WorldWideScience

Sample records for preventing adult emergence

  1. Concepts of Infidelity among African American Emerging Adults: Implications for HIV/STI Prevention

    Science.gov (United States)

    Eyre, Stephen L.; Flythe, Michelle; Hoffman, Valerie; Fraser, Ashley E.

    2012-01-01

    In this study, we used an exploratory methodology to determine what cultural models African American emerging adults use to understand infidelity/cheating. Cultural models are defined as "cognitive schema[s] that [are] intersubjectively shared by a social group" (D'Andrade, 1987, p. 112). We interviewed 144 participants ages 19-22 from three…

  2. Older adult falls prevention behaviors 60 days post-discharge from an urban emergency department after treatment for a fall.

    Science.gov (United States)

    Shankar, Kalpana Narayan; Treadway, Nicole J; Taylor, Alyssa A; Breaud, Alan H; Peterson, Elizabeth W; Howland, Jonathan

    2017-12-01

    Falls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury. We enrolled English speaking patients, aged ≥ 65 years, who presented to the ED of an urban level one trauma center with a fall or fall related injury and discharged home. During subjects' initial visits to the ED, we screened and enrolled patients, gathered patient demographics and provided them with a flyer for a Matter of Balance course. Sixty-days post enrollment, we conducted a phone follow-up interview to collect information on post-fall behaviors including information regarding the efforts to engage family and the primary care provider, enroll in a falls prevention program, assess patients' attitudes towards falling and experiences with any subsequent falls. Eighty-seven community-dwelling people between the ages of 65 and 90 were recruited, the majority (76%) being women. Seventy-one percent of subjects reported talking to their provider regarding the fall; 37% reported engaging in falls prevention activities. No subjects reported enrolling in a fall prevention program although two reported contacting falls program staff. Fourteen percent of subjects (n=12) reported a recurrent fall and 8% (7) reported returning to the ED after a recurrent fall. Findings indicate a low rate of initiating fall prevention behaviors following an ED visit for a fall-related injury among community-dwelling older adults, and highlight the ED visit as an important, but underutilized, opportunity to mobilize health care resources for people at high risk for subsequent falls.

  3. Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients

    Directory of Open Access Journals (Sweden)

    Yoo JY

    2016-09-01

    Full Text Available Ji Young Yoo,1 Jong Yeop Kim,1 Hyun Jeong Kwak,2 Dong Chul Lee,2 Go Wun Kim,1 Sook Young Lee,1 Yun Jeong Chae1 1Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, 2Department of Anaesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea Purpose: Prevention of cough during emergence after nasal surgery is important for avoiding surgical site bleeding. We investigated the remifentanil effect-site concentration in 50% (EC50 of the elderly patients undergoing nasal surgery for smooth emergence without cough and compared it with that of adult patients.Methods: Twenty-two elderly (aged 65–80 years and 25 adult patients (aged 20–60 years with an American Society of Anesthesiologists physical status I/II undergoing nasal surgery were enrolled. Anesthesia was maintained with sevoflurane and remifentanil. Remifentanil EC50 and EC95 for preventing cough were determined using the modified Dixon’s up-and-down method and isotonic regression with bootstrapping approach. Recovery profiles were also recorded.Results: With Dixon’s up-and-down method, the EC50 of remifentanil in elderly patients (2.40±0.25 ng/mL was not significantly different from that of adults (2.33±0.30 ng/mL (P=0.687. With isotonic regression, the EC95 of remifentanil in elderly patients (3.32 [95% confidence interval: 3.06–3.38] ng/mL was not significantly different from that of adults (3.30 [95% confidence interval: 2.96–3.37] ng/mL. However, eye opening time (14.1±3.8 vs 12.0±2.9 seconds, extubation time (17.2±4.1 vs 14.0±3.0 seconds, and postanesthesia care unit duration (44.5±7.6 vs 38.7±3.4 minutes in elderly patients were significantly longer than those in adults (P<0.05.Conclusion: Remifentanil EC50 for preventing cough after nasal surgery with sevoflurane anesthesia did not differ between elderly and adult patients. However, delayed awakening and respiratory adverse events may warrant attention

  4. Emergency Preparedness Concerns for Older Adults

    Centers for Disease Control (CDC) Podcasts

    2009-01-26

    This podcast discusses the special concerns many older adults face during a disaster. It is primarily targeted to public health and aging services professionals.  Created: 1/26/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) and Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER).   Date Released: 1/26/2009.

  5. An emergency department-based vaccination program: overcoming the barriers for adults at high risk for vaccine-preventable diseases.

    Science.gov (United States)

    Rimple, Diane; Weiss, Steven J; Brett, Meghan; Ernst, Amy A

    2006-09-01

    More than 10% of the population visit emergency departments (ED) every year. Many of these patients are not up-to-date on routine vaccinations that could prevent future illnesses. The ED could significantly impact these vaccination trends. This study was a feasibility study to determine whether patients would be amenable to an ED-based program that provided appropriate immunizations when they were at high risk for these diseases. In addition, the authors sought to identify barriers that predict high-risk patients who did not receive immunizations before ED presentation and to identify barriers that predict those high-risk unvaccinated patients who are unwilling to receive vaccinations when offered in the ED. This study was a prospective cross-sectional study of all patients arriving in the ED at one inner-city trauma center between 10 am and 10 pm over the course of a three-week intervention period. The subjects completed a survey that included information about their risk of influenza (flu) and pneumococcal disease, their immunization history, and their perceptions of their need for immunization. Demographic information collected included insurance status, age, gender, and primary language. All high-risk patients who were not current with their immunizations were offered vaccination. The primary outcome was improvement in vaccination coverage based on an ED surveillance and treatment system for vaccinations. The secondary outcomes were barriers to successful vaccination before ED presentation and barriers to acceptance of vaccination in the ED. Results were compared using chi-square test and confidence interval analysis. Characteristics of barriers to immunization were determined using a logistic regression model. A p-value barriers to vaccination before ED presentation were lack of insurance (odds ratio [OR] = 0.31 for flu, 0.22 for pneumococcal disease), age younger than 50 years (OR = 0.18 for flu, 0.24 for pneumococcal disease), and no perceived need for

  6. OEM Emergency Prevention and Mitigation Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management maintains information relevant to preventing emergencies before they occur, and/or mitigating the effects of emergency when they...

  7. Obesity Prevention in Older Adults.

    Science.gov (United States)

    Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

    2016-06-01

    The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.

  8. Selecting Communication Channels for Substance Misuse Prevention with At-Risk African-American Emerging Adults Living in the Southern United States

    Science.gov (United States)

    Tucker, Jalie A.; Cheong, JeeWon; Chandler, Susan D.

    2016-01-01

    Natural health information sources used by African-American emerging adults were investigated to identify sources associated with high and low substance-related risk. Participants (110 males, 234 females; M age = 18.9 years) were recruited using respondent-driven sampling, and structured interviews assessed substance use, sources of health…

  9. Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients

    OpenAIRE

    Yoo JY; Kim JY; Kwak HJ; Lee DC; Kim GW; Lee SY; Chae YJ

    2016-01-01

    Ji Young Yoo,1 Jong Yeop Kim,1 Hyun Jeong Kwak,2 Dong Chul Lee,2 Go Wun Kim,1 Sook Young Lee,1 Yun Jeong Chae1 1Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, 2Department of Anaesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea Purpose: Prevention of cough during emergence after nasal surgery is important for avoiding surgical site bleeding. We investigated the remifentanil effect-site concentration in 50% (EC50...

  10. Predictors of Transience among Homeless Emerging Adults

    Science.gov (United States)

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2014-01-01

    This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

  11. Perspectives on housing among homeless emerging adults.

    Science.gov (United States)

    Ryan, Tiffany N; Thompson, Sanna J

    2013-02-01

    Homeless emerging adults need the safety and stability of housing programs if they are to avoid the elements and victimization of the streets, however, barriers to obtaining housing are numerous. This study identified factors associated with perspectives of housing services among 29 homeless emerging adults (ages 18-23 years) through one-on-one interviews. Data were gathered and analyzed using grounded theory methodology for qualitative information. Major themes of peer support and positive personal and programmatic interactions in the context of emerging adult development were noted as important factors in housing service utilization. These major themes should be taken into consideration for current housing programs, due to homeless emerging adults' oscillation between their desire for formal support and personal independence. Greater emphasis on services that do not require long term commitments and are more flexible in addressing specific barriers to housing for homeless emerging adults may increase use. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Cardiovascular Disease Risk Factors among Emerging Adults in College

    Science.gov (United States)

    Abshire, Demetrius Alexander

    2014-01-01

    The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

  13. Emergency Department and Older Adult Motor Vehicle Collisions

    Directory of Open Access Journals (Sweden)

    Lotfipour, Shahram

    2013-11-01

    Full Text Available In 2009, the Center for Disease Control and Prevention reported there were 33 million licensed drivers 65 years and older in the U.S. This represents a 23 percent increase from 1999, number that is predicted to double by 2030. Although, motor vehicle collisions (MVC-related to emergency department (ED visits for older adults are lower per capita than for younger adults, the older-adults MVCs require more resources, such as additional diagnostic imaging and increased odds of admission. Addressing the specific needs of older-adults could lead to better outcomes yet not enough research currently exists. It is important to continue training emergency physicians to treat the increasing older-patient population, but its also imperative we increase our injury prevention and screening methodology. We review research findings from the article: Emergency Department Visits by Older Adults for Motor Vehicle Collisions: A Five-year national study, with commentary on current recommendation and policies for the growing older-adult driving population. [West J Emerg Med.2013;14(6:582–584.

