy and anticoagulation therapy during pregnancy. This article attempts brief review on the current scientific knowledge that exists about the role of nutrition and physical activity in controlling the weight of obese pregnant women and its beneficial contribution to the health of both the mother and the newborn.

  5. Understanding the role of waste prevention in local waste management: A literature review.

    Science.gov (United States)

    Zacho, Kristina O; Mosgaard, Mette A

    2016-10-01

    Local waste management has so far been characterised by end-of-pipe solutions, landfilling, incineration, and recycling. End-of-pipe solutions build on a different mind-set than life cycle-based approaches, and for this reason, local waste managers are reluctant to consider strategies for waste prevention. To accelerate the transition of waste and resource management towards a more integrated management, waste prevention needs to play a larger role in the local waste management. In this review article, we collect knowledge from the scientific community on waste prevention of relevance to local waste management. We analyse the trends in the waste prevention literature by organising the literature into four categories. The results indicate an increasing interest in waste prevention, but not much literature specifically concerns the integration of prevention into the local waste management. However, evidence from the literature can inform local waste management on the prevention potential; the environmental and social effects of prevention; how individuals in households can be motivated to reduce waste; and how the effects of prevention measures can be monitored. Nevertheless, knowledge is still lacking on local waste prevention, especially regarding the methods for monitoring and how local waste management systems can be designed to encourage waste reduction in the households. We end the article with recommendations for future research. The literature review can be useful for both practitioners in the waste sector and for academics seeking an overview of previous research on waste prevention. © The Author(s) 2016.

  6. Educational program for the prevention and management of school violence

    Directory of Open Access Journals (Sweden)

    Viriam Leiva Díaz

    2013-04-01

    Full Text Available This article presents the main results of the implementation of an educational program for the preventionand management of violence in public schools by teachers of first and second cycle, the program was taught bythe School of Nursing at the University of Costa Rica, with a total of 40 hours from January to February 2011. Weused various teaching strategies based on the educational needs of this group of teachers, which were shown in aprevious study and application of a needs assessment. Attended by 33 teachers, 32 women and one man. Of theparticipants, 30 completed the program. The main results are as follows: participants were able to acquire, buildor improve their knowledge about the prevention and treatment of school violence, and also learned varioustechniques and strategies for prevention and control of violence in schools. It is concluded that success inachieving the goals set for each of the sessions is directly related to the fact that the entire educational programstuck to the educational needs expressed by the participating population and its characteristics as teachers, usingprinciples of andragogy, which allowed understanding learning as a knowledge sharing among stakeholders

  7. Complications of minimally invasive cosmetic procedures: Prevention and management

    Directory of Open Access Journals (Sweden)

    Lauren L Levy

    2012-01-01

    Full Text Available Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT, soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care.

  8. Small for size liver remnant following resection: prevention and management.

    Science.gov (United States)

    Eshkenazy, Rony; Dreznik, Yael; Lahat, Eylon; Zakai, Barak Bar; Zendel, Alex; Ariche, Arie

    2014-10-01

    In the latest decades an important change was registered in liver surgery, however the management of liver cirrhosis or small size hepatic remnant still remains a challenge. Currently post-hepatectomy liver failure (PLF) is the major cause of death after liver resection often associated with sepsis and ischemia-reperfusion injury (IRI). ''Small-for-size'' syndrome (SFSS) and PFL have similar mechanism presenting reduction of liver mass and portal hyper flow beyond a certain threshold. Few methods are described to prevent both syndromes, in the preoperative, perioperative and postoperative stages. Additionally to portal vein embolization (PVE), radiological examinations (mainly CT and/or MRI), and more recently 3D computed tomography are fundamental to quantify the liver volume (LV) at a preoperative stage. During surgery, in order to limit parenchymal damage and optimize regenerative capacity, some hepatoprotective measures may be employed, among them: intermittent portal clamping and hypothermic liver preservation. Regarding the treatment, since PLF is a quite complex disease, it is required a multi-disciplinary approach, where it management must be undertaken in conjunction with critical care, hepatology, microbiology and radiology services. The size of the liver cannot be considered the main variable in the development of liver dysfunction after extended hepatectomies. Additional characteristics should be taken into account, such as: the future liver remnant; the portal blood flow and pressure and the exploration of the potential effects of regeneration preconditioning are all promising strategies that could help to expand the indications and increase the safety of liver surgery.

  9. Predicting and preventing the future: actively managing multiple sclerosis.

    LENUS (Irish Health Repository)

    Hutchinson, Michael

    2012-02-01

    Relapsing-remitting multiple sclerosis (MS) has a highly variable clinical course but a number of demographic, clinical and MRI features can guide the clinician in the assessment of disease activity and likely disability outcome. It is also clear that the inflammatory activity in the first five years of relapsing-remitting MS results in the neurodegenerative changes seen in secondary progressive MS 10-15 years later. While conventional first-line disease modifying therapy has an effect on relapses, about one third of patients have a suboptimal response to treatment. With the advent of highly active second-line therapies with their evident marked suppression of inflammation, the clinician now has the tools to manage the course of relapsing-remitting MS more effectively. The development of treatment optimisation recommendations based on the clinical response to first-line therapies can guide the neurologist in more active management of the early course of relapsing-remitting MS, with the aim of preventing both acute inflammatory axonal injury and the neurodegenerative process which leads to secondary progressive MS.

  10. Temporal Concurrent Constraint Programming

    DEFF Research Database (Denmark)

    Nielsen, Mogens; Valencia Posso, Frank Dan

    2002-01-01

    The ntcc calculus is a model of non-deterministic temporal concurrent constraint programming. In this paper we study behavioral notions for this calculus. In the underlying computational model, concurrent constraint processes are executed in discrete time intervals. The behavioral notions studied...

  11. Temporal Concurrent Constraint Programming

    DEFF Research Database (Denmark)

    Valencia, Frank Dan

    Concurrent constraint programming (ccp) is a formalism for concurrency in which agents interact with one another by telling (adding) and asking (reading) information in a shared medium. Temporal ccp extends ccp by allowing agents to be constrained by time conditions. This dissertation studies...

  12. Building Safe Concurrency Abstractions

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann

    2014-01-01

    Concurrent object-oriented programming in Beta is based on semaphores and coroutines and the ability to define high-level concurrency abstractions like monitors, and rendezvous-based communication, and their associated schedulers. The coroutine mechanism of SIMULA has been generalized into the no...

  13. Impredicative concurrent abstract predicates

    DEFF Research Database (Denmark)

    Svendsen, Kasper; Birkedal, Lars

    2014-01-01

    We present impredicative concurrent abstract predicates { iCAP { a program logic for modular reasoning about concurrent, higher- order, reentrant, imperative code. Building on earlier work, iCAP uses protocols to reason about shared mutable state. A key novel feature of iCAP is the ability to dene...

  14. Fucoxanthin prevents H2O2-induced neuronal apoptosis via concurrently activating the PI3-K/Akt cascade and inhibiting the ERK pathway.

    Science.gov (United States)

    Yu, Jie; Lin, Jia-Jia; Yu, Rui; He, Shan; Wang, Qin-Wen; Cui, Wei; Zhang, Jin-Rong

    2017-01-01

    Background : As a natural carotenoid abundant in chloroplasts of edible brown algae, fucoxanthin possesses various health benefits, including anti-oxidative activity in particular. Objective : In the present study, we studied whether fucoxanthin protected against hydrogen peroxide (H 2 O 2 )-induced neuronal apoptosis. Design : The neuroprotective effects of fucoxanthin on H 2 O 2 -induced toxicity were studied in both SH-SY5Y cells and primary cerebellar granule neurons. Results : Fucoxanthin significantly protected against H 2 O 2 -induced neuronal apoptosis and intracellular reactive oxygen species. H 2 O 2 treatment led to the reduced activity of phosphoinositide 3-kinase (PI3-K)/Akt cascade and the increased activity of extracellular signal-regulated kinase (ERK) pathway in SH-SY5Y cells. Moreover, fucoxanthin significantly restored the altered activities of PI3-K/Akt and ERK pathways induced by H 2 O 2 . Both specific inhibitors of glycogen synthase kinase 3β (GSK3β) and mitogen-activated protein kinase kinase (MEK) significantly protected against H 2 O 2 -induced neuronal death. Furthermore, the neuroprotective effects of fucoxanthin against H 2 O 2 -induced neuronal death were abolished by specific PI3-K inhibitors. Conclusions : Our data strongly revealed that fucoxanthin protected against H 2 O 2 -induced neurotoxicity via concurrently activating the PI3-K/Akt cascade and inhibiting the ERK pathway, providing support for the use of fucoxanthin to treat neurodegenerative disorders induced by oxidative stress.

  15. AEGIS: a wildfire prevention and management information system

    Science.gov (United States)

    Kalabokidis, Kostas; Ager, Alan; Finney, Mark; Athanasis, Nikos; Palaiologou, Palaiologos; Vasilakos, Christos

    2016-03-01

    We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to information that is essential for wildfire management. The system uses a number of spatial and non-spatial data sources to support key system functionalities. Land use/land cover maps were produced by combining field inventory data with high-resolution multispectral satellite images (RapidEye). These data support wildfire simulation tools that allow the users to examine potential fire behavior and hazard with the Minimum Travel Time fire spread algorithm. End-users provide a minimum number of inputs such as fire duration, ignition point and weather information to conduct a fire simulation. AEGIS offers three types of simulations, i.e., single-fire propagation, point-scale calculation of potential fire behavior, and burn probability analysis, similar to the FlamMap fire behavior modeling software. Artificial neural networks (ANNs) were utilized for wildfire ignition risk assessment based on various parameters, training methods, activation functions, pre-processing methods and network structures. The combination of ANNs and expected burned area maps are used to generate integrated output map of fire hazard prediction. The system also incorporates weather information obtained from remote automatic weather stations and weather forecast maps. The system and associated computation algorithms leverage parallel processing techniques (i.e., High Performance Computing and Cloud Computing) that ensure computational power required for real-time application. All AEGIS functionalities are accessible to authorized end-users through a web-based graphical user interface. An innovative smartphone application, AEGIS App, also

  16. Preventive Rad/Nuc Detection Equipment Categorization for Consequence Management

    Energy Technology Data Exchange (ETDEWEB)

    Buddemeier, B. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Musolino, S. V. [Brookhaven National Lab. (BNL), Upton, NY (United States); Klemic, G. [US Dept. of Homeland Security National Security Technology Lab., New York, NY (United States)

    2017-06-01

    The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection equipment (PRND) to provide state and local agencies with guidance on how to best use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed for detection and interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management response take place. This effort will provide scientific guidance on the best way to deploy and operate this class of equipment for consequence management missions. With the support of the US Department of Homeland Security’s (DHS) Domestic Nuclear Detection Office (DNDO), PRND equipment has been placed into service at federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be repurposed to support the emergency response in the aftermath of a radiological of nuclear event. This report evaluates PRND equipment to define key categories of equipment and the types of missions they can be used for. This is important because there are over 100 different types of PRND equipment, often with significantly different capabilities with respect to the consequence management mission. The current DNDO draft NIMS PRND equipment types were used as a foundation and expanded, when necessary, to address key characteristics important for the consequence mission. Table 1 provides a summary of the PRND instrument categories developed for this effort. Also included on the table are some common response mission detection equipment categories that will be used for capability comparisons.

  17. Breast-feeding duration for the prevention of excess body weight of mother-child pairs concurrently: a 2-year cohort study.

    Science.gov (United States)

    Mastroeni, Marco Fabio; Mastroeni, Silmara Salete de Barros Silva; Czarnobay, Sandra Ana; Ekwaru, John Paul; Loehr, Sarah A; Veugelers, Paul J

    2017-10-01

    To examine the association between breast-feeding duration and the risk of excess body weight (children >85th percentile, mothers BMI≥25·0 kg/m2) concurrently in mother-child pairs two years after delivery. Prospective cohort study in Joinville, Brazil. Multivariable logistic regression was used to examine the independent relationship between breast-feeding duration and risk of excess body weight. Brazilian public maternity hospital. Three hundred and five mother-child pairs. At 2-year follow-up, 23·6 % of mother-child pairs had excess body weight. Children breast-fed for body weight than children breast-fed for ≥6 months (OR=2·4; 95 % CI 1·1, 5·1). Breast-feeding for body weight compared with those who breast-fed for ≥6 months (OR=2·9; 95 % CI 1·1, 8·1). There was a progressive increase in the likelihood of mother-child pairs having excess body weight as breast-feeding duration decreased. In addition to breast-feeding duration, other independent determinants of excess body weight were pre-pregnancy weight, gestational weight gain and number of pregnancies in mothers, and birth weight in children. Breast-feeding for a longer duration has a parallel protective effect on the risk of excess body weight in mother-child pairs two years after birth. Since members of the same family could be influenced by the same risk factors, continued promotion and support of breast-feeding may help to attenuate the rising prevalence of overweight in mother-child pairs.

  18. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School ...

  19. Development of a Patient Charting System to Teach Family Practice Residents Disease Management and Preventive Care

    National Research Council Canada - National Science Library

    Dickerman, Joel

    1997-01-01

    .... Designing notes which 'prompt' residents to gather patient information vital to optimal care can teach residents the concepts of longitudinal care, particularly chronic disease management and preventive care...

  20. Concurrent weighted logic

    DEFF Research Database (Denmark)

    Xue, Bingtian; Larsen, Kim Guldstrand; Mardare, Radu Iulian

    2015-01-01

    We introduce Concurrent Weighted Logic (CWL), a multimodal logic for concurrent labeled weighted transition systems (LWSs). The synchronization of LWSs is described using dedicated functions that, in various concurrency paradigms, allow us to encode the compositionality of LWSs. To reflect these......, CWL contains modal operators indexed with rational numbers to predicate over the numerical labels of LWSs as well as a binary modal operator that encodes properties concerning the (de-) composition of LWSs. We develop a Hilbert-style axiomatic system for CWL and we prove weak- and strong......-completeness results for this logic. To complete these proofs we involve advanced topological techniques from Model Theory....

  1. Diagnosis, prevention and management of postoperative pulmonary edema.

    Science.gov (United States)

    Bajwa, Sj Singh; Kulshrestha, A

    2012-07-01

    Postoperative pulmonary edema is a well-known postoperative complication caused as a result of numerous etiological factors which can be easily detected by a careful surveillance during postoperative period. However, there are no preoperative and intraoperative criteria which can successfully establish the possibilities for development of postoperative pulmonary edema. The aims were to review the possible etiologic and diagnostic challenges in timely detection of postoperative pulmonary edema and to discuss the various management strategies for prevention of this postoperative complication so as to decrease morbidity and mortality. The various search engines for preparation of this manuscript were used which included Entrez (including Pubmed and Pubmed Central), NIH.gov, Medknow.com, Medscape.com, WebMD.com, Scopus, Science Direct, MedHelp.org, yahoo.com and google.com. Manual search was carried out and various text books and journals of anesthesia and critical care medicine were also searched. From the information gathered, it was observed that postoperative cardiogenic pulmonary edema in patients with serious cardiovascular diseases is most common followed by noncardiogenic pulmonary edema which can be due to fluid overload in the postoperative period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post-extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure. NPPE carries a good prognosis if promptly diagnosed and appropriately treated with or without mechanical ventilation.

  2. 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)

  3. Nutraceutical Supplements in the Management and Prevention of Osteoarthritis.

    Science.gov (United States)

    Castrogiovanni, Paola; Trovato, Francesca Maria; Loreto, Carla; Nsir, Houda; Szychlinska, Marta Anna; Musumeci, Giuseppe

    2016-12-06

    Nutraceuticals are dietary compounds which have a role in the balance of anabolic and catabolic signals in joints. Their regulatory function on homeostasis of cartilage metabolism nutraceuticals is increasingly considered for the management and, above all, the prevention of osteoarthritis (OA). OA is a degenerative disease characterized by cartilage and synovium inflammation that can cause joint stiffness, swelling, pain, and loss of mobility. It is a multifactorial disease and, due to the great percentage of people suffering from it and the general increase in life expectancy, OA is considered as one of the most significant causes of disability in the world. OA impairs the structural integrity of articular cartilage that greatly depends on a balance between the anabolic and catabolic processes which occur in chondrocytes and synovial fluid of the joints, therefore the integration with nutraceutical compounds in diet increases the treatment options for patients with established OA beyond traditional rehabilitation, medications, and surgical strategies. In our review, with respect to the current literature, we highlight some of many existing nutraceutical compounds that could be used as integrators in a daily diet thanks to their easy availability, such as in olive oil, fish oil, and botanical extracts used as non-pharmacologic treatment.

  4. Nutraceutical Supplements in the Management and Prevention of Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Paola Castrogiovanni

    2016-12-01

    Full Text Available Nutraceuticals are dietary compounds which have a role in the balance of anabolic and catabolic signals in joints. Their regulatory function on homeostasis of cartilage metabolism nutraceuticals is increasingly considered for the management and, above all, the prevention of osteoarthritis (OA. OA is a degenerative disease characterized by cartilage and synovium inflammation that can cause joint stiffness, swelling, pain, and loss of mobility. It is a multifactorial disease and, due to the great percentage of people suffering from it and the general increase in life expectancy, OA is considered as one of the most significant causes of disability in the world. OA impairs the structural integrity of articular cartilage that greatly depends on a balance between the anabolic and catabolic processes which occur in chondrocytes and synovial fluid of the joints, therefore the integration with nutraceutical compounds in diet increases the treatment options for patients with established OA beyond traditional rehabilitation, medications, and surgical strategies. In our review, with respect to the current literature, we highlight some of many existing nutraceutical compounds that could be used as integrators in a daily diet thanks to their easy availability, such as in olive oil, fish oil, and botanical extracts used as non-pharmacologic treatment.

  5. Compositional relaxed concurrency.

    Science.gov (United States)

    Batty, Mark

    2017-10-13

    There is a broad design space for concurrent computer processors: they can be optimized for low power, low latency or high throughput. This freedom to tune each processor design to its niche has led to an increasing diversity of machines, from powerful pocketable devices to those responsible for complex and critical tasks, such as car guidance systems. Given this context, academic concurrency research sounds notes of both caution and optimism. Caution because recent work has uncovered flaws in the way we explain the subtle memory behaviour of concurrent systems: specifications have been shown to be incorrect, leading to bugs throughout the many layers of the system. And optimism because our tools and methods for verifying the correctness of concurrent code-although built above an idealized model of concurrency-are becoming more mature. This paper looks at the way we specify the memory behaviour of concurrent systems and suggests a new direction. Currently, there is a siloed approach, with each processor and programming language specified separately in an incomparable way. But this does not match the structure of our programs, which may use multiple processors and languages together. Instead we propose a compositional approach, where program components carry with them a description of the sort of concurrency they rely on, and there is a mechanism for composing these. This will support not only components written for the multiple varied processors found in a modern system but also those that use idealized models of concurrency, providing a sound footing for mature verification techniques.This article is part of the themed issue 'Verified trustworthy software systems'. © 2017 The Author(s).

  6. Tazarotene: Randomized, Double-Blind, Vehicle-Controlled and Open-Label Concurrent Trials for Basal Cell Carcinoma Prevention and Therapy in Patients with Basal Cell Nevus Syndrome

    OpenAIRE

    Tang, Jean Y.; Chiou, Albert S.; Mackay-Wiggan, Julian M.; Aszterbaum, Michelle; Chanana, Anita M.; Lee, Wayne; Lindgren, Joselyn A.; Raphael, Maria Acosta; Thompson, Bobbye J.; Bickers, David R.; Epstein, Ervin H.

    2014-01-01

    Sporadic human basal cell carcinomas (BCCs) are generally well managed with current surgical modalities. However in the subset of high-risk patients predisposed to developing large numbers of BCCs, there is an unmet need for effective, low morbidity chemoprevention. This population includes fair-skinned patients with extensive sun exposure and those with genodermatoses such as the basal cell nevus (Gorlin) syndrome (BCNS). Tazarotene (Tazorac, Allergan) is a topical retinoid with relative spe...

  7. Chronic Adolescent Δ9-Tetrahydrocannabinol Treatment of Male Mice Leads to Long-Term Cognitive and Behavioral Dysfunction, Which Are Prevented by Concurrent Cannabidiol Treatment.

    Science.gov (United States)

    Murphy, Michelle; Mills, Sierra; Winstone, Joanna; Leishman, Emma; Wager-Miller, Jim; Bradshaw, Heather; Mackie, Ken

    2017-01-01

    Introduction: The high prevalence of adolescent cannabis use, the association between this use and later psychiatric disease, and increased access to high-potency cannabis highlight the need for a better understanding of the long-term effects of adolescent cannabis use on cognitive and behavioral outcomes. Furthermore, increasing Δ 9 -tetrahydrocannabinol (THC) in high-potency cannabis is accompanied by a decrease in cannabidiol (CBD), thus an understanding of the interactions between CBD and THC in the neurodevelopmental effects of THC is also important. The current study examined the immediate and long-term behavioral consequences of THC, CBD, and their combination in a mouse model of adolescent cannabis use. Materials and Methods: Male CD1 mice received daily injections of THC (3 mg/kg), CBD (3 mg/kg), CBD+THC (3 mg/kg each), vehicle, or remained undisturbed in their home cage (no handling/injections), either during adolescence (postnatal day [PND] 28-48) or during early adulthood (PND 69-89). Animals were then evaluated with a battery of behavioral tests 1 day after drug treatment, and again after 42 drug-free days. The tests included the following: open field (day 1), novel object recognition (NOR; day 2), marble burying (day 3), elevated plus maze (EPM; day 4), and Nestlet shredding (day 5). Results: Chronic administration of THC during adolescence led to immediate and long-term impairments in object recognition/working memory, as measured by the NOR task. In contrast, adult administration of THC caused immediate, but not long term, impairment of object/working memory. Adolescent chronic exposure to THC increased repetitive and compulsive-like behaviors, as measured by the Nestlet shredding task. Chronic administration of THC, either during adolescence or during adulthood, led to a delayed increase in anxiety as measured by the EPM. All THC-induced behavioral abnormalities were prevented by the coadministration of CBD+THC, whereas CBD alone did not

  8. A global consensus on the prevention and management of ...

    African Journals Online (AJOL)

    pertain only to the prevention and treatment of nutritional rickets and do not attempt to address other possible clinical effects of a poor vitamin D status. It is not possible in this editorial to highlight all the recommendations made by the group, but there are a number of recommendations that are central to the global prevention ...

  9. Tazarotene: randomized, double-blind, vehicle-controlled, and open-label concurrent trials for basal cell carcinoma prevention and therapy in patients with basal cell nevus syndrome.

    Science.gov (United States)

    Tang, Jean Y; Chiou, Albert S; Mackay-Wiggan, Julian M; Aszterbaum, Michelle; Chanana, Anita M; Lee, Wayne; Lindgren, Joselyn A; Raphael, Maria Acosta; Thompson, Bobbye J; Bickers, David R; Epstein, Ervin H

    2014-03-01

    Sporadic human basal cell carcinomas (BCC) are generally well managed with current surgical modalities. However, in the subset of high-risk patients predisposed to developing large numbers of BCCs, there is an unmet need for effective, low-morbidity chemoprevention. This population includes fair-skinned patients with extensive sun exposure and those with genodermatoses such as the basal cell nevus (Gorlin) syndrome (BCNS). Tazarotene (Tazorac, Allergan) is a topical retinoid with relative specificity for RAR-β and RAR-γ receptors. We previously demonstrated tazarotene's robust anti-BCC efficacy in Ptch1(+/-) mice, a murine equivalent of BCNS, and others have found it to have some efficacy against sporadic human BCCs. We report here results of a randomized, double-blind, vehicle-controlled study in patients with BCNS evaluating the efficacy of topically applied tazarotene for BCC chemoprevention (N = 34 subjects), along with an open-label trial evaluating tazarotene's efficacy for chemotherapy of BCC lesions (N = 36 subjects) for a maximum follow-up period of 3 years. We found that only 6% of patients had a chemopreventive response and that only 6% of treated BCC target lesions were clinically cured. Our studies provide no evidence for either chemopreventive or chemotherapeutic effect of tazarotene against BCCs in patients with BCNS.

  10. Prevention and management of stroke in sickle cell disease

    Directory of Open Access Journals (Sweden)

    Y. Kilinç

    2011-12-01

    Full Text Available Sickle Cell Disease(SCD is one of the most common hemoglobinopathies in the world which causes stroke. The management of stroke depends on the manifestations and the age of the patient. Especially in childhood, anatomic and physiological abnormalities of CNS may be a predisposing factors. Stroke mostly affects the distal segments of the Internal Carotid Artery, but also middle and anterior segments of the cerebral arteries are involved. The most important predisposing factors are the arterial malformations, stenosis and obstructions in cranial arteries, generally involving Internal Carotid Artery, frequently Proximal Middle Cerebral or Anterior Cerebral Arteries. After infarcts at brain vessels, most frequent clinical findings are hemiparesis or hemiplegia, impaired speech, focal seizures, gait disturbances. Risk factors for predisposing stroke are prior transient ischemia, baseline Hb decrease, acute chest sydrome within previous two weeks, systolic blood pressure rises, leucocyte increases. The patient with silent stroke or transient ischemic attacks may be asymptomatic or without neurological symptoms. Neuroimaging abnormalities may be seen without significant clinical findings in children with SCD. We talk about silent stroke if there are neuroradiological abnormalities without clinical findings. Children with silent strokes are more prone to new strokes. If there is a significant stroke a ischemic stroke often present with focal neurological signs and symptoms. If patient is asymptomatic or have suspected stroke, first step may be performance of Transcranial Doppler Ultrasonography (TCD. Children with time-averaged mean velocity (TAMV, measured in Middle Carotid Artery or in distal internal carotid Artery abnormally elevated, defined as TAMV≥200cm/sec, have sixfold increase for stroke than those with normal TAMV≤170cm/sec. For these patients under the risk of stroke, chronic blood transfusion is recommended for prevention of primary

  11. Prevention and management of pressure ulcers: support surfaces.

    Science.gov (United States)

    Moore, Zena; Stephen Haynes, Jackie; Callaghan, Rosie

    Pressure ulcers are a common and debilitating problem in health care, impacting negatively on health-related quality of life and compounding challenges in achieving patient safety targets. Pressure ulcer prevention is a multidisciplinary team effort, involving a myriad of interventions, such as nutrition, skin care and repositioning. This article discusses the factors influencing pressure ulcer development, and then elaborates on the principles of prevention. This is followed by a focused discussion on the use of redistribution devices and the importance of the cover of such equipment in contributing to achieving good standards in prevention.

  12. Algebraic topology and concurrency

    DEFF Research Database (Denmark)

    Fajstrup, Lisbeth; Raussen, Martin; Goubault, Eric

    2006-01-01

    We show in this article that some concepts from homotopy theory, in algebraic topology,are relevant for studying concurrent programs. We exhibit a natural semantics of semaphore programs, based on partially ordered topological spaces, which are studied up to “elastic deformation” or homotopy...... differences between ordinary and directed homotopy through examples. We also relate the topological view to a combinatorial view of concurrent programs closer to transition systems, through the notion of a cubical set. Finally we apply some of these concepts to the proof of the safeness of a two...

  13. Concurrent chemoradiation for vaginal cancer.

    Directory of Open Access Journals (Sweden)

    David T Miyamoto

    Full Text Available BACKGROUND: It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT or concurrent chemoradiation therapy (CRT. METHODS: Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS and disease-free survival (DFS rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. RESULTS: The median age at diagnosis was 61 years (range, 18-92 years and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS = 56% vs. 79%, log-rank p = 0.037; 3-yr DFS = 43% vs. 73%, log-rank p = 0.011. Twenty-three patients (45% in the RT group had a relapse at any site compared to 3 (15% in the CRT group (p = 0.027. With regard to the sites of first relapse, 10 patients (14% had local only, 4 (6% had local and regional, 9 (13% had regional only, 1 (1% had regional and distant, and 2 (3% had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10-0.97; p = 0.04. CONCLUSIONS: Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients.

  14. Innovations in Wound Infection Prevention and Management and Antimicrobial Countermeasures

    Science.gov (United States)

    2011-01-24

    guidelines – Rapid evacuation to surgical care (irrigation/debridement) – Limit antibiotic spectrum/duration around wound management – Emphasize basic...clinical wound management decisions.  Expected Outcomes: – Discovery & characterization of host immune response biomarkers associated with...infection to inform clinical wound - management decisions (e.g., optimal wound closure time) – Development of tools for: • early detection of multidrug

  15. Correctness of concurrent processes

    NARCIS (Netherlands)

    E.R. Olderog (Ernst-Rüdiger)

    1989-01-01

    textabstractA new notion of correctness for concurrent processes is introduced and investigated. It is a relationship P sat S between process terms P built up from operators of CCS [Mi 80], CSP [Ho 85] and COSY [LTS 79] and logical formulas S specifying sets of finite communication sequences as in

  16. Composing Concurrent Objects

    NARCIS (Netherlands)

    Bergmans, Lodewijk

    1994-01-01

    Adopting the object-oriented paradigm for the development of large and complex software systems offers several advantages, of which increased extensibility and reusability are the most prominent ones. The object-oriented model is also quite suitable for modelling concurrent systems. However, it

  17. Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

    Science.gov (United States)

    Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard

    2015-11-01

    The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  18. Primary prevention and management of variceal bleeding: Review ...

    African Journals Online (AJOL)

    Background: Prevention and control of active bleeding caused by portal hypertension is still a challenge. Surgery used to be the only option in the earlier days, but now many options exist. Choice of the correct mode of treatment is important and is determined by many factors dictated by the condition of each patient and the

  19. Factors Preventing Women's Advancement in Management in Turkey

    Science.gov (United States)

    Sanal, Mustafa

    2008-01-01

    This article examines the reasons why there is relatively very small number of woman administrators in public and private sector in Turkey. We have tried to reveal the factors preventing women's advancement up the organizational ladder. Although there are no legal obstacles against woman administrators in Turkey, such factors as gender…

  20. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Technology LISTSERV Email Groups National Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School ...

  1. Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

    Science.gov (United States)

    Amputation and diabetes: How to protect your feet Good diabetes management and regular foot care help prevent severe foot sores that ... and may require amputation. By Mayo Clinic Staff Diabetes complications can include nerve damage and poor blood ...

  2. Streptococcal Disease Prevention and Management of Preterm Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    Nina E. Glass

    2005-01-01

    Full Text Available Objective: To identify opportunities to reduce overuse of antibiotics for prevention of perinatal group B streptococcal (GBS disease and management of preterm premature rupture of membranes (pPROM.

  3. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... National Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School Health Sustainability Visualizing Data Contacts Career Opportunities ...

  4. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School Health Sustainability Visualizing Data Contacts Career Opportunities Ambassador ...

  5. Update on Diagnosis, Management, and Prevention of Hepatitis B Virus Infection

    Science.gov (United States)

    1999-04-01

    1971. Viral hepatits type B MS-2 strain): studies on active immunization. JAMA 217:41-45. Lau, J. Y. N., and T. L. Wright. 1993. Molecular virology...PUBLICATION REPORT 1906 06/99 UPDATE ON DIAGNOSIS, MANAGEMENT, AND PREVENTION OF HEPATITIS B VIRUS INFECTION By Francis J. Mahoney U.S. NAVAL...MICROBIOLOGY REVIEWS, Apr. 1999, p. 351-366 0893-8512/99/$04.00+0 Vol. 12, No. 2 Update on Diagnosis, Management, and Prevention of Hepatitis B

  6. Pediatric Dental Care: Prevention and Management Protocols Based on Caries Risk Assessment

    OpenAIRE

    RAMOS-GOMEZ, FRANCISCO J.; CRYSTAL, YASMI O.; NG, MAN WAI; CRALL, JAMES J.; FEATHERSTONE, JOHN D.B.

    2010-01-01

    Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model.1–3 This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment, CAMBRA, in an effort to stimulate greater adoption of infan...

  7. 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

  8. Incorporating economic valuation into fire prevention planning and management in Southern European countries

    Directory of Open Access Journals (Sweden)

    Elsa Varela

    2015-08-01

    Full Text Available Aim of study: This article describes and analyzes the links between the fire-based scientific knowledge, the social perception of fire prevention and forest fires and the economic valuation requirements to assess social preferences for fire prevention measures. Area of study: Southern European countries. Material and Methods: For that purpose, we develop a critical revision of the existing literature on economic valuation of social preferences for fire risk reduction and fire prevention in terms of its links with fire science and social perceptions and the applicability of these results in fire management policies. Research highlights: The assessment of social preferences for fire related issues is challenging due to the difficulty of setting sound valuation scenarios that can simultaneously be relevant for the respondents and derive conclusions useful for fire management. Most of the revised studies set up valuation scenarios focused on the final management outcome e.g. number of burnt hectares, what is easier for the respondents to evaluate but weakens the scientific relationship with fire management, making difficult reaching conclusions for sound management advice. A more recent set of valuation studies has been developed where risk perception of homeowners is further assessed as a key variable determining their preferences in valuation scenarios. These studies are relevant for mangers setting fire prevention programs in wildland urban interface areas as understanding the factors that may promote or hinder the enrolment of these homeowners in fire prevention activities may have direct implication in addressing communication programs to promote fire prevention management.

  9. Concurrent credit portfolio losses.

    Science.gov (United States)

    Sicking, Joachim; Guhr, Thomas; Schäfer, Rudi

    2018-01-01

    We consider the problem of concurrent portfolio losses in two non-overlapping credit portfolios. In order to explore the full statistical dependence structure of such portfolio losses, we estimate their empirical pairwise copulas. Instead of a Gaussian dependence, we typically find a strong asymmetry in the copulas. Concurrent large portfolio losses are much more likely than small ones. Studying the dependences of these losses as a function of portfolio size, we moreover reveal that not only large portfolios of thousands of contracts, but also medium-sized and small ones with only a few dozens of contracts exhibit notable portfolio loss correlations. Anticipated idiosyncratic effects turn out to be negligible. These are troublesome insights not only for investors in structured fixed-income products, but particularly for the stability of the financial sector. JEL codes: C32, F34, G21, G32, H81.

  10. Alzheimer's disease and vascular dementia: one potentially preventable and modifiable disease? Part II: Management, prevention and future perspective.

    Science.gov (United States)

    Davey, Dennis A

    2014-01-01

    The management of dementia and mild cognitive impairment (MCI) includes pharmacological, nonpharmacological and caregiver interventions. Acetyl-cholinesterase inhibitors and memantine have a small beneficial effect in mild-to-moderate dementia. Attention is increasingly focused on long-term measures that may prevent, delay or minimize MCI and dementia, including Mediterranean diet, exercise, early active treatment of hypercholesterolaemia hypertension, and diabetes starting in midlife and earlier. High cognitive activity and a high cognitive reserve may prevent or delay the onset of aging-related MCI and dementia. Although the numbers of the elderly with dementia are rapidly increasing worldwide, the incidence of dementia in some countries is decreasing attributable to higher educational levels, decreased vascular risk factors and healthier lifestyles. Prevention of dementia is feasible and reasonable.

  11. How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey

    Science.gov (United States)

    Chicoulaa, Bruno; Haas, Hervé; Viala, Jérôme; Salvetat, Maryline; Olives, Jean-Pierre

    2017-01-01

    Background Recurrent respiratory tract infections (RRTIs) are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs) opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84%) prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse. They have a prevention-oriented approach, implement preventive measures when possible and prescribe products for prevention. PMID:28293116

  12. Prevention and management of lung cancer in China.

    Science.gov (United States)

    Hong, Qun-Ying; Wu, Guo-Ming; Qian, Gui-Sheng; Hu, Cheng-Ping; Zhou, Jian-Ying; Chen, Liang-An; Li, Wei-Min; Li, Shi-Yue; Wang, Kai; Wang, Qi; Zhang, Xiao-Ju; Li, Jing; Gong, Xin; Bai, Chun-Xue

    2015-09-01

    Lung cancer is the leading cause of cancer-related death worldwide. In China, the incidence of lung cancer has grown rapidly, resulting in a large social and economic burden. Several researchers have devoted their studies to lung cancer and have demonstrated that there are many risk factors for lung cancer in China, including tobacco use, environmental pollution, food, genetics, and chronic obstructive pulmonary disease. However, the lung cancer incidence is still growing rapidly in China, and there is an even higher incidence among the younger generation. One explanation may be the triple-neglect situation, in which medical policies that neglect prevention, diagnosis, and supportive care have increased patients' mortality and reduced their quality of life. Therefore, it is necessary to enhance the efficiency of prevention and early diagnosis not only by focusing more attention on treatment but also by drawing more attention to supportive care for patients with lung cancer. © 2015 American Cancer Society.

  13. Dementia prevention: shared questions for research and clinical management.

    Science.gov (United States)

    Robertson, Maggie; Brown, Eleanor; Whalley, Lawrence

    2014-02-01

    The emergence of advanced genetic technologies raises many challenges for dementia care and the conduct of related social, behavioural and clinical research. Genetic tests are already used to identify possible participants in dementia prevention trials. These tests are unlike any other in clinical medicine as they have the capacity to predict disease onset after intervals of many years with implications for other family members. Genetic counselling professionals support services in paediatrics, cancer diagnosis and some adult-onset diseases. Their capacity cannot meet the needs for pre- and post-test support of the many "at-risk" families living with late onset dementia. Most dementias are common, complex conditions in which multiple genetic and environmental factors play important and potentially modifiable roles. Large scale prevention studies are needed to test the effectiveness of interventions. Some economy of effort will be achieved by the preferential inclusion of "at-risk" families. Many such families are in contact with dementia care services and will be motivated to participate in prevention studies. However, practice standards and consensus-based guidelines do not yet exist. Support services are not available on a scale sufficient to prevent harm when risk is poorly communicated causing unnecessary psychological morbidity in unaffected family members. There is a pressing need for research to inform the development of study guidelines and to identify how services are strengthened to support these families during and after their participation in trials. Discourse analysis provides a useful method to collect and analyse data of this type and supports the conclusions of this review. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Stress prevention and management: a challenge for patients and physicians.

    Science.gov (United States)

    Duhault, Jacques L

    2002-06-01

    Chronic stress is now the commonest contributor to ill health in modern societies. The cost of stress in terms of absenteeism, lost productivity, and health care expense is rapidly increasing. As the problem continues to worsen, there will be an increasing need for interactive systems designed to help people cope with stress. Effective prevention of stress's adverse effects will require the widest possible deployment and implementation of stress reduction strategies. Copyright 2002, Elsevier Science (USA). All rights reserved.