  14. Religion and health-promoting behaviors among emerging adults.

    Science.gov (United States)

    Horton, Shalonda E B

    2015-02-01

    Studies suggest we capitalize upon religion's health benefits to prevent obesity. The purpose of this qualitative descriptive study was to determine how emerging adults used religion to manage their health. Two focus groups were conducted among White and African American participants. Content analysis of the data revealed categories about their attitudes regarding parental and religious influences, religion's influence on behavior, negative health effects of religion, barriers, obesity prevention, and health promotion programs. Society sends out "easy" solutions for unhealthy behaviors, but we should focus on healthy behavior benefits, remove barriers, and consider religion's part in health promotion (obesity prevention).

  15. Koru: Teaching Mindfulness to Emerging Adults

    Science.gov (United States)

    Rogers, Holly B.

    2013-01-01

    Although there is much interest in teaching mindfulness to college students and other emerging adults, traditional methods of teaching mindfulness and meditation are not always effective for reaching this age group. Koru is a program, developed at Duke University, that has been specifically designed with the developmental characteristics of…

  16. Fall prevention strategy in an emergency department.

    Science.gov (United States)

    Muray, Mwali; Bélanger, Charles H; Razmak, Jamil

    2018-02-12

    Purpose The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services. Design/methodology/approach The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ 2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables. Findings In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool. Originality/value Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

  17. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  18. Guidelines for accident prevention and emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Fthenakis, V.M.; Morris, S.C.; Moskowitz, P.D.

    1993-05-01

    This report reviews recent developments in the guidelines on chemical accident prevention, risk assessment, and management of chemical emergencies, principally in the United States and Europe, and discusses aspects of their application to developing countries. Such guidelines are either in the form of laws or regulations promulgated by governments, or of recommendations from international, professional, or non governmental organizations. In many cases, these guidelines specify lists of materials of concern and methods for evaluating safe usage of these materials and recommend areas of responsibility for different organizations; procedures to be included in planning, evaluation, and response; and appropriate levels of training for different classes of workers. Guidelines frequently address the right of communities to be informed of potential hazards and address ways for them to participate in planning and decision making.

  19. Injury prevention for adult male soccer players

    NARCIS (Netherlands)

    van Beijsterveldt, A.M.C.

    2013-01-01

    Soccer causes the largest number of injuries each year (18% of all sports injuries) in the Netherlands. The aim of this dissertation is to contribute to the body of evidence on injury prevention for adult male soccer players. Chapter 1 is a general introduction and presents the “sequence of

  20. Strokes in young adults: epidemiology and prevention

    Directory of Open Access Journals (Sweden)

    Smajlović D

    2015-02-01

    Full Text Available Dževdet Smajlović Department of Neurology, University Clinical Centre Tuzla, School of Medicine, University of Tuzla, Bosnia and Herzegovina Abstract: Strokes in young adults are reported as being uncommon, comprising 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of stroke in young adults. This is important given the fact that younger stroke patients have a clearly increased risk of death compared with the general population. The prevalence of standard modifiable vascular risk factors in young stroke patients is different from that in older patients. Modifiable risk factors for stroke, such as dyslipidemia, smoking, and hypertension, are highly prevalent in the young stroke population, with no significant difference in geographic, climatic, nutritional, lifestyle, or genetic diversity. The list of potential stroke etiologies among young adults is extensive. Strokes of undetermined and of other determined etiology are the most common types among young patients according to TOAST (Trial of Org 10172 in Acute Stroke Treatment criteria. Prevention is the primary treatment strategy aimed at reducing morbidity and mortality related to stroke. Therefore, primary prevention is very important with regard to stroke in young adults, and aggressive treatment of risk factors for stroke, such as hypertension, smoking, and dyslipidemia, is essential. The best form of secondary stroke prevention is directed toward stroke etiology as well as treatment of additional risk factors. However, there is a lack of specific recommendations and guidelines for stroke management in young adults. In conclusion, strokes in young adults are a major public health problem and further research, with standardized methodology, is needed in order to give us more

  1. Bedaquiline resistance: Its emergence, mechanism and prevention.

    NARCIS (Netherlands)

    Nguyen, Thi Van Anh; Anthony, Richard M; Bañuls, Anne-Laure; Vu, Dinh Hoa; Alffenaar, Jan-Willem C

    2017-01-01

    Bedaquiline, a new anti-tuberculosis drug, has already been used in more than 50 countries. The emergence of bedaquiline resistance is alarming, as it may result in the rapid loss of this new drug. This paper aims to review currently identified mechanisms of resistance, the emergence of bedaquiline

  2. Factors Influencing Dating Experiences Among African American Emerging Adults.

    Science.gov (United States)

    Hall, Naomi M; Lee, Anna K; Witherspoon, Daphne D

    2014-09-01

    This study examined sociocultural factors that impact dating and sexual experiences of heterosexual African American undergraduate college students attending a historically Black institution in the Southeastern United States. Specifically, mate availability and relationship involvement were analyzed to document students' experiences, and how these influences may be associated with sexual decision making and behavior. Data from nine focus groups ( N = 57) were aggregated and four subthemes were identified: competition among women, acceptability of mates, high prevalence of casual relationships, and lowered expectations for commitment. Power dynamics emerged as a contributing factor to the types of relationship involvement, sexual decision-making, and behavior among participants. The importance of prevention programs focusing on situational and cultural variables is highlighted. Additionally, implications for professionals working with emerging adults to consider the impact of the gender ratio imbalance, and perceived power distributions on perceptions of dating relationships, and sexual decision making and behavior are addressed.

  3. Politics of prevention: The emergence of prevention science.

    Science.gov (United States)

    Roumeliotis, Filip

    2015-08-01

    This article critically examines the political dimension of prevention science by asking how it constructs the problems for which prevention is seen as the solution and how it enables the monitoring and control of these problems. It also seeks to examine how prevention science has established a sphere for legitimate political deliberation and which kinds of statements are accepted as legitimate within this sphere. The material consists of 14 publications describing and discussing the goals, concepts, promises and problems of prevention science. The analysis covers the period from 1993 to 2012. The analysis shows that prevention science has established a narrow definition of "prevention", including only interventions aimed at the reduction of risks for clinical disorders. In publications from the U.S. National Institute of Drug Abuse, the principles of prevention science have enabled a commitment to a zero-tolerance policy on drugs. The drug using subject has been constructed as a rational choice actor lacking in skills in exerting self-control in regard to drug use. Prevention science has also enabled the monitoring and control of expertise, risk groups and individuals through specific forms of data gathering. Through the juxtaposition of the concepts of "objectivity" and "morality", prevention science has constituted a principle of delineation, disqualifying statements not adhering to the principles of prevention science from the political field, rendering ethical and conflictual dimensions of problem representations invisible. The valorisation of scientific accounts of drugs has acted to naturalise specific political ideals. It simultaneously marginalises the public from the public policy process, giving precedence to experts who are able to provide information that policy-makers are demanding. Alternative accounts, such as those based on marginalisation, poverty or discrimination are silenced within prevention science. Copyright © 2015 Elsevier B.V. All rights

  4. How Condom Discontinuation Occurs: Interviews With Emerging Adult Women.

    Science.gov (United States)

    Mullinax, Margo; Sanders, Stephanie; Dennis, Barbara; Higgins, Jenny; Fortenberry, J Dennis; Reece, Michael

    We have almost no data on how and when couples stop using condoms. This qualitative study investigated the process of condom discontinuation. From November 2013 to April 2014, a total of 25 women living in a college town in the Midwest, ages 18 to 25, participated in semistructured interviews centered around three domains: partner interactions, contraceptive use, and sexually transmitted infection (STI) prevention. Analysis followed a critical qualitative research orientation. Participants described actively seeking the best options to prevent pregnancy, perceiving condom discontinuation in favor of hormonal methods as a smart decision, and reported wanting to discontinue using condoms due to physical discomfort. Oftentimes, nonverbal communication around contextual instances of condom unavailability paved the way for discontinuation. Participants indicated the decision to stop using condoms was neither deliberate nor planned. Condom discontinuation rarely occurred at one point in time; instead, it was preceded by a period of occasional use. Even after participants described themselves as not using condoms, sporadic condom use was normal (typically related to fertility cycles). This study provides a more detailed understanding of how and why emerging adults negotiate condom discontinuation, thereby enhancing our ability to design effective condom continuation messages. Attention should be paid to helping emerging adults think more concretely about condom discontinuation.

  5. What Does It Take to Be an Adult in Austria? Views of Adulthood in Austrian Adolescents, Emerging Adults, and Adults

    Science.gov (United States)

    Sirsch, Ulrike; Dreher, Eva; Mayr, Eva; Willinger, Ulrike

    2009-01-01

    The present study examined the defining features of emerging adulthood, subjects' conceptions of the transition to adulthood, and the perceived adult status in Austria. The sample consisted of 775 subjects (226 adolescents, 317 emerging adults, 232 adults). Results showed that most Austrian emerging adults feel themselves to be between adolescence…

  6. Chemical Emergency Preparedness and Prevention Advisory: Ammonia

    Science.gov (United States)

    This advisory recommends ways Local Emergency Planning Committees (LEPCs) and chemical facilities can minimize risks from this extremely hazardous substance, especially when present in excess of its 500 pounds threshold planning quantity.

  7. Preventative maintenance plan for emergency pumping trailers

    International Nuclear Information System (INIS)

    Wiggins, D.D.

    1994-09-01

    The purpose/goal of this document is to identify the maintenance requirements and resources available to properly maintain the readiness and condition of the Emergency Pumping Equipment controlled by the Tank Waste Remediation System Tank Farms Plant Engineering and Tank Stabilization Operations. This equipment is intended to pump a single-shell tank (SST) that has been identified as an assumed leaking tank. The goal is to commence pumping (submersible or jet) as soon as safely possible after identifying a SST as an assumed leaking tank. Important information pertaining to the Emergency Pumping Equipment, Over-Ground Piping installation, and procedures is found in WHC-SD-WM-AP-005, ''Single Shell Tank Leak Emergency Pumping Guide.''

  8. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  9. Ready or Not? Criteria for Marriage Readiness among Emerging Adults

    Science.gov (United States)

    Carroll, Jason S.; Badger, Sarah; Willoughby, Brian J.; Nelson, Larry J.; Madsen, Stephanie D.; Barry, Carolyn McNamara

    2009-01-01

    This study examined emerging adults' criteria for marriage readiness and explored how these criteria are associated with their current attitudes and behaviors. This article establishes the psychometric value of the Criteria for Marriage Readiness Questionnaire and reports on a study of 788 emerging adults recruited from five college sites across…

  10. Longitudinal Changes in Religiosity among Emerging Adult College Students

    Science.gov (United States)

    Stoppa, Tara M.; Lefkowitz, Eva S.

    2010-01-01

    Issues of religion are important aspects of the identity process, which for many emerging adults may be intensified by the college experience. This study investigated longitudinal changes in the religiosity of 434 emerging adult college students (52% female) of diverse ethnic backgrounds (32% African American, 29% Latino American, and 39% European…

  11. Effectiveness and reliability analysis of emergency measures for flood prevention

    NARCIS (Netherlands)

    Lendering, K.T.; Jonkman, S.N.; Kok, M.

    2014-01-01

    During flood events emergency measures are used to prevent breaches in flood defences. However, there is still limited insight in their reliability and effectiveness. The objective of this paper is to develop a method to determine the reliability and effectiveness of emergency measures for flood

  12. Bedaquiline resistance: Its emergence, mechanism and prevention.

    Science.gov (United States)

    Nguyen, Thi Van Anh; Anthony, Richard M; Bañuls, Anne-Laure; Vu, Dinh Hoa; Alffenaar, Jan-Willem C

    2017-11-08

    Bedaquiline, a new anti-tuberculosis drug, has already been used in more than 50 countries. The emergence of bedaquiline resistance is alarming, as it may result in the rapid loss of this new drug. This paper aims to review currently identified mechanisms of resistance, the emergence of bedaquiline resistance, and discuss strategies to delay the resistance acquisition. In vitro and clinical studies as well as reports from the compassionate use have identified the threat of bedaquiline resistance and cross-resistance with clofazimine, emphasizing the crucial need for the systematic surveillance of resistance. Currently known mechanisms of resistance include mutations within the atpE, Rv0678 and pepQ genes. The development of standardized drug susceptibility testing (DST) for bedaquiline is urgently needed.Understanding any target and non-target based mechanisms is essential to minimize the resistance development and treatment failure, help to develop appropriate DST for bedaquiline and genetic based resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  13. Correlates of Perceived Smoking Prevalence Among Korean American Emerging Adults.

    Science.gov (United States)

    Cerrada, Christian J; Unger, Jennifer B; Huh, Jimi

    2016-10-01

    Perceived smoking prevalence, a strong predictor of actual smoking behavior, may be influenced by the ethnicity and gender of the reference group presented to Korean American emerging adults. Self-identifying Korean and Korean Americans aged 18-25 (N = 475), were invited to complete a 15-20 min online survey about their attitudes towards smoking. Predictors of perceived smoking prevalence were evaluated separately for four reference groups: Caucasian Americans, Korean Americans in general, Korean American men, and Korean American women. Respondents' smoking status was associated with perceived smoking prevalence for all reference groups except Caucasian Americans, even among light smokers. Father's smoking status was associated with perceived smoking prevalence for Korean American men, only among females respondents. Findings suggest that ethnicity and gender of both the reference group and respondents influence smoking rate estimates. Tailoring intervention content to the target population's gender and ethnicity may be a way to enhance smoking prevention strategies.

  14. Pediatric cardiac emergencies: Children are not small adults

    Directory of Open Access Journals (Sweden)

    Frazier Aisha

    2011-01-01

    Full Text Available Compared with adults, cardiac emergencies are infrequent in children and clinical presentation is often quite variable. In adults, cardiac emergencies are most commonly related to complications of coronary artery disease; however, in pediatric cases, the coronaries are only rarely the underlying problem. Pediatric cardiac emergencies comprise a range of pathology including but not limited to undiagnosed congenital heart disease in the infant; complications of palliated congenital heart disease in children; arrhythmias related to underlying cardiac pathology in the teenager and acquired heart disease. The emergency room physician and pediatric intensivist will usually be the first and second lines of care for pediatric cardiac emergencies and thus it is imperative that they have knowledge of the diverse presentations of cardiac disease in order to increase the likelihood of delivering early appropriate therapy and referral. The objective of this review is to outline cardiac emergencies in the pediatric population and contrast the presentation with adults.

  15. Adult Siblings Consider the Future: Emergent Themes

    Science.gov (United States)

    Davys, Deborah; Mitchell, Duncan; Haigh, Carol

    2016-01-01

    Background: This study aimed to explore the perceptions of adult siblings regarding a future care role and compare with perceived parental wishes as family often provide a key support role in the lives of people who have an intellectual disability. Materials and Method: Semi-structured interviews were undertaken with 15 adult siblings and an…

  16. Drug Abuse on College Campuses: Emerging Issues. Issues in Prevention

    Science.gov (United States)

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    This "Issues in Prevention" focuses on emerging issues concerning drug abuse on college campuses. This issue contains the following articles: (1) Drug Abuse Trends; (2) Q&A With Jim Lange; (3) Bath Salts; (4) Refuse to Abuse; (5) Related Federal Resource; and (6) Higher Education Center Resources.

  17. Emerging Adults' Identity Exploration: Illustrations from inside the "Camp Bubble"

    Science.gov (United States)

    Johnson, Sara K.; Goldman, Jane A.; Garey, Anita I.; Britner, Preston A.; Weaver, Shannon E.

    2011-01-01

    The study investigates the experiences of emerging adults who had worked as counselors at overnight summer camps; identity-related issues emerge as most salient in the analysis of in-depth interviews conducted with 12 women and 8 men from 8 camps. Their descriptions portray the identity exploration that took place within the camp context, through…

  18. 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

  19. Emerging Issues in Adult Female Acne

    Science.gov (United States)

    Baldwin, Hillary E.; Cook-Bolden, Fran E.; Eichenfield, Lawrence F.; Friedlander, Sheila F.; Rodriguez, David A.

    2017-01-01

    Acne vulgaris (acne) is a common affliction in adolescence and is a growing problem in adult women. Despite an increasing awareness of acne in the adult female population, there is a lack of good prospective studies assessing the severity, distribution, and differential response to treatment in this group. The long-held dogma that acne in adult women develops on the lower one-third of the face has been recently challenged, and here the authors critically review data from available literature. Moreover, while adult female acne has traditionally been defined as disease in women over age 25, it is the authors’ experience that this group is subdivided into women ages 25 to 44 years, separate from perimenopausal patients, ages 45 years and up. While there is no data specifically comparing these two groups, the authors will review the existing data and provide practical recommendations based on our experience in treating these groups of patients. Finally, while there is a lack of data on this subject, it is the group’s opinion that adherence to medication regimens is likely higher in women than men, which influences therapeutic outcomes. PMID:28210380

  20. Emergency diagnosis and treatment of adult meningitis

    NARCIS (Netherlands)

    Fitch, Michael T.; van de Beek, Diederik

    2007-01-01

    Despite the existence of antibiotic therapies against acute bacterial meningitis, patients with the disease continue to suffer significant morbidity and mortality in both high and low-income countries. Dilemmas exist for emergency medicine and primary-care providers who need to accurately diagnose

  1. Post-anaesthetic emergence delirium in adults

    DEFF Research Database (Denmark)

    Munk, L; Andersen, G; Møller, A M

    2016-01-01

    BACKGROUND: Emergence delirium (ED) after general anaesthesia (GA) is a well-known phenomenon, yet the risk factors are still unclear. The aims of this study were to determine the incidence and independent predictors of ED and secondly to determine to which degree ED has any relevant, clinical...

  2. Longitudinal Predictors of Intimate Partner Violence Perpetration and Victimization in Latino Emerging Adults.

    Science.gov (United States)

    Grest, Carolina Villamil; Amaro, Hortensia; Unger, Jennifer

    2018-03-01

    Despite the prevalence of intimate partner violence in emerging adulthood, literature focused on this life stage among Latinos remains limited. This longitudinal study examined acculturation; traditional gender role attitudes; use of alcohol, marijuana, and tobacco; and depressive symptoms in 10th grade as predictors of intimate partner violence perpetration and victimization among Latino emerging adults (N = 823; 58% female). Average age of participants was 15.5 years in 10th grade and 22.7 years in emerging adulthood. The results indicate important gender differences in intimate partner violence outcomes for Latino emerging adults. Higher U.S. acculturation predicted physical intimate partner violence perpetration among young men. More traditional gender role attitudes were significantly associated with psychological and physical intimate partner violence perpetration among male Latino emerging adults. Among Latinas, alcohol use in 10th grade predicted psychological perpetration and victimization in emerging adulthood. The findings have implications for developing gender- and ethnic-relevant prevention interventions focused on intimate partner violence among Latino adolescents and emerging adults.