  15. Information management in Malawi's prevention of Mother-to-Child ...

    African Journals Online (AJOL)

    In addition, some believed lack of feedback, information sharing, and poor attitude toward information management tasks were challenges. Conclusion: Based on the study findings, there is need to find ways of motivating data quality improvement practises in the health facilities, as health workers view this as a tangential, ...

  16. Loss Prevention through Safety Belt Use: A Handbook for Managers.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This handbook is designed to help managers address safety belt usage issues through a cost-effective and direct approach--establishing an employee safety belt program. The handbook offers a hands-on guide for conducting the program and provides for implementation at all levels. The handbook contains cost information, a program overview, policy and…

  17. Obesity Prevention and Management Strategies in Canada: Shifting Paradigms and Putting People First.

    Science.gov (United States)

    Sharma, Arya M; Ramos Salas, Ximena

    2018-04-17

    The purpose of this study was to review public and private sector obesity policies in Canada and to make recommendations for future evidence-based obesity prevention and management strategies. Synthesis of obesity prevention and management policies and research studies are presented in three primary themes: (1) Increased awareness about the impact of weight bias and obesity stigma in Canada; (2) Inadequate government obesity prevention and management policies and strategies; and (3) Lack of comprehensive private sector obesity prevention and management policies. Findings suggest that in Canada, obesity continues to be treated as a self-inflicted risk factor, which affects the type of interventions and approaches that are implemented by governments or covered by private health plans. The lack of recognition of obesity as a chronic disease by Canadian public and private payers, health systems, employers, and the public, has a trickle-down effect on access to evidence-based prevention and treatment. Although there is increasing recognition and awareness about the impact of weight bias and obesity stigma on the health and social well-being of Canadians, interventions are urgently needed in education, healthcare, and public policy sectors. We conclude by making recommendations for the advancement of evidence-based obesity prevention and management policies that can improve the lives of Canadians affected by obesity.

  18. [Role and integration of technical prevention figures in the management system].

    Science.gov (United States)

    Bartolucci, G B; Santantonio, P; Casciani, M; Dagazzini, I

    2010-01-01

    The multifarious issues of health and safety at work require multi-disciplinary skills, both in the risk assessment and in the subsequent definition and management of preventive measures, and this requires a renewed operational protocol that supports integration and co-operation between the technical prevention figures. Thus, between occupational physicians and technical advisers there should be a concrete and fruitful interaction, which should not be episodic or occasional, but a modus operandi systematic and constant. In this contribution is discussed as the technical prevention figures should be included in the Health and Safety Management System and should make a specific contribution in defining corporate policies on prevention. In particular it is outlined the role that the occupational physician may play in the development of prevention and health promotion activities within the strategies of corporate social responsibility.

  19. Prevention and management of work-related cardiovascular disorders

    Directory of Open Access Journals (Sweden)

    Akizumi Tsutsumi

    2015-02-01

    Full Text Available Cardiovascular disorders (CVDs constitute a major burden for health of working populations throughout the world with as much as 50% of all causes of death and at least 25% of work disability. There are some changes in CVD risk factors among occupational classes. This is mainly due to the new types of work-related causes of morbidity associated with the recent developments in global work life, particularly in the industrialized countries. Meanwhile, in the developing countries or those in transition (e.g., in Eastern Europe, CVD mortality is increasing due to major socioeconomic changes, the demographic transition and rapid industrialisation and urbanisation, all leading to growing challenges to cardiovascular health. Better control of known risk factors (i.e., smoking, obesity, physical inactivity, high cholesterol, high blood pressure, and high blood glucose is effective to prevent CVD incidence. But the expected improvement has not been achieved. The obstacles of achieving such impact are due to lack of awareness, lack of policies and their implementation into practice and shortage of infrastructures and human resources. These are needed for wide-scale and long-term programme implementation. Considering the WHO Global Strategy on Occupational Health for All, the WHO Global Action Plan on Workers’ Health, the WHO Programme on Prevention of Non-communicable Diseases and the ILO Decent Work agenda, the 6th ICOH International Conference on Work Environment and Cardiovascular Diseases adopted the Tokyo Declaration.

  20. Cholera in travelers: shifting tides in epidemiology, management, and prevention.

    Science.gov (United States)

    Fillion, Katie; Mileno, Maria D

    2015-01-01

    The distribution of cholera's devastating effects has changed. While cholera is endemic in 50 countries mostly in Asia and Africa, more than half of the cases reported in 2012 were in the Western Hemisphere, predominantly Haiti. Since the current epidemic began in Haiti in 2010, there has been spread to the Dominican Republic, Cuba, and most recently Mexico. Several recent case reports document individuals returning home from affected areas with diarrhea from cholera, in some cases severe. Hopeful news reported the containment of an outbreak through the use of a Vibrio cholera vaccine. There are safe and effective oral cholera vaccines available and recommended in outbreaks and endemic areas, although they are not currently available in the USA or to travelers. This review aims to discuss the latest data to aid our current recommendations for the prevention of cholera in travelers beyond standard personal and food hygiene precautions for the prevention of travelers' diarrhea and to offer insights on the most current data available about cholera vaccine progress and potential use.

  1. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  2. [Prevention and management of intestinal obstruction after gastrointestinal surgery].

    Science.gov (United States)

    Zhu, Weiming

    2016-04-01

    Intestinal obstruction is the most common complication after gastrointestinal surgery, and will endanger the patients if not managed properly. The key to the management of intestinal obstruction includes not only the selection of treatment, but also adequate judgment of the cause, location, extent and the probability of reoperation by detailed inquiry of the history, thorough physical examination, and imaging studies, which will guide the treatment. Non-operative therapy is the mainstay of treatment for incomplete obstruction, whilebowel decompression the gut by small intestinal decompression tube, preoperative procedures including restoration of systemic homeostasis should be performed. Efforts should be made to avoid emergency laparotomy without any preparations. Procedures to avoid intestinal obstruction include all the efforts to protect the gut and the intra-abdominal viscera during laparotomy, and to clear all the foreign body and tissues by thorough lavage of the abdominal cavity with saline before closing the abdomen.

  3. Boardroom strategies for managing risks and preventing frauds

    OpenAIRE

    Coulson-Thomas, Colin

    2017-01-01

    Directors are expected to be entrepreneurial while at the same time exercising prudent control. Enterprise and control are two sides of the directorial coin. Considers whether risk management professionals should do more in support of creativity, innovation, enterprise and entrepreneurship before turning to some cyber security and fraud control issues and dilemmas relating to data security breaches, the internet of things, protecting customer communications, and data sharing with collaborator...

  4. Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies.

    Science.gov (United States)

    Caroly, S; Coutarel, F; Landry, A; Mary-Cheray, I

    2010-07-01

    To increase output and meet customers' needs, companies have turned to the development of production management systems: Kaizen, one piece flow, Kanban, etc. The aim of such systems is to accelerate decisions, react to environmental issues and manage various productions. In the main, this type of management system has led to the continuous improvement of production performance. Consequently, such production management systems can have unexpected negative effects on operators' health and safety. Conversely, regulation and control systems focusing on work-related risks have obliged firms to implement health and safety management systems such as OHSAS 18001. The purpose of this type of system, also based on continuous improvement, is to reduce risks, facilitate work-related activities and identify solutions in terms of equipment and tools. However, the prevention actions introduced through health and safety systems often result in other unexpected and unwanted effects on production. This paper shows how companies can improve the way they are run by taking into account both types of management system. Copyright 2010 Elsevier Ltd. All rights reserved.

  5. Management of postmenopausal osteoporosis and the prevention of fractures.

    Science.gov (United States)

    Gambacciani, M; Levancini, M

    2014-06-01

    Postmenopausal osteoporosis affects millions of women, being estrogen deficiency the key factor in the pathogenesis of involutional osteoporosis. Fracture prevention is one of the public health priorities worldwide. Different treatments for osteoporosis are available. The various options are aimed to maintain bone health and decrease the risk of fractures. The majority of these drugs are antiresorptive agents, i.e., drugs that lower bone turnover, inhibiting osteoclastic bone resorption. Dietary sources of calcium intake and vitamin D are ideal, while pharmachological supplements should be used if diet alone cannot provide the recommended daily intake. Bisphosphonates are first-line therapy for patients with established osteoporosis at high risk of fracture. Some serious, but rare, adverse events have been associated with their long-term administration. The monoclonal antibody to RANKL, named denosumab, administered as a 60-mg subcutaneous injection every 6 months, is a valuable option for the treatment of postmenopausal osteoporosis in women at increased or high risk of fractures, who are unable to take other osteoporosis treatments. Teriparatide (PTH 1-34) is the only available osteoanabolic drugs for osteoporosis treatment at present. Its use is limited to severe osteoporosis because of the high cost of the treatment. In climacteric women, in different stages of menopausal transition, and beyond, hormone replacement therapy at different doses (HRT) rapidly normalizes turnover, preventing and/or treating osteoporosis. HRT is able to preserve and even increase BMD at all skeletal sites, leading to a significant reduction in vertebral and non-vertebral fractures. Selective estrogen modulators (SERMs) as raloxifene and bazedoxifene reduce bone turnover and maintains or increases vertebral and femoral BMDs in comparison to placebo and reduces the risk of vertebral and new vertebral fractures, in high risk women. The combination of a SERM with an estrogen has been

  6. Prevention and management of work-related cardiovascular disorders.

    Science.gov (United States)

    Tsutsumi, Akizumi

    2015-01-01

    Cardiovascular disorders (CVDs) constitute a major burden for health of working populations throughout the world with as much as 50% of all causes of death and at least 25% of work disability. There are some changes in CVD risk factors among occupational classes. This is mainly due to the new types of work-related causes of morbidity associated with the recent developments in global work life, particularly in the industrialized countries. Meanwhile, in the developing countries or those in transition (e.g., in Eastern Europe), CVD mortality is increasing due to major socioeconomic changes, the demographic transition and rapid industrialisation and urbanisation, all leading to growing challenges to cardiovascular health. Better control of known risk factors (i.e., smoking, obesity, physical inactivity, high cholesterol, high blood pressure, and high blood glucose) is effective to prevent CVD incidence. But the expected improvement has not been achieved. The obstacles of achieving such impact are due to lack of awareness, lack of policies and their implementation into practice and shortage of infrastructures and human resources. These are needed for wide-scale and long-term programme implementation. Considering the WHO Global Strategy on Occupational Health for All, the WHO Global Action Plan on Workers' Health, the WHO Programme on Prevention of Non-communicable Diseases and the ILO Decent Work agenda, the 6th ICOH International Conference on Work Environment and Cardiovascular Diseases adopted the Tokyo Declaration. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. Morse Theory and Concurrency

    DEFF Research Database (Denmark)

    Wisniewski, Rafal

    2003-01-01

    The work is intended to provide some insight about concurrency theory using ideas from geometry and algebraic topology. We define a topological space containing all traces of execution of the computer program and the information about how time flows. This is the main difference with standard...... topological reasoning in which there is no information about relation "in time" among points. The main task is to define equivalence of paths reflecting execution of a program. We use the notion of homotopy history equivalence relation. The model space considered in this work is a differentiable manifold...

  8. A Concurrent Logical Relation

    DEFF Research Database (Denmark)

    Birkedal, Lars; Sieczkowski, Filip; Thamsborg, Jacob Junker

    2012-01-01

    We present a logical relation for showing the correctness of program transformations based on a new type-and-effect system for a concurrent extension of an ML-like language with higher-order functions, higher-order store and dynamic memory allocation. We show how to use our model to verify a number...... of interesting program transformations that rely on effect annotations. In particular, we prove a Parallelization Theorem, which expresses when it is sound to run two expressions in parallel instead of sequentially. The conditions are expressed solely in terms of the types and effects of the expressions...

  9. Mastering concurrency in Go

    CERN Document Server

    Kozyra, Nathan

    2014-01-01

    A practical approach covering everything you need to know to get up and running with Go, starting with the basics and imparting increasingly more detail as the examples and topics become more complicated. The book utilizes a casual, conversational style, rife with actual code and historical anecdotes for perspective, as well as usable and extensible example applications. This book is intended for systems developers and programmers with some experience in either Go and/or concurrent programming who wish to become fluent in building high-performance applications that scale by leveraging single-c

  10. Prevention and management of postoperative urinary retention after urogynecologic surgery

    Directory of Open Access Journals (Sweden)

    Geller EJ

    2014-08-01

    Full Text Available Elizabeth J Geller Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Abstract: Postoperative urinary retention (POUR is a frequent consequence of gynecologic surgery, especially with surgical correction of urinary incontinence and pelvic organ prolapse. Estimates of retention rates after pelvic surgery range from 2.5%–43%. While there is no standard definition for POUR, it is characterized by impaired bladder emptying, with an elevation in the volume of retained urine. The key to management of POUR is early identification. All patients undergoing pelvic surgery, especially for the correction of incontinence or prolapse, should have an assessment of voiding function prior to discharge. There are several ways to assess voiding function – the gold standard is by measuring a postvoid residual. Management of POUR is fairly straightforward. The goal is to decompress the bladder to avoid long-term damage to bladder integrity and function. The decision regarding when to discontinue catheter-assisted bladder drainage in the postoperative period can be assessed in an ongoing fashion by measurement of postvoid residual. The rate of prolonged POUR beyond 4 weeks is low, and therefore most retention can be expected to resolve spontaneously within 4–6 weeks. When POUR does not resolve spontaneously, more active management may be required. Techniques include urethral dilation, sling stretching, sling incision, partial sling resection, and urethrolysis. While some risk of POUR is inevitable, there are risk factors that are modifiable. Patients that are at higher risk – either due to the procedures being performed or their clinical risk factors – should be counseled regarding the risks and management options for POUR prior to their surgery. Although POUR is a serious condition that can have serious consequences if left untreated, it

  11. Managing workplace stress in community pharmacy organisations:Lessons from a review of the wider stress management and prevention literature

    OpenAIRE

    Jacobs, Sally; Johnson, Sheena; Hassell, Karen

    2017-01-01

    Background Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists’ expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings.Aim To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from...

  12. The Zika virus and pregnancy: evidence, management, and prevention.

    Science.gov (United States)

    Citil Dogan, Ayse; Wayne, Sandra; Bauer, Samuel; Ogunyemi, Dotun; Kulkharni, Santosh K; Maulik, Devika; Carpenter, Christopher F; Bahado-Singh, Ray O

    2017-02-01

    To comprehensively review the available evidence and existing consensus reports and guidelines regarding the pregnancy and reproductive implications of the mosquito-transmitted Zika virus (ZIKV) infection. A primary focus was to provide pertinent information to aid clinicians in the management of pregnancies at risk for, exposed to, or with confirmed ZIKV infection. An extensive literature review was performed using Pubmed. Practice guidelines and consensus reports were accessed from international, national, and professional organizations' websites. The clinical articles for ZIKV infection testing varied from case reports to small epidemiologic studies. A ZIKV epidemic has been declared in several countries in the Americas. Fifty-two travel-associated ZIKV infection cases have been reported throughout the USA (as of February 10, 2016). The consequences of congenital fetal/newborn ZIKV infection could potentially have devastating consequences including miscarriage, fetal death, and major anomalies such as microcephaly, brain and brain-stem defects, and long-term neurologic sequelae. While not definitive, current evidence suggests the existence of nonvector-borne transmission through sexual activity with an infected male partner. For women at risk for sexual transmission, condom use is advised, especially during pregnancy. While ZIKV infection appears to be a mild disease in the general population the potential consequences to the fetus and newborn could be profound. Management guidelines are currently evolving and will be significantly impacted as new evidence develops. It is therefore imperative that obstetric health-care providers keep abreast of this rapidly evolving information landscape that has so far characterized this outbreak.

  13. How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey

    Directory of Open Access Journals (Sweden)

    Chicoulaa B

    2017-03-01

    Full Text Available Bruno Chicoulaa,1 Hervé Haas,2 Jérôme Viala,3 Maryline Salvetat,4 Jean-Pierre Olives,5 1Faculty of Medicine, Toulouse Rangueil, Toulouse, 2Paediatric Emergency and Infectious Disease Departments, Lenval University Hospital, Nice, 3Gastroenterology Department, Robert-Debré Hospital, Paris, 4Sports and General Medicine Practice, Labruguière, 5Gastroenterology and Nutrition Department, Children’s Hospital, University Hospital, Toulouse, France Background: Recurrent respiratory tract infections (RRTIs are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose: To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods: A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results: A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84% prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions: French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse

  14. Management of Pneumonia in Kidney Transplantation to Prevent Further Outbreak

    Directory of Open Access Journals (Sweden)

    Norihiko Goto

    2015-01-01

    Full Text Available The outbreak of Pneumocystis jirovecii pneumonia (PJP among kidney transplant recipients is emerging worldwide. It is important to control nosocomial PJP infection. A delay in diagnosis and treatment increases the number of reservoir patients and the number of cases of respiratory failure and death. Owing to the large number of kidney transplant recipients compared to other types of organ transplantation, there are greater opportunities for them to share the same time and space. Although the use of trimethoprim-sulfamethoxazole (TMP-SMX as first choice in PJP prophylaxis is valuable for PJP that develops from infections by trophic forms, it cannot prevent or clear colonization, in which cysts are dominant. Colonization of P. jirovecii is cleared by macrophages. While recent immunosuppressive therapies have decreased the rate of rejection, over-suppressed macrophages caused by the higher levels of immunosuppression may decrease the eradication rate of colonization. Once a PJP cluster enters these populations, which are gathered in one place and uniformly undergoing immunosuppressive therapy for kidney transplantation, an outbreak can occur easily. Quick actions for PJP patients, other recipients, and medical staff of transplant centers are required. In future, lifelong prophylaxis may be required even in kidney transplant recipients.

  15. “Hepatitis” – Prevention and management in dental practice

    Science.gov (United States)

    Dahiya, Parveen; Kamal, Reet; Sharma, Varun; Kaur, Saravpreet

    2015-01-01

    Today, viral hepatitis has become a silent epidemic worldwide. It is the major cause of liver cirrhosis and liver carcinoma. In a dental office, infections can be expedited through several routes, including direct or indirect contact with blood, oral fluids, droplet splatter, aerosols, etc. The aim of the present review is to increase the awareness among dental practitioners, so as to reduce the burden of hepatitis in their community. Electronic databases like PubMed, Medline, ProQuest, etc. were searched using the keywords hepatitis, dentist, liver disease, and infection control. Manual search of various journals and books was also carried out. Only highly relevant articles from English literature were considered for the present review. The results revealed that the dentists were among the high-risk groups for hepatitis, and they have little information on the factors associated with adherence to hepatitis B vaccination. A dentist can play a major role in the prevention of hepatitis by considering each and every patient as a potential carrier of hepatitis. Proper infection control, sterilization, and prophylactic vaccination protocols should be followed in order to reduce the risk of hepatitis. PMID:26097847

  16. Life-cycle modelling of waste management in Europe: tools, climate change and waste prevention

    DEFF Research Database (Denmark)

    Gentil, Emmanuel

    operated by each member state (structural indicators). Managing waste appropriately generates environmental benefits, leading to the comforting, and potentially misleading impression that waste generation is acceptable, as long as environmental value is gained from the recovery of materials and energy...... and benefits of waste management systems (not necessarily proportionally). Furthermore, significant environmental savings are observed from the avoided production of goods (upstream from waste management) due to waste prevention. More specifically, the study showed that the prevention of meat waste generates......Europe has a long history of waste management, where regulation, implementation and enforcement have been the main drivers for the development and diversification of waste management technologies since the late 70s. Despite strong engineering development to minimise impacts to human health...

  17. Conservative fluid management prevents age-associated ventilator induced mortality.

    Science.gov (United States)

    Herbert, Joseph A; Valentine, Michael S; Saravanan, Nivi; Schneck, Matthew B; Pidaparti, Ramana; Fowler, Alpha A; Reynolds, Angela M; Heise, Rebecca L

    2016-08-01

    Approximately 800 thousand patients require mechanical ventilation in the United States annually with an in-hospital mortality rate of over 30%. The majority of patients requiring mechanical ventilation are over the age of 65 and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) and in-hospital mortality rates. However, the mechanisms which predispose aging ventilator patients to increased mortality rates are not fully understood. Ventilation with conservative fluid management decreases mortality rates in acute respiratory distress patients, but to date there has been no investigation of the effect of conservative fluid management on VILI and ventilator associated mortality rates. We hypothesized that age-associated increases in susceptibility and incidence of pulmonary edema strongly promote age-related increases in ventilator associated mortality. 2month old and 20month old male C57BL6 mice were mechanically ventilated with either high tidal volume (HVT) or low tidal volume (LVT) for up to 4h with either liberal or conservative fluid support. During ventilation, lung compliance, total lung capacity, and hysteresis curves were quantified. Following ventilation, bronchoalveolar lavage fluid was analyzed for total protein content and inflammatory cell infiltration. Wet to dry ratios were used to directly measure edema in excised lungs. Lung histology was performed to quantify alveolar barrier damage/destruction. Age matched non-ventilated mice were used as controls. At 4h, both advanced age and HVT ventilation significantly increased markers of inflammation and injury, degraded pulmonary mechanics, and decreased survival rates. Conservative fluid support significantly diminished pulmonary edema and improved pulmonary mechanics by 1h in advanced age HVT subjects. In 4h ventilations, conservative fluid support significantly diminished pulmonary edema, improved lung mechanics, and resulted in significantly lower mortality rates in

  18. Current strategies for the prevention and management of central line-associated bloodstream infections

    Directory of Open Access Journals (Sweden)

    Zhuolin Han

    2010-11-01

    Full Text Available Zhuolin Han, Stephen Y Liang, Jonas MarschallDivision of Infectious Diseases, Washington University School of Medicine in St Louis, St Louis, MO, USAAbstract: Central venous catheters are an invaluable tool for diagnostic and therapeutic purposes in today’s medicine, but their use can be complicated by bloodstream infections (BSIs. While evidence-based preventive measures are disseminated by infection control associations, the optimal management of established central line-associated BSIs has been summarized in infectious diseases guidelines. We prepared an overview of the state-of-the-art of prevention and management of central line-associated BSIs and included topics such as the role of antibiotic-coated catheters, the role of catheter removal in the management, and a review of currently used antibiotic compounds and the duration of treatment.Keywords: central venous catheters, bloodstream infections, guidelines, prevention

  19. Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

    Directory of Open Access Journals (Sweden)

    Ahsan Ahsan

    2016-09-01

    Full Text Available Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasi experimental design. The population was all of nursing staff who working in obstetrics installation in hospitals A and B as much as 46 people. Sample was the total population. Data was collected through questionnaire, observation sheets and examination of the wound culture. Data was analyzed using t test B 1.274 dan p=0.028 Result: The result showed that 1 there was difference in knowledge management implementation before and after training; 2 there was difference in nurse’s performance in preventing nosocomial infection before and after training; 3 there is significant relationship between nurse’s performance in preventing nosocomial infection and infection incidence; 4 there is no significant difference of nursing care impementation on nosocomial incidence. Discussion: In conclusion, the development of nursing care based on knowledge management as a synthesis or induction of findings directed at 1 nurses’ knowledge does not affect the performance of the prevention of nosocomial infections; 2 knowledge management has a positive effect on the performance of the prevention of nosocomial infections; 3 implementation of infection prevention is integrated capabilities between knowledge, skills and attitudes of nurses in implementing performance in care. Keywords: model prevention, nosocomial infections, nursing care, knowledge management, sectio Caesarea

  20. Prevention and management of noncommunicable disease: the IOC Consensus Statement, Lausanne 2013.

    Science.gov (United States)

    Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

    2013-11-01

    Morbidity and mortality from preventable, noncommunicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioral change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centers to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design (HCD) in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet, and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad hoc Working Group charged with the responsibility of moving this

  1. Prevention and management of non-communicable disease: the IOC consensus statement, Lausanne 2013.

    Science.gov (United States)

    Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

    2013-11-01

    Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April, 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioural change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centres to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad-hoc Working Group charged with the responsibility of moving this

  2. Implications of pollution prevention experience for environmental management

    International Nuclear Information System (INIS)

    Schramm, W.

    1993-01-01

    Conventional wisdom in the US is that firms face a trade-off between environmental efforts and profit because of the belief that environmental protection invariably involves costs that reduce profits. Firms, therefore, generally perceive environmental protection as an impediment to their goal of profit maximization. Environmental efforts are viewed as an added hurdle in producing a product, rather than an as intrinsic part of well-designed operations. From this perspective, firms have no incentive to engage in environmental protection efforts, and will do so only if they are forced (or are given incentives) by government or if they perceive in advance potential profits from their efforts (e.g., a market for environmental products). The concept of a trade-off between the environment and profit, however, has been challenged recently. A common argument raised for questioning this trade-off is that efforts directed at environmental protection will lead to the development of new technologies and will give US firms a competitive advantage in the emerging environmental industry. It is argued that opportunities available within this growth field outweigh costs of entry and research. Recent publications (World Wildlife Fund, 1992; Resources for the Future, 1993) have proposed that government actions, may encourage the development of the environmental industry and, thus, improve both economic and environmental performance. Suggested governmental actions include using market incentives rather than command and control regulation to achieve environmental goals, integrating environmental values into governmental policy analysis, and supporting investments in environmental technologies. This paper details the economics and benefits of various waste management efforts

  3. Preventative Disease Management and Grower Decision Making: A Case Study of California Wine-Grape Growers.

    Science.gov (United States)

    Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Baumgartner, Kendra

    2017-06-01

    Preventative disease management is challenging to farmers because it requires paying immediate costs in the hopes of returning uncertain future benefits. Understanding farmer decision making about prevention has the potential to reduce disease incidence and minimize the need for more costly postinfection practices. For example, the grapevine trunk-disease complex (esca, Botryosphaeria dieback, Eutypa dieback, and Phomopsis dieback) significantly affects vineyard productivity and longevity. Given the chronic nature of the infections and inability to eradicate the fungal pathogens, the preventative practices of delayed pruning, applications of pruning-wound protectants, and double pruning (also known as prepruning) are the most effective means of management. We surveyed wine-grape growers in six regions of California on their use of these three practices. In spite of acknowledging the yield impacts of trunk diseases, a substantial number of respondents either choose not to use preventative practices or incorrectly adopted them in mature vineyards, too late in the disease cycle to be effective. Growers with more negative perceptions of cost efficacy were less likely to adopt preventative practices or were more likely to time adoption incorrectly in mature vineyards. In general, preventative management may require strong intervention in the form of policy or extension to motivate behavioral change.

  4. Prevention, management, and rehabilitation of stroke in low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Lijing L. Yan

    2016-03-01

    Full Text Available Although stroke incidence in high-income countries (HICs decreased over the past four decades, it increased dramatically in low- and middle-income countries (LMICs. In this review, we describe the current status of primary prevention, treatment, and management of acute stroke and secondary prevention of and rehabilitation after stroke in LMICs. Although surveillance, screening, and accurate diagnosis are important for stroke prevention, LMICs face challenges in these areas due to lack of resources, awareness, and technical capacity. Maintaining a healthy lifestyle, such as no tobacco use, healthful diet, and physical activity are important strategies for both primary and secondary prevention of stroke. Controlling high blood pressure is also critically important in the general population and in the acute stage of hemorrhagic stroke. Additional primary prevention strategies include community-based education programs, polypill, prevention and management of atrial fibrillation, and digital health technology. For treatment of stroke during the acute stage, specific surgical procedures and medications are recommended, and inpatient stroke care units have been proven to provide high quality care. Patients with a chronic condition like stroke may require lifelong pharmaceutical treatment, lifestyle maintenance and self-management skills, and caregiver and family support, in order to achieve optimal health outcomes. Rehabilitation improves physical, speech, and cognitive functioning of disabled stroke patients. It is expected that home- or community-based services and tele-rehabilitation may hold special promise for stroke patients in LMICs.

  5. Managing workplace stress in community pharmacy organisations: lessons from a review of the wider stress management and prevention literature.

    Science.gov (United States)

    Jacobs, Sally; Johnson, Sheena; Hassell, Karen

    2018-02-01

    Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists' expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. © 2017 Royal Pharmaceutical Society.

  6. Pediatric Dental Care: Prevention and Management Protocols Based on Caries Risk Assessment

    Science.gov (United States)

    RAMOS-GOMEZ, FRANCISCO J.; CRYSTAL, YASMI O.; NG, MAN WAI; CRALL, JAMES J.; FEATHERSTONE, JOHN D.B.

    2012-01-01

    Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model.1–3 This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment, CAMBRA, in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. PMID:21162350

  7. RT-ABCDE strategy for management and prevention of human diseases.

    Science.gov (United States)

    Hu, Chun-song

    2008-06-01

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

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

    NARCIS (Netherlands)

    Z. Trogrlic (Zoran); M. van der Jagt (Mathieu); J. Bakker (Jan); M.C. Balas (Michele C.); E.W. Ely (Wesley E.); P.H.J. van der Voort (Peter); E. Ista (Erwin)

    2015-01-01

    textabstractIntroduction: Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize

  9. Concurrent emphysematous cholecystitis and emphysematous pancreatitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hee Seok; Lee, Yong Seok; Yoon, Yup [Dongguk University International Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of); Park, Sung Bin [Ulsan University Hospital, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2008-01-15

    Emphysematous infections of the abdomen and pelvis are potentially life-threatening conditions which require aggressive medical and surgical management. Therefore, early radiographic detection is important in the management of these conditions. Concurrent emphysematous infections involving different organs have been rarely reported, and primarily occur in immunocompromised patients. Here, we report a rare case of concurrent emphysematous cholecystitis and emphysematous pancreatitis in a 97 year old male patient.

  10. Concurrent Models for Object Execution

    OpenAIRE

    Diertens, Bob

    2012-01-01

    In previous work we developed a framework of computational models for the concurrent execution of functions on different levels of abstraction. It shows that the traditional sequential execution of function is just a possible implementation of an abstract computational model that allows for the concurrent execution of functions. We use this framework as base for the development of abstract computational models that allow for the concurrent execution of objects.

  11. Recommendations for policy development regarding sport-related concussion prevention and management in Canada.

    Science.gov (United States)

    Frémont, Pierre; Bradley, Lindsay; Tator, Charles H; Skinner, Jill; Fischer, Lisa K

    2015-01-01

    The Canadian Concussion Collaborative (CCC) is composed of health-related organisations concerned with the recognition, treatment and management of concussion. Its mission is to create synergy between organisations concerned with concussion to improve education and implementation of best practices for the prevention and management of concussions. Each of the organisations that constitute the CCC has endorsed two recommendations that address the need for relevant authorities to develop policies about concussion management in sports. The recommendations were developed to support advocacy for regulations, policies or legislation to improve concussion prevention and management at all levels of sport. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. The important role of physical activity in the prevention and management of gestational diabetes mellitus.

    Science.gov (United States)

    Ruchat, Stephanie-May; Mottola, Michelle F

    2013-07-01

    The actual pathophysiology behind gestational diabetes mellitus (GDM) is still unclear, but a deterioration in insulin resistance beyond that induced by pregnancy, combined with beta cell dysfunction, plays a key role. Interventions that help improve glucose tolerance by attenuating pregnancy-induced insulin resistance or achieve glycaemic control may therefore help in preventing and managing GDM. In non-pregnant populations, physical activity has been associated with an improvement in glucose homeostasis and insulin sensitivity and a risk reduction for type 2 diabetes mellitus (T2DM) and is a cornerstone for T2DM treatment. However, there is still controversy regarding the benefits of physical activity in preventing and managing GDM. The objective of this review is therefore to provide a comprehensive overview of the effect of prenatal physical activity-based interventions on (1) glucose tolerance, insulin sensitivity and GDM prevention and (2) glycaemic control and insulin use in GDM women. On the basis of the available literature, there is a lack of consistent evidence regarding the benefits of physical activity on improving glucose tolerance and insulin sensitivity and preventing GDM. However, it appears that physical activity may help to achieve good glycaemic control and limit insulin use in GDM women. Compliance appears to be a major problem in physical activity-based intervention studies aimed at GDM prevention. Rigorous scientific research is still required to make an informed decision about the role of physical activity in the prevention and management of GDM and to develop evidence-based physical activity guidelines for GDM prevention and management. Copyright © 2013 John Wiley & Sons, Ltd.

  13. Prevention

    Science.gov (United States)

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

  14. The disaster prevention awareness of foreign residents and disaster management of organizations for foreign employees

    Science.gov (United States)

    Xin, Tan Yen; Sugiki, Nao; Matsuo, Kojiro

    2017-10-01

    Japan is known to have many natural disasters occurrences, especially in recent years, the seismic hazard named "Nankai-trough Disastrous Earthquake" of magnitude 9(M) was predicted and will have caused huge damages. Therefore, disaster management should be well planned and executed to ensure minimal amount of victims and damages from disaster. However, foreign residents are mostly vulnerable and ill-equipped to face such consequences compared to Japanese residents, especially when there is limited information available for foreigners presently. As the influx of foreigner migration has been steadily increasing annually, it is vital for disaster management to be compulsively planned to cope up with the great variety of foreigners' needs from diverse backgrounds accordingly. The purpose of this study is to comprehend foreign residents' disaster prevention awareness, in order to provide a more effective information provision on disaster management, so as to help improve their disaster prevention awareness. Thus, this study is set in Toyohashi city, and the methodology used is by conducting two questionnaires. Firstly, to have an accurate understanding on the awareness of foreign residents towards disasters prevention, the questionnaire is conducted towards foreign university students, on pertinent issues such as on the degree of preparedness and their matters of concern of which is related to natural disasters. Secondly, to comprehend disaster management of organizations, the other focuses on preventive measures adopted by manufacturing industry organizations, such as types of preventive measures as a whole and on the issues and challenges encountered during foreign employee-related enforcement of disaster management. Finally, based both results of the questionnaire, the key factors on effective information provision of disaster management is considered.

  15. CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core: Canadian Guidelines for Management and Treatment of HIV/Hepatitis C Coinfection in Adults

    Directory of Open Access Journals (Sweden)

    Mark Hull

    2013-01-01

    Full Text Available BACKGROUND: Hepatitis C virus (HCV coinfection occurs in 20% to 30% of Canadians living with HIV, and is responsible for a heavy burden of morbidity and mortality. HIV-HCV management is more complex due to the accelerated progression of liver disease, the timing and nature of antiretroviral and HCV therapy, mental health and addictions management, socioeconomic obstacles and drug-drug interactions between new HCV direct-acting antiviral therapies and antiretroviral regimens.

  16. 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.

  17. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    Science.gov (United States)

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  18. The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

    Science.gov (United States)

    Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

    2006-01-01

    Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

  19. Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review.

    Science.gov (United States)

    Han, Claire Jungyoun; Lee, Young Ji; Demiris, George

    2017-07-27

    Regarding cancer awareness, social media effectively promotes health and supports self-management. Given the diverse study designs, methodologies, and approaches of social media interventions in oncology, it is difficult to determine the effects of social media on cancer prevention and management. We aim to systematically review intervention studies using social media for cancer care. A systematic search, using 7 electronic databases (PubMed, Web of Science, CINAHL, Cochrane Library, Scopus, EMBASE, and PsycINFO), was conducted to identify surveys and interventions using contemporary social media tools with a focus on cancer. Of the 18 selected studies, 7 were randomized controlled trials. Most studies were conducted for all types of cancer, and some were conducted for breast cancer in the United States, with mostly white female participants. Facebook was the most frequently used platform. Most studies targeted healthy participants providing cancer prevention education. With social media platforms as part of a larger intervention, or the main component of interventions, interventions were overall feasible and showed a significant improvement in cancer prevention and management. Social media tools have the potential to be effective in delivering interventions for cancer prevention and management. However, there was a dearth of studies with rigorous study methodologies to test social media effects on various cancer-related clinical outcomes. Social media use in cancer care will facilitate improved communication and support among patients, caregivers, and clinicians and, ultimately, improved patient care. Clinicians need to carefully harness social media to enhance patient care and clinical outcomes.

  20. Identification and management of psychosocial problems by preventive child health care

    NARCIS (Netherlands)

    Brugman, E.; Reijneveld, S.A.; Verhulst, F.C.; Verloove-Vanhorick, S.P.

    2001-01-01

    Objectives: To assess the degree to which physicians and nurses working in preventive child health care (child health professionals [CHPs]) identify and manage psychosocial problems in children, and to determine its association with parent-reported behavioral and emotional problems, sociodemographic

  1. Special issue review of pollution prevention management within the Department of Energy, final report

    International Nuclear Information System (INIS)

    1994-08-01

    The Department of Energy's (DOE) national role and overall mission has been undergoing significant change. In the post-Cold War era, a new emphasis on cleaning up the wastes from the past has emerged. These changes provide both significant challenges as well as new opportunities for DOE. While the challenges may seem overwhelming as DOE realizes the magnitude of its environmental problems, its network of national laboratories and sites provide the resources to become a leader in environmental management through the development of new technologies and management practices. Because of the growing importance of pollution prevention in the United States and more specifically to DOE's environmental management strategy, the Office of Environmental Audit (EH-24) identified this as an area worthy of a Special Issue Review. A Special Issue Review is not an audit but rather an in-depth review of key environmental programs or activities which cut across organizational boundaries. The purpose of a Special Issue Review is to identify strengths and weaknesses of a program as well as significant crosscutting issues or challenges that are important to the future success of that program. The scope of the review included an assessment of pollution prevention program activities at Headquarters, selected operations offices, and selected sites offices and contractor organizations. All aspects of a pollution prevention program were considered including program strategy, infrastructure, management systems, and implementation practices. Also summarized are future pollution prevention challenges and recommendations

  2. Tai Ji Quan as an exercise modality to prevent and manage cardiovascular disease: A review

    Directory of Open Access Journals (Sweden)

    Ruth E. Taylor-Piliae

    2014-03-01

    Conclusion: Collectively, these studies indicate that Tai Ji Quan is a safe form of exercise to prevent and manage CVD. Further research is needed with more rigorous study designs, larger sample sizes, adequate Tai Ji Quan exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Ji Quan, before widespread recommendations can be made.

  3. Caries management by risk assessment: A review on current strategies for caries prevention and management

    OpenAIRE

    Maheswari, S. Uma; Raja, Jacob; Kumar, Arvind; Seelan, R. Gnana

    2015-01-01

    The current trend in treating dental caries is using nondestructive risk-based caries management strategies rather than focusing on the restorative treatment alone. Currently, there have been many changes in understanding of the multifaceted nature of caries process and its management. Caries Management by Risk Assessment (CAMBRA) which is an evidence-based approach focuses on determining many factors causing the expression of disease and take corrective action. The clinicians can ascertain w...

  4. Management and prevention of chronic obstructive pulmonary disease exacerbations: a state of the art review

    Directory of Open Access Journals (Sweden)

    Wedzicha Jadwiga A

    2009-08-01

    Full Text Available Abstract Exacerbations of chronic obstructive pulmonary disease (COPD are important events in the natural history of this prevalent and devastating condition. This review provides a concise, state of the art summary on prevention and management of exacerbations. Considerable new data underpins evidence in support of many preventative interventions, pharmacological and non-pharmacological, that are now available. Challenges remain in developing new approaches, and delivering those that already exist to the right patient at the right time. Management of an exacerbation remains stepwise according to clinical severity, but there is now additional focus on addressing comorbidities and taking the opportunity at acute events to optimise preventative strategies for the future. Ultimately, exacerbations are heterogeneous events in a heterogeneous disease, and an individualised approach is paramount.

  5. 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)

  6. Preservation of the roots--management and prevention protocols for cracked tooth syndrome.

    Science.gov (United States)

    Zimet, P O; Endo, C

    2000-10-01

    It is essential that symptomatic fractures of teeth be suitably diagnosed to prevent propagation of the fracture and continuation of the symptoms. The importance of understanding the mechanism and progression of fractures within teeth is essential when considering the management of fractures within teeth. The relation of the fracture line to the pulp, periodontal ligament and root will influence the management protocols for the involved teeth. When does a Cracked Tooth Syndrome (CTS) become a cracked tooth i.e., unrestorable? Consideration is also required regarding when endodontic treatment should be commenced. Further, suitable-coronal restoration of teeth is required to prevent propagation of the fracture line and persistence of the symptoms. Patients diagnosed with CTS should be counselled in strategies to prevent CTS in other teeth.

  7. Diagnosis, management and prevention of ischemic stroke for non-neurologists

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2011-07-01

    Full Text Available Background: Stroke is the third common cause of disability and death. Diagnosis of stroke is based on its clinical manifestations and/or observation of infarct in the neuroimaging. Standard battery of diagnostic investigations and classification criteria is required for detection of stroke etiology. Materials and Method: This review article deals with the diagnosis and management of brain infarction particularly in our country and is provided for non-neurologists. Using online scientific search engines and in some parts referring to laboratory archives constituted base of this review article.Results: Acute stroke management is almost similar in its various etiologies. Neuroprotective drugs have little value in acute stroke management. At present time, a few Iranian medical centers have infrastructure of thrombolysis therapy. Prevention of stroke is based on the detection and control of its risk factors. Aspirin, 80 mg per day is the most common drug for stroke prevention. Co-administration of aspirin 80 mg/d and Dipyridamole 200-400 mg/d increases the preventive effects of aspirin. Clopidogrel 75 mg/d is the stroke preventive drug of choice in patients with peptic ulcer and coronary artery disease. Co-administration of aspirin and clopidogrel is more effective in stroke prevention but has more hemorrhagic complications. Using warfarin for stroke prevention is suggested only in patients who have facilities for repetitive coagulation tests. Carotid endarterectomy is indicated in symptomatic patients with more than 70% stenosis of extracranial internal carotid artery, if performed only by vascular surgeons experienced in carotid surgery.Conclusion: Many stroke patients are managed by general practitioners and non-neurologists, e.g. internists, cardiologists and neurosurgeons. This review article provides continuous medical education according to Iranian medical curriculum

  8. Public health program planning logic model for community engaged type 2 diabetes management and prevention.

    Science.gov (United States)

    West, Joseph F

    2014-02-01

    Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

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

  10. The Effectiveness of Cognitive-Behavioral Stress Management on Relapse Prevention in Substance Dependent Men

    Directory of Open Access Journals (Sweden)

    Negar Karimian

    2012-02-01

    Full Text Available Introduction: The purpose of this study is to investigate the effectiveness of cognitive-behavioral stress management on relapse prevention in men who are substance dependent. Method: In a experimental study, 30 individuals who settled in Esfahan therapeutic community center were accidently divided in to an experimental (15 subjects and a control (15 subjects group. The experimental group underwent ten 90 minutes sessions of cognitive-behavioral stress management and the control group didn't receive any particular treatment. All participants underwent urine tests at the beginning of the study, completion of treatment and three months following the completion of treatment. Data were analyzed using descriptive statistics and X2 test. Findings: results showed significant difference in relapse rates of two groups in the following stage. Conclusion: Cognitive-behavioral stress management is effective in relapse prevention in men who are substance dependent.

  11. National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

    Science.gov (United States)

    Kaminski, Thomas W.; Hertel, Jay; Amendola, Ned; Docherty, Carrie L.; Dolan, Michael G.; Hopkins, J. Ty; Nussbaum, Eric; Poppy, Wendy; Richie, Doug

    2013-01-01

    Objective: To present recommendations for athletic trainers and other allied health care professionals in the conservative management and prevention of ankle sprains in athletes. Background: Because ankle sprains are a common and often disabling injury in athletes, athletic trainers and other sports health care professionals must be able to implement the most current and evidence-supported treatment strategies to ensure safe and rapid return to play. Equally important is initiating preventive measures to mitigate both first-time sprains and the chance of reinjury. Therefore, considerations for appropriate preventive measures (including taping and bracing), initial assessment, both short- and long-term management strategies, return-to-play guidelines, and recommendations for syndesmotic ankle sprains and chronic ankle instability are presented. Recommendations: The recommendations included in this position statement are intended to provide athletic trainers and other sports health care professionals with guidelines and criteria to deliver the best health care possible for the prevention and management of ankle sprains. An endorsement as to best practice is made whenever evidence supporting the recommendation is available. PMID:23855363

  12. Application of virtual reality methods to obesity prevention and management research.

    Science.gov (United States)

    Persky, Susan

    2011-03-01

    There is a great need for empirical evidence to inform clinical prevention and management of overweight and obesity. Application of virtual reality (VR) methods to this research agenda could present considerable advantages. Use of VR methods in basic and applied obesity prevention and treatment research is currently extremely limited. However, VR has been employed for social and behavioral research in many other domains where it has demonstrated validity and utility. Advantages of VR technologies as research tools include the ability to situate hypothetical research scenarios in realistic settings, tight experimental control inherent in virtual environments, the ability to manipulate and control any and all scenario elements, and enhanced behavioral measurement opportunities. The means by which each of these features could enhance obesity prevention and management research is discussed and illustrated in the context of an example research study. Challenges associated with the application of VR methods, such as technological limitations and cost, are also considered. By employing experimental VR methods to interrogate clinical encounters and other health-related situations, researchers may be able to elucidate causal relationships, strengthen theoretical models, and identify potential targets for intervention. In so doing, researchers stand to make important contributions to evidence-based practice innovation in weight management and obesity prevention. © 2011 Diabetes Technology Society.

  13. Preventing postpartum haemorrhage: active management of the third stage of labour.

    Science.gov (United States)

    de Castro Parreira, Maria V B; Gomes, Nádia C Ferreira

    2013-12-01

    To review scientific publications on health to identify the main practices used for the active management of the third stage of vaginal labour and to assess their effectiveness in preventing postpartum haemorrhage. According to the World Health Organization (WHO Recommendations for the Prevention of Postpartum Haemorrhage, 2007. WHO Document Production Services, Geneva), postpartum haemorrhage is considered to be the cause of a quarter of maternal morbidity and mortality rates worldwide. In an attempt to reduce the risk of haemorrhage, a group of interventions have been introduced into clinical practice that constitute active management conduct during the third stage of labour and are recommended by the international organisations. An integrative literature review of studies on the subject in question, indexed in databases of health between the years 2006-2012, was conducted. The analysis included 13 articles, six of which were original articles and seven of which were literature reviews. Based on our data analysis, we found that most studies supported the effectiveness of active management in reducing the risk of haemorrhage, in the immediate postpartum period. Despite the fact that active management practices for the third stage of labour differ in their specific elements, in the majority of the selected studies, the interventions followed those recommended by the international organisations. The results of this review of management practices supported active management of the third stage of labour to prevent postpartum haemorrhage, with five main forms of intervention: administration of oxytocin, delayed clamping of umbilical cord, draining of placental blood, controlled cord traction and uterine massage. There is a need to determine gaps in the clinical practices of midwives in regard to the active management of third stage of labour, to update knowledge and practices with the latest scientific evidence. © 2013 John Wiley & Sons Ltd.

  14. Tackling stress management, addiction, and suicide prevention in a predoctoral dental curriculum.

    Science.gov (United States)

    Brondani, Mario A; Ramanula, Dhorea; Pattanaporn, Komkhamn

    2014-09-01

    Health care professionals, particularly dentists, are subject to high levels of stress. Without proper stress management, problems related to mental health and addiction and, to a lesser extent, deliberate self-harm such as suicide may arise. There is a lack of information on teaching methodologies employed to discuss stress management and suicide prevention in dental education. The purpose of this article is to describe a University of British Columbia Faculty of Dentistry module designed to address stress management and suicide prevention, using students' personal reflections to illustrate the impact of the pedagogies used. The module enrolls more than 200 students per year and has sessions tailored to the discussion of stress management and suicide prevention. The pedagogies include standardized patients, invited guest lectures, in-class activities, video presentation, and self-reflections. More than 500 students' self-reflections collected over the past five years illustrate the seriousness of the issues discussed and the level of discomfort students experience when pondering such issues. The instructors hope to have increased students' awareness of the stressors in their profession. Further studies are needed to unravel the extent to which such pedagogy influences a balanced practice of dentistry.

  15. 75 FR 40845 - Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at Structure Fires

    Science.gov (United States)

    2010-07-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket Number NIOSH 141-A] Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION: Notice of...

  16. Transactions Concurrency Control in Web Service Environment

    DEFF Research Database (Denmark)

    Alrifai, Mohammad; Dolog, Peter; Nejdl, Wolfgang

    2006-01-01

    an engineering point of view as it does not change the way consumers or clients of web services have to be programmed. Furthermore, it avoids direct communication between transaction coordinators which preserves security by keeping the information about business transactions restricted to the coordinators which......Business transactions in web service environments run with relaxed isolation and atomicity property. In such environments, transactions can commit and roll back independently on each other. Transaction management has to reflect this issue and address the problems which result for example from...... concurrent access to web service resources and data. In this paper we propose an extension to the WS-Transaction Protocol which ensures the consistency of the data when independent business transactions access the data concurrently under the relaxed transaction properties. Our extension is based...

  17. Promotora assisted depression and self-care management among predominantly Latinos with concurrent chronic illness: Safety net care system clinical trial results.

    Science.gov (United States)

    Ell, Kathleen; Aranda, María P; Wu, Shinyi; Oh, Hyunsung; Lee, Pey-Jiuan; Guterman, Jeffrey

    2017-10-01

    The study evaluated depression and self-care management among patients with diabetes and/or heart disease in a 12-month randomized trial conducted in Los Angeles County Department of Health Services (LAC-DHS) community clinics. We compared LAC-DHS clinic usual care (UC) versus A-Helping-Hand (AHH) intervention in which bilingual promotoras, hired and supervised by the research project, provided 6 weekly psychoeducational sessions followed by boosters. Of 1957 screened, 348 depressed patients (PHQ-9 score≥10) were enrolled, randomized to AHH (n=178) or UC (n=170) after baseline interview assessing mental health, treatment receipt, co-morbid illness, self-care management, and environmental stressors. Comprehensive assessments were repeated at 6 and 12months by an independent interviewer blind to the study group. Patients (85% diabetes, 4% heart disease, 11% both) were predominantly female (85%), Latino (99%), born outside of the US (91%). Study attrition at 12months was 30% (AHH 31%, UC 28%, P=0.51). No baseline characteristics were associated with attrition. Half of AHH patients received 4 or more sessions. Intend-to-treat analysis found study groups did not vary significantly at 6 and 12months. Before-after paired t-tests showed significant improvements in most measures in each group. During the trial, LAC-DHS activated healthcare improvements including depression screening, referral to clinic staff including community health workers (with the same role as the promotoras) to improve patient care management. Both patient groups performed equally well which may be a function of the enhanced healthcare model. Future research should replicate the promotora-integrated care model with other groups and care settings with similar comorbid conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core: Canadian guidelines for management and treatment of HIV/hepatitis C coinfection in adults

    Science.gov (United States)

    Hull, Mark; Klein, Marina; Shafran, Stephen; Tseng, Alice; Giguère, Pierre; Côté, Pierre; Poliquin, Marc; Cooper, Curtis

    2013-01-01

    BACKGROUND: Hepatitis C virus (HCV) coinfection occurs in 20% to 30% of Canadians living with HIV, and is responsible for a heavy burden of morbidity and mortality. HIV-HCV management is more complex due to the accelerated progression of liver disease, the timing and nature of antiretroviral and HCV therapy, mental health and addictions management, socioeconomic obstacles and drug-drug interactions between new HCV direct-acting antiviral therapies and antiretroviral regimens. OBJECTIVE: To develop national standards for the management of HCV-HIV coinfected adults in the Canadian context. METHODS: A panel with specific clinical expertise in HIV-HCV co-infection was convened by The CIHR HIV Trials Network to review current literature, existing guidelines and protocols. Following broad solicitation for input, consensus recommendations were approved by the working group, and were characterized using a Class (benefit verses harm) and Level (strength of certainty) quality-of-evidence scale. RESULTS: All HIV-HCV coinfected individuals should be assessed for HCV therapy. Individuals unable to initiate HCV therapy should initiate antiretroviral therapy to slow liver disease progression. Standard of care for genotype 1 is pegylated interferon and weight-based ribavirin dosing plus an HCV protease inhibitor; traditional dual therapy for 24 weeks (for genotype 2/3 with virological clearance at week 4); or 48 weeks (for genotypes 2–6). Therapy deferral for individuals with mild liver disease may be considered. HIV should not be considered a barrier to liver transplantation in coinfected patients. DISCUSSION: Recommendations may not supersede individual clinical judgement. PMID:24489565

  19. Evaluation, prevention and management of radiotherapy-induced xerostomia in head and neck cancer patients.

    Science.gov (United States)

    de Castro, Gilberto; Federico, Miriam Hatsue Honda

    2006-05-01

    As part of the multidisciplinary approach to head and neck cancer patients, radiation therapy plays an essential role, improving locoregional control. Radiation therapy-induced xerostomia is a late side-effect that increases the risk for developing dental caries and compromises oral mucosal integrity, resulting in oral pain, loss of taste, difficulties with swallowing and chewing, sleep disorders and worse quality of life. This review focuses on evaluation, prevention and management of radiation therapy-induced xerostomia. In terms of xerostomia prevention, some clinical trials evaluating amifostine and intensity-modulated radiation therapy have shown positive results. Pilocarpine is a useful agent as a treatment of radiation-induced xerostomia in head and neck cancer patients. Despite some advances in radiation therapy-induced xerostomia prevention, its treatment is an area in which advances are urgently needed.

  20. Galician consensus on management of cardiotoxicity in breast cancer: risk factors, prevention, and early intervention.

    Science.gov (United States)

    Cueva, J F; Antolín, S; Calvo, L; Fernández, I; Ramos, M; de Paz, L; Mata, J G; López, R; Constenla, M; Pérez, E; González, A; Pellón, M L; Varela, S; López, T

    2017-09-01

    This Galician consensus statement is a joint oncologists/cardiologists initiative indented to establish basic recommendations on how to prevent and to manage the cardiotoxicity in breast cancer with the aim of ensuring an optimal cardiovascular care of these patients. A clinical screening of the patients before treatment is recommended to stratify them into a determined risk group based on their intrinsic cardiovascular risk factors and those extrinsic arose from breast cancer therapy, thereby providing individualized preventive and monitoring measures. Suitable initial and ongoing assessments for patients with low and moderate/high risk and planned treatment with anthracyclines and trastuzumab are given; also, measures aimed at preventing and correcting any modifiable risk factor are pointed out .

  1. Primary prevention of peri-implantitis: Managing peri-implant mucositis

    OpenAIRE

    Jepsen, Søren; Berglundh, Tord; Genco, Robert; Aass, Anne Merete; Demirel, Korkud; Derks, Jan; Figuero, Elena; Giovannoli, Jean Louis; Goldstein, Moshe; LAMBERT, France; Ortiz-Vigon, Alberto; Polyzois, Ioannis; Salvi, Giovanni; Schwarz, Frank; Serino, Giovanni

    2015-01-01

    Abstract AIMS: Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considere...

  2. The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management.

    Science.gov (United States)

    Mokomane, Margaret; Kasvosve, Ishmael; de Melo, Emilia; Pernica, Jeffrey M; Goldfarb, David M

    2018-01-01

    Acute diarrhoeal diseases remain a leading cause of global morbidity and mortality particularly among young children in resource-limited countries. Recent large studies utilizing case-control design, prospective sampling and more sensitive and broad diagnostic techniques have shed light on particular pathogens of importance and highlighted the previously under recognized impact of these infections on post-acute illness mortality and growth. Vaccination, particularly against rotavirus, has emerged as a key effective means of preventing significant morbidity and mortality from childhood diarrhoeal disease. Other candidate vaccines against leading diarrhoeal pathogens, such as enterotoxigenic Escherichia coli and Shigella spp., also hold significant promise in further ameliorating the burden of enteric infections in children. Large studies are also currently underway evaluating novel and potential easy-to-implement water, sanitation and hygiene (WASH) preventive strategies. Given the ongoing global burden of this illness, the paucity of new advances in case management over the last several decades remains a challenge. The increasing recognition of post-acute illness mortality and growth impairment has highlighted the need for interventions that go beyond management of dehydration and electrolyte disturbances. The few trials of novel promising interventions such as probiotics have mainly been conducted in high-income settings. Trials of antimicrobials have also been primarily conducted in high-income settings or in travellers from high-income settings. Bloody diarrhoea has been shown to be a poor marker of potentially treatable bacterial enteritis, and rising antimicrobial resistance has also made empiric antimicrobial therapy more challenging in many settings. Novel effective and sustainable interventions and diagnostic strategies are clearly needed to help improve case management. Diarrhoeal disease and other enteric infections remain an unmet challenge in global

  3. Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

    OpenAIRE

    Ahsan Ahsan

    2016-01-01

    Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality) in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: T...

  4. Outcomes in randomised controlled trials in prevention and management of carious lesions: a systematic review

    OpenAIRE

    Levey, Colin; Innes, Nicola; Schwendicke, Falk; Lamont, Thomas; Göstemeyer, Gerd

    2017-01-01

    Background Inconsistent outcome reporting is one significant hurdle to combining results from trials into systematic reviews. Core outcome sets (COS) can reduce this barrier. The aim of this review was to map outcomes reported in caries prevention and management randomised controlled trials (RCT) as a first step to COS development. We also investigated RCT characteristics and reporting of primary outcomes and sample size calculations. Methods PubMed, Embase, Web of Knowledge and Cochrane CENT...

  5. Reference Capabilities for Concurrency Control

    OpenAIRE

    Castegren, Elias; Wrigstad, Tobias

    2016-01-01

    The proliferation of shared mutable state in object-oriented programming complicates software development as two seemingly unrelated operations may interact via an alias and produce unexpected results. In concurrent programming this manifests itself as data-races. Concurrent object-oriented programming further suffers from the fact that code that warrants synchronisation cannot easily be distinguished from code that does not. The burden is placed solely on the programmer to reason ab...

  6. Successful Nonoperative Management of HAGL (Humeral Avulsion of Glenohumeral Ligament) Lesion With Concurrent Axillary Nerve Injury in an Active-Duty US Navy SEAL.

    Science.gov (United States)

    Ernat, Justin J; Bottoni, Craig R; Rowles, Douglas J

    2016-01-01

    Humeral avulsion of the glenohumeral ligament (HAGL) is a lesion that has been recognized as a cause of recurrent shoulder instability. To our knowledge there are no reports of successful return to full function in young, competitive athletes or return to manual labor following nonoperative management of a HAGL lesion. A 26-year-old Navy SEAL was diagnosed with a HAGL injury, and associated traction injury of the axillary nerve as well as a partial tear of the rotator cuff. Operative intervention was recommended; however, due to issues with training and with inability to properly rehab with the axillary nerve injury, surgical plans were delayed. Interestingly, the patient demonstrated both clinical and radiographic magnetic resonance imaging healing of his lesion over an 18-month period. At 18 months the patient had returned to full active duty without pain or instability as a Navy SEAL.

  7. New insight in pediatric dentistry: preventive dentistry in allergy management protocol

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2007-09-01

    Full Text Available ; "> The relationship between oral health and systemic diseases had been abundantly studied, however, mostly were related to adultsuch as cerebrovascular disease, cardiovascular disease, diabetes mellitus etc. Nevertheless, it was still uncommon that oral healthalso related to allergic disease. The field of pediatric dentistry is mostly related to preventive dentistry (i.e. prophylactic procedures,preventive orthodontic etc., but rarely related to preventive medicine such allergy prevention in children. Allergic diseases develop outof a close interaction between genetic predisposition and environmental triggers, and progress continuously since infancy regarding tothe allergic march. Concerning to the partially developed immunity in children, children are more susceptible to infection and allergicdiseases than adults. Unfortunately, infection and allergic diseases are interrelated; infection impaired allergy and vice versa. Poororal health is closely related to infection; however, improving oral health is not included in allergy management protocol. In order toanticipate the future, dentist or especially pediatric dentist should be able to review about basic children immunity and oral mucosalimmunity. Additionally, it is essential to explain to the parents and medical practitioners who are not familiar to this new paradigm.The objective of this study is to review articles related to children’s oral health and allergic symptoms. Regarding to the successfuloral management of allergic symptoms, the propensity that improving oral health could be included in children’s allergy managementprotocol is likely.

  8. National athletic trainers' association position statement: preventing, detecting, and managing disordered eating in athletes.

    Science.gov (United States)

    Bonci, Christine M; Bonci, Leslie J; Granger, Lorita R; Johnson, Craig L; Malina, Robert M; Milne, Leslie W; Ryan, Randa R; Vanderbunt, Erin M

    2008-01-01

    To present recommendations for the prevention, detection, and comprehensive management of disordered eating (DE) in athletes. Athletes with DE rarely self-report their symptoms. They tend to deny the condition and are often resistant to referral and treatment. Thus, screenings and interventions must be handled skillfully by knowledgeable professionals to obtain desired outcomes. Certified athletic trainers have the capacity and responsibility to play active roles as integral members of the health care team. Their frequent daily interactions with athletes help to facilitate the level of medical surveillance necessary for early detection, timely referrals, treatment follow-through, and compliance. These recommendations are intended to provide certified athletic trainers and others participating in the health maintenance and performance enhancement of athletes with specific knowledge and problem-solving skills to better prevent, detect, and manage DE. The individual biological, psychological, sociocultural, and familial factors for each athlete with DE result in widely different responses to intervention strategies, challenging the best that athletics programs have to offer in terms of resources and expertise. The complexity, time intensiveness, and expense of managing DE necessitate an interdisciplinary approach representing medicine, nutrition, mental health, athletic training, and athletics administration in order to facilitate early detection and treatment, make it easier for symptomatic athletes to ask for help, enhance the potential for full recovery, and satisfy medicolegal requirements. Of equal importance is establishing educational initiatives for preventing DE.

  9. Concurrent engineering: effective deployment strategies

    Directory of Open Access Journals (Sweden)

    Unny Menon

    1996-12-01

    Full Text Available This paper provides a comprehensive insight into current trends and developments in Concurrent Engineering for integrated development of products and processes with the goal of completing the entire cycle in a shorter time, at lower overall cost and with fewer engineering design changes after product release. The evolution and definition of Concurrent Engineering are addressed first, followed by a concise review of the following elements of the concurrent engineering approach to product development: Concept Development: The Front-End Process, identifying Customer Needs and Quality Function Deployment, Establishing Product Specifications, Concept Selection, Product Architecture, Design for Manufacturing, Effective Rapid Prototyping, and The Economics of Product Development. An outline of a computer-based tutorial developed by the authors and other graduate students funded by NASA ( accessible via the world-wide-web . is provided in this paper. A brief discussion of teamwork for successful concurrent engineering is included, t'ase histories of concurrent engineering implementation at North American and European companies are outlined with references to textbooks authored by Professor Menon and other writers. A comprehensive bibliography on concurrent engineering is included in the paper.

  10. Management characteristics of successful public health programs: "Avahan" HIV prevention program in India.

    Science.gov (United States)

    Mabuchi, Shunsuke; Singh, Suneeta; Bishnu, Rituparna; Bennett, Sara

    2013-01-01

    This paper analyzes Avahan, an HIV prevention program in India, that achieved very rapid scale-up. The paper aims to (i) define the distinctive features of the management of Avahan, (ii) examine how the distinctive features relate to key constructs in management frameworks and (iii) investigate how the management approaches of Avahan contributed to the program's ability to scale-up rapidly while maintaining service quality. The Delphi method was used to identify the distinctive features of Avahan. Through three rounds of questions, 38 participants closely associated with Avahan were asked to identify and develop consensus on its distinctive features. These features were then mapped against the Baldrige Health Care Criteria for Performance Excellence to investigate how they related to important dimensions of management. A total of 17 distinctive features of Avahan were identified. These distinctive features emphasized the importance of data use and performance monitoring at all levels, especially combined with a flexible management style that facilitated local responsiveness to community, innovation and learning. The distinctive features comprehensively addressed the criteria for management excellence in the Baldridge framework. In the case of Avahan, the rigorous application of known management techniques to public health programs appears to have been an important factor in the successful scale-up of the program. Also, the Baldrige criteria seem applicable to health programs in low-income and middle-income countries; further applications would help test their robustness and utility in such contexts. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Case management helps prevent criminal justice recidivism for people with serious mental illness.

    Science.gov (United States)

    Leutwyler, Heather; Hubbard, Erin; Zahnd, Elaine

    2017-09-11

    Purpose The purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism. Design/methodology/approach Examples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented. Findings Currently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management. Originality/value Providing effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

  12. Storm Water Management for Industrial Activities: Developing Pollution Prevention Plans and Best Management Practices

    Science.gov (United States)

    1992-09-01

    out over a wide area. So, small oil and grease spills at hundreds of different facilities within a single city can collectively represent a major...adsorption and absorption. Sorbents adsorb (an attraction to the outer surface of a material) or absorb (taken in by the material like a sponge ) only when... Stormwater Management, Special Report No. 49," American Public Works Association Research Foundation. 1981. Arapahoe County, "Erosion Control

  13. Caries management by risk assessment: A review on current strategies for caries prevention and management

    Science.gov (United States)

    Maheswari, S. Uma; Raja, Jacob; Kumar, Arvind; Seelan, R. Gnana

    2015-01-01

    The current trend in treating dental caries is using nondestructive risk-based caries management strategies rather than focusing on the restorative treatment alone. Currently, there have been many changes in understanding of the multifaceted nature of caries process and its management. Caries Management by Risk Assessment (CAMBRA) which is an evidence-based approach focuses on determining many factors causing the expression of disease and take corrective action. The clinicians can ascertain what behaviors are increasing a patient's risk for disease and disease progression by evaluating the current caries risk of a patient. With this modern CAMBRA protocol, a novel treatment plan can be designed to arrest dental caries thereby decreasing the chance of cavitation. After the recognition of the multi factorial nature of caries involving the biofilm, the contemporary approaches focused mainly on the various options to cope with the locally out-of-balance oral biofilm and stop the progression of the disease. The initial caries lesions can be diagnosed with modern diagnostic aids and with the help of CAMBRA, reestablishment of the integrity of the tooth surface early on in the caries process will bring great rewards for patients. This review focuses on the repair of hard tooth tissues using noninvasive strategies. PMID:26538870

  14. Caries management by risk assessment: A review on current strategies for caries prevention and management.

    Science.gov (United States)

    Maheswari, S Uma; Raja, Jacob; Kumar, Arvind; Seelan, R Gnana

    2015-08-01

    The current trend in treating dental caries is using nondestructive risk-based caries management strategies rather than focusing on the restorative treatment alone. Currently, there have been many changes in understanding of the multifaceted nature of caries process and its management. Caries Management by Risk Assessment (CAMBRA) which is an evidence-based approach focuses on determining many factors causing the expression of disease and take corrective action. The clinicians can ascertain what behaviors are increasing a patient's risk for disease and disease progression by evaluating the current caries risk of a patient. With this modern CAMBRA protocol, a novel treatment plan can be designed to arrest dental caries thereby decreasing the chance of cavitation. After the recognition of the multi factorial nature of caries involving the biofilm, the contemporary approaches focused mainly on the various options to cope with the locally out-of-balance oral biofilm and stop the progression of the disease. The initial caries lesions can be diagnosed with modern diagnostic aids and with the help of CAMBRA, reestablishment of the integrity of the tooth surface early on in the caries process will bring great rewards for patients. This review focuses on the repair of hard tooth tissues using noninvasive strategies.

  15. CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment

    Science.gov (United States)

    Hull, Mark; Wong, Alex; Tseng, Alice; Giguère, Pierre; Barrett, Lisa; Haider, Shariq; Conway, Brian; Klein, Marina; Cooper, Curtis

    2016-01-01

    Background. Hepatitis C virus (HCV) coinfection occurs in 20–30% of Canadians living with HIV and is responsible for a heavy burden of morbidity and mortality. Purpose. To update national standards for management of HCV-HIV coinfected adults in the Canadian context with evolving evidence for and accessibility of effective and tolerable DAA therapies. The document addresses patient workup and treatment preparation, antiviral recommendations overall and in specific populations, and drug-drug interactions. Methods. A standing working group with HIV-HCV expertise was convened by The Canadian Institute of Health Research HIV Trials Network to review recently published HCV antiviral data and update Canadian HIV-HCV Coinfection Guidelines. Results. The gap in sustained virologic response between HCV monoinfection and HIV-HCV coinfection has been eliminated with newer HCV antiviral regimens. All coinfected individuals should be assessed for interferon-free, Direct Acting Antiviral HCV therapy. Regimens vary in content, duration, and success based largely on genotype. Reimbursement restrictions forcing the use of pegylated interferon is not acceptable if optimal patient care is to be provided. Discussion. Recommendations may not supersede individual clinical judgement. Treatment advances published since December 2015 are not considered in this document. PMID:27471521

  16. Health promotion and disease prevention: a look at demand management programs.

    Science.gov (United States)

    Fronstin, P

    1996-09-01

    This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health

  17. How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

    Science.gov (United States)

    ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

    2017-10-01

    Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

  18. Concurrent Sr/Ca Ratios and Bomb Test 14C Records from a Porites evermanni Colony on Kure Atoll: SST, Climate Change, Ocean Circulation and Management Applications

    Science.gov (United States)

    Covarrubias, S.; Potts, D.; Siciliano, D.; Andrews, A.; Franks, R.

    2013-12-01

    timeline of when carbon isotope spikes appear in this region from large scale atomic testing. Changes in 14C along the length of our core have important implications for understanding regional oceanic circulation, and for the life history age validation of marine organisms, including long-lived fishes whose calcareous otoliths retain a 14C signal. These results have direct application for improved management of commercially important reef and bottom fishes of Hawaii. By tracing the bomb 14C signal in the otolith (ear bone) of regional fishes, important population parameters can be validated (e.g. age of maturity and longevity). At present, the bomb 14C record is incomplete for the Hawaiian Archipelago, but the work presented will fill the void.

  19. Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

    Directory of Open Access Journals (Sweden)

    Marlene M. de Vries

    2015-12-01

    Full Text Available In the Western Cape Province of South Africa (ZA a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD. FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI techniques and the Community Reinforcement Approach (CRA. Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD.

  20. Construction safety: Can management prevent all accidents or are workers responsible for their own actions?

    International Nuclear Information System (INIS)

    Cotten, G.B.; Jenkins, S.L.

    1997-01-01

    The construction industry has struggled for many years with the answer to the question posed in the title: Can Management Prevent All Accidents or Are Workers Responsible for Their Own Actions? In the litigious society that we live, it has become more important to find someone open-quotes at faultclose quotes for an accident than it is to find out how we can prevent it from ever happening again. Most successful companies subscribe to the theme that open-quotes all accidents can be prevented.close quotes They institute training and qualification programs, safe performance incentives, and culture-change-driven directorates such as the Voluntary Protection Program (VPP); yet we still see construction accidents that result in lost time, and occasionally death, which is extremely costly in the shortsighted measure of money and, in real terms, impact to the worker''s family. Workers need to be properly trained in safety and health protection before they are assigned to a job that may expose them to safety and health hazards. A management committed to improving worker safety and health will bring about significant results in terms of financial savings, improved employee morale, enhanced communities, and increased production. But how can this happen, you say? Reduction in injury and lost workdays are the rewards. A decline in reduction of injuries and lost workdays results in lower workers'' compensation premiums and insurance rates. In 1991, United States workplace injuries and illnesses cost public and private sector employers an estimated $62 billion in workers'' compensation expenditures

  1. Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management.

    Science.gov (United States)

    Cheung, Ka-Shing; Leung, Wai K

    2017-03-21

    Novel oral anticoagulants (NOACs), which include direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of venous thromboembolism. However, similar to traditional anticoagulants, NOACs have the side effects of bleeding, including gastrointestinal bleeding (GIB). Results from both randomized clinical trials and observations studies suggest that high-dose dabigatran (150 mg b.i.d), rivaroxaban and high-dose edoxaban (60 mg daily) are associated with a higher risk of GIB compared with warfarin. Other risk factors of NOAC-related GIB include concomitant use of ulcerogenic agents, older age, renal impairment, Helicobacter pylori infection and a past history of GIB. Prevention of NOAC-related GIB includes proper patient selection, using a lower dose of certain NOACs and in patients with renal impairment, correction of modifiable risk factors, and prescription of gastroprotective agents. Overt GIB can be managed by withholding NOACs followed by delayed endoscopic treatment. In severe bleeding, additional measures include administration of activated charcoal, use of specific reversal agents such as idarucizumab for dabigatran and andexanent alfa for factor Xa inhibitors, and urgent endoscopic management.

  2. The role of episiotomy in prevention and management of shoulder dystocia: a systematic review.

    Science.gov (United States)

    Sagi-Dain, Lena; Sagi, Shlomi

    2015-05-01

    Shoulder dystocia is an obstetric emergency with potential catastrophic outcomes. To perform a systematic literature review examining the effectiveness of episiotomy in the prevention and management of shoulder dystocia during vaginal birth. Search was conducted by a research librarian in MEDLINE, Web of Science, Cochrane Library, and SCOPUS databases using the terms "episiotomy" and "shoulder dystocia," with no language or time restrictions. Two investigators independently selected original researches examining the effects of episiotomy on shoulder dystocia and its neonatal andmaternal outcomes. Relevant articles were accessed in full text, including manual search of the references. We contacted authors of studies with insufficient or unclear data. Because of clinical and methodological diversity of the studies, meta-analysis was not performed. Fourteen articles met the inclusion criteria, encompassing a total of 9769 shoulder dystocia cases. Only 1 study effectively evaluated the role of episiotomy in shoulder dystocia prevention, yielding a nonsignificant result. Three articles assessed neonatal consequences of shoulder dystocia, one of them linking episiotomy to higher risk of neonatal injury. Two of the 3 studies evaluating maternal outcomes showed that episiotomy is related to increased risk of advanced perineal tears. Overall quality of evidence was rated as very low. Our systematic review found no evidence supporting the use of episiotomy in the prevention and management of shoulder dystocia. This observation carries major clinical and legal implications for the obstetricians. Higher-quality studies are needed to evaluate this important issue.

  3. Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation.

    Science.gov (United States)

    Pérez-Martínez, Pablo; Mikhailidis, Dimitri P; Athyros, Vasilios G; Bullo, Mónica; Couture, Patrick; Covas, María I; de Koning, Lawrence; Delgado-Lista, Javier; Díaz-López, Andrés; Drevon, Christian A; Estruch, Ramón; Esposito, Katherine; Fitó, Montserrat; Garaulet, Marta; Giugliano, Dario; García-Ríos, Antonio; Katsiki, Niki; Kolovou, Genovefa; Lamarche, Benoît; Maiorino, Maria Ida; Mena-Sánchez, Guillermo; Muñoz-Garach, Araceli; Nikolic, Dragana; Ordovás, José M; Pérez-Jiménez, Francisco; Rizzo, Manfredi; Salas-Salvadó, Jordi; Schröder, Helmut; Tinahones, Francisco J; de la Torre, Rafael; van Ommen, Ben; Wopereis, Suzan; Ros, Emilio; López-Miranda, José

    2017-05-01

    The importance of metabolic syndrome (MetS) lies in its associated risk of cardiovascular disease and type 2 diabetes, as well as other harmful conditions such as nonalcoholic fatty liver disease. In this report, the available scientific evidence on the associations between lifestyle changes and MetS and its components is reviewed to derive recommendations for MetS prevention and management. Weight loss through an energy-restricted diet together with increased energy expenditure through physical activity contribute to the prevention and treatment of MetS. A Mediterranean-type diet, with or without energy restriction, is an effective treatment component. This dietary pattern should be built upon an increased intake of unsaturated fat, primarily from olive oil, and emphasize the consumption of legumes, cereals (whole grains), fruits, vegetables, nuts, fish, and low-fat dairy products, as well as moderate consumption of alcohol. Other dietary patterns (Dietary Approaches to Stop Hypertension, new Nordic, and vegetarian diets) have also been proposed as alternatives for preventing MetS. Quitting smoking and reducing intake of sugar-sweetened beverages and meat and meat products are mandatory. Nevertheless, there are inconsistencies and gaps in the evidence, and additional research is needed to define the most appropriate therapies for MetS. In conclusion, a healthy lifestyle is critical to prevent or delay the onset of MetS in susceptible individuals and to prevent cardiovascular disease and type 2 diabetes in those with existing MetS. The recommendations provided in this article should help patients and clinicians understand and implement the most effective approaches for lifestyle change to prevent MetS and improve cardiometabolic health. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Identifying, managing and preventing skin maceration: a rapid review of the clinical evidence.