  3. Repositioning for pressure ulcer prevention in adults.

    Science.gov (United States)

    Gillespie, Brigid M; Chaboyer, Wendy P; McInnes, Elizabeth; Kent, Bridie; Whitty, Jennifer A; Thalib, Lukman

    2014-04-03

    A pressure ulcer (PU), also referred to as a 'pressure injury', 'pressure sore', or 'bedsore' is defined as an area of localised tissue damage that is caused by unrelieved pressure, friction or shearing forces on any part of the body. PUs commonly occur in patients who are elderly and less mobile, and carry significant human and economic impacts. Immobility and physical inactivity are considered to be major risk factors for PU development and the manual repositioning of patients in hospital or long-term care is a common pressure ulcer prevention strategy. The objectives of this review were to:1) assess the effects of repositioning on the prevention of PUs in adults, regardless of risk or in-patient setting;2) ascertain the most effective repositioning schedules for preventing PUs in adults; and3) ascertain the incremental resource consequences and costs associated with implementing different repositioning regimens compared with alternate schedules or standard practice. We searched the following electronic databases to identify reports of the relevant randomised controlled trials: the Cochrane Wounds Group Specialised Register (searched 06 September 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 8); Ovid MEDLINE (1948 to August, Week 4, 2013); Ovid EMBASE (1974 to 2013, Week 35); EBESCO CINAHL (1982 to 30 August 2013); and the reference sections of studies that were included in the review. Randomised controlled trials (RCTs), published or unpublished, that assessed the effects of any repositioning schedule or different patient positions and measured PU incidence in adults in any setting. Two review authors independently performed study selection, risk of bias assessment and data extraction. We included three RCTs and one economic study representing a total of 502 randomised participants from acute and long-term care settings. Two trials compared the 30º and 90º tilt positions using similar repositioning frequencies (there was a

  4. Vaccines for preventing influenza in healthy adults.

    Science.gov (United States)

    Demicheli, Vittorio; Jefferson, Tom; Ferroni, Eliana; Rivetti, Alessandro; Di Pietrantonj, Carlo

    2018-02-01

    most relevant to decision-making. The studies were conducted over single influenza seasons in North America, South America, and Europe between 1969 and 2009. We did not consider studies at high risk of bias to influence the results of our outcomes except for hospitalisation.Inactivated influenza vaccines probably reduce influenza in healthy adults from 2.3% without vaccination to 0.9% (risk ratio (RR) 0.41, 95% confidence interval (CI) 0.36 to 0.47; 71,221 participants; moderate-certainty evidence), and they probably reduce ILI from 21.5% to 18.1% (RR 0.84, 95% CI 0.75 to 0.95; 25,795 participants; moderate-certainty evidence; 71 healthy adults need to be vaccinated to prevent one of them experiencing influenza, and 29 healthy adults need to be vaccinated to prevent one of them experiencing an ILI). The difference between the two number needed to vaccinate (NNV) values depends on the different incidence of ILI and confirmed influenza among the study populations. Vaccination may lead to a small reduction in the risk of hospitalisation in healthy adults, from 14.7% to 14.1%, but the CI is wide and does not rule out a large benefit (RR 0.96, 95% CI 0.85 to 1.08; 11,924 participants; low-certainty evidence). Vaccines may lead to little or no small reduction in days off work (-0.04 days, 95% CI -0.14 days to 0.06; low-certainty evidence). Inactivated vaccines cause an increase in fever from 1.5% to 2.3%.We identified one RCT and one controlled clinical trial assessing the effects of vaccination in pregnant women. The efficacy of inactivated vaccine containing pH1N1 against influenza was 50% (95% CI 14% to 71%) in mothers (NNV 55), and 49% (95% CI 12% to 70%) in infants up to 24 weeks (NNV 56). No data were available on efficacy against seasonal influenza during pregnancy. Evidence from observational studies showed effectiveness of influenza vaccines against ILI in pregnant women to be 24% (95% CI 11% to 36%, NNV 94), and against influenza in newborns from vaccinated women

  5. Preventable deaths following emergency medical dispatch - an audit study

    DEFF Research Database (Denmark)

    Andersen, Mikkel S; Johnsen, Søren; Hansen, Andreas

    2014-01-01

    an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC).MethodsAn audit was performed by an external panel of experienced prehospital consultant anaesthesiologists. The panel focused exclusively on the role of the EMCC, assessing whether same-day deaths among 112 callers could...... have been prevented if the EMCC had assessed the situations as highly urgent. The panels¿ assessments were based on review of patient charts and voice-log recordings of 112 calls. All patient related material was reviewed by the audit panel and all cases where then scored as preventable, potentially......¿100 years) and 45.4% were female. The audit panel found no definitively preventable deaths; however, 18 (11.8%) of the analysed same-day deaths (0.02% of all non-high-acuity callers) were found to be potentially preventable. In 13 of these 18 cases, the dispatch protocol was either not used or not used...

  6. Prevention and treatment of sleep deprivation among emergency physicians.

    Science.gov (United States)

    Nelson, Douglas

    2007-07-01

    Emergency physicians commonly experience sleep deprivation because of the need to work shifts during evening and late night hours. The negative effects of this problem are compounded by job stress and traditional methods of scheduling work shifts. Sleep deprivation may be reduced by schedules designed to lessen interference with normal sleep patterns and circadian rhythms. Pharmacological treatments for sleep deprivation exist in the form of alertness-enhancing agents, caffeine and modafinil. Sleep-promoting agents may also help treat the problem by helping physicians to sleep during daytime hours. Minimizing sleep deprivation may help prevent job burnout and prolong the length of an emergency physician's career.

  7. Adult Catheter Care and Infection Prevention Guide

    Science.gov (United States)

    ... and go to an emergency room or clinic. Bring your repair kit because, unfortunately, many emergency rooms do not have them. • Ask your clinician about a sutureless securement device to reduce the risk of infection and accidental ...

  8. Social Media Use and Conduct Problems in Emerging Adults.

    Science.gov (United States)

    Galica, Victoria L; Vannucci, Anna; Flannery, Kaitlin M; Ohannessian, Christine McCauley

    2017-07-01

    Social media use has become pervasive in the lives of emerging adults. Although social media may provide individuals with positive opportunities for communication and learning, social media sites also may provide an outlet for youth conduct problems, such as bullying, harassment, and intentional hostility and aggression toward others. Yet, the relationship between social media use and conduct problems remains unclear. This study investigated the association between conduct disorder (CD) symptoms before age 15 and social media use during emerging adulthood in a large, nationally representative sample. Concurrent associations between antisocial personality disorder (ASPD) symptoms and social media use in emerging adults also were examined. Data for this study were based on 567 emerging adults (50.2 percent female; M age  = 20.0 years). Self-report questionnaires were completed online. Results suggested that more childhood CD symptoms were significantly associated with greater daily social media use during emerging adulthood, and that more daily social media use was significantly associated with current ASPD symptoms. Possible directional and cyclical explanations for these findings are explored. Given the pervasiveness of social media in the lives of emerging adults, these results underscore the importance of considering nuanced methods for using social media sites to encourage positive social interactions and to displace the promotion of conduct problems.

  9. Access Barriers to Prenatal Care in Emerging Adult Latinas.

    Science.gov (United States)

    Torres, Rosamar

    2016-03-01

    Despite efforts to improve access to prenatal care, emerging adult Latinas in the United States continue to enter care late in their pregnancies and/or underutilize these services. Since little is known about emerging adult Latinas and their prenatal care experiences, the purpose of this study was to identify actual and perceived prenatal care barriers in a sample of 54 emerging adult Latinas between 18 and 21 years of age. More than 95% of the sample experienced personal and institutional barriers when attempting to access prenatal care. Results from this study lend support for policy changes for time away from school or work to attend prenatal care and for group prenatal care. © 2016. All rights reserved.

  10. Cultural values associated with substance use among Hispanic emerging adults in Southern California.

    Science.gov (United States)

    Escobedo, Patricia; Allem, Jon-Patrick; Baezconde-Garbanati, Lourdes; Unger, Jennifer B

    2018-02-01

    Hispanic emerging adults are a priority population for substance use prevention, yet few studies have examined whether traditional Hispanic cultural values serve as risk or protective factors for substance use among emerging adults. This study examined the relationship between familism, respeto, fatalism, and substance use among Hispanic emerging adults. Participants (ages 18 to 25) completed surveys indicating identification with familism, respeto, and fatalism, past month use of tobacco, marijuana, hard drugs and binge drinking. Separate logistic regression models examined the association between cultural values and each substance use outcome, controlling for acculturation, age and gender. Among participants (n=1445, mean age=23, 60% female), 21% reported past month cigarette use, 18% reported past month alternative tobacco product (ATP) use, 25% reported past month marijuana use, 44% reported past month binge drinking, and 7% reported past month hard drug use. Higher fatalism scores were associated with increased ATP use. Higher familism scores were associated with binge drinking, while higher respeto scores were associated with decreased binge drinking, marijuana, and hard drug use. These findings suggest that substance use prevention and intervention programs should emphasize how substance use interferes with caring and honoring parents (respeto) and family cohesion and functioning (familism). Programs that highlight these cultural values and beliefs may be beneficial for Hispanic emerging adults and members of other collectivistic cultures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Emerging nanotechnology approaches for HIV/AIDS treatment and prevention

    Science.gov (United States)

    Mamo, Tewodros; Moseman, E Ashley; Kolishetti, Nagesh; Salvador-Morales, Carolina; Shi, Jinjun; Kuritzkes, Daniel R; Langer, Robert; von Andrian, Ulrich

    2010-01-01

    Currently, there is no cure and no preventive vaccine for HIV/AIDS. Combination antiretroviral therapy has dramatically improved treatment, but it has to be taken for a lifetime, has major side effects and is ineffective in patients in whom the virus develops resistance. Nanotechnology is an emerging multidisciplinary field that is revolutionizing medicine in the 21st century. It has a vast potential to radically advance the treatment and prevention of HIV/AIDS. In this review, we discuss the challenges with the current treatment of the disease and shed light on the remarkable potential of nanotechnology to provide more effective treatment and prevention for HIV/AIDS by advancing antiretroviral therapy, gene therapy, immunotherapy, vaccinology and microbicides. PMID:20148638

  12. Use of Technology for HIV Prevention Among Adolescent and Adult Women in the United States.

    Science.gov (United States)

    Blackstock, Oni J; Patel, Viraj V; Cunningham, Chinazo O

    2015-12-01

    Although the proportion of new HIV infections in the USA among women has decreased over the last few years, still, approximately 20 % of new infections occur annually among adolescent and adult women. The development of effective evidence-based prevention interventions remains an important approach to further decreasing these numbers. Technology-delivered prevention interventions hold tremendous potential due, in part, to their ability to reach beyond the walls of brick-and-mortar intervention sites to engage individuals where they are. While most technology-delivered interventions have focused on adolescents and men who have sex with men, much fewer have specifically targeted adolescent or adult women despite evidence showing that interventions tailored to specific target populations are most effective. We summarize the recently published literature on technology-delivered HIV prevention interventions for US adolescent and adult women and provide suggestions for next steps in this nascent but emergent area of prevention research.