    Science.gov (United States)

    Whitehead, F; Giampieri, S; Graham, T; Grocott, P

    2017-04-02

    To identify the clinical empirical evidence for identifying, managing and preventing skin maceration in human subjects. A rapid review of the current literature was undertaken between 5 September and 19 September 2016 using the electronic databases CINAHL, MEDLINE, PUBMED and Cochrane, with the key words: skin macerat*, wound macerat*, moisture associated skin damage, wound exudate and hyper-hydration of skin, Results: Of 526 papers found using an electronic database search, four were identified as fitting the search parameters, and a further two were retrieved from a manual search of reference lists. There were three themes that emerged: how to identify and measure maceration, how to manage and reduce maceration once it has already occurred, and how to prevent skin maceration. Hyper-hydration can reach greater skin depths than previously thought, thus engendering more extensive damage potential, which in turn can impact on treatments and healing time. Realistically, the deeper the hyper-hydration issue, the more extensive the damage and it will take longer to recover-a problem compounded if the hyper-hydration is due to incontinence and skin is also exposed to urine and/or faeces. In relation to wound management, the authors advocate the removal of moisture away from the wound or skin, either through superabsorbent dressings, or by allowing the excess moisture to evaporate through semi-permeable dressings to reduce maceration, enhance patient comfort and encourage healing. However, we found no evidence regarding the limits of hydration of the dermis and epidermis and thereby the optimal conditions for managing exuding wounds and promoting skin health. Each of the six papers in this review calls for further research to help identify, treat and prevent maceration. Maceration causes patients' discomfort and pain as well as prolonging healing time and deserves more focused research. This rapid review highlights how limited the clinical empirical research is on

  5. Stress-Preventive Management Competencies, Psychosocial Work Environments, and Affective Well-Being: A Multilevel, Multisource Investigation

    Science.gov (United States)

    Balducci, Cristian

    2018-01-01

    The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors’ stress-preventive management competencies, as measured by the Stress Management Competencies Indicator Tool (SMCIT), are related to employees’ affective well-being through psychosocial work environmental factors. To this end, multilevel structural equation modelling (MSEM) was developed and tested, including data provided by both supervisors and employees. Supervisors (n = 84) self-assessed their stress-preventive management competencies (i.e., being respectful and responsible, managing and communicating existing and future work, reasoning and managing difficult situations, and managing the individual within the team) with a previously validated reduced version of the SMCIT. The supervised employees (n = 584) rated job content (e.g., job demands) and work context (e.g., role clarity) psychosocial factors and their job-related affective well-being. Supervisors’ job-related affective well-being was also included in the tested model. The results revealed that the stress-preventive competencies factor was related to employees’ affective well-being through the psychosocial work environment only when the latter was operationalized by means of contextual work factors. Supervisors’ affective well-being was related to their stress-preventive competencies, but it was not related to employees’ affective well-being. We discuss the implications of the results obtained. PMID:29495360

  6. Stress-Preventive Management Competencies, Psychosocial Work Environments, and Affective Well-Being: A Multilevel, Multisource Investigation.

    Science.gov (United States)

    Toderi, Stefano; Balducci, Cristian

    2018-02-26

    The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors' stress-preventive management competencies, as measured by the Stress Management Competencies Indicator Tool (SMCIT), are related to employees' affective well-being through psychosocial work environmental factors. To this end, multilevel structural equation modelling (MSEM) was developed and tested, including data provided by both supervisors and employees. Supervisors ( n = 84) self-assessed their stress-preventive management competencies (i.e., being respectful and responsible, managing and communicating existing and future work, reasoning and managing difficult situations, and managing the individual within the team) with a previously validated reduced version of the SMCIT. The supervised employees ( n = 584) rated job content (e.g., job demands) and work context (e.g., role clarity) psychosocial factors and their job-related affective well-being. Supervisors' job-related affective well-being was also included in the tested model. The results revealed that the stress-preventive competencies factor was related to employees' affective well-being through the psychosocial work environment only when the latter was operationalized by means of contextual work factors. Supervisors' affective well-being was related to their stress-preventive competencies, but it was not related to employees' affective well-being. We discuss the implications of the results obtained.

  7. Does information overload prevent chronic patients from reading self-management educational materials?

    Science.gov (United States)

    Liu, Chung-Feng; Kuo, Kuang-Ming

    2016-05-01

    Self-care management is becoming an important part of care for chronic patients. However, various kinds of self-management educational materials which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients' use intention could be patients' perceived information overload regarding the self-management educational materials. This study proposed an extended model of the Theory of Planned Behavior (TPB), which incorporated perceived information overload, to explore if information overload will prevent chronic patients from reading educational materials for self-care management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the self-management educational materials. Perceived information overload is also referred to as an antecedent variable which may has impacts on attitude and perceived behavior control. The cross-sectional study interviewed newly diagnosed chronic patients with coronary artery disease, who are the potential users of the self-management educational materials, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the respondents, and structural equation modeling to study the reliability and validity for testing hypotheses. A total of 110 respondents were enrolled in this study and successful interview data were collected from 106 respondents. The result indicates that the patients' perceived information overload of self-management educational materials was validated to have impacts on attitude and perceived behavioral control constructs of the TPB as well as contributing a direct impact on patients' intentions to use self-management educational materials. Besides, subjective norm and perceived behavioral control constructs were validated to have significant impacts on

  8. Identifying the causes, prevention and management of crises in dementia. An online survey of stakeholders.

    Science.gov (United States)

    Ledgerd, Ritchard; Hoe, Juanita; Hoare, Zoë; Devine, Mike; Toot, Sandeep; Challis, David; Orrell, Martin

    2016-06-01

    Crisis situations in dementia can lead to hospital admission or institutionalisation. Offering immediate interventions may help avoid admission, whilst stabilising measures can help prevent future crises. Our objective was to identify the main causes of crisis and interventions to treat or prevent crisis in persons with dementia based on different stakeholder perspectives. An online questionnaire was developed to identify the causes of crisis and appropriate interventions in a crisis. Participants included people with dementia, family carers and staff working in health and social care, including emergency and voluntary sectors, and academia. The results ranked the main causes of crisis, interventions that can prevent a crisis and interventions that can be useful in a crisis. Wandering, falls and infection were highly rated as risk factors for crises across all stakeholder groups. Consumers rated aggression as less important but severity of memory impairment as much more important than the other groups did. Education and support for family carers and home care staff were highly valued for preventing crises. Well-trained home care staff, communication equipment, emergency contacts and access to respite were highly valued for managing crises. We identified triggers and interventions that different stakeholders see as important for crisis in dementia. Recognition of these may be critical to planning effective and accepted support and care for people with dementia. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Disruptive behavior in the operating room: prevalence, consequences, prevention, and management.

    Science.gov (United States)

    Villafranca, Alexander; Fast, Ian; Jacobsohn, Eric

    2018-04-13

    Disruptive workplace behavior can have serious consequences to clinicians, institutions, and patients. There is a range of disruptive behaviors, and the consequences are often underappreciated. The purpose of this manuscript is to review the definition, prevalence, consequences, prevention, and management of disruptive behavior in the operating room. Although a small minority of operating room clinicians act disruptively, 98% of clinicians report having recently been exposed to disruptive behavior, with the average being 64 events per clinician per year. The causes include intrapersonal factors, workplace relationships, workplace logistics, and broader contextual factors. Disruptive behavior undermines patient care by decreasing individual and team clinical performance. It decreases clinician well being, sets a poor example for medical students who are susceptible to negative role models, and decreases hospital efficiency. The way that clinicians respond to disruptive behavior may either exacerbate or reduce the consequences of the behavior. In order to prevent disruptive behavior, the causes must be addressed. Institutions must have robust policies to deal with disruptive behavior and have preventive measures that include regular staff education. Whenever disruptive behavior does occur, it must be expeditiously addressed, which may include graded discipline. Disruptive intraoperative behavior is prevalent and harms multiple parties in the operating room. Institutions require comprehensive measures to prevent the behavior and to mitigate consequences.

  10. Creative Arts Interventions for Stress Management and Prevention-A Systematic Review.

    Science.gov (United States)

    Martin, Lily; Oepen, Renate; Bauer, Katharina; Nottensteiner, Alina; Mergheim, Katja; Gruber, Harald; Koch, Sabine C

    2018-02-22

    Stress is one of the world's largest health problems, leading to exhaustion, burnout, anxiety, a weak immune system, or even organ damage. In Germany, stress-induced work absenteeism costs about 20 billion Euros per year. Therefore, it is not surprising that the Central Federal Association of the public Health Insurance Funds in Germany ascribes particular importance to stress prevention and stress management as well as health enhancing measures. Building on current integrative and embodied stress theories, Creative Arts Therapies (CATs) or arts interventions are an innovative way to prevent stress and improve stress management. CATs encompass art, music, dance/movement, and drama therapy as their four major modalities. In order to obtain an overview of CATs and arts interventions' efficacy in the context of stress reduction and management, we conducted a systematic review with a search in the following data bases: Academic Search Complete, ERIC, Medline, Psyndex, PsycINFO and SocINDEX. Studies were included employing the PICOS principle and rated according to their evidence level. We included 37 studies, 73% of which were randomized controlled trials. 81.1% of the included studies reported a significant reduction of stress in the participants due to interventions of one of the four arts modalities.

  11. Community-Based Efforts to Prevent and Manage Diabetes in Women Living in Vulnerable Communities.

    Science.gov (United States)

    Lachance, Laurie; Kelly, R Patrick; Wilkin, Margaret; Burke, Jodi; Waddell, Sandra

    2017-11-13

    Social determinants of health likely play a significant role in the development of type 2 diabetes for women in vulnerable communities. Adult African American women diagnosed with or at-risk for diabetes in Inkster, Michigan (n = 113) and a group of demographically similar women in Flint, Michigan (n = 48) participated in programs aimed at increasing diabetes-related self-management behaviors through peer coaching, health literacy training, and social support. Participants completed surveys to measure changes in health, health behaviors, health literacy, and social support. We found that these diabetes programs with a focus on increasing women's capacity to practice health management behaviors, navigate the health care system, and connect with social support, led to an increase in healthy behaviors and a reported increase in both overall and diabetes-specific health over an 18 month period. Overall health, general diet and specific diet improved significantly (p change was not statistically significant. Women who participated in the intervention changed health behaviors, and increased their sense of health literacy and social support. Improvement in women's access to and use of community preventive services, and the provision of outreach support using community health workers (CHWs) and peer mentorship was an integral part of creating these changes. Although this study found that a variety of diabetes prevention and management programs provided opportunities for positive health changes, findings also suggest that it is critical to address the burdens women from vulnerable communities face in order to participate in these programs.

  12. ACC/AHA Guidelines for Cardiovascular Disease Prevention and Cholesterol Management: Implications of New Therapeutic Agents

    Directory of Open Access Journals (Sweden)

    Nathan D. Wong, PhD, FACC, FAHA, FNLA

    2016-09-01

    Full Text Available In 2014 the American College of Cardiology/American Heart Association issued four new guidelines for cardiovascular disease prevention that focused on cardiovascular risk assessment, lifestyle management, obesity management, and blood cholesterol management. The development of an atherosclerotic cardiovascular disease risk calculator formed the basis of the risk assessment guideline, and the lifestyle management guideline focused on recommending an evidence-based dietary pattern. The blood cholesterol management guideline specifically identified four groups of patients shown to benefit from moderate-intensity or high-intensity statin therapy from previous clinical trials and abandoned the use of specific low-density lipoprotein (LDL cholesterol (LDL-C goal levels on the basis of the lack of clinical trial evidence. The recommendations for treatment with moderate-intensity or high-intensity statin therapy are based on rigorous evidence from randomized clinical trials. Guidance has since been provided for the use of nonstatin therapies, including cholesterol absorption inhibitor and proprotein convertase subtilisin/kexin type 9 monoclonal antibody therapy when adequate reduction of LDL-C levels is not achieved with maximally tolerated statin therapy. The recent development and application of these therapies have resulted in remarkable reductions in LDL-C levels that are well tolerated, and preliminary outcome data are promising in showing substantial atherosclerotic cardiovascular disease event reductions beyond statin therapy.

  13. Nutritional management of breastfeeding infants for the prevention of common nutrient deficiencies and excesses

    Directory of Open Access Journals (Sweden)

    Jin Soo Moon

    2011-07-01

    Full Text Available Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children’s daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

  14. The roles of community pharmacists in cardiovascular disease prevention and management

    Directory of Open Access Journals (Sweden)

    George J

    2011-05-01

    Full Text Available There is ample evidence in the international literature forpharmacist involvement in the prevention and managementof cardiovascular disease (CVD conditions in primary care.Systematic reviews and meta-analyses have confirmed thesignificant clinical benefits of pharmacist interventions for arange of CVD conditions and risk factors. Evidence generatedin research studies of Australian community pharmacistinvolvement in CVD prevention and management issummarised in this article.Commonwealth funding through the Community PharmacyAgreements has facilitated research to establish the feasibilityand effectiveness of new models of primary care involvingcommunity pharmacists. Australian community pharmacistshave been shown to effect positive clinical, humanistic andeconomic outcomes in patients with CVD conditions.Improvements in blood pressure, lipid levels, medicationadherence and CVD risk have been demonstrated usingdifferent study designs. Satisfaction for GPs, pharmacists andconsumers has also been reported. Perceived ‘turf’encroachment, expertise of the pharmacist, space, time andremuneration are challenges to the implementation of diseasemanagement services involving community pharmacists.

  15. Can we reduce preventable heart failure readmissions in patients enrolled in a Disease Management Programme?

    LENUS (Irish Health Repository)

    Phelan, D

    2012-02-01

    BACKGROUND: Disease Management Programmes (DMPs) are successful in reducing hospital readmissions in heart failure (HF). However, there remain a number of patients enrolled in a DMP who are readmitted with HF. The primary aim of the study was to determine the proportion of preventable readmissions (PR). The secondary aim was to recognise patient characteristics which would identify certain patients at risk of having a PR. METHODS: A retrospective chart search was performed on patients readmitted over a 1-year period. RESULTS: 38.5% of readmissions were classified as PR. None of these patients made prior contact with the DMP. Admission levels of BNP, potassium, urea and creatinine were significantly lower in the PR group. CONCLUSION: DMP have proven benefits in reducing hospital readmission nonetheless a significant proportion of these readmissions are preventable. Further work is required to prospectively analyse why these patients fail to contact the DMP.

  16. Managing genetic tests, surveillance, and preventive medicine under a public health insurance system.

    Science.gov (United States)

    Filipova-Neumann, Lilia; Hoy, Michael

    2014-03-01

    There is a prospect in the medium to long term future of substantial advancements in the understanding of the relationship between disease and genetics. We consider the implications of increased information from genetic tests about predisposition to diseases from the perspective of managing health care provision under a public health insurance scheme. In particular, we consider how such information may potentially improve the targeting of medical surveillance (or prevention) activities to improve the chances of early detection of disease onset. We show that the moral hazard implications inherent in surveillance and prevention decisions that are chosen to be privately rather than socially optimal may be exacerbated by increased information about person-specific predisposition to disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. An ethical framework for identifying, preventing, and managing conflicts confronting leaders of academic health centers.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2004-11-01

    Leaders of academic health centers (AHCs) hold positions that by their very nature have a high potential for ethical conflict. The authors offer an ethical framework for identifying, preventing, and managing conflicts in the leadership of AHCs. This framework is based on and implements both the ethical concept of AHCs as fiduciary organizations and also the legitimate interests of various stakeholders. The authors describe practical steps that can be tools for the preventive-ethics leadership of AHCs that enable leaders to avoid strategic ambiguity and strategic procrastination and replace these with transparency. The ethical framework is illustrated by applying it to an organizational case study. The major contribution of the ethical framework is that it transforms decision making from simply negotiating power struggles to explicitly identifying and making ethical decisions based on the legitimate interests and fiduciary responsibilities of all stakeholders.

  18. Pediatric heat-related illness: recommendations for prevention and management [digest].

    Science.gov (United States)

    Dunn, Roberta J; Kim, Tommy Y; Chaudhari, Pradip

    2017-08-22

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  19. Regorafenib-associated hand-foot skin reaction: practical advice on diagnosis, prevention, and management.

    Science.gov (United States)

    McLellan, B; Ciardiello, F; Lacouture, M E; Segaert, S; Van Cutsem, E

    2015-10-01

    Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand-foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand-foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and tried-and-tested empirical

  20. Regorafenib-associated hand–foot skin reaction: practical advice on diagnosis, prevention, and management

    Science.gov (United States)

    McLellan, B.; Ciardiello, F.; Lacouture, M. E.; Segaert, S.; Van Cutsem, E.

    2015-01-01

    Background Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand–foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. Design This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Results Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand–foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and

  1. Concurrency & Asynchrony in Declarative Workflows

    DEFF Research Database (Denmark)

    Debois, Søren; Hildebrandt, Thomas; Slaats, Tijs

    2015-01-01

    Declarative or constraint-based business process and workflow notations have received increasing interest in the last decade as possible means of addressing the challenge of supporting at the same time flexibility in execution, adaptability and compliance. However, the definition of concurrent...... of concurrency in DCR Graphs admits asynchronous execution of declarative workflows both conceptually and by reporting on a prototype implementation of a distributed declarative workflow engine. Both the theoretical development and the implementation is supported by an extended example; moreover, the theoretical...

  2. Concurrent Delay in Construction Disputes

    DEFF Research Database (Denmark)

    Cavaleri, Sylvie Cécile

    period of delay can potentially be attributed to several events falling within both parties' spheres of responsibility, commonly termed concurrent delay, is rarely regulated in construction contracts in spite of its common occurrence. This book analyses both the theoretical foundations and the practical......Delay is one of the issues most frequently encountered in today’s construction industry; it causes significant economic damage to all parties involved. Construction contracts, standard and bespoke, almost invariably consider delay from a perspective of single liability. If the event causing...... solutions to the issue of concurrent delay in a comparative perspective between common and civil law systems, with an emphasis on Danish and English law....

  3. Fuzzy simulation in concurrent engineering

    Science.gov (United States)

    Kraslawski, A.; Nystrom, L.

    1992-01-01

    Concurrent engineering is becoming a very important practice in manufacturing. A problem in concurrent engineering is the uncertainty associated with the values of the input variables and operating conditions. The problem discussed in this paper concerns the simulation of processes where the raw materials and the operational parameters possess fuzzy characteristics. The processing of fuzzy input information is performed by the vertex method and the commercial simulation packages POLYMATH and GEMS. The examples are presented to illustrate the usefulness of the method in the simulation of chemical engineering processes.

  4. A randomized trial to evaluate a management training program to prevent illegal alcohol sales.

    Science.gov (United States)

    Toomey, Traci L; Erickson, Darin J; Lenk, Kathleen M; Kilian, Gunna R; Perry, Cheryl L; Wagenaar, Alexander C

    2008-03-01

    To evaluate effects of a training program for owners/managers of alcohol establishments-Alcohol Risk Management (ARM)-on: (i) propensity to sell alcohol to obviously intoxicated patrons; and (ii) changing establishment-level policies/practices. We assigned alcohol establishments randomly to intervention (full-ARM) and delayed-intervention/control (ARM Express) conditions. One large metropolitan area in Midwestern United States. Owners and managers at 231 on-premise alcohol establishments (i.e. bars, restaurants). Training programs consisted of one-to-one sessions with the owner/manager at each establishment. The goal of training was to help owners/managers to select and implement alcohol control policies in their establishments. The full-ARM training consisted of four one-to-one sessions and the ARM Express was a single session. We measured intervention effects through baseline and follow-up pseudo-intoxicated alcohol purchase attempts (i.e. feigning intoxication while attempting to purchase alcohol) and telephone surveys of owners/managers at alcohol establishments. Sales rates to pseudo-intoxicated patrons reduced 23% (relative to delayed-intervention/control condition) at the first follow-up purchase attempt (P = 0.06) but returned to baseline levels 3 months later. On average, establishments selected 13 of 18 recommended policies, but in multivariate models we observed no significant differences at follow-up in reported policies/practices across establishments. Reliance on manager training to promote responsible establishment alcohol policies is not sufficient to prevent illegal alcohol sales to obviously intoxicated patrons and to reduce alcohol-related problems.

  5. Sexual Assault: Better Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army Reserve

    Science.gov (United States)

    2017-02-01

    the commanding officer of an accused servicemember. 21Army Regulation 600-20 defines sexual harassment as a form of gender discrimination that...SEXUAL ASSAULT Better Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army...Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army Reserve What GAO Found The Army National Guard

  6. The Preventive Signaling Maintenance Crew Scheduling Problem for European Railway Traffic Management system (ERTMS)

    DEFF Research Database (Denmark)

    M. Pour, Shahrzad; Stidsen, Thomas Jacob Riis; Rasmussen, Kourosh Marjani

    , the western part of Denmark. This case is particularly interesting, since the entire railway signalling system is currently being upgraded to the new European Railway Traffic Management System (ERTMS) standard. The new signals need continuous maintenance and in this article we plan the distribution of crew......A railway system is a large and complex infrastructure, which requires continuous maintenance in order to function correctly. Proper maintenance is critical but can also be costly. In this paper we consider the practical case of planning the preventive maintenance of railway signals in Jutland...

  7. Management and Prevention of Surgical and Nutritional Complications After Bariatric Surgery.

    Science.gov (United States)

    Marcotte, Eric; Chand, Bipan

    2016-08-01

    Bariatric surgery is well-recognized for its effects on health, beyond weight-loss. It underwent a revolution recently with the growing performance of laparoscopic procedures, leading to enhanced recovery and a reduction in procedural risk. However, surgical complications, although rare, do develop. It is important to recognize the complications, and ideally prevent them from happening. This article reviews the risks of the four most commonly performed bariatric procedures, with an emphasis on technique and management in the intraoperative and postoperative period. The nutritional aspect of bariatric surgery is of the utmost importance, because catastrophic consequences have been linked to malnutrition and vitamin deficiencies. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Immediate implant placement: surgical techniques for prevention and management of complications.

    Science.gov (United States)

    Al-Sabbagh, Mohanad; Kutkut, Ahmad

    2015-01-01

    Loss of soft and hard tissue is common after tooth extraction. Substantial resorption of alveolar bone compromises esthetics and may result in prosthetic and surgical limitations. Immediate implant placement at the time of tooth extraction is used to maintain alveolar ridge dimensions. Clinical studies support the successful outcome of immediate placement of dental implants in fresh extraction sockets; comparative clinical studies have found that implant survival rates after immediate placement are similar to those after delayed placement. This article addresses surgical techniques for immediate implant placement and the prevention and the management of complications associated with this procedure. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

  10. Positive strategies men regularly use to prevent and manage depression: a national survey of Australian men.

    Science.gov (United States)

    Proudfoot, Judy; Fogarty, Andrea S; McTigue, Isabel; Nathan, Sally; Whittle, Erin L; Christensen, Helen; Player, Michael J; Hadzi-Pavlovic, Dusan; Wilhelm, Kay

    2015-11-16

    Men are at greater risk than women of dying by suicide. One in eight will experience depression--a leading contributor to suicide--in their lifetime and men often delay seeking treatment. Previous research has focused on men's use of unhelpful coping strategies, with little emphasis on men's productive responses. The present study examines the positive strategies men use to prevent and manage depression. A national online survey investigated Australian men's use of positive strategies, including 26 strategies specifically nominated by men in a previous qualitative study. Data were collected regarding frequency of use or openness to using untried strategies, depression risk, depression symptoms, demographic factors, and other strategies suggested by men. Multivariate regression analyses explored relationships between regular use of strategies and other variables. In total, 465 men aged between 18 and 74 years participated. The mean number of strategies used was 16.8 (SD 4.1) for preventing depression and 15.1 (SD 5.1) for management. The top five prevention strategies used regularly were eating healthily (54.2 %), keeping busy (50.1 %), exercising (44.9 %), humour (41.1 %) and helping others (35.7 %). The top five strategies used for management were taking time out (35.7 %), rewarding myself (35.1 %), keeping busy (35.1 %), exercising (33.3 %) and spending time with a pet (32.7 %). With untried strategies, a majority (58 %) were open to maintaining a relationship with a mentor, and nearly half were open to using meditation, mindfulness or gratitude exercises, seeing a health professional, or setting goals. In multivariate analyses, lower depression risk as measured by the Male Depression Risk Scale was associated with regular use of self-care, achievement-based and cognitive strategies, while lower scores on the Patient Health Questionnaire-9 was associated with regular use of cognitive strategies. The results demonstrate that the men in the study currently use, and

  11. Pressure-ulcer management and prevention in acute and primary care.

    Science.gov (United States)

    Newham, Roger; Hudgell, Lynne

    This article describes a study to ascertain what it is like to follow the processes in practice for prevention and management of pressure ulcers as one aspect of care among others. The participants in this study were bands 5 and 6 staff nurses and healthcare assistants (HCAs) (n=72) recruited from two acute and two primary NHS trusts. Data were gathered from open-ended questions via an online survey (n=61) and interviews (n=11). The interviews were transcribed and all the data were analysed by thematic analysis. The findings show that participants believe there has been a high-profile imposition of guidelines and policies by management during at least the past 18 months, resulting in perceived good outcomes in the form of fewer pressure ulcers generally and less fragmentation of care, particularly within primary care. However, a number of perceived obstacles to the implementation of recommended interventions remain, notably lack of time and lack of knowledge.

  12. Ergonomic work analysis as a tool of prevention for the occupational safety and health management system.

    Science.gov (United States)

    de Miranda Prottes, Verônica; Oliveira, Nádia Cristina; de Oliveira Andrade, Alessandra Barbosa

    2012-01-01

    This paper introduces the Ergonomic Work Analysis as a relevant instrument to identify the risks in occupational environments through the investigation of factors that influence the relationship between the worker and the productive process. It draws a parallel between the several aspects of risk identification in traditional tools of Health and Safety Management and the factors embraced by the Ergonomic Work Analysis, showing that the ergonomic methodology is able to go deeper in the scenarios of possible incident causes. This deepening enables the establishment of a relationship between the work context and the upcoming damage to the physical integrity of the worker. It acts as a complementary instrument in the traditional approach to the risk management. In order to explain the application of this methodology in a preventive way, it is presented a case study of a coal mill inspector in a siderurgic company.

  13. Obesity and the challenges of caesarean delivery: prevention and management of wound complications.

    Science.gov (United States)

    Ayres-de-Campos, Diogo

    2015-04-01

    Caesarean section in obese patients is associated with an increased risk of surgical wound complications, including haematoma, seroma, abscess and dehiscence. This review focusses on the available strategies to decrease wound complications in this population, and on the clinical management of these situations. Appropriate dose of prophylactic antibiotics, closure of the subcutaneous tissue, and avoidance of subcutaneous drains reduce the incidence of wound complications associated with caesarean section in obese patients. For treatment of superficial wound infection associated with dehiscence, there are data from general surgery patients to suggest that the use of vacuum-assisted devices leads to faster healing and that surgical reclosure is preferable to healing by secondary intention, when there are no signs of ongoing infection. There is a need for stronger evidence regarding the prevention and management of wound complications for caesarean section in obese women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Prevention of thyroid associated-ophthalmopathy in children and adults: current views and management of preventable risk factors.

    Science.gov (United States)

    Krassas, Gerasimos E; Perros, Petros

    2007-03-01

    Primary, secondary and tertiary prevention are defined according to the timing of the preventive intervention in the natural history of a disease. Secondary prevention in Graves' ophthalmopathy (GO) is challenging in the absence of reliable specific serum markers for subclinical GO that would allow an early diagnosis. Some risk factors for occurrence or progression of GO have been identified. Cigarette smoking, thyroid dysfunction and radioactive iodine (RAI) are known preventable risk factors. The list is probably much longer, and future research should be aimed at identifying more. Smoking cessation, restoration of euthyroidism by antithyroid drugs or L-thyroxine, glucocorticoid coverage after RAI or deferring RAI until the eye disease is inactive, may prevent progression of GO. Passive smoking seems to exacerbate autoimmune thyroid disease (AITD) in general, and may have a deleterious effect on childhood GO in particular, therefore avoidance of passive smoking is likely to be beneficial.

  15. Mission Analysis for Using Preventive Radiological/Nuclear Detection Equipment for Consequence Management

    Energy Technology Data Exchange (ETDEWEB)

    Buddemeier, Brooke R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wood-Zika, Annmarie R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Haynes, Daniel [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Klemic, Gladys A. [US Dept. of Homeland Security National Urban Security Technology Lab., Manhattan, NY (United States); Musolino, Stephen V. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2017-09-01

    The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection (PRND) equipment to provide state and local agencies with scientific guidance on how to effectively use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed by technology manufacturers and purchased by responders for preventive detection and source interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management (CM) response take place, as it is currently the most widely available and fielded radiological instrumentation by state and local agencies. This effort will provide scientific guidance on the most effective way to utilize this class of equipment for consequence management missions. Gaining a better understanding of how PRND equipment can operate and perform for these missions will allow for recommendations on the tactical approach responders can use for consequence management operations. PRND equipment has been placed into service by federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be leveraged to support the emergency response in the aftermath of a radiological or nuclear event. With several hundred makes and models of PRND equipment, often with significantly different detection capabilities that do not align with their nominal PRND equipment type, development of a streamlined categorization scheme with respect to consequence management missions was the first step to identifying safe and effective uses of PRND equipment for radiological/nuclear incident response.

  16. Modal abstractions of concurrent behavior

    DEFF Research Database (Denmark)

    Nielson, Flemming; Nanz, Sebastian; Nielson, Hanne Riis

    2011-01-01

    We present an effective algorithm for the automatic construction of finite modal transition systems as abstractions of potentially infinite concurrent processes. Modal transition systems are recognized as valuable abstractions for model checking because they allow for the validation as well as re...

  17. Relationships between models of concurrency

    DEFF Research Database (Denmark)

    Nielsen, Mogens; Sassone, Vladimiro; Winskel, Glynn

    1994-01-01

    Models for concurrency can be classified with respect to the three relevant parameters: behaviour/system, interleaving/noninterleaving, linear/branching time. When modelling a process, a choice concerning such parameters corresponds to choosing the level of abstraction of the resulting semantics....

  18. Permanency Action through Concurrent Planning.

    Science.gov (United States)

    Katz, Linda

    1996-01-01

    Highlights a failure on the part of social services to respond to the current needs of the child welfare system. Strongly advocates a commitment to concurrent planning, defined here as the process of working toward family reunification while at the same time establishing an alternative plan, usually in the form of permanency with a relative or…

  19. Concurrent flow lanes - phase III.

    Science.gov (United States)

    2011-01-01

    This report describes efforts taken to develop and calibrate VISSIM models of existing : concurrent flow lane designs of north- and southbound lanes of I-270 from the interchange at : I-70 to interchanges on I-495 at Connecticut Avenue in Maryland an...

  20. 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

  1. Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting

    Directory of Open Access Journals (Sweden)

    Ofori SN

    2014-05-01

    Full Text Available Sandra N Ofori, Chioma N Unachukwu Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria Abstract: Diabetes mellitus (DM is a chronic, progressive metabolic disorder with several complications that affect virtually all the systems in the human body. Type 2 DM (T2DM is a major risk factor for cardiovascular disease (CVD. The management of T2DM is multifactorial, taking into account other major modifiable risk factors, like obesity, physical inactivity, smoking, blood pressure, and dyslipidemia. A multidisciplinary team is essential to maximize the care of individuals with DM. DM self-management education and patient-centered care are the cornerstones of management in addition to effective lifestyle strategies and pharmacotherapy with individualization of glycemic goals. Robust evidence supports the effectiveness of this approach when implemented. Individuals with DM and their family members usually share a common lifestyle that, not only predisposes the non-DM members to developing DM but also, increases their collective risk for CVD. In treating DM, involvement of the entire family, not only improves the care of the DM individual but also, helps to prevent the risk of developing DM in the family members. Keywords: cardiovascular disease, multifactorial management

  2. Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

    Directory of Open Access Journals (Sweden)

    James Coyle

    2012-06-01

    Full Text Available Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP, a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  3. The role of disease management in the treatment and prevention of obesity with associated comorbidities.

    Science.gov (United States)

    May, Jeanette; Buckman, Ellen

    2007-06-01

    Nearly two thirds of the US population is overweight or obese and those numbers are climbing. Many organizations are beginning to recognize overweight and obesity as severe health threats and to acknowledge that treatment can serve as an important first step in addressing this epidemic. Through its Obesity with Co-morbidities Initiative, the Disease Management Association of America (DMAA) seeks to raise awareness and improve understanding of the role disease management (DM) can play in the treatment and management of obesity with comorbidities. Among the objectives of the Obesity with Co-morbidities Initiative was to develop standard definitions of obesity and obesity with comorbidities and to conduct qualitative research among key DM stakeholders. The first project undertaken and completed by the Obesity with Associated Co-morbidities Steering Committee and work group was to define the term "obesity" for consistent usage within the DM community for the purposes of population-based interventions. As part of this initiative, DMAA partnered with Synovate, a global market research firm, to conduct focus groups and in-depth interviews in order to collect qualitative data on attitudes and practices related to obesity treatment and coverage among key industry stakeholders, including health plans, disease management organizations, employers, and the business community. The findings indicated that obesity was widely recognized as a serious issue, but there remained varying opinions regarding responsibility, health and productivity costs, coverage, and best treatment methods among the participants. DMAA will continue this initiative through 2007 and will continue to develop a knowledge base of obesity guidelines and management practices, create valuable tools and resources including an online resource center, and facilitate partnerships with other organizations involved in the management and prevention of obesity.

  4. Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being".

    Science.gov (United States)

    Cramm, Jane Murray; Nieboer, Anna Petra

    2016-09-21

    managing their own well-being and adequately addressing their needs in a broader sense. So, is disease management the answer to our problems in the time of aging populations and increased prevalence of unhealthy lifestyles, chronic illnesses, and comorbidity? No! Effective (disease) prevention, disease management, patient-centered care, and high-quality chronic care and/or population health management calls for management of overall well-being.

  5. NASA's Corrosion Technology Laboratory at the Kennedy Space Center: Anticipating, Managing, and Preventing Corrosion

    Science.gov (United States)

    Calle, Luz Marina

    2015-01-01

    The marine environment at NASAs Kennedy Space Center (KSC) has been documented by ASM International (formerly American Society for Metals) as the most corrosive in North America. With the introduction of the Space Shuttle in 1981, the already highly corrosive conditions at the launch pads were rendered even more severe by the highly corrosive hydrochloric acid (HCl) generated by the solid rocket boosters (SRBs). Numerous failures at the launch pads are caused by corrosion. The structural integrity of ground infrastructure and flight hardware is critical to the success, safety, cost, and sustainability of space missions. NASA has over fifty years of experience dealing with unexpected failures caused by corrosion and has developed expertise in corrosion control in the launch and other environments. The Corrosion Technology Laboratory at KSC evolved, from what started as an atmospheric exposure test site near NASAs launch pads, into a capability that provides technical innovations and engineering services in all areas of corrosion for NASA, external partners, and customers.This paper provides a chronological overview of NASAs role in anticipating, managing, and preventing corrosion in highly corrosive environments. One important challenge in managing and preventing corrosion involves the detrimental impact on humans and the environment of what have been very effective corrosion control strategies. This challenge has motivated the development of new corrosion control technologies that are more effective and environmentally friendly. Strategies for improved corrosion protection and durability can have a huge impact on the economic sustainability of human spaceflight operations.

  6. Cinnamic Acid and Its Derivatives: Mechanisms for Prevention and Management of Diabetes and Its Complications

    Directory of Open Access Journals (Sweden)

    Sirichai Adisakwattana

    2017-02-01

    Full Text Available With recent insight into the development of dietary supplements and functional foods, search of effective phytochemical compounds and their mechanisms involved in prevention and management of diabetes and its complications are now being assessed. Cinnamic acid and its derivatives occur naturally in high levels of plant-based foods. Among various biological activities, cinnamic acid and its derivatives are associated with a beneficial influence on diabetes and its complications. The aim of the review is to summarize the potential mechanisms of these compounds for prevention and management of diabetes and its complications. Based on several in vitro studies and animal models, cinnamic acid and its derivatives act on different mechanism of actions, including stimulation of insulin secretion, improvement of pancreatic β-cell functionality, inhibition of hepatic gluconeogenesis, enhanced glucose uptake, increased insulin signaling pathway, delay of carbohydrate digestion and glucose absorption, and inhibition of protein glycation and insulin fibrillation. However, due to the limited intestinal absorption being a result of low bioavailability of cinnamic acid and its derivatives, current improvement efforts with entrapping into solid and liquid particles are highlighted. Further human clinical studies are needed to clarify the effects of cinnamic acid and its derivatives in diabetic patients.

  7. Prevention and management of type 2 diabetes: dietary components and nutritional strategies.

    Science.gov (United States)

    Ley, Sylvia H; Hamdy, Osama; Mohan, Viswanathan; Hu, Frank B

    2014-06-07

    In the past couple of decades, evidence from prospective observational studies and clinical trials has converged to support the importance of individual nutrients, foods, and dietary patterns in the prevention and management of type 2 diabetes. The quality of dietary fats and carbohydrates consumed is more crucial than is the quantity of these macronutrients. Diets rich in wholegrains, fruits, vegetables, legumes, and nuts; moderate in alcohol consumption; and lower in refined grains, red or processed meats, and sugar-sweetened beverages have been shown to reduce the risk of diabetes and improve glycaemic control and blood lipids in patients with diabetes. With an emphasis on overall diet quality, several dietary patterns such as Mediterranean, low glycaemic index, moderately low carbohydrate, and vegetarian diets can be tailored to personal and cultural food preferences and appropriate calorie needs for weight control and diabetes prevention and management. Although much progress has been made in development and implementation of evidence-based nutrition recommendations in developed countries, concerted worldwide efforts and policies are warranted to alleviate regional disparities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. 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)

  9. Innovations in preventing and managing chronic conditions: what's working in the real world?

    Science.gov (United States)

    Cassil, Alwyn

    2010-06-01

    Wellness and prevention strategies are fast becoming a standard feature of employer-based health benefits in hopes of countering rapidly rising health care costs that drive higher insurance premiums. At the same time, payers and health care providers are experimenting with how to improve care coordination for high-cost patients with multiple chronic conditions, an ongoing challenge in the fragmented U.S. health care system. Promoting health and wellness and improving the care of people with chronic conditions offer promise in helping to improve the value of health care and control costs, according to experts at a Center for Studying Health System Change (HSC) conference titled, Innovations in Preventing and Managing Chronic Conditions: What's Working in the Real World? Panelists explored how effective employer-sponsored wellness and prevention initiatives focus on health improvement as a business strategy and foster work and community environments that help people lower risk factors--smoking, diet, lack of exercise--that lead to disease. Panelists also discussed various models--centered on strong primary care-to improve care for people with chronic conditions.

  10. [Early detection, prevention and management of renal failure in liver transplantation].

    Science.gov (United States)

    Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

    2014-10-01

    Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function. Copyright © 2013 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  11. Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.

    Science.gov (United States)

    Sgaier, Sema K; Reed, Jason B; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-05-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009-2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection "Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up." The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform.

  12. Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.

    Directory of Open Access Journals (Sweden)

    Sema K Sgaier

    2014-05-01

    Full Text Available Voluntary medical male circumcision (VMMC is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009-2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection "Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up." The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform.

  13. Achieving the HIV Prevention Impact of Voluntary Medical Male Circumcision: Lessons and Challenges for Managing Programs

    Science.gov (United States)

    Sgaier, Sema K.; Reed, Jason B.; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-01-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009–2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection “Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up.” The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform. PMID:24800840

  14. Lifestyle changes and the risk of developing endometrial and ovarian cancers: opportunities for prevention and management

    Directory of Open Access Journals (Sweden)

    Beavis AL

    2016-05-01

    Full Text Available Anna L Beavis,1,* Anna Jo Bodurtha Smith,2,* Amanda Nickles Fader1 1Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, Johns Hopkins Medicine, Baltimore, MD, 2Harvard Medical School, Boston, MA, USA *These authors contributed equally to this work Abstract: Modifiable lifestyle factors, such as obesity, lack of physical activity, and smoking, contribute greatly to cancer and chronic disease morbidity and mortality worldwide. This review appraises recent evidence on modifiable lifestyle factors in the prevention of endometrial cancer (EC and ovarian cancer (OC as well as new evidence for lifestyle management of EC and OC survivors. For EC, obesity continues to be the strongest risk factor, while new evidence suggests that physical activity, oral contraceptive pills, and bariatric surgery may be protective against EC. Other medications, such as metformin and nonsteroidal anti-inflammatory drugs, may be protective, and interventional research is ongoing. For OC, we find increasing evidence to support the hypothesis that obesity and hormone replacement therapy increase the risk of developing OC. Oral contraceptive pills are protective against OC but are underutilized. Dietary factors such as the Mediterranean diet and alcohol consumption do not seem to affect the risk of either OC or EC. For EC and OC survivors, physical activity and weight loss are associated with improved quality of life. Small interventional trials show promise in increasing physical activity and weight maintenance for EC and OC survivors, although the impact on long-term health, including cancer recurrence and overall mortality, is unknown. Women’s health providers should integrate counseling about these modifiable lifestyle factors into both the discussion of prevention for all women and the management of survivors of gynecologic cancers. Keywords: lifestyle, prevention, endometrial cancer, ovarian cancer, gynecologic cancer, obesity

  15. Construction safety: Can management prevent all accidents or are workers responsible for their own actions?

    Energy Technology Data Exchange (ETDEWEB)

    Cotten, G.B.; Jenkins, S.L.

    1997-10-01

    The construction industry has struggled for many years with the answer to the question posed in the title: Can Management Prevent All Accidents or Are Workers Responsible for Their Own Actions? In the litigious society that we live, it has become more important to find someone {open_quotes}at fault{close_quotes} for an accident than it is to find out how we can prevent it from ever happening again. Most successful companies subscribe to the theme that {open_quotes}all accidents can be prevented.{close_quotes} They institute training and qualification programs, safe performance incentives, and culture-change-driven directorates such as the Voluntary Protection Program (VPP); yet we still see construction accidents that result in lost time, and occasionally death, which is extremely costly in the shortsighted measure of money and, in real terms, impact to the worker`s family. Workers need to be properly trained in safety and health protection before they are assigned to a job that may expose them to safety and health hazards. A management committed to improving worker safety and health will bring about significant results in terms of financial savings, improved employee morale, enhanced communities, and increased production. But how can this happen, you say? Reduction in injury and lost workdays are the rewards. A decline in reduction of injuries and lost workdays results in lower workers` compensation premiums and insurance rates. In 1991, United States workplace injuries and illnesses cost public and private sector employers an estimated $62 billion in workers` compensation expenditures.

  16. Improving quality of fall prevention and management in elderly patients using information technology: The impact of computerized decision support

    NARCIS (Netherlands)

    Askari, M.

    2014-01-01

    This thesis explores the role of information technology (IT) for prevention and management of falls in both general practice and hospital settings. Specifically, we address the question of how disease management concepts, process modeling, prognostic models and computerized decision support systems

  17. The prevention, detection and management of cancer treatment-induced cardiotoxicity: a meta-review

    International Nuclear Information System (INIS)

    Conway, Aaron; McCarthy, Alexandra L; Lawrence, Petra; Clark, Robyn A

    2015-01-01

    The benefits associated with some cancer treatments do not come without risk. A serious side effect of some common cancer treatments is cardiotoxicity. Increased recognition of the public health implications of cancer treatment-induced cardiotoxicity has resulted in a proliferation of systematic reviews in this field to guide practice. Quality appraisal of these reviews is likely to limit the influence of biased conclusions from systematic reviews that have used poor methodology related to clinical decision-making. The aim of this meta-review is to appraise and synthesise evidence from only high quality systematic reviews focused on the prevention, detection or management of cancer treatment-induced cardiotoxicity. Using Cochrane methodology, we searched databases, citations and hand-searched bibliographies. Two reviewers independently appraised reviews and extracted findings. A total of 18 high quality systematic reviews were subsequently analysed, 67 % (n = 12) of these comprised meta-analyses. One systematic review concluded that there is insufficient evidence regarding the utility of cardiac biomarkers for the detection of cardiotoxicity. The following strategies might reduce the risk of cardiotoxicity: 1) The concomitant administration of dexrazoxane with anthracylines; 2) The avoidance of anthracyclines where possible; 3) The continuous administration of anthracyclines (>6 h) rather than bolus dosing; and 4) The administration of anthracycline derivatives such as epirubicin or liposomal-encapsulated doxorubicin instead of doxorubicin. In terms of management, one review focused on medical interventions for treating anthracycline-induced cardiotoxicity during or after treatment of childhood cancer. Neither intervention (enalapril and phosphocreatine) was associated with statistically significant improvement in ejection fraction or mortality. This review highlights the lack of high level evidence to guide clinical decision-making with respect to the detection

  18. Primary prevention of peri-implantitis: managing peri-implant mucositis.

    Science.gov (United States)

    Jepsen, Søren; Berglundh, Tord; Genco, Robert; Aass, Anne Merete; Demirel, Korkud; Derks, Jan; Figuero, Elena; Giovannoli, Jean Louis; Goldstein, Moshe; Lambert, France; Ortiz-Vigon, Alberto; Polyzois, Ioannis; Salvi, Giovanni E; Schwarz, Frank; Serino, Giovanni; Tomasi, Cristiano; Zitzmann, Nicola U

    2015-04-01

    Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis. Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants. Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention

  19. Prioritizing and optimizing sustainable measures for food waste prevention and management.

    Science.gov (United States)

    Cristóbal, Jorge; Castellani, Valentina; Manfredi, Simone; Sala, Serenella

    2018-02-01

    Food waste has gained prominence in the European political debate thanks to the recent Circular Economy package. Currently the waste hierarchy, introduced by the Waste Framework Directive, has been the rule followed to prioritize food waste prevention and management measures according to the environmental criteria. But when considering other criteria along with the environmental one, such as the economic, other tools are needed for the prioritization and optimization. This paper addresses the situation in which a decision-maker has to design a food waste prevention programme considering the limited economic resources in order to achieve the highest environmental impact prevention along the whole food life cycle. A methodology using Life Cycle Assessment and mathematical programing is proposed and its capabilities are shown through a case study. Results show that the order established in the waste hierarchy is generally followed. The proposed methodology revealed to be especially helpful in identifying "quick wins" - measures that should be always prioritized since they avoid a high environmental impact at a low cost. Besides, in order to aggregate the environmental scores related to a variety of impact categories, different weighting sets were proposed. In general, results show that the relevance of the weighting set in the prioritization of the measures appears to be limited. Finally, the correlation between reducing food waste generation and reducing environmental impact along the Food Supply Chain has been studied. Results highlight that when planning food waste prevention strategies, it is important to set the targets at the level of environmental impact instead of setting the targets at the level of avoided food waste generation (in mass). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. Genetics-Current and Future Role in the Prevention and Management of Coronary Artery Disease.

    Science.gov (United States)

    Roberts, Robert

    2016-12-01

    The purpose of this study is to review genetic risk variants for coronary artery disease (CAD) and how they will change the management and prevention of CAD currently and in the future. Through the efforts of international consortia, 58 genetic risk variants for CAD of genome-wide significance have been replicated in appropriate independent populations. Only one third of these variants mediate their risk through known conventional risk factors for CAD. Thus, unknown mechanisms contribute to CAD. Secondly, the genetic risk is proportional to the total number of risk variants rather than the intensity of any risk factor. Thirdly, the availability of the genetic risk variants enables one to perform Mendelian randomization (MR) studies since they are randomized at conception, not confounded, fixed for life, and can be used to determine if a risk factor is causative or just a marker. MR can also be used to determine the safety and efficacy of a gene product targeted for drug therapy. Genetic risk variants have been shown to successfully risk stratify for CAD in both primary and secondary preventions. Contrary to dogma, MR documents that plasma HDL-C is not protective of CAD. The use of genetic risk score (GRS) for CAD is shown to be more effective in risk stratifying for CAD than the Framingham risk score and independent of the conventional risk factors including family history. Furthermore, the GRS predicts the response to statin therapy in primary and secondary preventions. The use of GRS could represent a paradigm shift in the prevention of CAD.

  1. Employer Policies and Practices to Manage and Prevent Disability: Conclusion to the Special Issue.

    Science.gov (United States)

    Main, Chris J; Shaw, William S

    2016-12-01

    Purpose Research of employer policies and practices to manage and prevent disability spans many disciplines and perspectives, and there are many challenges related to stakeholder collaboration, data access, and interventions. The purpose of this article is to synthesize the findings from a conference and year-long collaboration among a group of invited researchers intended to spur new research innovations in this field. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The conference goals were to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. In this paper, we summarize key points from the 6 resulting papers, compare them with an earlier 2005 conference on improving return-to-work research, and conclude with recommendations for further overarching research directions. Results/Conclusion In comparison with the 2005 conference, a greater emphasis was placed on organizational and social factors, employer roles and responsibilities, methods of implementation, non-clinical approaches, and facilitating stay-at-work as well as return-to-work. A special panel of employer consultants and representatives who were featured at the 2015 conference reinforced the importance of organizational culture, leadership style, and financial decision-making strategies at the employer level. Based on the conference proceedings, we recommend that future research in this area should strive for: (a) broader inclusion of workers and workplaces; (b) attention to multilevel influences in the workplace; (c) a focus on social as well as physical aspects of work; (d) earlier employer collaboration efforts; (e) more attention to

  2. 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.

  3. Guideline for the prevention, diagnosis and management of cryptococcal meningitis among HIV-infected persons: 2013 update

    Directory of Open Access Journals (Sweden)

    The Southern African HIV Clinicians Society

    2013-06-01

    Full Text Available Six years after the first Society guidelines were published, cryptococcal meningitis (CM remains an important cause of morbidity and mortality among HIV-infected adults in South Africa. Several important developments have spurred the  publication of updated guidelines to manage this common fungal opportunistic infection. Recommendations described here include: (1 screening and pre-emptive treatment; (2 laboratory diagnosis and monitoring; (3 management of a first episode of CM; (4 amphotericin B deoxycholate toxicity prevention, monitoring and management; (5 timing of antiretroviral therapy among patients with CM; (6 management of raised intracranial pressure; (7 management of relapse episodes of CM.

  4. National Athletic Trainers' Association Position Statement: Preventing and Managing Sport-Related Dental and Oral Injuries

    Science.gov (United States)

    Gould, Trenton E.; Piland, Scott G.; Caswell, Shane V.; Ranalli, Dennis; Mills, Stephen; Ferrara, Michael S.; Courson, Ron

    2016-01-01

    Objective: To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. Background: Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma. Recommendations: Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals. PMID:27875057

  5. Preventing and managing workplace violence against healthcare workers in Emergency Departments.

    Science.gov (United States)

    D'Ettorre, Gabriele; Pellicani, Vincenza; Mazzotta, Mauro; Vullo, Annamaria

    2018-02-21

    Healthcare workers (HCWs) employed in Emergency Departments (EDs) frequently face with patients becoming violent because of long wait or diseases or under the influence of alcohol or drugs. Globally, workplace violence (WPV) in EDs is a major challenge to safety for HCWs, involving significant consequences to the victims, patients, and healthcare organizations. We reviewed the current literature with the aim to explore the topics focused on and to detect new evidences about approaching the issue of WPV toward HCWs in EDs. A search for articles regarding WPV toward HCWs employed in EDs and published from January 2007 through December 2017 was performed; using predetermined criteria for inclusion, selected articles were reviewed and qualitatively assessed for the aims of the review. We found 60 papers which matched our inclusion criteria; the topics, discussed in order of frequency from highest to lowest, were: "Risk Assessment", "Occurrence Rates", "Risk Management", and "Physical/non Physical Consequences". Dementia, schizophrenia, anxiety, acute stress reaction, suicidal ideation, and alcohol and drug intoxication were found as predictors of physical violence perpetrated by patients against HCWs. A strategic way to the effective management of WPV should prioritize training courses focused on: constructing HCW-patient relationship, improving the workers' communication skills, accurate reporting of each violent incident, and improving the labor context through management commitment and employee involvement in WPV prevention programs. A special effort is required in implementing workplace design effective in minimizing stressful conditions in waiting rooms which turned out to be the most frequent site of assaults.

  6. [Quality management for preventing healthcare-acquired infections. The importance of surveillance].

    Science.gov (United States)

    Gastmeier, P; Behnke, M; Reichardt, C; Geffers, C

    2011-02-01

    Healthcare acquired (nosocomial) infections are one of the most frequent complications of medical care. The management to prevent such nosocomial infections is a typical example of the use of the general principles of quality management in healthcare institutions: each institution should compare their own nosocomial infection rates for defined patient risk groups with reference data and identify problems concerning specific infection types or units/departments. This comparison should stimulate a careful analysis of the process of care and the options to improve the situation. Structured interventions, such as the introduction of bundles of infection control measures or checklists, are very helpful to increase compliance with infection control measures and to decrease nosocomial infection rates. However, often only interventions individually designed according to the specific needs in a particular unit/department are successful to improve infection rates. Therefore, the employment of experienced infection control personnel and surveillance strategies designed according to the specific needs of the institution are key elements of a good infection control management within healthcare institutions.

  7. The first Iranian recommendations on prevention, evaluation and management of high blood pressure.

    Science.gov (United States)

    Noohi, Feridoun; Sarrafzadegan, Nizal; Khosravi, Alireza; Andalib, Elham

    2012-01-01

    This paper presents the complete report of the first Iranian Recommendations on Prevention, Evaluation and Management of High Blood Pressure. The purpose is to provide an evidence-based approach to the prevention, management and control of hypertension (HTN) by adapting the most internationally known and used guidelines to the local health care status with consideration of the currently available data and based on the locally conducted researches on HTN as well as social and health care requirements. A working group of national and international experts participated in discussions and collaborated in decision-making, writing and reviewing the whole report. Multiple subcommittees worked together to review the recent national and international literature on HTN in different areas. We used the evaluation tool that is called "AGREE" and considered a score of > 60% as a high score. We adapted the Canadian Hypertension Education Program (CHEP), the United Kingdom's National Institute for Health and Clinical Excellence (NICE) and the US-based joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). The key topics that are highlighted in this report include: The importance of ambulatory and self-measurement of blood pressure, evaluation of cardiovascular risk in HTN patients, the role of lifestyle modification in the prevention of HTN and its control with more emphasis on salt intake reduction and weight control, introducing pharmacotherapy suitable for uncomplicated HTN or specific situations and the available drugs in Iran, highlighting the importance of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers and calcium channel blockers as the first line therapy in many situations, the non-use of beta blockers as the first time treatment except in specific conditions, treating HTN in women, children, obese and elderly patients, the patient compliance to improve HTN control, practical guidelines to improve

  8. Data refinement for true concurrency

    Directory of Open Access Journals (Sweden)

    Brijesh Dongol

    2013-05-01

    Full Text Available The majority of modern systems exhibit sophisticated concurrent behaviour, where several system components modify and observe the system state with fine-grained atomicity. Many systems (e.g., multi-core processors, real-time controllers also exhibit truly concurrent behaviour, where multiple events can occur simultaneously. This paper presents data refinement defined in terms of an interval-based framework, which includes high-level operators that capture non-deterministic expression evaluation. By modifying the type of an interval, our theory may be specialised to cover data refinement of both discrete and continuous systems. We present an interval-based encoding of forward simulation, then prove that our forward simulation rule is sound with respect to our data refinement definition. A number of rules for decomposing forward simulation proofs over both sequential and parallel composition are developed.

  9. Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study.

    Science.gov (United States)

    Nunn, Amy; Dickman, Samuel; Cornwall, Alexandra; Kwakwa, Helena; Mayer, Kenneth H; Rana, Aadia; Rosengard, Cynthia

    2012-07-01

    African American women are disproportionately affected by HIV/AIDS. Concurrent sexual partnerships may contribute to racial disparities in HIV infection. Little is known about attitudes and practices related to concurrency among African American women, or the social, structural and behavioural factors influencing concurrency. We recruited 19 heterosexual African American women engaging in concurrent sexual partnerships from a public clinic in Philadelphia in 2009. We conducted interviews exploring social norms, attitudes and practices about concurrency, and the structural, social and behavioural factors influencing concurrent sexual partnerships, guided by grounded theory. Seventeen women reported one main and one or more non-main partners; two reported no main partners. Many women used condoms more frequently with non-main than main partners, noting they trust main partners more than non-main partners. Social factors included social normalisation of concurrency, inability to negotiate partners' concurrent partnerships, being unmarried, and not trusting partners. Lack of trust was the most commonly cited reason that women engaged in concurrent partnerships. Structural factors included economic dependence on partners, partners' dependence on women for economic support and incarceration that interrupted partnerships. Behavioural factors included alcohol and cocaine use. Social, structural and behavioural factors strongly influenced these African American women's concurrent sexual partnerships. Many HIV interventions disseminated by the CDC focus largely on behavioural factors and may fail to address the social and structural factors influencing African American women's sexual networks. Novel HIV prevention interventions that address the social determinants of African American women's HIV risks are urgently needed.

  10. PyCSP - controlled concurrency

    DEFF Research Database (Denmark)

    Friborg, Rune Møllegaard; Vinter, Brian; Bjørndalen, John Markus

    Producing readable and correct programs while at the same time taking advantage of multi-core architectures is a challenge. PyCSP is an implementation of Communicating Sequential Processes algebra (CSP) for the Python programming language, taking advantage of CSP’s formal and verifiable approach...... to controlling concurrency and the readability of Python source code. We describe PyCSP, demonstrate it through examples and demonstrate how PyCSP compares to Pthreads using a benchmark....

  11. PyCSP - controlled concurrency

    DEFF Research Database (Denmark)

    Vinter, Brian; Friborg, Rune Møllegaard; Bjørndalen, John Markus

    2010-01-01

    Producing readable and correct programs while at the same time taking advantage of multi-core architectures is a challenge. PyCSP is an implementation of Communicating Sequential Processes algebra (CSP) for the Python programming language, that take advantage of CSP's formal and verifiable approach...... to controlling concurrency and the readability of Python source code. We describe PyCSP, demonstrate it through examples and demonstrate how PyCSP compares to Pthreads in a master-worker benchmark....

  12. Generalized coherence concurrence and path distinguishability

    International Nuclear Information System (INIS)

    Chin, Seungbeom

    2017-01-01

    We propose a new family of coherence monotones, named the generalized coherence concurrence (or coherence k -concurrence), which is an analogous concept to the generalized entanglement concurrence. The coherence k -concurrence of a state is nonzero if and only if the coherence number (a recently introduced discrete coherence monotone) of the state is not smaller than k , and a state can be converted to a state with nonzero entanglement k -concurrence via incoherent operations if and only if the state has nonzero coherence k -concurrence. We apply the coherence concurrence family to the problem of wave-particle duality in multi-path interference phenomena. We obtain a sharper equation for path distinguishability (which witnesses the duality) than the known one and show that the amount of each concurrence for the quanton state determines the number of slits which are identified unambiguously. (paper)

  13. Generalized coherence concurrence and path distinguishability

    Science.gov (United States)

    Chin, Seungbeom

    2017-11-01

    We propose a new family of coherence monotones, named the generalized coherence concurrence (or coherence k-concurrence), which is an analogous concept to the generalized entanglement concurrence. The coherence k-concurrence of a state is nonzero if and only if the coherence number (a recently introduced discrete coherence monotone) of the state is not smaller than k, and a state can be converted to a state with nonzero entanglement k-concurrence via incoherent operations if and only if the state has nonzero coherence k-concurrence. We apply the coherence concurrence family to the problem of wave-particle duality in multi-path interference phenomena. We obtain a sharper equation for path distinguishability (which witnesses the duality) than the known one and show that the amount of each concurrence for the quanton state determines the number of slits which are identified unambiguously.

  14. Modification of pathological type A as worksite stress management and disease prevention intervention.

    Science.gov (United States)

    Zonierczyk-Zreda, D

    2000-01-01

    The importance of helping an employee to better cope with occupational stress as the aim of stress management interventions is presented. It particularly concerns the employees who have the poorest temperamental and personality potential for effective coping and should be the target of primary stress intervention and prevention. According to evidence, Type A workers are at risk of occupational stress and disease, especially when some personality features of Type A are accompanied by high reactivity. The concept of pathological Type A is introduced. The already existing programs of modifying Type A and the framework of a program based on the elements that have been established to be the most therapeutic for pathological Type A are presented.

  15. Ultraviolet Keratitis: From the Pathophysiological Basis to Prevention and Clinical Management.

    Science.gov (United States)

    Willmann, Gabriel

    2015-12-01

    Ultraviolet keratitis is caused by the toxic effects of acute high-dose ultraviolet radiation (UVR) reflecting the sensitivity of the ocular surface to photochemical injury. The clinical syndrome presents with ocular pain, tearing, conjunctival chemosis, blepharospasm, and deterioration of vision typically several hours after exposure, lasting up to 3 days. Mountaineers, skiers, and beach recreationalists are particularly at risk to suffer from ultraviolet (UV) keratitis as the reflectivity of UVR in these environments is extremely high. The aim of this review is to raise awareness about the potential of UV damage on the eye with an emphasis on UV keratitis, to highlight the pathophysiological basis of corneal phototoxicity, and to provide practical guidance for the prevention and clinical management of UV keratitis commonly known as snow blindness.

  16. [Research of preferences and security management of tourists in Poyang Lake based on schistosomiasis prevention].

    Science.gov (United States)

    Feng, Shu-hua

    2015-04-01

    To discuss the prevention of schistosomiasis in tourism of lake region. The seasonal distribution of tourism activities and spatial distribution of scenic spots, as well as the coupling between space and temporal of Oncomelania snail distribution and the transmission time of schistosomiasis in Poyang Lake region were analyzed. The travel preference of schistosomiasis susceptible population was surveyed by questionnaires and interviews. There were couplings of space and temporal between tourism activities in Poyang Lake region and transmission time of schistosomiasis as well as space distribution of snails, respectively. The most popular tourism items were Shuishangrenjia (overwater household) and fishing folk culture with property of participation and experience. The suggestion is to establish health records of tourists, carry out health education of schistosomiasis, and enhance the management of tourism and activities of tourists.

  17. Information and communication technologies, a tool for risk prevention and accident management on sea ice

    Directory of Open Access Journals (Sweden)

    Elise Lépy

    2015-06-01

    Full Text Available Marine ice melting topic is a repetitive phenomenon in alarmist speeches on climate change. The present positive evolution of air temperatures has in all probability many impacts on the environment and more or less directly on societies. Face to the temperature elevation, the ice pack is undergone to an important temporal variability of ice growth and melting. Human populations can be exposed to meteorological and ice hazards engendering a societal risk. The purpose of this paper is to better understand how ICT get integrated into the risk question through the example of the Bay of Bothnia in the northern extremity of the Baltic Sea. The study deals with the way that Finnish society, advanced in the ICT field, faces to new technology use in risk prevention and accident management on sea ice.

  18. Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals.

    Science.gov (United States)

    Nugent, Rachel; Bertram, Melanie Y; Jan, Stephen; Niessen, Louis W; Sassi, Franco; Jamison, Dean T; Pier, Eduardo González; Beaglehole, Robert

    2018-04-05

    Reduction of the non-communicable disease (NCD) burden is a global development imperative. Sustainable Development Goal (SDG) 3 includes target 3·4 to reduce premature NCD mortality by a third by 2030. Progress on SDG target 3·4 will have a central role in determining the success of at least nine SDGs. A strengthened effort across multiple sectors with effective economic tools, such as price policies and insurance, is necessary. NCDs are heavily clustered in people with low socioeconomic status and are an important cause of medical impoverishment. They thereby exacerbate economic inequities within societies. As such, NCDs are a barrier to achieving SDG 1, SDG 2, SDG 4, SDG 5, and SDG 10. Productivity gains from preventing and managing NCDs will contribute to SDG 8. SDG 11 and SDG 12 offer clear opportunities to reduce the NCD burden and to create sustainable and healthy cities. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications

    Science.gov (United States)

    2017-01-01

    IN BRIEF Epidemiological studies have found a lower prevalence of type 2 diabetes among vegetarians compared to nonvegetarians. This reduced risk is likely a function of improved weight status, higher intake of dietary fiber, and the absence of animal protein and heme iron in the diet. Interventional studies have shown that vegetarian diets, especially a vegan diet, are effective tools in glycemic control and that these diets control plasma glucose to a greater level than do control diets, including diets traditionally recommended for patients with diabetes (e.g., diets based on carbohydrate counting). Vegetarian diets are associated with improvement in secondary outcomes such as weight reduction, serum lipid profile, and blood pressure. Studies indicate that vegetarian diets can be universally used in type 2 diabetes prevention and as tools to improve blood glucose management. PMID:28588373

  20. Get Connected: an HIV prevention case management program for men and women leaving California prisons.

    Science.gov (United States)

    Myers, Janet; Zack, Barry; Kramer, Katie; Gardner, Mick; Rucobo, Gonzalo; Costa-Taylor, Stacy

    2005-10-01

    Individuals leaving prison face challenges to establishing healthy lives in the community, including opportunities to engage in behavior that puts them at risk for HIV transmission. HIV prevention case management (PCM) can facilitate linkages to services, which in turn can help remove barriers to healthy behavior. As part of a federally funded demonstration project, the community-based organization Centerforce provided 5 months of PCM to individuals leaving 3 state prisons in California. Program effects were measured by assessing changes in risk behavior, access to services, reincarnation, and program completion. Although response rates preclude definitive conclusions, HIV risk behavior did decrease. Regardless of race, age, or gender, those receiving comprehensive health services were significantly more likely to complete the program. PCM appears to facilitate healthy behavior for individuals leaving prison.

  1. Concurrence classes for general pure multipartite states

    International Nuclear Information System (INIS)

    Heydari, Hoshang

    2005-01-01

    We propose concurrence classes for general pure multipartite states based on an orthogonal complement of a positive operator-valued measure on quantum phase. In particular, we construct W m class, GHZ m , and GHZ m-1 class concurrences for general pure m-partite states. We give explicit expressions for W 3 and GHZ 3 class concurrences for general pure three-partite states and for W 4 , GHZ 4 and GHZ 3 class concurrences for general pure four-partite states

  2. NASA's Corrosion Technology Laboratory at the Kennedy Space Center: Anticipating, Managing, and Preventing Corrosion

    Science.gov (United States)

    Calle, Luz Marina

    2014-01-01

    Corrosion is the degradation of a material that results from its interaction with the environment. The marine environment at NASAs Kennedy Space Center (KSC) has been documented by ASM International (formerly American Society for Metals) as the most corrosive in the United States. With the introduction of the Space Shuttle in 1981, the already highly corrosive conditions at the launch pads were rendered even more severe by the 70 tons of highly corrosive hydrochloric acid that were generated by the solid rocket boosters. Numerous failures at the launch pads are caused by corrosion.The structural integrity of ground infrastructure and flight hardware is critical to the success, safety, cost, and sustainability of space missions. As a result of fifty years of experience with launch and ground operations in a natural marine environment that is highly corrosive, NASAs Corrosion Technology Laboratory at KSC is a major source of corrosion control expertise in the launch and other environments. Throughout its history, the Laboratory has evolved from what started as an atmospheric exposure facility near NASAs launch pads into a world-wide recognized capability that provides technical innovations and engineering services in all areas of corrosion for NASA and external customers.This presentation will provide a historical overview of the role of NASAs Corrosion Technology in anticipating, managing, and preventing corrosion. One important challenge in managing and preventing corrosion involves the detrimental impact on humans and the environment of what have been very effective corrosion control strategies. This challenge has motivated the development of new corrosion control technologies that are more effective and environmentally friendly. Strategies for improved corrosion protection and durability can have a huge impact on the economic sustainability of human spaceflight operations.

  3. Evaluation, management and prevention of lower extremity youth ice hockey injuries

    Directory of Open Access Journals (Sweden)

    Popkin CA

    2016-11-01

    Full Text Available Charles A Popkin,1 Brian M Schulz,2 Caroline N Park,1 Thomas S Bottiglieri,1 T Sean Lynch1 1Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY, 2Kerlan‑Jobe Orthopedic Clinic, Los Angeles, CA, USA Abstract: Ice hockey is a fast-paced sport played by increasing numbers of children and adolescents in North America and around the world. Requiring a unique blend of skill, finesse, power and teamwork, ice hockey can become a lifelong recreational activity. Despite the rising popularity of the sport, there is ongoing concern about the high frequency of musculoskeletal injury associated with participation in ice hockey. Injury rates in ice hockey are among the highest in all competitive sports. Numerous research studies have been implemented to better understand the risks of injury. As a result, rule changes were adopted by the USA Hockey and Hockey Canada to raise the minimum age at which body checking is permitted to 13–14 years (Bantam level from 11–12 years (Pee Wee. Continuing the education of coaches, parents and players on rules of safe play, and emphasizing the standards for proper equipment use are other strategies being implemented to make the game safer to play. The objective of this article was to review the evaluation, management and prevention of common lower extremity youth hockey injuries. Keywords: youth hockey, body checking, injury prevention, femoroacetabular impingement, apophyseal avulsions

  4. Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Robert F. Pass

    2018-03-01

    Full Text Available Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection.

  5. Acute respiratory distress syndrome: clinical recognition and preventive management in chiropractic acute care practice.

    Science.gov (United States)

    Mirtz, T A

    2001-09-01

    To present clinical information relevant to acute respiratory distress syndrome (ARDS) and its appearance in chiropractic acute care practice. The National Library of Medicine MEDLINE database was used, along with the bibliographies of selected articles and textbooks commonly found in chiropractic college libraries and bookstores. Clinical studies from the English literature were selected if they pertained to incidence, clinical relevancy, or the association of ARDS with commonly-seen diagnoses in chiropractic neuromusculoskeletal or orthopedic practice. All relevant studies identified by the search were evaluated based on information pertinent to chiropractic management of acute care patients. ARDS is a pulmonary distress syndrome with a high mortality rate. Recognizable indications for the possible development of ARDS include chest pain, head injury, and thoracic spine pain with or without trauma. Clinical evaluation, radiographic findings, and laboratory findings are presented to assist practitioners in identifying this disease process of multiple etiology. A study of the basic pathophysiologic processes that occur in the formation of ARDS is presented to help practitioners gain clinical appreciation. Strategies for preventing respiratory distress in chiropractic patients are also presented and include use of the postural position and the clinical maxim of "slow, deep breathing despite pain" to lessen incident rates of subjects at risk. Although ARDS may not be prevalent in chiropractic practice, it is important for physicians to be aware of the clinical basics (including its pathophysiology), its medical significance, and the preventive strategies that may be used to minimize its occurrence. This basic understanding will further advance knowledge of this disease complex.

  6. Preventing Disruptive Behavior via Classroom Management: Validating the Color Wheel System in Kindergarten Classrooms.

    Science.gov (United States)

    Watson, Tiffany L; Skinner, Christopher H; Skinner, Amy L; Cazzell, Samantha; Aspiranti, Kathleen B; Moore, Tara; Coleman, MariBeth

    2016-07-01

    Evidence suggests that installing a classroom management system known as the Color Wheel reduced inappropriate behaviors and increased on-task behavior in second- and fourth-grade classrooms; however, no systematic studies of the Color Wheel had been disseminated targeting pre-school or kindergarten participants. To enhance our understanding of the Color Wheel System (CWS) as a prevention system, a multiple-baseline design was used to evaluate the effects of the Color Wheel on inappropriate vocalizations (IVs) in three general education kindergarten classrooms. Partial-interval time-sampling was used to record classwide IVs, which were operationally defined as any comment or vocal noise that was not solicited by the teacher. Time series graphs and effect size calculations suggest that the CWS caused immediate, large, and sustained decreases in IVs across the three classrooms. Teacher acceptability and interview data also supported the CWS. Implications related to prevention are discussed and directions for future research are provided. © The Author(s) 2016.

  7. Use of clonidine in the prevention and management of neonatal abstinence syndrome.

    Science.gov (United States)

    Leikin, Jerrold B; Mackendrick, William P; Maloney, Gerry E; Rhee, James W; Farrell, Elaine; Wahl, Michael; Kelly, Karen

    2009-07-01

    Neonatal abstinence syndrome (NAS) is a complicated medical condition with treatment regimens that traditionally have included methadone and other opioids, barbiturates, and benzodiazepines. We describe a case series in which clonidine was used for the prevention and management of patients with NAS. Medical records of infants treated with clonidine for NAS from January 2003 to March 2006 were reviewed for gestational age, birth weight, NAS score, dose of clonidine, duration of treatment, and additional medications required. Fourteen patients were identified. The mean gestational age was 30.1 weeks (range 24.4-40.7 weeks); three patients were full-term. Eleven had been on intravenous fentanyl for sedation; three were born to opioid-dependent mothers. All patients were treated with clonidine, administered in doses of 0.5-1.0 mcg/kg orally every 6 h. No patient received opioids. Mean duration of treatment was 6.8 days (range 4-15). Mean abstinence scores were 6.4 pretreatment (range 0-20) and 1.9 posttreatment (range 0-5). No patients suffered an adverse event (hypotension, bradycardia, excessive sedation, and oxygen desaturation) from clonidine administration, and no seizures were identified. Our data suggest that clonidine may be a reasonable alternative to more traditional agents used to prevent or treat NAS. We agree with the statement of the American Academy of Pediatrics Committee on Drugs that states that larger trials and pharmacologic data are needed before the routine use of clonidine can be recommended.

  8. Management of delayed hemolytic transfusion reaction in sickle cell disease: Prevention, diagnosis, treatment.

    Science.gov (United States)

    Pirenne, F; Bartolucci, P; Habibi, A

    2017-09-01

    Transfusion remains a key treatment of sickle cell disease complications. However, delayed hemolytic transfusion reaction, the most serious complication of transfusion, may be life-threatening if hyperhemolysis develops. This syndrome is generally underdiagnosed because its biological and clinical features resemble those of vaso-occlusive crisis, and red blood cell antibodies are frequently absent. Further transfusions may aggravate the symptoms, leading to severe multiple organ failure and death. It is therefore essential to prevent, diagnose and treat this syndrome efficiently. Prevention is based principally on the attenuation of allo-immunization through the provision of extended-matched RBCs or the use of rituximab. However, such treatment may be insufficient. Early diagnosis might make it possible to implement specific treatments in some cases, thereby avoiding the need for secondary transfusion. Diagnosis is dependent on the knowledge of the medical staff. Finally, many treatments, including steroids, immunoglobulins, erythropoietin and eculizumab, have been used to improve outcome. Improvements in our knowledge of the specific features of DHTR in SCD should facilitate management of this syndrome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. A decade of malaria during pregnancy in Brazil: what has been done concerning prevention and management

    Directory of Open Access Journals (Sweden)

    Paola Marchesini

    2014-08-01

    Full Text Available In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012 using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

  10. The Role of Nutritional Aspects in Food Allergy: Prevention and Management

    Science.gov (United States)

    Mazzocchi, Alessandra; Venter, Carina; Maslin, Kate

    2017-01-01

    The prevalence of food allergy in childhood appears to be increasing in both developed and transitional countries. The aim of this paper is to review and summarise key findings in the prevention and management of food allergy, focusing on the role of dietary components and nutritional habits in the development and optimal functioning of the immune system. Essential fatty acids, zinc and vitamin D are likely to enhance the anti-inflammatory and antioxidative barrier and promote immunologic tolerance. Additionally, nutritional components such as pre- and probiotics represent a novel research approach in the attempt to induce a tolerogenic immune environment. For all these reasons, the traditional avoidance diet has been, in recent years, completely reconsidered. New findings on the protective effect of an increased diversity of food introduced in the first year of life on allergic diseases are consistent with the hypothesis that exposure to a variety of food antigens during early life might play a role in the development of immune tolerance. Accordingly, therapeutic (and even preventive) interventions should be planned on an individual basis. PMID:28792480

  11. Prevention of stricture recurrence following urethral endoscopic management: what do we have?

    Science.gov (United States)

    Tian, Ye; Wazir, Romel; Yue, Xuan; Wang, Kun-Jie; Li, Hong

    2014-05-01

    Strictures of the urethra are the most common cause of obstructed micturition in younger men and there is frequent recurrence after initial treatment. This review was performed to determine the best strategy for stricture recurrence prevention following urethral endoscopic management. We reviewed the published literature in PubMed, the Cochrane Library, and Google Scholar focusing on this intractable problem regardless of language restrictions. Outcomes of interest included the study methods and the applied strategy's efficacy. The level of evidence and grade of recommendations of included studies were appraised with an Oxford Centre for Evidence-Based Medicine Scale. Currently, numerous techniques, including catheterization, repeated dilation, brachytherapy, and intraurethral use of various antifibrosis agents, have been employed to oppose the process of wound contraction or regulate the extracellular matrix. But unfortunately, none of these techniques or agents have demonstrated efficacy with enough evidence. Although lots of strategies are available, still, we do not have a suitable, single optimum solution for all the conditions. The clinical decision of stricture-recurrence-prevention techniques should be carefully tailored to every individual patient. As the studies are not sufficient, more efforts are warranted to address this interesting but challenging issue.

  12. 78 FR 41078 - Acceptance of Concurrent Jurisdiction

    Science.gov (United States)

    2013-07-09

    ... National Park Service Acceptance of Concurrent Jurisdiction AGENCY: National Park Service, Interior. ACTION: Notice of Concurrent Jurisdiction. SUMMARY: On behalf of the United States, the National Park Service has accepted concurrent legislative jurisdiction from the State of Michigan over lands and waters administered...

  13. 78 FR 8189 - Acceptance of Concurrent Jurisdiction

    Science.gov (United States)

    2013-02-05

    ... National Park Service Acceptance of Concurrent Jurisdiction AGENCY: National Park Service, Interior. ACTION: Notice of Concurrent Jurisdiction. SUMMARY: On behalf of the United States, the National Park Service has accepted concurrent legislative jurisdiction from the State of Washington over lands and waters...

  14. Simple concurrent garbage collection almost without synchronization

    NARCIS (Netherlands)

    Hesselink, Wim H.; Lali, M.I.