  13. Young Adults' Perceived Purposes of Emerging Adulthood: Implications for Cohabitation.

    Science.gov (United States)

    Rogers, Adam A; Willoughby, Brian J; Nelson, Larry J

    2016-01-01

    The authors investigated associations between young adults' perceived purposes of emerging adulthood and their attitudes toward and participation in cohabitation. In a sample of 775 never married individuals, ages 18-29 (69% female, 69% white) from the United States, young people's perceptions of this period of life were associated with their acceptance of cohabitation, their reasoning for accepting cohabitation, and the likelihood of cohabiting. Results showed that the perception that emerging adulthood is a time to prepare for future family roles was negatively associated with acceptance of cohabitation whereas the perception that emerging adulthood is a time to take risks was positively associated with acceptance of cohabitation. The perception that emerging adulthood is a time to prepare for future family roles was associated with an increased likelihood of having cohabited while the perception that emerging adulthood is a time of possibilities was associated with a decreased likelihood of having cohabited. Implications for future research are discussed.

  14. Falls among Older Adults: Public Health Impact and Prevention Strategies.

    Science.gov (United States)

    Stevens, Judy A.

    2003-01-01

    Provides an overview of the epidemiology of falls among older adults, describes current prevention strategies, and highlights key areas that need to be addressed, including risk assessments, exercise, and environmental changes. (Contains 50 references.) (JOW)

  15. Work-Family Planning Attitudes among Emerging Adults

    Science.gov (United States)

    Basuil, Dynah A.; Casper, Wendy J.

    2012-01-01

    Using social learning theory as a framework, we explore two sets of antecedents to work and family role planning attitudes among emerging adults: their work-family balance self-efficacy and their perceptions of their parents' work-to-family conflict. A total of 187 college students completed a questionnaire concerning their work-family balance…

  16. A Song to Remember: Emerging Adults Recall Memorable Music

    Science.gov (United States)

    Lippman, Julia R.; Greenwood, Dara N.

    2012-01-01

    The present study employs a mixed methods approach to understanding the psychological functions and contexts of music use. Seventy-six emerging adults selected a single piece of music that they considered personally significant and elaborated on the reasons for this significance in response to written prompts. A constant comparative analysis of…

  17. Larvicidal and adult emergence inhibition effect of Centella asiatica ...

    African Journals Online (AJOL)

    Ethanolic extract of Centella asiatica leaves were evaluated for the larvicidal and adult emergence inhibition activity against mosquito Culex quinquefasciatus under five constant temperatures 19, 22, 25, 28 and 31°C in the laboratory. Toxicity of this extract increased with temperature. The 50% medium lethal concentrations ...

  18. Adolescents' and Emerging Adults' Social Networking Online: Homophily or Diversity?

    Science.gov (United States)

    Mazur, Elizabeth; Richards, Lacey

    2011-01-01

    More than half of all online American adolescents and emerging adults have created personal profiles for social networking on the Internet. Does homophily in their offline friendships extend online? Drawing mainly on research of face-to-face friendship, we collected data from the public spaces, called "walls," of 129 young Americans ages 16 to 19…

  19. Reckless Behaviour and Sexual Practices of Emerging Adult Women

    Science.gov (United States)

    Mullis, Ronald L.; Byno, Lucy H.; Shriner, Michael; Mullis, Ann K.

    2009-01-01

    Relations between reckless behaviour and sexual practices of emerging adult women (ages 18-25) within a social cognitive theoretical perspective were examined. In addition, relations between self esteem, sexual attitudes and sexual behaviour were also examined. The Sexual Experience Inventory, Rosenberg Self-Esteem Scale, Hendrick Sexual Attitude…

  20. Generation XXX: Pornography Acceptance and Use among Emerging Adults

    Science.gov (United States)

    Carroll, Jason S.; Padilla-Walker, Laura M.; Nelson, Larry J.; Olson, Chad D.; McNamara Barry, Carolyn; Madsen, Stephanie D.

    2008-01-01

    This study examined correlates of pornography acceptance and use within a normative (nonclinical) population of emerging adults (individuals aged 18-26). Participants included 813 university students (500 women; M age = 20 years) recruited from six college sites across the United States. Participants completed online questionnaires regarding their…

  1. New technologies in predicting, preventing and controlling emerging infectious diseases.

    Science.gov (United States)

    Christaki, Eirini

    2015-01-01

    Surveillance of emerging infectious diseases is vital for the early identification of public health threats. Emergence of novel infections is linked to human factors such as population density, travel and trade and ecological factors like climate change and agricultural practices. A wealth of new technologies is becoming increasingly available for the rapid molecular identification of pathogens but also for the more accurate monitoring of infectious disease activity. Web-based surveillance tools and epidemic intelligence methods, used by all major public health institutions, are intended to facilitate risk assessment and timely outbreak detection. In this review, we present new methods for regional and global infectious disease surveillance and advances in epidemic modeling aimed to predict and prevent future infectious diseases threats.

  2. Prevention of parastomal hernia in the emergency setting

    DEFF Research Database (Denmark)

    Lykke, Anna; Andersen, Johnny F B; Jorgensen, Lars N

    2017-01-01

    period (July 2012-July 2014), we included 109 patients undergoing emergency surgery with formation of ileostomy or colostomy. All patients received a retromuscular slowly resorbable synthetic mesh (TIGR®, Novus Scientific) at the stoma site. The reference group included 117 patients who underwent...... emergency stoma formation without a prophylactic mesh in the 2-year period prior to July 2012. The primary endpoint was effect on prevention of parastomal hernia within 1 year. Secondary endpoints were 30-day and 1-year complications including mortality. RESULTS: The operative field was contaminated...... or dirty in 48% of the procedures. Operative time was significantly longer in the mesh group. The cumulative incidences of parastomal hernia at 1 year for the control and the mesh group were 8 and 7% (p = 0.424), respectively. The postoperative 30-day and 1-year rate of complications, reoperations...

  3. Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample.

    Science.gov (United States)

    Rivera, Donna R; Gallicchio, Lisa; Brown, Jeremy; Liu, Benmei; Kyriacou, Demetrios N; Shelburne, Nonniekaye

    2017-10-12

    The emergency department (ED) is used to manage cancer-related complications among the 15.5 million people living with cancer in the United States. However, ED utilization patterns by the population of US adults with cancer have not been previously evaluated or described in published literature. To estimate the proportion of US ED visits made by adults with a cancer diagnosis, understand the clinical presentation of adult patients with cancer in the ED, and examine factors related to inpatient admission within this population. Nationally representative data comprised of 7 survey cycles (January 2006-December 2012) from the Nationwide Emergency Department Sample were analyzed. Identification of adult (age ≥18 years) cancer-related visits was based on Clinical Classifications Software diagnoses documented during the ED visit. Weighted frequencies and proportions of ED visits among adult patients with cancer by demographic, geographic, and clinical characteristics were calculated. Weighted multivariable logistic regression was used to examine the associations between inpatient admission and key demographic and clinical variables for adult cancer-related ED visits. Adult cancer-related ED utilization patterns; identification of primary reason for ED visit; patient-related factors associated with inpatient admission from the ED. Among an estimated 696 million weighted adult ED visits from January 2006 to December 2012, 29.5 million (4.2%) were made by a patient with a cancer diagnosis. The most common cancers associated with an ED visit were breast, prostate, and lung cancer, and most common primary reasons for visit were pneumonia (4.5%), nonspecific chest pain (3.7%), and urinary tract infection (3.2%). Adult cancer-related ED visits resulted in inpatient admissions more frequently (59.7%) than non-cancer-related visits (16.3%) (P adults, breast, prostate, and lung cancer were the most common cancer diagnoses presenting to the ED. Pneumonia was the most common

  4. Post-war prevention: Emerging frameworks to prevent drug use after the War on Drugs.

    Science.gov (United States)

    Werb, Dan

    2018-01-01

    The prevention of drug use is one of the primary goals of the War on Drugs. However, despite investment in high-profile interventions such as social marketing campaigns and enforcement-based deterrence, these efforts have generally failed. With the emergence of novel policy frameworks to control and regulate drug use, a window of opportunity exists to test approaches to drug prevention that take into account existing evidence and the rights of individuals who use drugs. Specifically, there is a growing consensus that entry into drug use is a socially-defined event that individuals experience within particular socio-structural contexts. This understanding, coupled with a distinction between the value of preventing problematic drug use rather than all drug use, provides a useful framework within which to develop effective and rights-based approaches to drug prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Fall Prevention for Older Adults Receiving Home Healthcare.

    Science.gov (United States)

    Bamgbade, Sarah; Dearmon, Valorie

    2016-02-01

    Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

  6. Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

    Directory of Open Access Journals (Sweden)

    Teresita M. Hogan

    2014-07-01

    Full Text Available Introduction: The demands of our rapidly expanding older population strain many emergency departments (EDs, and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods: Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results: 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score. Attitudes trended to more negative in successive post-graduate year (PGY levels. Conclusion: EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. [West J Emerg Med. 2014;15(4:511–517.

  7. Multilevel interventions aimed at adult obesity prevention

    DEFF Research Database (Denmark)

    Benwell, Ann Fenger

    A growing body of literature emphasizes the importance of using both quantitative and qualitative methods to investigate the wide range of aspects which hinder or promote the success of health interventions. The pilot phase of this study highlights how mixed-method approaches can be strengthened ...... to investigate factors associated with multi-level obesity prevention....