    We present two simple mark and sweep algorithms, A and B, for concurrent garbage collection by a single collector running concurrently with a number of mutators that concurrently modify shared data. Both algorithms are based on the ideas of Ben-Ari's classical algorithm for on-the-fly garbage

  15. Preventive distribution and plans of iodine tablets stocks management; Distribution preventive et plans de gestion des stocks de comprimes d'iode

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This official note includes two parts: one concerns the new preventive distribution of iodine tablets on the areas defined by the Particular Intervention Plans (P.P.I.) around nuclear facilities and the other one the setting up of iodine tablets stocks beyond the P.P.I. areas. In annexe is a guide for the elaboration of stocks management plans for steady iodine tablets. (N.C.)

  16. Partnership duration, concurrency, and HIV in sub-Saharan Africa.

    Science.gov (United States)

    Sawers, Larry; Isaac, Alan

    2017-07-01

    A widely accepted explanation for the exceptionally high HIV prevalence in sub-Saharan Africa is the practice of long-term overlapping heterosexual partnering. This article shows that long-duration concurrent partnering can be protective against HIV transmission rather than promoting it. Monogamous partnering prevents sexual transmission to anyone outside the partnership and, in an initially concordant-seronegative partnership, prevents sexual acquisition of HIV by either partner. Those protections against transmission and acquisition last as long as the partnership persists without new outside partnerships. Correspondingly, these two protective effects characterise polygynous partnerships, whether or not the polygyny is formal or informal, until a partner initiates a new partnership. Stable and exclusive unions of any size protect against HIV transmission, and more durable unions provide a longer protective effect. Survey research provides little information on partnership duration in sub-Saharan Africa and sheds no light on the interaction of duration, concurrency, and HIV. This article shows how assumptions about partnership duration in individual-based sexual-network models affect the contours of simulated HIV epidemics. Longer mean partnership duration slows the pace at which simulated epidemics grow. With plausible assumptions about partnership duration and at levels of concurrency found in the region, simulated HIV epidemics grow slowly or not at all. Those results are consistent with the hypothesis that long-duration partnering is protective against HIV and inconsistent with the hypothesis that long-term concurrency drives the HIV epidemics in sub-Saharan Africa.

  17. Health workers perceptions and attitude about Ghana's preparedness towards preventing, containing, and managing Ebola Virus Disease.

    Science.gov (United States)

    Adongo, Philip Baba; Tabong, Philip Teg-Nefaah; Asampong, Emmanuel; Ansong, Joana; Robalo, Magda; Adanu, Richard M

    2017-04-12

    Ebola virus is highly infectious and the disease can be very fatal. The World Health Organization has declared the 2014-2015 Ebola Virus Disease outbreak a Public Health Emergency of International Concern. In response to this, preparations were made in various health facilities and entry points across Ghana. This study explored health workers perceptions, and attitude about Ghana's preparedness towards preventing and containing Ebola Virus Disease. We conducted a qualitative study in five (5) of the ten (10) regions in Ghana. Five focus group discussions (N = 44) were conducted among nurses; one in each region. In addition, ten (10) health workers (2 in each region) who are members of regional Ebola Virus Disease task force were recruited and interviewed. In the Greater Accra, Volta and Western regions that have ports, six (6) port health officials: two in each of these regions were also interviewed. The interviews were recorded digitally and transcribed verbatim. Thematic content analysis was used to analyze the transcripts with the aid of NVivo 10 software. The results of this study showed that Ghanaian health workers perceived the screening at various ports as important and ongoing but felt that the screenings at in-land ports were being undermined by the use of unapproved routes. Training of health workers was also being carried out in all the regions, however, there was a general perception among 33 out of 44 nurses that majority of health workers have not received training on Ebola Virus Disease prevention and management. Logistical challenges were also reported as some health facilities did not have adequate Personal Protective Equipment. In facilities where equipment was available, they were stored in places which are not easily accessible to health workers at all times of the day. Human resource preparation was also perceived to be a challenge as health workers (38/44 of nurses) generally expressed fear and unwillingness to work in Ebola treatment

  18. Software for storage and management of microclimatic data for preventive conservation of cultural heritage.

    Science.gov (United States)

    Fernández-Navajas, Angel; Merello, Paloma; Beltrán, Pedro; García-Diego, Fernando-Juan

    2013-02-27

    Cultural Heritage preventive conservation requires the monitoring of the parameters involved in the process of deterioration of artworks. Thus, both long-term monitoring of the environmental parameters as well as further analysis of the recorded data are necessary. The long-term monitoring at frequencies higher than 1 data point/day generates large volumes of data that are difficult to store, manage and analyze. This paper presents software which uses a free open source database engine that allows managing and interacting with huge amounts of data from environmental monitoring of cultural heritage sites. It is of simple operation and offers multiple capabilities, such as detection of anomalous data, inquiries, graph plotting and mean trajectories. It is also possible to export the data to a spreadsheet for analyses with more advanced statistical methods (principal component analysis, ANOVA, linear regression, etc.). This paper also deals with a practical application developed for the Renaissance frescoes of the Cathedral of Valencia. The results suggest infiltration of rainwater in the vault and weekly relative humidity changes related with the religious service schedules.

  19. Prevention and management of the complications during embolizing intracranial aneurysm with GDC

    International Nuclear Information System (INIS)

    Zhong Ming; Tan Xianxi; Wang Junlu; Hu Wenhao; Fan Lianghao

    2002-01-01

    Objective: To sum up the experience of embolization of intracranial aneurysm with Guglielmi detachable coil (GDC) and to discuss how to prevent and manage the complications during the endovascular treatment. Methods: 108 patients with intracranial aneurysm were embolized with GDC. 24 accident out of 20 patients during embolization were reviewed. Results: Among the 24 accidents, there were 10 aneurysm rupture, 5 over- embolization 5 coils end protruding to parent artery, and 4 thrombosis. Once the aneurysm ruptures, neutralizing heparin and continuing embolization was administered. Among 10 cases of aneurysm ruptures, 4 were death, 1 was severe deformity, 1 was mild deformity. Thrombolysis, heparinisation and raising blood pressure were used to control over-embolization, coil protrusion, and thrombosis. Among 5 cases of over-embolization, 1 died, 4 recovered. Among 5 cases of coils end protruding, 1 was severe deformity, 1 was mild deformity. Among 4 cases of embolization, 1 died, 1 was led sensory aphasics. The accidents resulted in 5 deaths (4.6%), 4 permanent neurological deficits (3.7%). Conclusion: The correct management of the complications during the treatment, the better understanding of the aneurysm and its parent artery angio-anatomy and the improved skill of embolizing technique are helpful to reduce the accidents and increase the cure rate

  20. Pharmacological therapy for the prevention and management of cardiomyopathy in Duchenne muscular dystrophy: A systematic review.

    Science.gov (United States)

    El-Aloul, Basmah; Altamirano-Diaz, Luis; Zapata-Aldana, Eugenio; Rodrigues, Rebecca; Malvankar-Mehta, Monali S; Nguyen, Cam-Tu; Campbell, Craig

    2017-01-01

    Cardiomyopathy is a major source of morbidity and mortality in Duchenne muscular dystrophy (DMD) patients now that respiratory care has improved. There is currently no definitive evidence guiding the management of DMD-associated cardiomyopathy (DMD-CM). The objective of this systematic review was to evaluate the effectiveness of pharmacotherapies for the prevention and/or management of DMD-CM and to determine the optimal timing to commence these interventions. A systematic search was conducted in January 2016 using MEDLINE, EMBASE and CINAHL databases and grey literature sources for studies evaluating the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta-blockers or aldosterone antagonists. Study quality assessment was conducted using the Downs and Black quality assessment checklist. PRISMA reporting guidelines were used. Of the 15 studies included in this review, most were of low methodological quality. Meta-analysis was not possible due to heterogeneity of studies. ACE inhibitors, angiotensin receptor blockers, beta-blockers and/or aldosterone antagonists tended to improve or preserve left ventricular systolic function and delay the progression of DMD-CM. While there is evidence supporting the use of heart failure medication in patients with DMD, data regarding these interventions for delaying the onset of DMD-CM and when to initiate therapy are lacking. PROSPERO registration: CRD42015029555. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Effectiveness of a nurse-managed protocol to prevent hypoglycemia in hospitalized patients with diabetes.

    Science.gov (United States)

    Marelli, Giuseppe; Avanzini, Fausto; Iacuitti, Giuseppe; Planca, Enrico; Frigerio, Ilaria; Busi, Giovanna; Carlino, Liliana; Cortesi, Laura; Roncaglioni, Maria Carla; Riva, Emma

    2015-01-01

    Hypoglycemia due to inadequate carbohydrate intake is a frequent complication of insulin treatment of diabetic in-patients. Objective. To assess the effectiveness of a nurse-managed protocol to prevent hypoglycemia during subcutaneous insulin treatment. Prospective pre-post-intervention study. In 350 consecutive diabetic in-patients the incidence of hypoglycemia (blood glucose food to integrate incomplete carbohydrate intake in the meal; (2) in case of lack of appetite or repeatedly partial intake of the planned food, prandial insulin administered at the end of the meal to be related to the actual amount of carbohydrates eaten; (3) intravenous infusion of glucose during prolonged fasting. Eighty-four patients in phase A and 266 in phase B received subcutaneous insulin for median periods of, respectively, 7 (Q1-Q3 6-12) and 6 days (Q1-Q3 4-9). Hypoglycemic events declined significantly from 0.34 ± 0.33 per day in phase A to 0.19 ± 0.30 in phase B (P > 0.001). A nurse-managed protocol focusing on carbohydrate intake reduced the incidence of hypoglycemia in patients with diabetes receiving subcutaneous insulin in hospital.

  2. Pollution prevention opportunity assessment for the SNL/California waste management facilities

    International Nuclear Information System (INIS)

    Braye, S.; Phillips, N.M.

    1995-01-01

    SNL/California's waste management facilities, Bldgs. 961 and 962-2, generate a secondary stream of hazardous and radioactive waste. This waste stream is generated mainly during the processing and handling of hazardous, radioactive, and mixed wastes (primary waste stream), which are generated by the laboratories, and when cleaning up spills. The secondary waste stream begins with the removal of a generator's hazardous, radioactive, and mixed waste from specified collection areas. The waste stream ends when the containers of processed waste are loaded for shipment off-site. The total amount of secondary hazardous waste generated in the waste management facilities from January 1993 to July 1994 was 1,160.6 kg. The total amount of secondary radioactive waste generated during the same period was 1,528.8 kg (with an activity of 0.070 mCi). Mixed waste usually is not generated in the secondary waste stream. This pollution prevention opportunity assessment (PPOA) was conducted using the graded approach methodology developed by the Department of Energy (DOE) PPOA task group. The original method was modified to accommodate the needs of Sandia's site-specific processes. The options generated for potential hazardous waste minimization, cost savings, and environmental health and safety were the result of a waste minimization team effort. The results of the team efforts are summarized

  3. Radiological characterisation and its role in the efficient management of low-level radioactive material supporting concurrent reuse, recycling and disposal. WNA Statement - Towards Greater Efficiency in the Management of Low-Level Radioactive Material that Concurrently Supports Reuse, Recycling and Disposal

    International Nuclear Information System (INIS)

    Townes, Jamie

    2012-01-01

    already exist this would show that, properly managed and regulated, these materials and practices pose no genuine health issues for people or the environment. Through the Position Paper of the Working Group the WNA emphasizes the importance of converging towards greater efficiency in the management of low-level radioactive material. This requires internationally consistent strategies and approaches for proper reuse, recycling and disposal. The WNA statement sets the stage for constructive discussions toward this international goal with a view to facilitate practical implementation at the national level. (author)

  4. Prevention and Management of Cow's Milk Allergy in Non-Exclusively Breastfed Infants.

    Science.gov (United States)

    Vandenplas, Yvan

    2017-07-10

    Introduction: The prevention and management of cow milk allergy (CMA) is still debated. Since CMA is much less frequent in breastfed infants, breastfeeding should be stimulated. Method: Literature was searched using databases to find original papers and reviews on this topic. Results: Hydrolysates with a clinical proof of efficacy are recommended in the prevention and treatment of CMA. However, not all meta-analyses conclude that hydrolysates do prevent CMA or other atopic manifestations such as atopic dermatitis. There are pros and cons to consider partially hydrolysed protein as an option for starter infant formula for each non-exclusively breastfed infant. A challenge test is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof that the immune system is involved. The Cow Milk Symptom Score (CoMiSS™) is an awareness tool that enables healthcare professionals to better recognize symptoms related to the ingestion of cow milk, but it still needs validation as diagnostic tool. The current recommended elimination diet is a cow milk based extensive hydrolysate, although rice hydrolysates or soy infant formula can be considered in some cases. About 10 to 15% of infants allergic to cow milk will also react to soy. Mainly because of the higher cost, amino acid based formula is reserved for severe cases. There is no place for infant formula with intact protein from other animals as cross-over allergenicity is high. During recent years, attention focused also on the bifidogenic effect of prebiotics and more recently also on human milk oligosaccharides. A bifidogenic gastrointestinal microbiome may decrease the risk to develop allergic disease. The addition of probiotics and prebiotics to the elimination diet in treatment may enhance the development of tolerance development. Conclusion: Breastfeeding is the best way to feed infants. Cow milk based extensive hydrolysates remain the first option for the

  5. Social science research in malaria prevention, management and control in the last two decades: an overview.

    Science.gov (United States)

    Mwenesi, Halima Abdullah

    2005-09-01

    In the recent past, considerable progress has been made in understanding how human behavior and social organization, macro- and micro-level economic processes, and health and political systems affect responses to malaria at global, national, community, household, and individual levels. Advances in malaria-related social, behavioral, economic, evaluation, health systems, and policy (social science) research have resulted in improvements in the design and implementation of malaria prevention, management and control (PMC) strategies. Indeed, the past two decades chronicle dramatic advances in the implementation of evidence-based interventions, drawn not only from biomedical but also from social science research. Malaria awareness-raising, advocacy, case management, and prevention efforts have reaped the benefits of social science research and as a result, many programs are implemented and evaluated in a more effective manner than in the past. However, the pace at which findings from social science research are integrated into program and policy implementation is unsatisfactory. Additionally, examples remain of programs that fail to utilize findings from social science research and as a result, achieve minimal results. Furthermore, there is a sizeable body of knowledge that is underutilized and which, if assimilated into programs and policies, could accelerate progress in malaria PMC. Examples include information on meaningful community participation, gender, socio-economic status, and health systems. Regrettably, although social science input is necessary for almost all interventions for malaria management and control, the numbers of scientists working in this area are dismal in most of the key disciplines-medical anthropology; demography; geography and sociology; health economics and health policy; social psychology; social epidemiology; and behavior-change communication. Further, skills of program workers charged with implementation of interventions and strategies

  6. Resource Management and Prevention of Moral Harassment: The Cases of Two Agricultural Cooperatives of Paraná

    Directory of Open Access Journals (Sweden)

    Aline Alves Storti

    2017-05-01

    Full Text Available The objective of this study was to identify and analyze how preventive work is done on issues related to moral harassment in two agricultural cooperatives in Paraná. The locus chosen for analysis was justified by the need for actions that curb harassment in organizations and by the peculiarity of the environment, in addition to the two cooperatives surveyed being large employers in their region. A qualitative case study approach was taken. Descriptive data was collected through document research and interviews with four managers of the two cooperatives. Findings revealed that both cooperatives analyzed have no records of moral harassment in the Regional Labor Court and use some prevention methods. In addition, statements by personnel management professionals presented some discrepancies with other professionals interviewed, which may be related to a lack of knowledge on the theme or to cultural aspects. The Green Cooperative presented more preventive methods to moral harassment than the Blue Cooperative, including a code of ethics, denunciations via e-mail, organization environment research, a denunciation box and harassment prevention training for future leaders. The Blue Cooperative uses formal channels of communication and employee dialogue, but nothing specifically directed towards situations of harassment, organization climate research, or a code of ethics. Areas of personnel management are suggested to invest more in communicating prevention actions with those involved, which encourages dialogue and the dissemination of knowledge on what harassment is and how to prevent it.

  7. Study 3: Energy, alimentation and competition for soils use: problematic and safety principles; Etude 3: energie, alimentation et concurrence d'usage des sols: problematique et principes de prevention

    Energy Technology Data Exchange (ETDEWEB)

    Monot, C. [Solagral (France)

    2000-07-01

    For long-dated, the development of energies resulting from the biomass should aggravate the risks of soils use competition. On one hand the energy crops increase on fertile soils will limit the surfaces devoted to the alimentation and on the other hand intensive energy crops will risk to degrade the soils (erosion, pollution). The energy policies have to preserve from now onwards, the fossil energies resources, to limit the greenhouse effect and the nuclear wastes proliferation, but also to manage the soils resources to produce the bio-energies. This study tries to answer the following questions: Is there enough soils to produce the bio-energies in substitution to the fossil energies and food the humanity? Which is the policy that will participate to a good soils management, in order to preserve the alimentary potential? (A.L.B.)

  8. The prevention and management of chronic disease in primary care: recommendations from a knowledge translation meeting.

    Science.gov (United States)

    Ahmed, Sara; Ware, Patrick; Visca, Regina; Bareil, Celine; Chouinard, Maud-Christine; Desforges, Johanne; Finlayson, Roderick; Fortin, Martin; Gauthier, Josée; Grimard, Dominique; Guay, Maryse; Hudon, Catherine; Lalonde, Lyne; Lévesque, Lise; Michaud, Cecile; Provost, Sylvie; Sutton, Tim; Tousignant, Pierre; Travers, Stella; Ware, Mark; Gogovor, Amede

    2015-10-15

    Seven chronic disease prevention and management programs were implemented across Quebec with funding support from a provincial-private industry funding initiative. Given the complexity of implementing integrated primary care chronic disease management programs, a knowledge transfer meeting was held to share experiences across programs and synthesize common challenges and success factors for implementation. The knowledge translation meeting was held in February 2014 in Montreal, Canada. Seventy-five participants consisting of 15 clinicians, 14 researchers, 31 knowledge users, and 15 representatives from the funding agencies were broken up into groups of 10 or 11 and conducted a strengths, weaknesses, opportunities, and threats analysis on either the implementation or the evaluation of these chronic disease management programs. Results were reported back to the larger group during a plenary and recorded. Audiotapes were transcribed and summarized using pragmatic thematic analysis. Strengths to leverage for the implementation of the seven programs include: (1) synergy between clinical and research teams; (2) stakeholders working together; (3) motivation of clinicians; and (4) the fact that the programs are evidence-based. Weaknesses to address include: (1) insufficient resources; (2) organizational change within the clinical sites; (3) lack of referrals from primary care physicians; and (4) lack of access to programs. Strengths to leverage for the evaluation of these programs include: (1) engagement of stakeholders and (2) sharing of knowledge between clinical sites. Weaknesses to address include: (1) lack of referrals; (2) difficulties with data collection; and (3) difficulties in identifying indicators and control groups. Opportunities for both themes include: (1) fostering new and existing partnerships and stakeholder relations; (2) seizing funding opportunities; (3) knowledge transfer; (4) supporting the transformation of professional roles; (5) expand the use of

  9. Concurrent ultrasonic weld evaluation system

    Science.gov (United States)

    Hood, Donald W.; Johnson, John A.; Smartt, Herschel B.

    1987-01-01

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws.

  10. A Model for Concurrent Objects

    DEFF Research Database (Denmark)

    Sørensen, Morten U.

    1996-01-01

    We present a model for concurrent objects where obejcts interact by taking part in common events that are closely matched to form call-response pairs, resulting in resulting in rendez-vous like communications. Objects are built from primitive objects by parallel composition, encapsulation and hid...... and hiding. The behavour of a composite object is straightforwardly derived from the behavour of the constituent objects. Defining refinement as a strengthened form of trace inclusion, object composition and refinement togehter form a basis for step-wise development....

  11. A system of safety management practices and worker engagement for reducing and preventing accidents: an empirical and theoretical investigation.

    Science.gov (United States)

    Wachter, Jan K; Yorio, Patrick L

    2014-07-01

    The overall research objective was to theoretically and empirically develop the ideas around a system of safety management practices (ten practices were elaborated), to test their relationship with objective safety statistics (such as accident rates), and to explore how these practices work to achieve positive safety results (accident prevention) through worker engagement. Data were collected using safety manager, supervisor and employee surveys designed to assess and link safety management system practices, employee perceptions resulting from existing practices, and safety performance outcomes. Results indicate the following: there is a significant negative relationship between the presence of ten individual safety management practices, as well as the composite of these practices, with accident rates; there is a significant negative relationship between the level of safety-focused worker emotional and cognitive engagement with accident rates; safety management systems and worker engagement levels can be used individually to predict accident rates; safety management systems can be used to predict worker engagement levels; and worker engagement levels act as mediators between the safety management system and safety performance outcomes (such as accident rates). Even though the presence of safety management system practices is linked with incident reduction and may represent a necessary first-step in accident prevention, safety performance may also depend on mediation by safety-focused cognitive and emotional engagement by workers. Thus, when organizations invest in a safety management system approach to reducing/preventing accidents and improving safety performance, they should also be concerned about winning over the minds and hearts of their workers through human performance-based safety management systems designed to promote and enhance worker engagement. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Interference between concurrent resistance and endurance exercise: molecular bases and the role of individual training variables.

    Science.gov (United States)

    Fyfe, Jackson J; Bishop, David J; Stepto, Nigel K

    2014-06-01

    Concurrent training is defined as simultaneously incorporating both resistance and endurance exercise within a periodized training regime. Despite the potential additive benefits of combining these divergent exercise modes with regards to disease prevention and athletic performance, current evidence suggests that this approach may attenuate gains in muscle mass, strength, and power compared with undertaking resistance training alone. This has been variously described as the interference effect or concurrent training effect. In recent years, understanding of the molecular mechanisms mediating training adaptation in skeletal muscle has emerged and provided potential mechanistic insight into the concurrent training effect. Although it appears that various molecular signaling responses induced in skeletal muscle by endurance exercise can inhibit pathways regulating protein synthesis and stimulate protein breakdown, human studies to date have not observed such molecular 'interference' following acute concurrent exercise that might explain compromised muscle hypertrophy following concurrent training. However, given the multitude of potential concurrent training variables and the limitations of existing evidence, the potential roles of individual training variables in acute and chronic interference are not fully elucidated. The present review explores current evidence for the molecular basis of the specificity of training adaptation and the concurrent interference phenomenon. Additionally, insights provided by molecular and performance-based concurrent training studies regarding the role of individual training variables (i.e., within-session exercise order, between-mode recovery, endurance training volume, intensity, and modality) in the concurrent interference effect are discussed, along with the limitations of our current understanding of this complex paradigm.

  13. Patients survey after concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Shimane, Toshikazku; Egawa, Syunya; Mori, Tomoaki; Ono, Tomohiro; Monden, Tetsuya; Kobayashi, Sei; Sanbe, Takeyuki; Suzaki, Harumi

    2010-01-01

    Concurrent chemoradiotherapy for cancer of head and neck is becoming more popular as the treatment of choice. It is considered to maintain the quality of life (QOL) of patients better than operative treatments in terms of preserving the functions, organs, and figure, but recently we cannot necessarily say that it maintains the QOL of patients better than operative treatments because its complications after therapy disturb daily life. We report the results of a questionnaire survey about complications after therapy, problems during therapy, improvements, and satisfaction level directed at patients with cancer of the head and neck who received Concurrent chemoradiotherapy for the purpose of ascertaining if patients can actually maintain their QOL after therapy. As a result, the most controversial problem was mouth dryness, but the symptom improved as the follow-up duration got longer. As for the satisfaction level, 'very-satisfied' and 'almost-satisfied' were more than 90%, so we concluded that the QOL of patients is maintained after therapy, while there are still improvements to be made. We also concluded that we should continue to make improvement and try to improve the QOL of patients during and after therapy. (author)

  14. Concurrency at work with Go

    CERN Document Server

    CERN. Geneva

    2017-01-01

    High Energy and Nuclear Physics (HENP) libraries are now required to be increasingly multi-thread-safe, if not multi-thread-friendly and multi-threaded. This is usually done using the new constructs and library components offered by the C++11 and C++14 standards. These components are however quite low-level (threads, mutexes, locks, ...) and hard to use and compose, or easy to misuse. However, Go -- a somewhat new language -- provides a set of better building blocks for tackling concurrency: goroutines and channels. This language is now used by the cloud industry at large; docker/moby, rkt, Kubernetes, OpenShift, etc... are obvious flagships for Go. It is also used in other interesting places like SpaceX's telemetry monitoring system and in the New York Times', YouTube's or Disney's content delivery infrastructures. In this talk, we will describe the building blocks of Go and see how they are combined to easily create concurrent programs that grow with grace, are fast to compile and deploy, but also easy to...

  15. A classification scheme for analyzing mobile apps used to prevent and manage disease in late life.

    Science.gov (United States)

    Wang, Aiguo; An, Ning; Lu, Xin; Chen, Hongtu; Li, Changqun; Levkoff, Sue

    2014-02-17

    There are several mobile apps that offer tools for disease prevention and management among older adults, and promote health behaviors that could potentially reduce or delay the onset of disease. A classification scheme that categorizes apps could be useful to both older adult app users and app developers. The objective of our study was to build and evaluate the effectiveness of a classification scheme that classifies mobile apps available for older adults in the "Health & Fitness" category of the iTunes App Store. We constructed a classification scheme for mobile apps according to three dimensions: (1) the Precede-Proceed Model (PPM), which classifies mobile apps in terms of predisposing, enabling, and reinforcing factors for behavior change; (2) health care process, specifically prevention versus management of disease; and (3) health conditions, including physical health and mental health. Content analysis was conducted by the research team on health and fitness apps designed specifically for older adults, as well as those applicable to older adults, released during the months of June and August 2011 and August 2012. Face validity was assessed by a different group of individuals, who were not related to the study. A reliability analysis was conducted to confirm the accuracy of the coding scheme of the sample apps in this study. After applying sample inclusion and exclusion criteria, a total of 119 apps were included in the study sample, of which 26/119 (21.8%) were released in June 2011, 45/119 (37.8%) in August 2011, and 48/119 (40.3%) in August 2012. Face validity was determined by interviewing 11 people, who agreed that this scheme accurately reflected the nature of this application. The entire study sample was successfully coded, demonstrating satisfactory inter-rater reliability by two independent coders (95.8% initial concordance and 100% concordance after consensus was reached). The apps included in the study sample were more likely to be used for the

  16. Recording and Evaluating the Role of Volunteers Regarding Natural Hazards Prevention and Disaster Management in Greece

    Science.gov (United States)

    Papanikolaou, Ioannis; Papanikolaou, Dimitrios; Diakakis, Michalis; Deligiannakis, Georgios

    2013-04-01

    The role of volunteers in disaster management is of decisive importance, particularly for major catastrophes. In Northern Europe, volunteers are the main group that responds even in regular low impact incidents. On the other hand, in Southern Europe, state professionals hold the primary role. This is partly cultural, but it is also defined by the different types of hazards involved. For example, Southern Europe suffers from earthquakes and wildfires that can cause severe and widespread damage. This implies that there is a need for highly trained and skilled personnel, not only for efficiency purposes, but also in order to avoid casualties among the operating staff. However, the need of volunteers' involvement is well recognised both for prevention measures (mainly regarding forest fires) and for disaster management purposes particularly during major catastrophes whereas the professional personnel are outsourced. Moreover, the economic crisis stretches the public sector, decreasing the capability and resources of the state mechanism. The latter increases the need for the volunteers' active participation, which is also regarded as cost effective. Greece has a short tradition regarding volunteers and their official involvement with natural hazards. This is also due to the fact that civil protection has a short history in Greece, since it was established in 1995, whereas its legal framework was only shaped in 2002. The act 3013/2002 introduces officially the role of volunteers within the legal framework. In particular, the act N3013/2002 offers a detailed description of the role of voluntary organizations within the civil protection system, the interagency cooperation, and the financial instruments through which the various bodies secure their funding along with the establishment of an inventory from the General Secretariat of Civil Protection. However, several provisions described in the 2002 Act have not been applied yet. For instance voluntary organizations are not

  17. The prevention and management of constipation in older adults in a residential aged care facility.

    Science.gov (United States)

    Grieve, Jennifer

    2006-03-01

    The need to implement programs for developing leadership and practice improvement skills using an evidence-based practice approach to practice change is becoming more apparent in the health and aged care services. This is no more apparent than in high care residential health and aged care services, where health professionals are increasingly required to provide care for older people with multifocal and complex healthcare needs. This paper describes one of the projects undertaken as part of the Joanna Briggs Institute Commonwealth Department of Health and Ageing Clinical Aged Care Fellowship program from February 2005 to June 2005. This purpose of this particular project was twofold. First it sought to improve the local practice in the prevention and management of constipation and that this practice was performed according to the best available evidence. Second to use the Joanna Briggs Institute Practical Application of Clinical Guidance (PACES) program to implement a process of audit and feedback as a strategy to improve practice. The project was designed to link in with the facility's existing quality improvement program and better practice continence management project. The project was conducted over 6 months and was divided into six stages involving the identification of evidence-based standards of care, an initial audit to determine appropriate sample size, a clinical audit across the facility, planning of the implementation process, implementation of the action plan and re-audit to assess practice change. Overall, the results were extremely positive and demonstrated a real improvement in practice relating to constipation in the project facility. This success, however, needs to be seen in the context of the benefits of having the support of senior management, an existing quality improvement and continence management better practice project, and a culture of clinical review. Although there will always be more work to be done, the success of this project can be

  18. [Knowledge and prevention management of vitamin D deficiency in primary care].

    Science.gov (United States)

    Senan Sanz, M R; Gilaberte Calzada, Y; Olona Tabueña, N; Magallón Botaya, R

    2014-01-01

    To determine the knowledge and management of vitamin D (Vit D) in primary care (PC). Observational study. A total of 69 primary care centres, with 57 in Barcelona and 12 in Huesca. All medical and nursing graduates of these centres. A specifically designed questionnaire was used to collect knowledge on the actions of Vit D (on bone metabolism, cardiovascular and immune systems), its deficiency and prevention measures. Of the total of 2100 professionals, 785 completed the survey (37.78%), of whom 79.9% were women. Their mean age was 47 years (SD: 9.7). Only 4.8% knew the overall actions of Vitamin D, although the majority (66%) knew only its effects on bone metabolism. Almost two-thirds (62.4%) were unaware that its deficiency was a common problem, and 54.9% believed that photoprotection was contraindicated. Almost three-quarters of those surveyed (73.6%) never or almost never determined Vit D levels in their patients. A minority (23%) offered advice to maintain an adequate level of Vit D, with the most frequent being sun exposure (16.8%). Pediatricians were more knowledgeable (p<.001) and offered more advice for maintaining adequate levels of Vit D in blood (p<.001). Most of the professionals were unaware of the overall actions of Vit D, or that its deficiency was common, or the factors contributing to this. The advice that was more often offered to avoid its deficiency was not the safest. Paediatricians are more aware of how to prevent Vit D deficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  19. Evaluating the integration of chronic disease prevention and management services into primary health care.

    Science.gov (United States)

    Fortin, Martin; Chouinard, Maud-Christine; Bouhali, Tarek; Dubois, Marie-France; Gagnon, Cynthia; Bélanger, Martin

    2013-04-08

    The increasing number of patients with chronic diseases represents a challenge for health care systems. The Chronic Care Model suggests a multi-component remodelling of chronic disease services to improve patient outcomes. To meet the complex and ongoing needs of patients, chronic disease prevention and management (CDPM) has been advocated as a key feature of primary care producing better outcomes, greater effectiveness and improved access to services compared to other sectors. The objective of this study is to evaluate the adaptation and implementation of an intervention involving the integration of chronic disease prevention and management (CDPM) services into primary health care. The implementation of the intervention will be evaluated using descriptive qualitative methods to collect data from various stakeholders (decision-makers, primary care professionals, CDPM professionals and patients) before, during and after the implementation. The evaluation of the effects will be based on a combination of experimental designs: a randomized trial using a delayed intervention arm (n = 326), a before-and-after design with repeated measures (n = 163), and a quasi-experimental design using a comparative cohort (n = 326). This evaluation will utilize self-report questionnaires measuring self-efficacy, empowerment, comorbidity, health behaviour, functional health status, quality of life, psychological well-being, patient characteristics and co-interventions. The study will take place in eight primary care practices of the Saguenay region of Quebec (Canada). To be included, patients will have to be referred by their primary care provider and present at least one of the following conditions (or their risk factors): diabetes, cardiovascular diseases, chronic obstructive pulmonary disease, asthma. Patients presenting serious cognitive problems will be excluded. In the short-term, improved patient self-efficacy and empowerment are expected. In the mid-term, we expect to observe an

  20. Preventing and managing exacerbations in COPD – critical appraisal of the role of tiotropium

    Directory of Open Access Journals (Sweden)

    Donald P Tashkin

    2010-02-01

    Full Text Available Donald P TashkinDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA,Los Angeles, CA, USAAbstract: The course of COPD is punctuated by acute exacerbations that are associated with an increase in the morbidity and mortality related to this chronic disease and may contribute to its rate of progression. Therefore, preventing and treating exacerbations are major goals of COPD management. The role of tiotropium in the prevention of exacerbations has been investigated in several placebo-controlled randomized clinical trials varying in duration from 3 months to 4 years in patients with moderate to very severe COPD. In all of these trials, tiotropium has uniformly reduced the proportion of patients experiencing at least one exacerbation and delayed the time to the first exacerbation compared with placebo. In the longer trials (≥6 months’ duration tiotropium has also reduced the exposure-adjusted incidence rate of exacerbations. In trials of at least 1 year in duration, tiotropium either significantly reduced the risk of hospitalization for an exacerbation and/or the proportion of patients with an exacerbation-related hospitalization. In a meta-analysis that included 15 trials of tiotropium vs either placebo (n = 13 and/or a longacting beta-agonist (LABA; n = 4, tiotropium significantly reduced the odds of experiencing an exacerbation compared to placebo as well as a LABA. The potential additive benefits of tiotropium to those of a LABA and/or inhaled corticosteroid in reducing exacerbations require further investigation. The mechanism whereby tiotropium reduces exacerbations is not due to an anti-inflammatory effect but more likely relates to its property of causing a sustained increase in airway patency and reduction in hyperinflation, thereby counteracting the tendency for respiratory insults to worsen airflow obstruction and hyperinflation. For the management of acute exacerbations, an

  1. Testing the Runoff Tool in Sicilian vineyards: adopting best management practices to prevent agricultural surface runoff

    Science.gov (United States)

    Singh, Manpriet; Dyson, Jeremy; Capri, Ettore

    2016-04-01

    Over the last decades rainfall has become more intense in Sicily, making large proportions of steeply sloping agricultural land more vulnerable to soil erosion, mainly orchards and vineyards (Diodato and Bellocchi 2010). The prevention of soil degradation is indirectly addressed in the European Union's Water Framework Directive (2000/60/EC) and Sustainable Use Directive (2009/128/EC). As a consequence, new EU compliance conditions for food producers requires them to have tools and solutions for on-farm implementation of sustainable practices (Singh et al. 2014). The Agricultural Runoff and Best Management Practice Tool has been developed by Syngenta to help farm advisers and managers diagnose the runoff potential from fields with visible signs of soil erosion. The tool consists of 4 steps including the assessment of three key landscape factors (slope, topsoil permeability and depth to restrictive horizon) and 9 mainly soil and crop management factors influencing the runoff potential. Based on the runoff potential score (ranging from 0 to 10), which is linked to a runoff potential class, the Runoff Tool uses in-field and edge-of-the-field Best Management Practices (BMPs) to mitigate runoff (aligned with advice from ECPA's TOPPS-prowadis project). The Runoff tool needs testing in different regions and crops to create a number of use scenarios with regional/crop specific advice on BMPs. For this purpose the Tool has been tested in vineyards of the Tasca d'Almerita and Planeta wineries, which are large family-owned estates with long-standing tradition in viticulture in Sicily. In addition to runoff potential scores, Visual Soil Assessment (VSA) scores have been calculated to allow for a comparison between different diagnostic tools. VSA allows for immediate diagnosis of soil quality (a higher score means a better soil quality) including many indicators of runoff (Shepherd 2008). Runoff potentials were moderate to high in all tested fields. Slopes were classified as

  2. Rheumatic and nonrheumatic valvular heart disease: epidemiology, management, and prevention in Africa.

    Science.gov (United States)

    Essop, Mohammed Rafique; Nkomo, Vuyisile T

    2005-12-06

    Unlike the Western world, valvular disease ranks among the major cardiovascular afflictions in Africa. Acute rheumatic fever and chronic rheumatic valvular disease in their most virulent form are still commonly encountered and impose a huge burden on limited healthcare resources. We performed a systematic review of the literature with PubMed using rheumatic fever, rheumatic heart disease, valvular disease, warfarin anticoagulation, and pregnancy as search items. Literature emanating from Africa was emphasized. Epidemiology, current concepts on pathogenesis, and aspects of the medical and surgical management of this disease as seen from an African perspective are presented. The association of pregnancy with mitral stenosis is common and may be fatal if not managed appropriately. A practical approach to these patients is presented to optimize maternal and fetal outcome. Pregnant patients with mechanical valves require careful attention to ensure maternal survival and prevent fetal warfarin embryopathy. Prolonged subcutaneous heparin and frequent monitoring of the partial thromboplastin time are impractical in this setting, and the merits of different anticoagulation regimens are discussed. Congenital submitral aneurysms are a unique cause of mitral regurgitation, with the vast majority of cases originating from sub-Saharan Africa. Although the precise etiology is as yet unclear, the clinical and echocardiographic features are sufficiently characteristic to allow a preoperative diagnosis to be made. Transesophageal echocardiography allows much better definition of the size and anatomic relationships of the aneurysm. Surgical resection can be difficult but is usually curative. Mitral valve prolapse and endocarditis constitute the remaining frequent causes of valvular disease and are discussed briefly. The spectrum and presentation of valvular disease in Africa are uniquely different from elsewhere. Together with socioeconomic issues and the HIV pandemic, this fact

  3. Invited review : Determinants of farmers' adoption of management-based strategies for infectious disease prevention and control

    NARCIS (Netherlands)

    Ritter, Caroline; Jansen, Jolanda; Roche, Steven; Kelton, David F; Adams, Cindy L; Orsel, Karin; Erskine, Ron J; Benedictus, Geart; Lam, Theo J G M; Barkema, Herman W

    2017-01-01

    The prevention and control of endemic pathogens within and between farms often depends on the adoption of best management practices. However, farmers regularly do not adopt recommended measures or do not enroll in voluntary disease control programs. This indicates that a more comprehensive

  4. Encouraging employees to speak up to prevent infections: Opportunities to leverage quality improvement and care management processes.