  8. Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study.

    Science.gov (United States)

    Dykeman, Catherine S; Markle-Reid, Maureen F; Boratto, Lorna J; Bowes, Chris; Gagné, Hélène; McGugan, Jennifer L; Orr-Shaw, Sarah

    2018-02-01

    Despite evidence for effective fall prevention interventions, measurable reductions in older adult (≥ 65 years) fall rates remain unrealized. This study aimed to describe the perceived barriers to and effective strategies for the implementation of evidence-based fall prevention practices within and across diverse community organizations. This study is unique in that it included community service providers who are not generally thought to provide fall prevention services to older adults, such as retail business, community support, volunteer services, community foundations, recreation centres, and various emergency services. Interviews and focus groups were conducted with a purposive sampling of providers (n = 84) in varied roles within diverse community-based organizations across disparate geographical settings. Community service providers experience significant multi-level barriers to fall prevention within and across organizations and settings. The overall challenge of serving dispersed populations in adverse environmental conditions was heightened in northern rural areas. Barriers across the system, within organizations and among providers themselves emerged along themes of Limited Coordination of Communication, Restrictive Organizational Mandates and Policies, Insufficient Resources, and Beliefs about Aging and Falls. Participants perceived that Educating Providers, Working Together, and Changing Policies and Legislation were strategies that have worked or would work well in implementing fall prevention. An unintentional observation was made that several participants in this extremely varied sample identified expanded roles in fall prevention for themselves during the interview process. Community service providers experience disabling contexts for implementing fall prevention on many levels: their specific geography, their service systems, their organizations and themselves. A systemic lack of fit between the older adult and fall prevention services

  9. Reading for pleasure and reading circles for adult emergent readers insights in adult learning

    CERN Document Server

    Duncan, Sam

    2014-01-01

    In the UK, the adult literacy provision has become more functional and more assessment driven over the last decade, largely due to funding requirements. However, one result of this is that the clear benefits of reading for pleasure in adult skills development have become less apparent. This book addresses the need to support teachers in the development of adults' skills through reading for pleasure, by incorporating the activity into the curriculum. It focuses on reading for pleasure for adult emergent readers - those who consider themselves non-readers, either because they feel they cannot or

  10. Osteoporosis knowledge translation for young adults: new directions for prevention programs.

    Science.gov (United States)

    Holland, Alyson

    2017-08-01

    Osteoporosis prevention is heavily reliant on education programs, which are most effective when tailored to their intended audience. Most osteoporosis prevention education is designed for older adults, making application of these programs to younger adults difficult. Designing programs for young adults requires understanding the information-seeking practices of young adults, so that knowledge about osteoporosis can be effectively translated. Individual interviews were conducted with 60 men and women-multiethnic, Canadian young adults-to explore both the sources and types of information they search for when seeking information on nutrition or bone health. The results of this study raised themes related to the sources participants use, to their interests and to ways of engaging young adults. Prevention programs should make use of traditional sources, such as peers, family members and medical professionals, as well as emerging technologies, such as social media. Choice of sources was related to the perceived authority of and trust associated with the source. Messaging should relate to young adult interests, such as fitness and food-topics on which young adults are already seeking information-rather than being embedded within specific osteoporosis awareness materials. Engaging young adults means using relatable messages that are short and encourage small changes. Small gender-based differences were found in the information-seeking interests of participants. Differences related to age were not examined. Creating short, action-oriented messages that are designed to encourage small changes in behaviour and are packaged with information that young adults are actively seeking is more likely to result in active engagement in prevention behaviours.

  11. Advance provision of emergency contraception for pregnancy prevention (full review).

    Science.gov (United States)

    Polis, C B; Schaffer, K; Blanchard, K; Glasier, A; Harper, C C; Grimes, D A

    2007-04-18

    Emergency contraception can prevent pregnancy when taken after unprotected intercourse. Obtaining emergency contraception within the recommended time frame is difficult for many women. Advance provision, in which women receive a supply of emergency contraception before unprotected sex, could circumvent some obstacles to timely use. To summarize randomized controlled trials evaluating advance provision of emergency contraception to explore effects on pregnancy rates, sexually transmitted infections, and sexual and contraceptive behaviors. In August 2006, we searched CENTRAL, EMBASE, POPLINE, MEDLINE via PubMed, and a specialized emergency contraception article database. We also searched reference lists and contacted experts to identify additional published or unpublished trials. We included randomized controlled trials comparing advance provision and standard access, which was defined as any of the following: counseling which may or may not have included information about emergency contraception, or provision of emergency contraception on request at a clinic or pharmacy. We evaluated all identified titles and abstracts found for potential inclusion. Two reviewers independently abstracted data and assessed study quality. We entered and analyzed data using RevMan 4.2.8. We calculated odds ratios with 95% confidence intervals for dichotomous data and weighted mean differences with 95% confidence intervals for continuous data. Eight randomized controlled trials met our criteria for inclusion, representing 6389 patients in the United States, China and India. Advance provision did not decrease pregnancy rates (OR 1.0; 95% CI: 0.78 to 1.29 in studies for which we included twelve month follow-up data; OR 0.91; 95% CI: 0.69 to 1.19 in studies for which we included six month follow-up data; OR 0.49; 95% CI: 0.09 to 2.74 in a study with three month follow up data), despite increased use (single use: OR 2.52; 95% CI 1.72 to 3.70; multiple use: OR 4.13; 95% CI 1.77 to 9.63) and

  12. Preventing Depression in Adults With Subthreshold Depression

    DEFF Research Database (Denmark)

    Buntrock, Claudia; Berking, Matthias; Smit, Filip

    2017-01-01

    BACKGROUND: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. OBJECTIVE: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD......) in people with subthreshold depression (sD). METHODS: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web......-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs...

  13. Emergency Department Use among Adults with Autism Spectrum Disorders (ASD)

    Science.gov (United States)

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha

    2016-01-01

    A cross-sectional analyses using Nationwide Emergency Department Sample (2006-2011) was conducted to examine the trends, type of ED visits, and mean total ED charges for adults aged 22-64 years with and without ASD (matched 1:3). Around 0.4% ED visits (n = 25,527) were associated with any ASD and rates of such visits more than doubled from 2006 to…

  14. Social media use and anxiety in emerging adults.

    Science.gov (United States)

    Vannucci, Anna; Flannery, Kaitlin M; Ohannessian, Christine McCauley

    2017-01-01

    Social media use is central to the lives of emerging adults, but the implications of social media use on psychological adjustment are not well understood. The current study aimed to examine the impact of time spent using social media on anxiety symptoms and severity in emerging adults. Using a web-based recruitment technique, we collected survey information on social media use and anxiety symptoms and related impairment in a nationally representative sample of 563 emerging adults from the U.S. (18-22 years-old; 50.2% female; 63.3% Non-Hispanic White). Participants self-reported the amount of time they spent using various social media sites on an average day, and responded to anxiety questionnaires RESULTS: Hierarchical regression revealed that more time spent using social media was significantly associated with greater symptoms of dispositional anxiety (B=0.74, 95% CI=0.59-0.90, psocial media use was significantly associated with a greater likelihood of participants scoring above the anxiety severity clinical cut-off indicating a probable anxiety disorder (AOR=1.032, 95% CI=1.004-1.062, p=0.028). Study limitations include the cross-sectional design and reliance on self-report questionnaires. Given the ubiquity of social media among emerging adults, who are also at high risk for anxiety disorders, the positive association between social media use and anxiety has important implications for clinicians. Gaining a more nuanced understanding of this relationship will help to inform novel approaches to anxiety treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Do health checks for adults with intellectual disability reduce emergency hospital admissions? Evaluation of a natural experiment.

    Science.gov (United States)

    Carey, Iain M; Hosking, Fay J; Harris, Tess; DeWilde, Stephen; Beighton, Carole; Shah, Sunil M; Cook, Derek G

    2017-01-01

    Annual health checks for adults with intellectual disability (ID) have been incentivised by National Health Service (NHS) England since 2009, but it is unclear what impact they have had on important health outcomes such as emergency hospitalisation. An evaluation of a 'natural experiment', incorporating practice and individual-level designs, to assess the effectiveness of health checks for adults with ID in reducing emergency hospital admissions using a large English primary care database. For practices, changes in admission rates for adults with ID between 2009-2010 and 2011-2012 were compared in 126 fully participating versus 68 non-participating practices. For individuals, changes in admission rates before and after the first health check for 7487 adults with ID were compared with 46 408 age-sex-practice matched controls. Incident rate ratios (IRRs) comparing changes in admission rates are presented for: all emergency, preventable emergency (for ambulatory care sensitive conditions (ACSCs)) and elective emergency. Practices with high health check participation showed no change in emergency admission rate among patients with ID over time compared with non-participating practices (IRR=0.97, 95% CI 0.78 to 1.19), but emergency admissions for ACSCs did fall (IRR=0.74, 0.58 to 0.95). Among individuals with ID, health checks had no effect on overall emergency admissions compared with controls (IRR=0.96, 0.87 to 1.07), although there was a relative reduction in emergency admissions for ACSCs (IRR=0.82, 0.69 to 0.99). Elective admissions showed no change with health checks in either analysis. Annual health checks in primary care for adults with ID did not alter overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Osteoporosis knowledge translation for young adults: new directions for prevention programs

    Directory of Open Access Journals (Sweden)

    Alyson Holland

    2017-08-01

    Full Text Available Introduction: Osteoporosis prevention is heavily reliant on education programs, which are most effective when tailored to their intended audience. Most osteoporosis prevention education is designed for older adults, making application of these programs to younger adults difficult. Designing programs for young adults requires understanding the information-seeking practices of young adults, so that knowledge about osteoporosis can be effectively translated. Methods: Individual interviews were conducted with 60 men and women—multiethnic, Canadian young adults—to explore both the sources and types of information they search for when seeking information on nutrition or bone health. Results: The results of this study raised themes related to the sources participants use, to their interests and to ways of engaging young adults. Prevention programs should make use of traditional sources, such as peers, family members and medical professionals, as well as emerging technologies, such as social media. Choice of sources was related to the perceived authority of and trust associated with the source. Messaging should relate to young adult interests, such as fitness and food—topics on which young adults are already seeking information—rather than being embedded within specific osteoporosis awareness materials. Engaging young adults means using relatable messages that are short and encourage small changes. Small gender-based differences were found in the information-seeking interests of participants. Differences related to age were not examined. Conclusion: Creating short, action-oriented messages that are designed to encourage small changes in behaviour and are packaged with information that young adults are actively seeking is more likely to result in active engagement in prevention behaviours.