    Science.gov (United States)

    Robbins, Julie; McAlearney, Ann Scheck

    2016-11-01

    Central line-associated bloodstream infections (CLABSIs) are associated with increased morbidity, mortality, and cost for U.S. hospitals, but many infections are preventable. Employees' willingness to speak up about errors or opportunities for improvement has been associated with a stronger safety culture in hospitals. However, the link between organizations' efforts to promote speaking up and prevent CLABSIs has not been studied. This exploratory, qualitative study included interviews with 158 key informants, including hospital executives, managers, and staff employees, in 6 hospitals that participated in the federally funded On the CUSP-Stop BSI initiative. Verbatim transcripts were analyzed to examine whether and how speaking up was addressed in CLABSI prevention efforts. Hospitals implementing evidence-based practices for CLABSI prevention facilitated employees' improvement-oriented speaking up by leveraging quality improvement and care management processes. Leader behavior, employee training, and error reporting systems also facilitated speaking up. Although the focus of this study was on CLABSI prevention, broader organizational practices to improve patient safety were salient in creating a nonpunitive, highly inclusive environment in which employees felt comfortable speaking up. These findings provide insight into the factors that may support speaking up to foster a safety culture and prevent health care-associated infection at unit and organization levels. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Automated telephone communication systems for preventive healthcare and management of long-term conditions.

    Science.gov (United States)

    Posadzki, Pawel; Mastellos, Nikolaos; Ryan, Rebecca; Gunn, Laura H; Felix, Lambert M; Pappas, Yannis; Gagnon, Marie-Pierre; Julious, Steven A; Xiang, Liming; Oldenburg, Brian; Car, Josip

    2016-12-14

    Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention. To assess the effects of ATCS for preventing disease and managing long-term conditions on behavioural change, clinical, process, cognitive, patient-centred and adverse outcomes. We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled-trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015. Randomised, cluster- and quasi-randomised trials, interrupted time series and controlled before-and-after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible. We used standard Cochrane methods to select and extract data and to appraise eligible studies. We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty-one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long-term conditions, and seven studies for appointment reminders

  6. Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis.

    Science.gov (United States)

    Antunes, Héliton S; Herchenhorn, Daniel; Small, Isabele A; Araújo, Carlos M M; Viégas, Celia Maria Pais; de Assis Ramos, Gabriela; Dias, Fernando L; Ferreira, Carlos G

    2017-08-01

    The impact of low-level laser therapy (LLLT) to prevent oral mucositis in patients treated with exclusive chemoradiation therapy remains unknown. This study evaluated the overall, disease-free and progression-free survival of these patients. Overall, disease-free and progression-free survival of 94 patients diagnosed with oropharynx, nasopharynx, and hypopharynx cancer, who participated on a phase III study, was evaluated from 2007 to 2015. The patients were subjected to conventional radiotherapy plus cisplatin every 3weeks. LLLT was applied with an InGaAlP diode (660nm-100mW-1J-4J/cm 2 ). With a median follow-up of 41.3months (range 0.7-101.9), patients receiving LLLT had a statistically significant better complete response to treatment than those in the placebo group (LG=89.1%; PG=67.4%; p=0.013). Patients subjected to LLLT also displayed increase in progression-free survival than those in the placebo group (61.7% vs. 40.4%; p=0.030; HR:1:93; CI 95%: 1.07-3.5) and had a tendency for better overall survival (57.4% vs. 40.4%; p=0.90; HR:1.64; CI 95%: 0.92-2.91). This is the first study to suggest that LLLT may improve survival of head and neck cancer patients treated with chemoradiotherapy. Further studies, with a larger sample, are necessary to confirm our findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Concurrent Performance of Gunner's and Robotic Operator's Tasks in a Simulated Mounted Combat System Environment

    National Research Council Canada - National Science Library

    Chen, Jessie Y; Joyner, Carla

    2006-01-01

    .... Results showed that gunner's target detection performance degraded significantly when s/he had to concurrently monitor, manage, or teleoperate an unmanned ground vehicle compared to the baseline condition (gunnery task...

  8. Precision Nutrition: A Review of Personalized Nutritional Approaches for the Prevention and Management of Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Juan de Toro-Martín

    2017-08-01

    Full Text Available The translation of the growing increase of findings emerging from basic nutritional science into meaningful and clinically relevant dietary advices represents nowadays one of the main challenges of clinical nutrition. From nutrigenomics to deep phenotyping, many factors need to be taken into account in designing personalized and unbiased nutritional solutions for individuals or population sub-groups. Likewise, a concerted effort among basic, clinical scientists and health professionals will be needed to establish a comprehensive framework allowing the implementation of these new findings at the population level. In a world characterized by an overwhelming increase in the prevalence of obesity and associated metabolic disturbances, such as type 2 diabetes and cardiovascular diseases, tailored nutrition prescription represents a promising approach for both the prevention and management of metabolic syndrome. This review aims to discuss recent works in the field of precision nutrition analyzing most relevant aspects affecting an individual response to lifestyle/nutritional interventions. Latest advances in the analysis and monitoring of dietary habits, food behaviors, physical activity/exercise and deep phenotyping will be discussed, as well as the relevance of novel applications of nutrigenomics, metabolomics and microbiota profiling. Recent findings in the development of precision nutrition are highlighted. Finally, results from published studies providing examples of new avenues to successfully implement innovative precision nutrition approaches will be reviewed.

  9. Soil Salinity: Effect on Vegetable Crop Growth. Management Practices to Prevent and Mitigate Soil Salinization

    Directory of Open Access Journals (Sweden)

    Rui Manuel Almeida Machado

    2017-05-01

    Full Text Available Salinity is a major problem affecting crop production all over the world: 20% of cultivated land in the world, and 33% of irrigated land, are salt-affected and degraded. This process can be accentuated by climate change, excessive use of groundwater (mainly if close to the sea, increasing use of low-quality water in irrigation, and massive introduction of irrigation associated with intensive farming. Excessive soil salinity reduces the productivity of many agricultural crops, including most vegetables, which are particularly sensitive throughout the ontogeny of the plant. The salinity threshold (ECt of the majority of vegetable crops is low (ranging from 1 to 2.5 dS m−1 in saturated soil extracts and vegetable salt tolerance decreases when saline water is used for irrigation. The objective of this review is to discuss the effects of salinity on vegetable growth and how management practices (irrigation, drainage, and fertilization can prevent soil and water salinization and mitigate the adverse effects of salinity.

  10. Systematic review to inform prevention and management of chronic disease for Indigenous Australians: overview and priorities.

    Science.gov (United States)

    Gomersall, Judith Streak; Canuto, Karla; Aromataris, Edoardo; Braunack-Mayer, Annette; Brown, Alex

    2016-02-01

    To describe the main characteristics of systematic reviews addressing questions of chronic disease and related risk factors for Indigenous Australians. We searched databases for systematic reviews meeting inclusion criteria. Two reviewers assessed quality and extracted characteristics using pre-defined tools. We identified 14 systematic reviews. Seven synthesised evidence about health intervention effectiveness; four addressed chronic disease or risk factor prevalence; and six conducted critical appraisal as per current best practice. Only three reported steps to align the review with standards for ethical research with Indigenous Australians and/or capture Indigenous-specific knowledge. Most called for more high-quality research. Systematic review is an under-utilised method for gathering evidence to inform chronic disease prevention and management for Indigenous Australians. Relevance of future systematic reviews could be improved by: 1) aligning questions with community priorities as well as decision maker needs; 2) involvement of, and leadership by, Indigenous researchers with relevant cultural and contextual knowledge; iii) use of critical appraisal tools that include traditional risk of bias assessment criteria and criteria that reflect Indigenous standards of appropriate research. Systematic review method guidance, tools and reporting standards are required to ensure alignment with ethical obligations and promote rigor and relevance. © 2015 Public Health Association of Australia.

  11. Identification, Prevention, and Management of Childhood Overweight and Obesity in a Pediatric Primary Care Center.

    Science.gov (United States)

    Reed, Monique; Cygan, Heide; Lui, Karen; Mullen, Mary

    2016-08-01

    Background In the United States, overweight/obesity among youth has reached epidemic proportions. The purpose of this project was to (1) examine primary care provider adherence to American Academy of Pediatrics guidelines; (2) compare adherence based on patients' weight classification, age, race, and gender; and (3) identify areas for improvement in health care delivery. Methods A retrospective chart audit and feedback quality improvement project was conducted with a stratified random sample of 175 charts of 6- to 19-year-olds seen for well-child visits. Frequencies of provider adherence were reported. χ(2) Analyses of weight classification, age, race, or gender influence on adherence was calculated. Results After discussion with the primary care providers, 5 areas were identified as priorities for change (diagnosis based on BMI, parental history of obesity, sleep assessment, endocrine assessment, and attendance of patients at the follow-up visit). Conclusion Cost-efficient, feasible strategies to improve provider adherence to recommendations for identification, prevention and management of childhood overweight and obesity were identified. © The Author(s) 2015.

  12. Evaluation, management and prevention of lower extremity youth ice hockey injuries

    Science.gov (United States)

    Popkin, Charles A; Schulz, Brian M; Park, Caroline N; Bottiglieri, Thomas S; Lynch, T Sean

    2016-01-01

    Ice hockey is a fast-paced sport played by increasing numbers of children and adolescents in North America and around the world. Requiring a unique blend of skill, finesse, power and teamwork, ice hockey can become a lifelong recreational activity. Despite the rising popularity of the sport, there is ongoing concern about the high frequency of musculoskeletal injury associated with participation in ice hockey. Injury rates in ice hockey are among the highest in all competitive sports. Numerous research studies have been implemented to better understand the risks of injury. As a result, rule changes were adopted by the USA Hockey and Hockey Canada to raise the minimum age at which body checking is permitted to 13–14 years (Bantam level) from 11–12 years (Pee Wee). Continuing the education of coaches, parents and players on rules of safe play, and emphasizing the standards for proper equipment use are other strategies being implemented to make the game safer to play. The objective of this article was to review the evaluation, management and prevention of common lower extremity youth hockey injuries. PMID:27920584

  13. Identification of environmentally vulnerable areas with priority for prevention and management of pipeline crude oil spills.

    Science.gov (United States)

    Mendoza-Cantú, Ania; Heydrich, Silke Cram; Cervantes, Irene Sommer; Orozco, Oralia Oropeza

    2011-07-01

    The oil industry is one of the main productive activities in Mexico and has a huge infrastructure, including a wide pipeline network that crosses urban, industrial, agricultural and natural areas. The threat of crude oil spills is greatest in those regions with a high concentration of oil extraction and refining activities, as in the case of the Coatzacoalcos and Tonalá Rivers Low Basin. This study ranked the geosystems of the basin in terms of vulnerability to pipeline crude oil spills. Very high vulnerability (level I) was assigned to the water bodies (lakes and rivers) and their margins of influence, including surfaces that flood during normal hydraulic load. High vulnerability areas (level II) comprised surfaces that can flood during extraordinary hydraulic load related with extreme hydrometeorological events. The remaining three vulnerability levels were defined for areas with low or negligible flooding potential, these were ranked according to physical (slope, relief and permeability), biological (richness, singularity and integrity) and socio-economic (social marginalization index and economic activities index) conditions. These results are presented on a map for better visualization and interpretation. This study will be useful to establish preventive and effective emergency management actions in order to reduce remediation costs and adverse effects on wild species. It also can help local and national authorities, oil industry and civil protection corps to better protect ecosystems, natural resources and human activities and goods. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Coalition contract management as a systems change strategy for HIV prevention.

    Science.gov (United States)

    Darrow, William W; Montanea, Julie E; Sánchez-Braña, Elizabeth

    2010-11-01

    Racial and Ethnic Approaches to Community Health (REACH) 2010 provided a unique opportunity for minority community-based organizations (CBOs) to work together to eliminate disparities in HIV disease. A coalition was formed in Broward County to respond to the REACH 2010 program announcement, a university was chosen to coordinate efforts, and contracts were negotiated with CBO partners to develop, implement, and evaluate a community action plan. Contract management provided stability, focus, and a mechanism for coalition partners to measure progress toward achieving project objectives. By emphasizing documentation as well as the delivery of services, however, contract conditions also placed a heavy burden on educational outreach workers, restricted the reimbursable activities of member organizations, and created friction between minority agencies and university staff. Although the coalition met many of its objectives, the introduction and enforcement of a mutually agreed on set of rules and obligations as a way of promoting systems change in Broward County failed to make a lasting impact among community partners. CBOs continued to compete with one another for HIV prevention project funding and stopped collaborating as closely with another when federal support for our REACH 2010 community demonstration project ran out.

  15. Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis.

    Science.gov (United States)

    Misra, S; Oliver, N S

    2015-01-01

    Ketone measurement is advocated for the diagnosis of diabetic ketoacidosis and assessment of its severity. Assessing the evidence base for ketone measurement in clinical practice is challenging because multiple methods are available but there is a lack of consensus about which is preferable. Evaluating the utility of ketone measurement is additionally problematic because of variability in the biochemical definition of ketoacidosis internationally and in the proposed thresholds for ketone measures. This has led to conflicting guidance from expert bodies on how ketone measurement should be used in the management of ketoacidosis. The development of point-of-care devices that can reliably measure the capillary blood ketone β-hydroxybutyrate (BOHB) has widened the spectrum of applications of ketone measurement, but whether the evidence base supporting these applications is robust enough to warrant their incorporation into routine clinical practice remains unclear. The imprecision of capillary blood ketone measures at higher values, the lack of availability of routine laboratory-based assays for BOHB and the continued cost-effectiveness of urine ketone assessment prompt further discussion on the role of capillary blood ketone assessment in ketoacidosis. In the present article, we review the various existing methods of ketone measurement, the precision of capillary blood ketone as compared with other measures, its diagnostic accuracy in predicting ketoacidosis and other clinical applications including prevention, assessment of severity and resolution of ketoacidosis. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  16. Stool management systems for preventing environmental spread of Clostridium difficile: a comparative trial.

    Science.gov (United States)

    Gray, Mikel; Omar, Amin; Buziak, Brenton

    2014-01-01

    The purpose of this study was to compare contamination of the immediate environment with Clostridium difficile spores and vegetative cells from 2 stool management systems over a period of 30 days in a controlled laboratory setting. In vitro, comparison trial. Two stool management systems were compared over a 30-day period in a controlled laboratory setting. Sixteen systems were filled with sterile loose canine stool inoculated with 10 colony-forming units (CFUs) per milliliter of C difficile; specially prepared culture media were used to detect C difficile contamination on various surfaces of the device and in the immediate environment. Containment bags were changed daily and devices were refilled with inoculated stool to more closely imitate use in the clinical setting. A dichotomous outcome variable (growth vs no growth) was used to analyze contamination on a daily basis via the generalized estimating equation; devices were also compared on days 3, 10, 20, and 30 by measuring CFUs per device surface. Logistic regression analysis was used to analyze growth over time. When observations showed no growth, the Cochran-Mantel Haenszel test was used to compare study devices. Analysis revealed that 20.8% of anterior surfaces of the collection bags for device 1 were contaminated versus 83.9% of collection bags for device 2 (P < .001). Comparison of the tubing/hub interface resulted in similar findings; 20.8% of device 1 group were contaminated versus 86.3% of device 2 group (P < .001). Analysis of an absorbent pad placed under the device during daily changes found that 0.5% of device 1 were contaminated versus 38.1% of pads placed under device 2 (P < .001). Findings from this in vitro study show that stool management systems can limit or prevent environmental contamination of C difficile. Results also reveal significant differences in the 2 systems tested; we hypothesize that these differences are attributable to the interface between the tubing and collection bag, the

  17. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) About SDPI ... diabetes education. Find Guides for Diabetes Programs, Diabetes Prevention Program Toolkit, Program Spotlights, and more! Announcing Online ...

  18. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) About SDPI Community-Directed SDPI ... who provide diabetes education. Find Guides for Diabetes Programs, Diabetes Prevention Program Toolkit, Program Spotlights, and more! ...

  19. Complementary Role of Herbal Medicine and Exercise in Cardiovascular Disease Prevention and Management: A Review of Evidence.

    Science.gov (United States)

    Veluswamy, Sundar Kumar; Babu, Abraham Samuel; Sundar, Lakshmi Manickavasagam

    2017-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. Herbal medicine and exercise interventions have individually been shown to be effective in the prevention and management of CVD. However, the complementary roles of herbal medicine and exercise interventions for CVD prevention and management have not been adequately reported. 1. Identify studies analysing complementary roles of herbal medicine and exercise intervention in CVD prevention and management, 2. Identify herbs and exercise strategies that have been reported to exhibit complementary roles in CVD prevention and management, and 3. Summarize evidence of complementary roles of herbal medicine and exercise interventions for CVD prevention and management. PubMed, CINAHL and Web of Science were searched with a customised search strategy in May 2015. Two reviewers screened the search results for inclusion using pre-specified criteria. Data were extracted from full text of selected abstracts in a predetermined template by two reviewers and verified by the third reviewer when needed. A total of 35 titles were identified for full texts review after screening 827 abstracts. Data were extracted from 23 titles, representing 12 human studies and six animal studies. This review identified effects of 14 different herbs and 10 exercise strategies on over 18 CVD risk factors and markers. Complementary roles of herbal medicine and exercise were reported from five studies. Evidence of complementary role of herbal medicine and exercise is emerging from animal studies. More robust clinical studies on proven risk factors are needed before they can be recommended for clinical practice. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Nutritional strategies to support concurrent training.

    Science.gov (United States)

    Perez-Schindler, Joaquin; Hamilton, D Lee; Moore, Daniel R; Baar, Keith; Philp, Andrew

    2015-01-01

    Concurrent training (the combination of endurance exercise to resistance training) is a common practice for athletes looking to maximise strength and endurance. Over 20 years ago, it was first observed that performing endurance exercise after resistance exercise could have detrimental effects on strength gains. At the cellular level, specific protein candidates have been suggested to mediate this training interference; however, at present, the physiological reason(s) behind the concurrent training effect remain largely unknown. Even less is known regarding the optimal nutritional strategies to support concurrent training and whether unique nutritional approaches are needed to support endurance and resistance exercise during concurrent training approaches. In this review, we will discuss the importance of protein supplementation for both endurance and resistance training adaptation and highlight additional nutritional strategies that may support concurrent training. Finally, we will attempt to synergise current understanding of the interaction between physiological responses and nutritional approaches into practical recommendations for concurrent training.

  1. Molecular adaptations to concurrent training.

    Science.gov (United States)

    de Souza, E O; Tricoli, V; Roschel, H; Brum, P C; Bacurau, A V N; Ferreira, J C B; Aoki, M S; Neves, M; Aihara, A Y; da Rocha Correa Fernandes, A; Ugrinowitsch, C

    2013-03-01

    This study investigated the chronic effects of concurrent training (CT) on morphological and molecular adaptations. 37 men (age=23.7±5.5 year) were divided into 4 groups: interval (IT), strength (ST) and concurrent (CT) training and a control group (C) and underwent 8 weeks of training. Maximum strength (1RM) and muscle cross-sectional area (CSA) were evaluated before and after training. Muscle samples were obtained before the training program and 48 h after the last training session. VO2max improved in 5±0.95% and 15±1.3% (pre- to post-test) in groups CT and IT, respectively, when compared to C. Time to exhaustion (TE) improved from pre- to post-test when compared to C (CT=6.1±0.58%; IT=8.3±0.88%; ST=3.2±0.66%). 1RM increased from pre-to post-test only in ST and CT groups (ST=18.5±3.16%; CT=17.6±3.01%). Similarly, ST and CT groups increased quadriceps CSA from pre-to post-test (6.2±1.4%; 7.8±1.66%). The p70S6K1 total protein content increased after CT. The ST group showed increased Akt phosphorylation at Ser473 (45.0±3.3%) whereas AMPK phosphorylation at Thr172 increased only in IT group, (100±17.6%). In summary, our data suggest that despite the differences in molecular adaptations between training regimens, CT did not blunt muscle strength and hypertrophy increments when compared with ST. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Assessment of the management factors that influence the development of preventive care in the New South Wales public dental service.

    Science.gov (United States)

    Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A

    2015-01-01

    Oral diseases, particularly dental caries, remain one of the most common chronic health problems for adolescents, and are a major public health concern. Public dental services in New South Wales, Australia offer free clinical care and preventive advice to all adolescents under 18 years of age, particularly those from disadvantaged backgrounds. This care is provided by dental therapists and oral health therapists (therapists). It is incumbent upon clinical directors (CDs) and health service managers (HSMs) to ensure that the appropriate clinical preventive care is offered by clinicians to all their patients. The aims of this study were to 1) explore CDs' and HSMs' perceptions of the factors that could support the delivery of preventive care to adolescents, and to 2) record the strategies they have utilized to help therapists provide preventive care to adolescents. In-depth, semistructured interviews were undertaken with 19 CDs and HSMs from across NSW local health districts. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. The 19 CDs and HSMs reported that fiscal accountability and meeting performance targets impacted on the levels and types of preventive care provided by therapists. Participants suggested that professional clinical structures for continuous quality improvement should be implemented and monitored, and that an adequate workforce mix and more resources for preventive dental care activities would enhance therapists' ability to provide appropriate levels of preventive care. CDs and HSMs stated that capitalizing on the strengths of visiting pediatric dental specialists and working with local health district clinical leaders would be a practical way to improve models of preventive oral health care for adolescents. The main issue raised in this study is that preventive dentistry per se lacks strong support from the central funding agency, and that increasing prevention activities is not a simple

  3. Concurrent Engineering Approaches for Sustainable Product Development in a Multi-Disciplinary Environment : Proceedings of the 19th ISPE International Conference on Concurrent Engineering

    CERN Document Server

    Rock, Georg; Bil, Cees

    2013-01-01

    The CE Conference series is organized annually by the International Society for Productivity Enhancement (ISPE) and constitutes an important forum for international scientific exchange on concurrent and collaborative enterprise engineering. These international conferences attract a significant number of researchers, industrialists and students, as well as government representatives, who are interested in the recent advances in concurrent engineering research and applications. Concurrent Engineering Approaches for Sustainable Product Development in a Multi-Disciplinary Environment: Proceedings of the 19th ISPE International Conference on Concurrent Engineering contains papers accepted, peer reviewed and presented at the annual conference held  at the University of Applied Sciences in Trier, Germany, from 3rd-7th of September 2012. This covers a wide range of cutting-edge topics including: •Systems Engineering and Innovation •Design for Sustainability •Knowledge Engineering and ManagementManaging pro...

  4. 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.

  5. Flow Java: Declarative Concurrency for Java

    OpenAIRE

    Drejhammar, Frej

    2005-01-01

    This thesis presents the design, implementation, and evaluation of Flow Java, a programming language for the implementation of concurrent programs. Flow Java adds powerful programming abstractions for automatic synchronization of concurrent programs to Java. The abstractions added are single assignment variables (logic variables) and futures (read-only views of logic variables). The added abstractions conservatively extend Java with respect to types, parameter passing, and concurrency. Future...

  6. Concurrence of three Jaynes-Cummings systems

    Science.gov (United States)

    Qiang, Wen-Chao; Sun, Guo-Hua; Dong, Qian; Camacho-Nieto, Oscar; Dong, Shi-Hai

    2018-04-01

    We apply genuine multipartite concurrence to investigate entanglement properties of three Jaynes-Cummings systems. Three atoms are initially put in GHZ-like state and locally interact with three independent cavities, respectively. We present analytical concurrence expressions for various subsystems including three-atom, three-cavity and some atom-cavity mixed systems. We also examine the global system and illustrate the evolution of its concurrence. Except for the sudden death of entanglement, we find for some initial entanglement parameter θ , the concurrence of the global system may maintain unchanged in some time intervals.

  7. Concurrent rendezvous control of underactuated spacecraft

    Science.gov (United States)

    Muralidharan, Vijay; Reza Emami, M.

    2017-09-01

    The concurrent control of spacecraft equipped with one-axis unilateral thruster and three-axis attitude actuator is considered in this paper. The proposed control law utilizes attitude control channels along with the single thrust force concurrently, for three-dimensional trajectory tracking and rendezvous with a target object. The concurrent controller also achieves orbital transfer to low Earth orbits with long range separation. To demonstrate the orbit transfer capabilities of the concurrent controller, a smooth elliptical orbit transfer trajectory for co-planar circular orbits is designed. The velocity change and energy consumption of the designed orbit transfer trajectory is observed to be equivalent to that of Hohmann transfer.

  8. Concurrent alcohol and medication poisoning hospital admissions among older rural and urban residents.

    Science.gov (United States)

    Zanjani, Faika; Smith, Rachel; Slavova, Svetla; Charnigo, Richard; Schoenberg, Nancy; Martin, Catherine; Clayton, Richard

    2016-07-01

    Alcohol and medication interactions are projected to increase due to the growth of older adults that are unsafely consuming alcohol and medications. Plus, aging adults who reside in rural areas are at the highest risk of experiencing medication interactions. Estimate concurrent alcohol and medication (alcohol/medication) hospitalizations in adults 50+ years, comparing age groups and rural/urban regions. Kentucky nonfederal, acute care inpatient hospital discharge electronic records for individuals aged 50+ years from 2001 to 2012 were examined. Rate differences were estimated across age and regional strata. Differences in the underlying principal diagnosis, intent, and medications were also examined. There were 2168 concurrent alcohol/medication hospitalizations among 50+ year olds identified. There was a 187% increase in alcohol/medication hospitalizations from 2001 (n = 104) to 2012 (n = 299). The per capita alcohol/medication hospitalization rate increased from 8.91 (per 100,000) in 2001 to 19.98 (per 100,000) in 2012, a 124% increase. The characteristics of the hospitalizations included 75% principal diagnosis as medication poisoning, self-harm as the primary intent (55%) in 50-64-year olds, and unintentional intent (41%) in 65+ adults. Benzodiazepines were most often involved in the poisonings (36.5%). Concurrent alcohol/medication hospitalizations in Kentucky are increasing among aging adults. Greater increases in rural areas and the 65+ aged adults were seen, although there were also higher alcohol/medication hospitalizations in urban and 50-64 aged adults. These findings indicate the need for public-health prevention and clinical intervention to better educate and manage alcohol consuming older adults on safe medication and alcohol practices.

  9. [Chronic obstructive pulmonary disease concurrent with metabolic syndrome: Pathophysiological and clinical features].

    Science.gov (United States)

    Budnevsky, A V; Ovsyannikov, E S; Labzhania, N B

    2017-01-01

    Chronic obstructive pulmonary disease (COPD) still remains a serious public health problem, which is a common cause of disability and death in the able-bodied population. Furthermore, the number of patients with metabolic syndrome (MS) is steadily increasing worldwide. Recently, there is also an increase in the number of patients with COPD concurrent with MS, which is a mutually confounding risk factor for concomitant cardiovascular disease and adversely affects prognosis in these patients. Systemic subclinical inflammation is a common link between COPD and the components of MS. Systemic inflammation in patients with comorbidity is complemented by an inflammatory process in the abdominal visceral adipose tissue that serves as a source of proinflammatory adipokines (leptin, resistin, and tumor necrosis factor-α). Patients with COPD in the presence of MS components have in general higher ventilation needs, more obvious clinical manifestations of bronchopulmonary diseases, and more frequent COPD exacerbations and frequently require higher doses of inhaled glucocorticosteroids. As compared with normal-weight patients with COPD, obese patients with this condition have more limited physical activity and much more exercise intolerance. There are currently no practical recommendations for the management of patients with comorbidity; patients with COPD concurrent with MS need an individual therapeutic approach. It is important to elaborate a package of preventive measures to improve quality of life in patients, to reduce the incidence of systemic complications, and to achieve symptomatic improvements. Thus, to develop and implement practical guidelines for physicians and patients are an urgent issue.

  10. Solid waste prevention and management at green festivals: A case study of the Andanças Festival, Portugal.

    Science.gov (United States)

    Martinho, Graça; Gomes, Ana; Ramos, Mário; Santos, Pedro; Gonçalves, Graça; Fonseca, Miguel; Pires, Ana

    2018-01-01

    Research on waste prevention and management at green festivals is scarce. The present study helps to fill this gap by analyzing waste prevention/reduction and management measures implemented at the Andanças festival, Portugal. Waste characterization campaigns and a questionnaire survey were conducted during the festival. The results show that the largest amount of waste generated was residual waste, followed by food and kitchen waste and packaging waste. The amount of waste generated per person per day at the festival was lower than that of other festivals for both the entire venue and the canteen. Concerning food and kitchen waste generated at the canteen, the amounts are in accordance with the findings of previous studies, but the amount of the edible fraction is comparatively low. Source separation rates are high, in line with other festivals that engage in food-waste source separation. Factors affecting the participation of attendees in waste prevention measures at the festival are the type of participant, their region of origin, the frequency of visits, and whether they are attending as a family. Efforts must be made to increase the awareness of attendees about waste prevention measures, to develop guidelines and methods to quantify the waste prevention measures, and to formulate policies aimed at increasing the application of the zero-waste principle at festivals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Assessment of the management factors that influence the development of preventive care in the New South Wales public dental service

    Directory of Open Access Journals (Sweden)

    Masoe AV

    2015-03-01

    Full Text Available Angela V Masoe,1 Anthony S Blinkhorn,2 Jane Taylor,1 Fiona A Blinkhorn1 1Faculty of Health and Medicine, School of Health Sciences, Oral Health, University of Newcastle, Ourimbah, 2Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia Background: Oral diseases, particularly dental caries, remain one of the most common chronic health problems for adolescents, and are a major public health concern. Public dental services in New South Wales, Australia offer free clinical care and preventive advice to all adolescents under 18 years of age, particularly those from disadvantaged backgrounds. This care is provided by dental therapists and oral health therapists (therapists. It is incumbent upon clinical directors (CDs and health service managers (HSMs to ensure that the appropriate clinical preventive care is offered by clinicians to all their patients. The aims of this study were to 1 explore CDs’ and HSMs’ perceptions of the factors that could support the delivery of preventive care to adolescents, and to 2 record the strategies they have utilized to help therapists provide preventive care to adolescents. Subjects and methods: In-depth, semistructured interviews were undertaken with 19 CDs and HSMs from across NSW local health districts. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results: The 19 CDs and HSMs reported that fiscal accountability and meeting performance targets impacted on the levels and types of preventive care provided by therapists. Participants suggested that professional clinical structures for continuous quality improvement should be implemented and monitored, and that an adequate workforce mix and more resources for preventive dental care activities would enhance therapists’ ability to provide appropriate levels of preventive care. CDs and HSMs stated that capitalizing on the strengths of visiting pediatric

  12. Irrelevant water-management scales for flood prevention, water harvesting and eutrophication control.

    Science.gov (United States)

    Andersson, Jafet; Arheimer, Berit

    2017-04-01

    This poster will give three examples of popular water-management methods, which we discovered had very little effect in practice because they were applied on irrelevant scales. They all use small scale solutions to large scale problems, and did not provide expected results due to neglecting the magnitude of components in the large-scale water budget. 1) Flood prevention: ponds are considered to be able to buffer water discharge in catchments and was suggested as a measure to reduce the 20-years return floods in an exposed areas in Sweden. However, when experimenting with several ponds allocation and size in a computational model, we found out that ponds had to cover 5-10% of the catchment to convert the 20-yr flood into an average flood. Most effective was to allocate one single water body at the catchment outlet, but this would correspond to 95 km2 which is by far too big to be called a pond. 2) Water Harvesting: At small-scale it is designed to increase water availability and agricultural productivity in smallholder agriculture. On field scale, we show that water harvesting decreases runoff by 55% on average in 62 investigated field-scale trials of drainage area ≤ 1ha in sub-Saharan Africa (Andersson et al., 2011). When upscaling, to river basin scale in South Africa (8-1.8×106 km2), using a scenario approach and the SWAT hydrological model we found that all smallholder fields would not significantly alter downstream river discharge (10.1021/es304585p Andersson JCM, Zehnder AJB, Rockström J, Yang H (2011). Potential impacts of water harvesting…. Agricultural Water Management, 98(7), pp. 1113-1124, http://dx.doi.org/10.1016/j.agwat.2011.02.004 Arheimer, B., Nilsson, J. and Lindström, G. 2015. Experimenting with Coupled Hydro-Ecological Models ….. Water 7(7):3906-3924. doi:10.3390/w7073906 Arheimer, B. and Pers B.C. 2016. Lessons learned? …. Ecological Engineering (in press). doi:10.1016/j.ecoleng.2016.01.088

  13. Diabetes Prevention and Management among Minority Ethnic Groups in Nicaragua: Findings from Phase 2 of a Community-Based Participatory Research Study

    Science.gov (United States)

    Newlin Lew, Kelley; Mitchell, Emma McKim; Mclean, Yolanda

    2016-01-01

    Objectives: To (1) describe barriers to diabetes prevention and self-management, (2) explore how religious beliefs inform diabetes prevention and self-management and (3) describe community action strategies to address the problem of diabetes locally. Design: Qualitative, descriptive design. Setting: Three Moravian Churches located, respectively,…

  14. The Application of Concurrent Engineering in Infrastructure Projects

    OpenAIRE

    Wolden, Sigurd

    2017-01-01

    The construction industry today is considered to be lagging competitively behind in comparison to other industries. The reason for this is thought of by many researchers to be the fragmented project process, the traditional principles and the, sometimes adversarial environment. In order to solve some of these obstacles and at the same time enhance productivity, the Norwegian infrastructure sector has recently developed an interest towards the project management method Concurrent Engineering (...

  15. Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults.

    Science.gov (United States)

    George, Elena S; Forsyth, Adrienne; Itsiopoulos, Catherine; Nicoll, Amanda J; Ryan, Marno; Sood, Siddharth; Roberts, Stuart K; Tierney, Audrey C

    2018-01-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. In the absence of effective pharmacotherapies, clinical guidelines focus primarily on weight loss to treat this condition. Established consensus, evidence-based, and clinical dietary recommendations for NAFLD are currently lacking. The aim of this paper is to provide evidence-based practical dietary recommendations for the prevention and management of NAFLD in adults. A literature review focusing on established principles for the development of clinical practice recommendations was employed using the following criteria: based on substantial evidence, ensures risk minimization, is flexible for an individual patient approach, and is open to further modification as evidence emerges. The Practice-based Evidence in Nutrition classification system was used to grade these principles. Five key dietary recommendations were developed: 1) follow traditional dietary patterns, such as the Mediterranean diet; 2) limit excess fructose consumption and avoid processed foods and beverages with added fructose; 3) PUFAs, especially long-chain omega-3 rich foods and MUFAs, should replace SFAs in the diet; 4) replace processed food, fast food, commercial bakery goods, and sweets with unprocessed foods high in fiber, including whole grains, vegetables, fruits, legumes, nuts, and seeds; and 5) avoid excess alcohol consumption. Improving diet quality may reduce the incidence and progression of NAFLD and associated risk factors. Many of the benefits are likely to result from the collective effect of dietary patterns. High-quality research-in particular, randomized clinical trials assessing dietary interventions that focus on liver-specific endpoints-are needed as a priority. © 2018 American Society for Nutrition. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Okello A

    2017-06-01

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

  17. Safety of the concurrent treatment of dogs with Bravecto (fluralaner) and Scalibor protectorband (deltamethrin).

    Science.gov (United States)

    Walther, Feli M; Fisara, Petr; Allan, Mark J; Roepke, Rainer K A; Nuernberger, Martin C

    2014-03-19

    Bravecto (fluralaner; MSD Animal Health) is a novel systemic ectoparasiticide for dogs providing long-acting flea- and tick-control after a single oral dose. Scalibor Protectorband (deltamethrin; MSD Animal Health) is a collar often used to reduce sandfly feeding for leishmaniasis prevention. This study investigated the safety of the concurrent use of Bravecto and Scalibor Protectorband at the recommended dosage regimens. Throughout the study period of 24 weeks, there were no clinical findings related to the concurrent treatment with Bravecto in dogs fitted with Scalibor Protectorband at the recommended dosage regimen. Concurrent treatment with Bravecto in dogs fitted with Scalibor Protectorband is well tolerated.

  18. Formulation of evidence-based messages to promote the use of physical activity to prevent and manage Alzheimer's disease.

    Science.gov (United States)

    Ginis, Kathleen A Martin; Heisz, Jennifer; Spence, John C; Clark, Ilana B; Antflick, Jordan; Ardern, Chris I; Costas-Bradstreet, Christa; Duggan, Mary; Hicks, Audrey L; Latimer-Cheung, Amy E; Middleton, Laura; Nylen, Kirk; Paterson, Donald H; Pelletier, Chelsea; Rotondi, Michael A

    2017-02-17

    The impending public health impact of Alzheimer's disease is tremendous. Physical activity is a promising intervention for preventing and managing Alzheimer's disease. However, there is a lack of evidence-based public health messaging to support this position. This paper describes the application of the Appraisal of Guidelines Research and Evaluation II (AGREE-II) principles to formulate an evidence-based message to promote physical activity for the purposes of preventing and managing Alzheimer's disease. A messaging statement was developed using the AGREE-II instrument as guidance. Methods included (a) conducting a systematic review of reviews summarizing research on physical activity to prevent and manage Alzheimer's disease, and (b) engaging stakeholders to deliberate the evidence and formulate the messaging statement. The evidence base consisted of seven systematic reviews focused on Alzheimer's disease prevention and 20 reviews focused on symptom management. Virtually all of the reviews of symptom management conflated patients with Alzheimer's disease and patients with other dementias, and this limitation was reflected in the second part of the messaging statement. After deliberating the evidence base, an expert panel achieved consensus on the following statement: "Regular participation in physical activity is associated with a reduced risk of developing Alzheimer's disease. Among older adults with Alzheimer's disease and other dementias, regular physical activity can improve performance of activities of daily living and mobility, and may improve general cognition and balance." The statement was rated favourably by a sample of older adults and physicians who treat Alzheimer's disease patients in terms of its appropriateness, utility, and clarity. Public health and other organizations that promote physical activity, health and well-being to older adults are encouraged to use the evidence-based statement in their programs and resources. Researchers, clinicians

  19. Investigating the Alignment of Concurrent Design Strategies with Business Strategies

    Directory of Open Access Journals (Sweden)

    Heidar Mirfakhredini

    2013-08-01

    Full Text Available In recent years, managing the interface between design and other activities has received considerable attention. Effective coordination among these areas is therefore vital for effectiveness of the organization. The ideal situation would be continuous interdepartmental contact with well-developed channels of communication. In this study, the best strategy for product design department has been chosen using the strategic formulation framework with fuzzy approach. Subsequently, alignment of each functional design strategy with SAPCO business strategies has been explained. Findings indicate that developing partnerships with global automotive and engineering design companies and building strategic alliances with rival firms to achieve competitive advantages have maximum alignment with business strategies. In addition, findings provide a basis for firms in evaluating the concurrent design strategies and a reference for them to strengthen their concurrent capabilities. There are few reports on sustained use of concurrent design as an on-going strategic process in an organization. This study aims at contributing to the concurrent design solutions.