  17. Primary prevention of food allergy in children and adults

    DEFF Research Database (Denmark)

    de Silva, D; Geromi, M; Halken, S

    2014-01-01

    BACKGROUND: Food allergies can have serious physical, social, and financial consequences. This systematic review examined ways to prevent the development of food allergy in children and adults. METHODS: Seven bibliographic databases were searched from their inception to September 30, 2012...... food allergy in older children or adults. CONCLUSIONS: There is much to learn about preventing food allergy, and this is a priority given the high societal and healthcare costs involved....... or breastfeeding women should change their diet or take supplements to prevent allergies in infants at high or normal risk. There were mixed findings about the preventive benefits of breastfeeding for infants at high or normal risk, but there was evidence to recommend avoiding cow's milk and substituting...

  18. Daily associations between cannabis motives and consumption in emerging adults.

    Science.gov (United States)

    Bonar, Erin E; Goldstick, Jason E; Collins, R Lorraine; Cranford, James A; Cunningham, Rebecca M; Chermack, Stephen T; Blow, Frederic C; Walton, Maureen A

    2017-09-01

    Increasing rates of cannabis use among emerging adults is a growing public health problem. Intensive longitudinal data can provide information on proximal motives for cannabis use, which can inform interventions to reduce use among emerging adults. As part of a larger longitudinal study, patients aged 18-25 years (N=95) recruited from an urban Emergency Department completed daily text message assessments of risk behaviors for 28days, including daily cannabis quantity and motives. Using a mixed effects linear regression model, we examined the relationships between daily quantity of cannabis consumed and motives (i.e., enhancement, social, conformity, coping, and expansion). Participants were, on average, 22.0 years old (SD=2.2); 48.4% were male, 45.3% were African American, and 56.8% received public assistance. Results from the multi-level analysis (clustering day within individual), controlling for gender, race, and receipt of public assistance, indicated daily use of cannabis use for enhancement (β=0.27), coping (β=0.15), and/or social motives (β=0.34) was significantly associated with higher quantities of daily cannabis use; whereas expansion and conformity motives were not. Daily data show that emerging adults who use cannabis for enhancement, social, and coping motives reported using greater quantities of cannabis. Future research should examine more comprehensive cannabis motives (e.g., boredom, social anxiety, sleep) and test tailored interventions focusing on alternative cognitive/behavioral strategies to address cannabis motives. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Preventive Dental Care in Older Adults with Diabetes

    Science.gov (United States)

    Shen, Chan; Sambamoorthi, Nethra; Sambamoorthi, Usha

    2016-01-01

    Background The association between poor oral health and diabetes is well documented. Therefore, preventive oral health is strongly indicated for individuals with diabetes. The purposes of this study were 1) to determine if there were a difference in preventive dental care utilization among older adults with diabetes from 2002 and 2011, and 2) to compare preventive dental care utilization of older adults with and without diabetes from 2002 and 2011. Methods The data were from the Medicare Current Beneficiary Survey. The sample included older, fee-for-service Medicare beneficiaries (ages 65 years and above). The key outcome was self-reported preventive dental care. In 2002, there were 8,725 participants; in 2011, there were 7,425 participants. Chi square and logistic regressions were conducted. Results In 2002, 28.8 % of participants with diabetes had preventive dental care. In 2011, this percentage increased to 36.0%. Similar results were seen among individuals without diabetes (42.9% in 2002 and 45.5% in 2011). The increase in preventive dental care was statistically significant for individuals with and without diabetes. The participants with diabetes, as compared with participants without diabetes, remained statistically less likely to have preventive dental care in adjusted logistic regression analysis with and without considering the interaction between observation year and diabetes (adjusted odds ratios= 0.73, and 0.86, respectively). Conclusion While the increase in preventive dental care is welcoming, older adults with diabetes continue to have significant preventive dental care need. Practical Implication Additional efforts are needed to encourage individuals with diabetes to obtain preventive dental care. PMID:27189741

  20. Prevention of alcohol misuse among children, youths and young adults.

    Science.gov (United States)

    Korczak, Dieter; Steinhauser, Gerlinde; Dietl, Markus

    2011-01-01

    Despite many activities to prevent risky alcohol consumption among adolescents and young adults there is an increase of alcohol intoxications in the group of ten to twenty year old juveniles. This report gives an overview about the recent literature as well as the German federal prevention system regarding activities concerning behavioral and policy prevention of risky alcohol consumption among children, adolescents and young adults. Furthermore, effective components of prevention activities are identified and the efficiency and efficacy of ongoing prevention programs is evaluated. A systematic literature review is done in 34 databases using Bool'sche combinations of the key words alcohol, prevention, treatment, children, adolescents and young adults. 401 studies were found and 59 studies were selected for the health technology assessment (HTA). Most of the studies are done in USA, nine in Germany. A family strengthening program, personalized computer based intervention at schools, colleges and universities, brief motivational interventions and policy elements like increase of prices and taxes proved effective. Among the 59 studies there are three meta-analyses, 15 reviews, 17 randomized controlled trials (RCT) and 18 cohort studies. Despite the overall high quality of the study design, many of them have methodological weaknesses (missing randomization, missing or too short follow-ups, not clearly defined measurement parameters). The transferability of US-results to the German context is problematic. Only a few prevention activities reach a sustainable reduction of frequency and/or amount of alcohol consumption. The HTA-report shows the need to develop specific and target group focused prevention activities for the German situation. Essential for that is the definition of target goals (reduction of consumption, change of behaviour) as well as the definition and empirical validation of risky alcohol consumption. The efficacy of prevention activities should be proven

  1. Prevention of alcohol misuse among children, youths and young adults

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2011-01-01

    Full Text Available Background: Despite many activities to prevent risky alcohol consumption among adolescents and young adults there is an increase of alcohol intoxications in the group of ten to twenty year old juveniles. Objectives: This report gives an overview about the recent literature as well as the German federal prevention system regarding activities concerning behavioral and policy prevention of risky alcohol consumption among children, adolescents and young adults. Furthermore, effective components of prevention activities are identified and the efficiency and efficacy of ongoing prevention programs is evaluated. Methods: A systematic literature review is done in 34 databases using Bool’sche combinations of the key words alcohol, prevention, treatment, children, adolescents and young adults. Results: 401 studies were found and 59 studies were selected for the health technology assessment (HTA. Most of the studies are done in USA, nine in Germany. A family strengthening program, personalized computer based intervention at schools, colleges and universities, brief motivational interventions and policy elements like increase of prices and taxes proved effective. Discussion: Among the 59 studies there are three meta-analyses, 15 reviews, 17 randomized controlled trials (RCT and 18 cohort studies. Despite the overall high quality of the study design, many of them have methodological weaknesses (missing randomization, missing or too short follow-ups, not clearly defined measurement parameters. The transferability of US-results to the German context is problematic. Only a few prevention activities reach a sustainable reduction of frequency and/or amount of alcohol consumption. Conclusion: The HTA-report shows the need to develop specific and target group focused prevention activities for the German situation. Essential for that is the definition of target goals (reduction of consumption, change of behaviour as well as the definition and empirical validation

  2. Academic versus Non-Academic Emerging Adult College Student Technology Use

    Science.gov (United States)

    Swanson, Joan Ann; Walker, Erica

    2014-01-01

    Emerging adult college students have developmental and educational needs which are unique to their phase of life. The purpose of this study was to examine academic and non-academic technology use by emerging adult college students. Survey results (N = 235) provided insights into emerging adult college student technology preferences and frequency…

  3. Academic versus Non-Academic Emerging Adult College Student Technology Use

    Science.gov (United States)

    Swanson, Joan Ann; Walker, Erica

    2015-01-01

    Emerging adult college students have developmental and educational needs which are unique to their phase of life. Emerging adults are also increasingly identified by their technology use and practices. Collegiate instructors will be better equipped for educating these individuals when armed with insights concerning emerging adults' technology…

  4. Key considerations for preventing suicide in older adults

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Nordentoft, Merete; Conwell, Yeates

    2011-01-01

    BACKGROUND: The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide....... AIMS: To disseminate key considerations for interventions addressing senior suicidal behavior. METHODS: An international expert panel has reviewed and discussed key considerations for interventions against suicide in older adults based on existing evidence, where available, and expert opinion. RESULTS...

  5. Perception of adult men on their preventive practices and health support networks

    Directory of Open Access Journals (Sweden)

    Guilherme Oliveira de Arruda

    2015-07-01

    Full Text Available Objectives: to know the preventive practices adopted by adult men in daily life and to identify health support networks. Methods: a descriptive qualitative study, made during the months of November and December 2012, at two emergency units, along with 32 men aged between 20 and 59 years. Data were collected through semi-structured interviews and subjected to content analysis with thematic modality. Results: men highlighted different preventive practices such as sanitizing hands, eating properly, having screening tests, avoiding psychoactive substance abuse, using personal protective equipment at work and condoms during sex. Most of the participants had nuclear family and its members were their primary support network regarding the health-disease process. Conclusion: it is for health team members to try to leverage the adoption of preventive practices by adult men from the support networks they consider significant.

  6. Preventive Healthcare and Health Promotion for Older Adults.

    Science.gov (United States)

    Rakowski, William; And Others

    1994-01-01

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

  7. Physical Exercise-Induced Adult Neurogenesis: A Good Strategy to Prevent Cognitive Decline in Neurodegenerative Diseases?

    Science.gov (United States)

    Yau, Suk-yu; Christie, Brian R.; So, Kwok-fai

    2014-01-01

    Cumulative evidence has indicated that there is an important role for adult hippocampal neurogenesis in cognitive function. With the increasing prevalence of cognitive decline associated with neurodegenerative diseases among the ageing population, physical exercise, a potent enhancer of adult hippocampal neurogenesis, has emerged as a potential preventative strategy/treatment to reduce cognitive decline. Here we review the functional role of adult hippocampal neurogenesis in learning and memory, and how this form of structural plasticity is altered in neurodegenerative diseases known to involve cognitive impairment. We further discuss how physical exercise may contribute to cognitive improvement in the ageing brain by preserving adult neurogenesis, and review the recent approaches for measuring changes in neurogenesis in the live human brain. PMID:24818140

  8. Physical Exercise-Induced Adult Neurogenesis: A Good Strategy to Prevent Cognitive Decline in Neurodegenerative Diseases?

    Directory of Open Access Journals (Sweden)

    Suk-yu Yau

    2014-01-01

    Full Text Available Cumulative evidence has indicated that there is an important role for adult hippocampal neurogenesis in cognitive function. With the increasing prevalence of cognitive decline associated with neurodegenerative diseases among the ageing population, physical exercise, a potent enhancer of adult hippocampal neurogenesis, has emerged as a potential preventative strategy/treatment to reduce cognitive decline. Here we review the functional role of adult hippocampal neurogenesis in learning and memory, and how this form of structural plasticity is altered in neurodegenerative diseases known to involve cognitive impairment. We further discuss how physical exercise may contribute to cognitive improvement in the ageing brain by preserving adult neurogenesis, and review the recent approaches for measuring changes in neurogenesis in the live human brain.

  9. Adolescent presentations to an adult hospital emergency department.

    Science.gov (United States)

    Noori, Omar; Batra, Shweta; Shetty, Amith; Steinbeck, Katharine

    2017-10-01

    Age-related policies allow adolescents to access paediatric and adult EDs. Anecdotally, paediatric and adult EDs report challenges when caring for older and younger adolescents, respectively. Our aim was to describe the characteristics of an adolescent population attending an adult ED, co-located with a tertiary paediatric ED. The Westmead Hospital ED database was accessed for 14.5-17.9 years old presentations between January 2010 and December 2012. Patient diagnosis coding (SNOMED) was converted to ICD-10. De-identified data were transferred into Microsoft Excel with analysis performed using spss V22. There were 5718 presentations made to the Westmead Hospital, Sydney, Australia ED by 4450 patients, representing 3.3% (95% CI 3.2-3.4) of total visits from all patients 14.5 years and above. The mean age of the sample was 16.6 years (male 51.8%). Presentations triaged as level 4 or 5 represented 61.0% (95% CI 58.7-61.3) of visits. The proportion of patients who did not wait to receive care was 13.8% (95% CI 12.9-14.7), which was significantly higher than adult rates (P < 0.01). There were 279 unscheduled return visits (visits made <72 h of discharge) representing 4.9% (95% CI 4.4-5.8) of all presentations. Injury was the most common diagnosis (30.2%, 95% CI 28.8-31.6). Chronic physical illness and alcohol-related visits comprised 2.1% (95% CI 1.7-2.5) and 0.8% (95% CI 0.6-1.0) of adolescent presentations, respectively. Contrary to reported staff perceptions, adolescent chronic physical illness presentations were not a major burden. Alcohol was likely under-recorded as a contributing factor to presentations. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  10. Emergency Department Visits by Older Adults for Motor Vehicle Collisions

    Directory of Open Access Journals (Sweden)

    Vogel, Jody A.

    2013-11-01

    Full Text Available Introduction: To describe the epidemiology and characteristics of emergency department (ED visits by older adults for motor vehicle collisions (MVC in the United States (U.S..Methods: We analyzed ED visits for MVCs using data from the 2003–2007 National Hospital Ambulatory Medical Care Survey (NHAMCS. Using U.S. Census data, we calculated annual incidence rates of driver or passenger MVC-related ED visits and examined visit characteristics, including triage acuity, tests performed and hospital admission or discharge. We compared older (65+ years and younger (18-64 years MVC patients and calculated odds ratios (OR and 95% confidence intervals (CIs to measure the strength of associations between age group and various visit characteristics. Multivariable logistic regression was used to identify independent predictors of admissions for MVC-related injuries among older adults.Results: From 2003–2007, there were an average of 237,000 annual ED visits by older adults for MVCs. The annual ED visit rate for MVCs was 6.4 (95% CI 4.6-8.3 visits per 1,000 for older adults and 16.4 (95% CI 14.0-18.8 visits per 1,000 for younger adults. Compared to younger MVC patients, after adjustment for gender, race and ethnicity, older MVC patients were more likely to have at least one imaging study performed (OR 3.69, 95% CI 1.46-9.36. Older MVC patients were not significantly more likely to arrive by ambulance (OR 1.47; 95% CI 0.76–2.86, have a high triage acuity (OR 1.56; 95% CI 0.77-3.14, or to have a diagnosis of a head, spinal cord or torso injury (OR 0.97; 95% CI 0.42-2.23 as compared to younger MVC patients after adjustment for gender, race and ethnicity. Overall, 14.5% (95% CI 9.8-19.2 of older MVC patients and 6.1% (95% CI 4.8-7.5 of younger MVC patients were admitted to the hospital. There was also a non-statistically significant trend toward hospital admission for older versus younger MVC patients (OR 1.78; 95% CI 0.71-4.43, and admission to the ICU if

  11. Systems for prevention and control of epidemic emergencies.

    Science.gov (United States)

    Calistri, Paolo; Conte, Annamaria; Natale, Fabrizio; Possenti, Luigi; Savini, Lara; Danzetta, Maria Luisa; Iannetti, Simona; Giovannini, Armando

    2013-01-01

    The development of early warning systems is fundamental for preventing the spread of infectious diseases. Data collection, however, is a costly activity and it is not possible to implement early warning systems everywhere and for all possible events. Hence, tools helping to improve the focus of surveillance efforts are of paramount importance. Risk assessment methods and other provisional modelling techniques may permit to estimate the probability of introduction and spread of infectious diseases in different geographical areas. Similarly, efficient information systems must be in place to assist the veterinary services in case of epidemic emergencies in order to support the prompt application of control measures for the containment of the infection and the reduction of the magnitude of negative consequences. This review describes two recent approaches to the estimation of the probability of introduction and spread of infectious diseases based on the use of risk maps/ spatial modelling and Social Network Analysis (SNA) techniques. The review also describes a web application developed in Italy to help official veterinary services to trace animals in case of outbreaks of infectious diseases.

  12. Trajectories of Depressive Symptoms in Canadian Emerging Adults.

    Science.gov (United States)

    Ferro, Mark A; Gorter, Jan Willem; Boyle, Michael H

    2015-11-01

    We identified courses of depressive symptoms in an epidemiological sample of emerging adults. We used latent class growth modeling to identify trajectories of depressive symptoms measured by the 12-item Center for Epidemiological Studies Depression Scale (CES-D) during a 14-year follow-up of 2825 Canadian youths aged 10 to 25 years enrolled in the National Longitudinal Survey of Children and Youth between 1994 and 2009. After adjustment for youth, parent, and family factors, the 3 distinct trajectories of depressive symptoms were minimal (55%; CES-D  18). All trajectories exhibited a parallel course, with peak symptoms at 15 to 17 years of age. Subclinical and clinical symptoms were more common than minimal symptoms in female youths and in respondents with lower self-concept, lower socioeconomic status, poorer interpersonal relations, and chronic health conditions (P < .01). Among emerging adults, trajectories of depressive symptoms do not trend upward or downward, and variables associated with identified trajectories demonstrated dose-response effects that agreed with vulnerability-stress theories of depression.

  13. Trajectories of Depressive Symptoms in Canadian Emerging Adults

    Science.gov (United States)

    Gorter, Jan Willem; Boyle, Michael H.

    2015-01-01

    Objectives. We identified courses of depressive symptoms in an epidemiological sample of emerging adults. Methods. We used latent class growth modeling to identify trajectories of depressive symptoms measured by the 12-item Center for Epidemiological Studies Depression Scale (CES-D) during a 14-year follow-up of 2825 Canadian youths aged 10 to 25 years enrolled in the National Longitudinal Survey of Children and Youth between 1994 and 2009. Results. After adjustment for youth, parent, and family factors, the 3 distinct trajectories of depressive symptoms were minimal (55%; CES-D  18). All trajectories exhibited a parallel course, with peak symptoms at 15 to 17 years of age. Subclinical and clinical symptoms were more common than minimal symptoms in female youths and in respondents with lower self-concept, lower socioeconomic status, poorer interpersonal relations, and chronic health conditions (P < .01). Conclusions. Among emerging adults, trajectories of depressive symptoms do not trend upward or downward, and variables associated with identified trajectories demonstrated dose–response effects that agreed with vulnerability–stress theories of depression. PMID:26378840

  14. Latent Class Analysis of Intimate Partner Violence Perpetration and Victimization among Latino Emerging Adults.

    Science.gov (United States)

    Grest, Carolina Villamil; Lee, Jungeun Olivia; Gilreath, Tamika; Unger, Jennifer B

    2018-03-01

    While there are known developmental consequences and correlates of intimate partner violence perpetration and victimization, research focused on bidirectional and multiple forms of partner violence among Latino emerging adults is needed. This longitudinal study identified latent classes of intimate partner violence perpetration and victimization patterns among emerging adult Latinos (N = 1060; 60.6% female). A