  20. New insight in pediatric dentistry: preventive dentistry in allergy management protocol

    OpenAIRE

    Seno Pradopo; Haryono Utomo

    2007-01-01

    ; "> The relationship between oral health and systemic diseases had been abundantly studied, however, mostly were related to adultsuch as cerebrovascular disease, cardiovascular disease, diabetes mellitus etc. Nevertheless, it was still uncommon that oral healthalso related to allergic disease. The field of pediatric dentistry is mostly related to preventive dentistry (i.e. prophylactic procedures,preventive orthodontic etc., but rarely related to preventive medicine such allergy preventio...

  1. A change management approach to improving safety and preventing needle stick injuries.

    Science.gov (United States)

    Aziz, Ann-Marie

    2017-09-01

    Key drivers for preventing healthcare-associated infection (HCAI) include evidence-based practices and procedures that prevent infection. Among the current guidance for preventing HCAIs is evidence and mandatory requirements for reducing needle stick injuries (NSIs). This article highlights how John Kotter's model for change could help healthcare workers plan for successful and sustained deployment of needle safety devices (NSDs) and ultimately reduce the risk of a NSI.

  2. Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa.

    Science.gov (United States)

    Gaffoor, Zakir; Wand, Handan; Street, Renée A; Abbai, Nathlee; Ramjee, Gita

    2016-01-01

    Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women. Socio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in relation to perceived male partner concurrency using the Chi squared test. Univariate and multivariate logistic regression was performed to assess the independent predictors of perceived male partner concurrency. Kaplan-Meier survival estimates were obtained for HIV and STI incidence in relation to male partner concurrency. A Cox Proportional Hazards model was used to assess the association between perceived male partner concurrency and HIV and STI incidence. The results revealed that 29 % of women reported their male partners to be in concurrent sexual relationships, 22 % reported partners that were not engaging in concurrency, whilst 49 % reported not knowing their partners concurrency status. Older women, having never married, experiencing economic abuse, and women reporting individual concurrency, were found to be significant predictors of perceived male partner concurrency in the studied population. Perceived male partner concurrency was not found to be a significantly associated with incident HIV and STI infections in this analysis. The study provides insight into predictors of perceived male partner concurrency among women at high risk for STI and HIV acquisition. These results may inform the design of behavioural and biomedical interventions, to address the role of multiple sexual partnerships in HIV prevention.

  3. Criteria for inhalation exposure systems utilizing concurrent flow spirometry

    International Nuclear Information System (INIS)

    Raabe, O.G.; Yeh, H.C.

    1974-01-01

    Principles are given for the design and operation of a new class of inhalation exposure systems utilizing concurrent flow spirometry (CFS), a simple method for providing realtime measurement of respiratory volumes and rates during inhalation exposure by mouth or nose of individual experimental animals or man to aerosols or gases. This technique is especially useful for inhalation exposure of larger experimental animals, such as horses, where whole-body plethysmography is usually impractical. Difficulties encountered with conventional exposure systems in maintenance of uniform aerosol or gas concentrations and prevention of large pressure excursions in the exposure chamber during breathing are obviated by systems utilizing the principles of concurrent flow spirometry. For illustration, two exposure units with CFS are described, one for exposure of Beagle dogs and one for ponies. (U.S.)

  4. New concurrent iterative methods with monotonic convergence

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Qingchuan [Michigan State Univ., East Lansing, MI (United States)

    1996-12-31

    This paper proposes the new concurrent iterative methods without using any derivatives for finding all zeros of polynomials simultaneously. The new methods are of monotonic convergence for both simple and multiple real-zeros of polynomials and are quadratically convergent. The corresponding accelerated concurrent iterative methods are obtained too. The new methods are good candidates for the application in solving symmetric eigenproblems.

  5. Notes on Timed Concurrent Constraint Programming

    DEFF Research Database (Denmark)

    Nielsen, Mogens; Valencia, Frank D.

    2004-01-01

    A constraint is a piece of (partial) information on the values of the variables of a system. Concurrent constraint programming (ccp) is a model of concurrency in which agents (also called processes) interact by telling and asking information (constraints) to and from a shared store (a constraint...

  6. Effect of Concurrent Trypanosoma brucei Infection on ...

    African Journals Online (AJOL)

    The effect of concurrent Trypanosoma bruceiinfection on caprine haemonchosis was investigated in Red Sokoto (Maradi) goats infected with either Haemonchus contortus alone or concurrently with Trypanosoma brucei. The goats infected with H. contortus alone manifested clinical disease that was mild and without ...

  7. A Temporal Concurrent Constraint Programming Calculus

    DEFF Research Database (Denmark)

    Palamidessi, Catuscia; Valencia Posso, Frank Darwin

    2001-01-01

    The tcc model is a formalism for reactive concurrent constraint programming. In this paper we propose a model of temporal concurrent constraint programming which adds to tcc the capability of modeling asynchronous and non-deterministic timed behavior. We call this tcc extension the ntcc calculus...

  8. Ecological association between HIV and concurrency point ...

    African Journals Online (AJOL)

    Ecological association between HIV and concurrency point-prevalence in South Africa's ethnic groups. Chris Kenyon. Abstract. HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the ...

  9. Multiparty Compatibility for Concurrent Objects

    Directory of Open Access Journals (Sweden)

    Roly Perera

    2016-06-01

    Full Text Available Objects and actors are communicating state machines, offering and consuming different services at different points in their lifecycle. Two complementary challenges arise when programming such systems. When objects interact, their state machines must be "compatible", so that services are requested only when they are available. Dually, when objects refine other objects, their state machines must be "compliant", so that services are honoured whenever they are promised. In this paper we show how the idea of multiparty compatibility from the session types literature can be applied to both of these problems. We present an untyped language in which concurrent objects are checked automatically for compatibility and compliance. For simple objects, checking can be exhaustive and has the feel of a type system. More complex objects can be partially validated via test cases, leading to a methodology closer to continuous testing. Our proof-of-concept implementation is limited in some important respects, but demonstrates the potential value of the approach and the relationship to existing software development practices.

  10. Between quantum logic and concurrency

    Directory of Open Access Journals (Sweden)

    Luca Bernardinello

    2014-07-01

    Full Text Available We start from two closure operators defined on the elements of a special kind of partially ordered sets, called causal nets. Causal nets are used to model histories of concurrent processes, recording occurrences of local states and of events. If every maximal chain (line of such a partially ordered set meets every maximal antichain (cut, then the two closure operators coincide, and generate a complete orthomodular lattice. In this paper we recall that, for any closed set in this lattice, every line meets either it or its orthocomplement in the lattice, and show that to any line, a two-valued state on the lattice can be associated. Starting from this result, we delineate a logical language whose formulas are interpreted over closed sets of a causal net, where every line induces an assignment of truth values to formulas. The resulting logic is non-classical; we show that maximal antichains in a causal net are associated to Boolean (hence "classical" substructures of the overall quantum logic.

  11. Implementation of a protocol for the prevention and management of extravasation injuries in the neonatal intensive care patient.

    Science.gov (United States)

    Warren, Diane

    2011-06-01

    This project sought to determine nurses' understanding and management of infants with intravenous (IV) therapy. There were three specific aims: • To improve identification and management of extravasation injuries in neonates • To ensure management of extravasation injuries in neonates is classified according to IV extravasation staging guidelines • To develop a protocol that outlined actions required to manage extravasation injuries. This project utilised a pre- and post-implementation audit strategy using the Joanna Briggs Institute (JBI) Getting Research into Practice (GRIP) program. This method has been used to improve clinical practice by utilising an audit, feedback and re-audit sequence. The project was implemented in four stages over a 7-month period from 21 October 2009 to 30 May 2010. Initially, there was poor compliance with all four criteria, ranging from zero to 63%. The GRIP phase of the project identified five barriers which were addressed throughout this project. These related to education of staff and the development of a protocol for the prevention and management of extravasation injuries in the neonatal population. Following implementation of best practice, the second audit showed a marked improvement in all four criteria, ranging from 70 to 100% compliance. Overall, this project has led to improvements in clinical practice in line with current evidence. This has resulted in enhanced awareness of the risks associated with IV therapy and of measures to prevent an injury occurring within this clinical setting. © 2011 The Author. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

  12. Production software that works a guide to the concurrent development of realtime manufacturing systems

    CERN Document Server

    Courtright, Ann; Behuniak, John

    1991-01-01

    This useful reference addresses the key tasks that are integral to realtime software development in manufacturing plants: managing the design of the system, setting up and coordinating a development organization, and implementing tools for successfulcompletion and management. Both new and experienced project managers will discover how to use concurrent methodologies to create realtime systems in half the time it usually takes.

  13. Summary of the British Transplantation Society Guidelines for the Prevention and Management of CMV Disease After Solid Organ Transplantation.

    Science.gov (United States)

    Andrews, Peter A; Emery, Vincent C; Newstead, Chas

    2011-12-15

    The third edition of the British Transplantation Society Guidelines for the Prevention and Management of CMV Disease after Solid Organ Transplantation was published in March 2011. This article summarizes the important changes and advances in management in this rapidly evolving field. The pros and cons of universal, or targeted anti-cytomegalovirus (CMV) prophylaxis, and pre-emptive anti-CMV therapy are discussed, especially with respect to advances in CMV polymerase chain reaction monitoring. The evidence for oral anti-CMV prophylaxis using valganciclovir is presented, together with a summary of the treatment of CMV disease and emerging fields such as CMV vaccination, CMV genotyping, and drug resistance.

  14. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Congress Tribal Leader Letters Urban Leader Letters IHS Home Division of Diabetes Treatment and Prevention Division of Diabetes Treatment and Prevention About Us Training IHS Diabetes Audit Audit/SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special ...

  15. Leptin, cortisol and distinct concurrent training sequences.

    Science.gov (United States)

    Rosa, G; Dantas, E; Biehl, C; de Castro e Silva, H; Montano, M A E; de Mello, D B

    2012-03-01

    In order to investigate the effects of distinct concurrent training sequences on serum leptin and cortisol levels, 10 subjects (27.1±4.8 years, body mass index 25.38±0.09) were submitted to a control session, concurrent training 1 and concurrent training 2. Samples of leptin and cortisol were collected. Concurrent training 1 consisted of indoor cycling followed by strength training and concurrent training 2 of strength training followed by indoor cycling. No exercises were performed at the control session. Blood was collected once again to verify the same variables. Shapiro-Wilk, 2-way ANOVA and Tukey post-hoc tests were used. There was a reduction in leptin levels after concurrent training 1 (Δ%= - 16.04; p=0.05) and concurrent training 2 (Δ%= - 8.54; p=0.02). Cortisol decreased after concurrent training 1 (Δ%= - 26.32; p=0.02) and concurrent training 2 (Δ%= - 33.57; p=0.05). There was a high and significant correlation between blood variables only in CS (lep PRE X cort PRE and cort POST: r= - 0.80 and r= - 0.81; lep POST X cort PRE and cort POST: r= - 0.62 and r= - 0.62). Concurrent training promoted a reduction in leptin and cortisol levels irrespective of sequence. © Georg Thieme Verlag KG Stuttgart · New York.

  16. 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.

  17. The prevention of workplace bullying as a question of human resource management: measures adopted and underlying organizational factors

    OpenAIRE

    Salin, Denise

    2008-01-01

    The aim of this study has been to analyze measures adopted to counteract workplace bullying from the perspective of human resource management. First, the kind of measures that are adopted to prevent bullying were examined. Second, factors affecting the extent of such measures were explored. The introduction of written anti-bullying policies and the provision of information were found to be the most common measures adopted. The policies strongly emphasized the role of supervisors and the immed...

  18. Beliefs about causes of weight gain, effective weight gain prevention strategies, and barriers to weight management in the Australian population

    OpenAIRE

    Dryer, Rachel; Ware, Nicole

    2014-01-01

    Purpose: To identify beliefs held by the general public regarding causes of weight gain, weight prevention strategies, and barriers to weight management; and to examine whether such beliefs predict the actual body mass of participants. Methods: A questionnaire-based survey was administered to participants recruited from regional and metropolitan areas of Australia. This questionnaire obtained demographic information, height, weight; as well as beliefs about causes of weight gain, weight preve...

  19. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health ... Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating DSMES ...

  20. [Delivery management for the prevention of shoulder dystocia in case of identified risk factors].

    Science.gov (United States)

    Schmitz, T

    2015-12-01

    To determine the impact of (i) computed tomographic (CT) pelvimetry for the choice of the mode of delivery, (ii) cesarean, (iii) induction of labor, and of (iv) various delivery managements on the risk of shoulder dystocia in case of fetal macrosomia, with or without maternal diabetes, and in women with previous history of shoulder dystocia. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In case of clinically suspected macrosomia, a sonography should be performed to increase diagnostic performances and to assist in decision-making (Professional consensus). Because CT pelvimetry is associated with high false positive rates and increases cesarean deliveries, its use is not recommended to prevent shoulder dystocia in case of fetal macrosomia (Professional consensus). To avoid the neonatal complications of shoulder dystocia, mainly permanent brachial plexus palsy, cesarean delivery is recommended in case of estimated fetal weight (EFW) greater than 4500 g if associated with maternal diabetes (grade C), and greater than 5000 g in the absence of maternal diabetes (grade C). The published data do not provide definitive evidences to recommend systematic labor induction in case of impending fetal macrosomia (Professional consensus). In case of favourable cervix and gestational age greater than 39 weeks of gestation, labor induction should be promoted (Professional consensus). Prophylactic McRoberts maneuver is not recommended to prevent shoulder dystocia in case of fetal macrosomia (grade C). Because data are lacking, no recommendation is possible regarding the use of episiotomy. In case of fetal macrosomia and failure to progress in the second stage of labor, midpelvic and higher instrumental deliveries are not recommended and a cesarean delivery should be preferred (grade C), if the fetal head is at or lower than a +2 station, cesarean delivery is not recommended and an

  1. [Mind-body approach in the area of preventive medicine: focusing on relaxation and meditation for stress management].

    Science.gov (United States)

    Kang, Yunesik

    2010-09-01

    Emotional support and a stress management program should be simultaneously provided to clients as effective preventive services for healthy behavioral change. This study was conducted to review various relaxation and meditation intervention methods and their applicability for a preventive service program. The author of this paper tried to find various relaxation and meditation programs through a literature review and program searching and to introduce them. The 'Relaxation Response' and 'Mindfulness Based Stress Reduction (MBSR)' are the most the widely used meditative programs in mainstream medical systems. Abdominal breathing, Progressive Musclular Relaxation (PMR), Relaxative Imagery, Autogenic Training (AT) and Biofeedback are other well-known techniques for relaxation and stress management. I have developed and implemented some programs using these methods. Relaxation and meditation classes for cancer patients and a meditation based stress coping workshop are examples of this program. Relaxation and meditation seem to be good and effective methods for primary, secondary and tertiary preventive service programs. Program development and standardization and further study are needed for more and wider use of the mind-body approach in the preventive service area of medicine.

  2. Systematic review of prevention and management strategies for the consequences of gender-based violence in refugee settings.

    Science.gov (United States)

    Asgary, Ramin; Emery, Eleanor; Wong, Marcia

    2013-06-01

    Uncertainties continue regarding effective strategies to prevent and address the consequences of gender-based violence (GBV) among refugees. The databases of PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, Anthropology Plus, EMBASE, DARE, Google Scholar, MSF Field Research, UNHCR and the regional and global indices of the WHO Global Health Library were searched twice within a 6-month period (April and September 2011) for English-language clinical, public health, basic and social science studies evaluating strategies to prevent and manage health sequelae of GBV among refugees before September 2011. Studies not primarily about prevention and treatment, and not describing population, health outcome and interventions, were excluded. The literature search for the prevention and management arms produced 1212 and 1106 results, respectively. After reviewing the titles and abstracts, 29 and 27 articles were selected for review in their entirety, none of which met the inclusion criteria. Multiple panels of expert recommendations and guidelines were not supported by primary data on actual displaced populations. There is a dire need for research that evaluates the efficacy and effectiveness of various responses to GBV to ultimately allow a transition from largely theoretical and expertise driven to a more evidence-based field. We recommend strategies to improve data collection and to overcome barriers in primary data driven research.

  3. Comparison of preventive care in Medicaid managed care and Medicaid fee for service in institutions and private practices.

    Science.gov (United States)

    Fairbrother, G; Hanson, K L; Butts, G C; Friedman, S

    2001-01-01

    To compare preventive screening for children in Medicaid managed care (MMC) with children in Medicaid fee for service (M-FFS) in private and institutional settings. The sample included randomly selected institutions and private practice physicians in New York City. Within setting, children in MMC and M-FFS were sampled randomly and charts reviewed for immunizations and lead and anemia screening. In both institutions and private practices, children enrolled in MMC appeared more likely to be up-to-date than their M-FFS counterparts for immunizations (institution, P private practice, P institution, P private practice, P institution, P private practice, P private physicians. When considering 10 different attributes of managed care plans, no clear pattern of association with better preventive care services was observed. The positive effect of managed care on preventive care services was largely explained by more visits and longer follow-up time; however, there were differences between institutions and private practices, with enrollment in MMC associated with some positive effect on screenings in private practices.

  4. The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men: A Qualitative Analysis.

    Science.gov (United States)

    Seawell, Asani H; Hurt, Tera R; Shirley, Margaret C

    2016-03-01

    This study used focus-group methodology to seek understanding about the unique influence of stress, gender, and culture on type 2 diabetes mellitus (t2dm) prevention and management among Black men. Twenty men from Iowa were recruited from a larger longitudinal study on Black families; each of these men participated in one of three focus groups. Ninety-five percent of the men in the sample were Black and all were either diagnosed with t2dm (n = 10), were prediabetic (n = 1), or had experience with t2dm through family and friends (n = 9). Our results revealed the existence of significant stress and some pessimism with respect to perceived ability to prevent and manage t2dm. The participants made it clear that, while their families are primary sources of support for managing stress, including t2dm, they can also be a source of stress, particularly with respect to parenting. Black men had mixed opinions on their relationships with respect to their health care providers; some had positive, long-standing relationships while others reported little or no relationship with their providers. In response to life stress, Black men reported experiencing inadequate and disrupted sleep as well as consuming too much alcohol at times. Some of the participants reported engaging in physical activity to manage their stress. The study concluded that, as researchers develop t2dm prevention and management programs, they should continue to consider the unique role that stress in its various forms, plays in the lives of Black men. © The Author(s) 2015.

  5. Exclusive radiotherapy and concurrent endocrine therapy for the management of elderly breast cancer patients: Case study and review of hypo-fractionated schemes; Hormonoradiotherapie exclusive dans la prise en charge du cancer du sein de la personne agee: cas clinique et revue de la litterature des schemas hypofractionnes

    Energy Technology Data Exchange (ETDEWEB)

    Auberdiac, P.; Cartier, L.; Malkoun, N.; Chauleur, C.; De Laroche, G.; Magne, N. [Departement de radiotherapie, institut de cancerologie de la Loire, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex (France); Chargari, C. [Service d' oncologie radiotherapie, hopital d' instruction des armees du Val-de-Grace, 74, boulevard de Port-Royal, 75230 Paris cedex 5 (France); Melis, A.; Jacquin, J.P. [Departement d' oncologie medicale, institut de cancerologie de la Loire, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex (France)

    2011-12-15

    Normo-fractionated radiotherapy is standard for adjuvant management of patients treated with breast conservative surgery for breast cancer. However, many elderly patients are not eligible to such strategy, either because of concurrent diseases, or because the tumor is inoperable. Several protocols of exclusive radiotherapy have been reported in the literature, frequently using hypo-fractionated radiotherapy and endocrine therapy. We report a case of a patient treated with exclusive endocrine and radiotherapy and address the state of the art on hypo-fractionated schemes for the management of elderly breast cancer patients. While hypo-fractionated radiotherapy does not compromise the oncologic or cosmetic outcome, there is no prospective data that assesses the place of radiotherapy for the exclusive treatment of elderly patients. This strategy should be further assessed in clinical randomized trial. (authors)

  6. Management of pelvic inflammatory disease by primary care physicians. A comparison with Centers for Disease Control and Prevention guidelines.

    Science.gov (United States)

    Hessol, N A; Priddy, F H; Bolan, G; Baumrind, N; Vittinghoff, E; Reingold, A L; Padian, N S

    1996-01-01

    The Centers for Disease Control and Prevention published recommendations for clinicians on the management of pelvic inflammatory disease, but it is unknown if providers are aware of the guidelines or follow them. To compare pelvic inflammatory disease screening, diagnosis, treatment, and reporting practices among primary care physicians with the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. A weighted random sample of California primary care physicians surveyed in November 1992 and January 1993. Of the 1,165 physicians surveyed, 553 (48%) returned completed questionnaires. Among respondents, 302 (55%) reported having treated a case of pelvic inflammatory disease during the last 12 months, and of these, 52% answered that they were unsure of or do not follow the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. Pediatricians and those with more years since residency were less likely to deviate from the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease, and family practitioners were more likely to deviate from the guidelines. Pelvic inflammatory disease is commonly encountered by primary care physicians in California. Training and experience were important predictors of compliance with the Centers for Disease Control and Prevention recommendations; however, substantial divergence from the guidelines occurs.

  7. Locally-regionally advanced tonsillar squamous cell carcinoma treated with concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Krstevska, Valentina; Stojkovski, Igor

    2013-01-01

    Purpose: To perform a retrospective review of stage III-IV squamous cell carcinoma of the tonsil managed by definitive concurrent chemoradiotherapy (CCRT) in order to analyze the patients’ outcome and to evaluate the acute and late toxic effects of this treatment modality. Material and methods: Between January 2005 and December 2010, 36 patients with locally and/or regionally advanced tonsillar cancer underwent three dimensional conformal radiotherapy (3DCRT) with concurrent platinum-based chemotherapy. The dose prescription of the planning target volume for gross tumor and low-risk subclinical disease was 70 Gy and 50 Gy, respectively. Conventional fractionation with a daily dose of 2.0 Gy, 5 times per week was used. Concurrent chemotherapy consisted of cisplatin 30 mg/m2 given on a weekly basis. Acute and late radiotherapy-related toxicities were recorded using European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group (EORTC/RTOG) grading system. The 3-year locoregional relapse-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method. Results: The median follow-up of all patients was 20.5 months (range, 5 to 90 months). The median followup of living patients was 59 months (range, 30 to 90 months). Complete response rates of the primary tumor and of the nodal disease were 72.2% and 64.0%, respectively. A complete composite response was present in 25 patients (69.4%). Treatment failure occurred in 15 out of 25 patients who achieved complete composite response following CCRT. The 3-year LRRFS, DFS, and OS rate was 38.8%, 27.8%, and 27.3%, respectively. Grade 3 mucositis occurred in 58.3% of patients. Xerostomia grade 2 was revealed in 72.2% of patients. Conclusion: Taking into account the low 3-year survival rates observed in our study and the high percentage of grade 2 xerostomia, it can be concluded that in the future, instead of 3DCRT with concurrent

  8. Relapse prevention.

    Science.gov (United States)

    Hall, S M; Wasserman, D A; Havassy, B E

    1991-01-01

    Although knowledge about relapse prevention is still at an early stage, the extant data highlight the importance of several constructs. 1. Motivation for abstinence remains central. The construct itself is often clouded because of its association with mystical notions such as willpower and self-control. We know that manipulation of environmental events can increase motivation. These interventions are effective, however, only as long as the contingencies are in effect. We need to develop and evaluate strategies for transferring contingency management to the natural environment, that is, to institutions and groups that can perpetuate them for the long term. Also, clarification of the kinds of abstinence goals needed to prevent relapse is important. 2. Coping skills have been studied by several investigators, but research on these, except for job-finding skills, is not encouraging. The skills usually taught may be too basic. Skills training oriented to complex targets, such as building nondrug-using networks, may be useful and should be further explored. 3. Social support is clearly important, yet we do not know how best to use it to promote abstinence. The little research available suggests that both familial and nonfamilial systems should be mobilized. We need to define abstinence-promoting supportive behaviors, identify and engage important support systems in treatment, and help patients expand their nondrug-using contacts. 4. Negative affect may be causally related to relapse. We need to continue efforts to identify dysphoric patients and develop interventions to ameliorate dysphoria concurrent with drug abuse treatment (cf. Zweben and Smith 1989). 5. Drug cue reactivity and extinction to drug cues have been demonstrated in the laboratory. What is needed in this promising line of research are (1) investigation of cues and cue-reactivity phenomena in the natural environment or in conditions closely mimicking that environment and (2) extinction methods that transfer

  9. C.R.I.S.T.A.L. Concurrent Repository & Information System for Tracking Assembly and production Lifecycles A data capture and production management tool for the assembly and construction of the CMS ECAL detector

    CERN Document Server

    Le Goff, J M; Barone, G; Bazan, A; Heath, H F; Kovács, Z; Le Flour, T; Leonardi, E; Lieunard, S; McClatchey, R; Organtini, G; Rousset, D; Vialle, J P

    2001-01-01

    The CMS experiment will comprise several very large high resolution detectors for physics. Each detector may be constructed of well over a million parts and will be produced and assembled during the next decade by specialised centres distributed world-wide. Each constituent part of each detector must be accurately measured and tested locally prior to its ultimate assembly and integration in the experimental area at CERN. The CRISTAL project (Concurrent Repository and Information System for Tracking Assembly and production Lifecycles) [1] aims to monitor and control the quality of the production and assembly process to aid in optimising the performance of the physics detectors and to reject unacceptable constituent parts as early as possible in the construction lifecycle. During assembly CRISTAL will capture all the information required for subsequent detector calibration. Distributed instances of Object databases linked via CORBA [2] and with WWW/Java-based query processing are the main technology aspects of ...

  10. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Special Diabetes Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) ... On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes ...

  11. Wildland fire management. Volume 1: Prevention methods and analysis. [systems engineering approach to California fire problems

    Science.gov (United States)

    Weissenberger, S. (Editor)

    1973-01-01

    A systems engineering approach is reported for the problem of reducing the number and severity of California's wildlife fires. Prevention methodologies are reviewed and cost benefit models are developed for making preignition decisions.

  12. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Event Calendar Indian Health Manual Key Leaders Legislation Organizational Structure Our Employees Locations Headquarters Alaska Area Albuquerque ... Resources Community Health Behavioral Health Environmental Health Health ... Promotion Injury Prevention School Health Sustainability Visualizing ...

  13. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Diabetes LISTSERV to receive updates on training opportunities, research, and resources related to diabetes prevention and treatment in American Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, ...

  14. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Login WARNING! This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and ... or used for any lawful Government purpose. IHS Home Division of Diabetes Treatment and Prevention Division of ...

  15. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Diabetes LISTSERV to receive updates on training opportunities, research, and resources related to diabetes ... Mail Stops Office of Clinical and Preventive Services - 08N34 A&B Office of ...

  16. Fact Sheet: Clean Air Act Section 112(r): Accidental Release Prevention / Risk Management Plan Rule

    Science.gov (United States)

    EPA is required to publish regulations and guidance for chemical accident prevention at facilities that pose the greatest risk of harm from accidental releases of regulated flammable and toxic substances above threshold quantities.

  17. Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

    2016-10-01

    Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

  18. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... or used for any lawful Government purpose. IHS Home Division of Diabetes Treatment and Prevention Division of ... Live and On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools ...

  19. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Foot Care Training Tools for Diabetes Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan ... prevention and treatment in American Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, ...

  20. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... result in disciplinary action and/or civil and criminal penalties. At any time, and for any lawful ... Diabetes LISTSERV to receive updates on training opportunities, research, and resources related to diabetes prevention and treatment ...

  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... system is prohibited and may result in disciplinary action and/or civil and criminal penalties. At any time, ... on training opportunities, research, and resources related to diabetes prevention and treatment ...

  2. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery

    DEFF Research Database (Denmark)

    Alfieri, S; Amid, P K; Campanelli, G

    2011-01-01

    To provide uniform terminology and definition of post-herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain....

  3. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Treatment for the Prevention of Diabetes Richard Arakaki, MD Area Diabetes Consultant Phoenix Area IHS Stay Connected ... Headquarters, Indian Health Service, 5600 Fishers Lane, Rockville, MD 20857 - Find a Mail Stop Office Mail Stops ...

  4. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Calendar Indian Health Manual Key Leaders Legislation Organizational Structure Our Employees Locations Headquarters Alaska Area Albuquerque Area ... Health Promotion Injury Prevention School Health Sustainability Visualizing Data Contacts ... Career Opportunities Ambassador Program Applicant Forms & Documents ...

  5. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Us Special Diabetes Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) ... and On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes ...

  6. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Budget Eligibility Event Calendar Indian Health Manual Key Leaders Legislation Organizational Structure Our Employees Locations Headquarters Alaska ... Resources Community Health Behavioral Health Environmental Health Health ... Promotion Injury Prevention School Health Sustainability Visualizing ...

  7. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians ... Prevention Program Toolkit, Program Spotlights, and more! Announcing Online Lesson Plan Outlines for Educators New or seasoned ...

  8. Preventative and predictive maintenance as a function of spare part management

    International Nuclear Information System (INIS)

    LaRose, R.; Sloski, P.

    2006-01-01

    Preventive and predictive maintenance has many aspects, such as vibration monitoring, lubricating oil analysis, thermography etc. This presentation focuses on the material and design application of sealing devices. (author)

  9. Weight management in African-Americans using church-based community interventions to prevent type 2 diabetes and cardiovascular disease.

    Science.gov (United States)

    Thompson, Elizabeth; Berry, Diane; Nasir, Laura

    2009-07-01

    The purpose of this literature review was to examine the utilization of church-based interventions designed for African-Americans in the community for the management of overweight and obesity and prevention of type 2 diabetes and cardiovascular disease. PubMed, CINAHL, and Google scholar were searched using the following key search terms: type 2 diabetes, cardiovascular disease, prevention, management, African-Americans, Blacks, weight loss, weight management, church-based interventions, community interventions, faith-based interventions, and prayer. Sixteen primary studies were located and six met inclusion criteria. The studies were separated into two categories: faith-placed interventions or collaborative interventions. The overall results demonstrated significant weight loss ranging from 2.3 (SD = 4.1) pounds to 10.1 (SD = 10.3) pounds post-intervention. Further research is needed to understand interventions that are church-based and culturally sensitive for African-Americans. Weight management is important in order to decrease the morbidity and mortality related to type 2 diabetes and cardiovascular disease in the African-American population.

  10. Preventive protocols and oral management in childhood leukemia--the pediatric specialist's role.

    Science.gov (United States)

    Xavier, Arun M; Hegde, Amitha M

    2010-01-01

    The leukemias are the most common form of childhood malignancy. The pediatric dental professional plays a major role in the prevention, stabilization and treatment of the oral and dental problems that can compromise the child's health and quality of life before, during and after the cancer treatment. This manuscript highlights the incidence of oral complications in leukemic children receiving oncology treatment and the systematic preventive protocol followed during different phases of medical treatment.

  11. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery

    DEFF Research Database (Denmark)

    Alfieri, S; Amid, P K; Campanelli, G

    2011-01-01

    To provide uniform terminology and definition of post-herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain.......To provide uniform terminology and definition of post-herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain....

  12. Effectiveness of percutaneous flexor tenotomies for the management and prevention of recurrence of diabetic toe ulcers: a systematic review.

    Science.gov (United States)

    Scott, Jennifer E; Hendry, Gordon J; Locke, John

    2016-01-01

    Diabetic toe ulcers are a potentially devastating complication of diabetes. In recent years, the percutaneous flexor tenotomy procedure for the correction of flexible claw and hammer-toe contraction deformities has been proposed as a safe and effective technique for facilitating the healing of toe-deformity related diabetic ulcers. The aim of this review is to critically appraise the evidence for the effectiveness of this surgical procedure in achieving ulcer healing, prevention of re-ulceration, and to summarise the rate of post-operative complications. A search of medical databases, was performed to locate relevant literature. Titles were screened prior to abstract and full text review to identify articles relevant to the research question. Search terms included truncations of "tenotomy", "toe", "hallux", "digit", "diabetes" and "ulcer". Peer reviewed primary research study designs specified as suitable for systematic reviews by the Centre for Reviews and Dissemination were included. Studies were excluded if they used a concurrent secondary procedure or included non-diabetic patients without reporting outcomes separately. Included studies were appraised for quality using the Methodological Index for Non-Randomised Studies tool. Levels of evidence were subsequently assigned to each outcome of interest (healing rate and prevention of re-ulceration). From a total search yield of 42 articles, 5 eligible studies (all case series designs) were identified for inclusion. Included studies were of low-to-moderate methodological quality when assessed using the MINORS tool. A total of 250 flexor tenotomy procedures were performed in a total of 163 patients. Included studies generally reported good healing rates (92-100 % within 2 months) post-op follow-up), relatively few recurrences (0-18 % at 22 months median post-op follow-up), and low incidences of infection or new deformity. Transfer ulcers developing on adjacent areas as a result of shifted pressure were reported

  13. Proactive and Early Aggressive Wound Management: A Shift in Strategy Developed by a Consensus Panel Examining the Current Science, Prevention, and Management of Acute and Chronic Wounds.

    Science.gov (United States)

    Bohn, Gregory A; Schultz, Gregory S; Liden, Brock A; Desvigne, Michael N; Lullove, Eric J; Zilberman, Igor; Regan, Mary B; Ostler, Marta; Edwards, Karen; Arvanitis, Georgia M; Hartman, Jodi F

    2017-11-01

    Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For existing chronic wounds, early aggressive wound management is employed to break the pathophysiology cycle and drive wounds toward healing. Reducing bioburden through debridement and bioburden management and using collagen dressings to balance protease activity prior to the use of advanced modalities may enhance their effectiveness. This early aggressive wound management strategy is recommended for patients at high risk for chronic wound development at a minimum. In their own practices, the panel members apply this systematic strategy for all patients presenting with acute injuries or chronic wounds.

  14. How does concurrent sourcing affect performance?

    DEFF Research Database (Denmark)

    Mols, Niels Peter

    2010-01-01

    /methodology/approach – Based on transaction cost, agency, neoclassical economic, knowledge-based, and resource-based theory, it is proposed to show how concurrent sourcing affects performance. Findings – The paper argues that concurrent sourcing improves performance when firms face a combination of volume uncertainty......, performance uncertainty, non-decomposability, and asset specificity. Concurrent sourcing can also be a way to exploit both strong internal capabilities and external suppliers’ strong capabilities. Originality/value – The main contribution is a number of propositions, explanations, and discussions regarding...

  15. Concurrent interstitial ectopic pregnancy and appendicitis: a case report.

    Science.gov (United States)

    Biggs, R Lee; Magann, Everett F; O'Boyle, John D

    2008-05-01

    Concurrent ectopic pregnancy and acute appendicitis is rarely encountered. Since 1960, only 22 cases have been reported. No case of concurrent interstitial ectopic pregnancy and appendicitis has ever been reported. A 24-year-old, African American woman, gravida 4, para 3, had a right interstitial ectopic pregnancy. She was managed as an inpatient with parenteral methotrexate and her beta-human chorionic gonadotropin level decreased appropriately. She was discharged 3 days after treatment but subsequently returned with right lower quadrant pain, nausea, vomiting and fever. The patient underwent laparoscopy with removal of a suppurative appendix. A stable interstitial ectopic pregnancy was visualized and left in situ. The discipline to consider concomitant abdominal pathology is paramount. The perceived rarity of an ectopic pregnancy and appendicitis should not obscure a thorough clinical evaluation.

  16. Concurrent chemoradiotherapy for locoregionally advanced uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Toita, Takafumi; Ogawa, Kazuhiko; Moromizato, Hidehiko [Ryukyus Univ., Nishihara, Okinawa (Japan). Faculty of Medicine] [and others

    2000-12-01

    Twenty-two patients with locoregionally advanced uterine cervical squamous cell carcinoma were treated with concurrent chemoradiotherapy (CCRT). CDDP (20 mg/m{sup 2} daily) was concurrently administered for 5 days at 21-days intervals with external beam irradiation and HDR intracavitary therapy. Blood and gastrointestinal (nausea and vomiting) toxicities were severe but manageable. There was no grade 5 (fatal) toxicity. Nine (41%) experienced recurrence. The 2-year pelvic control rate, distant metastasis-free rate, disease-free survival rate, and absolute survival rate for all 22 patients were 77%, 72%, 57%, and 65%, respectively. One suffered small intestinal perforation (grade 4). We consider that our CCRT is feasible and may have positive therapeutic value on long-term prognosis for patients with locoregionally advanced uterine cervical squamous cell carcinoma. (author)

  17. Self-management support interventions that are clinically linked and technology enabled: can they successfully prevent and treat diabetes?

    Science.gov (United States)

    Kaufman, Neal D; Woodley, Paula D Patnoe

    2011-05-01

    Patients with diabetes need a complex set of services and supports. The challenge of integrating these services into the diabetes regimen can be successfully overcome through self-management support interventions that are clinically linked and technology enabled: self-management support because patients need help mastering the knowledge, attitudes, skills, and behaviors so necessary for good outcomes; interventions because comprehensive theory-based, evidence-proven, long-term, longitudinal interventions work better than direct-to-consumer or nonplanned health promotion approaches; clinically linked because patients are more likely to adopt new behaviors when the approach is in the context of a trusted therapeutic relationship and within an effective medical care system; and technology enabled because capitalizing on the amazing power of information technology leads to the delivery of cost-effective, scalable, engaging solutions that prevent and manage diabetes. © 2011 Diabetes Technology Society.

  18. Development of Human Factor Management Requirements and Human Error Classification for the Prevention of Railway Accident

    International Nuclear Information System (INIS)

    Kwak, Sang Log; Park, Chan Woo; Shin, Seung Ryoung

    2008-08-01

    Railway accident analysis results show that accidents cased by human factors are not decreasing, whereas H/W related accidents are steadily decreasing. For the efficient management of human factors, many expertise on design, conditions, safety culture and staffing are required. But current safety management activities on safety critical works are focused on training, due to the limited resource and information. In order to improve railway safety, human factors management requirements for safety critical worker and human error classification is proposed in this report. For this accident analysis, status of safety measure on human factor, safety management system on safety critical worker, current safety planning is analysis

  19. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... LISTSERV Email Groups National Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion ...

  20. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury ...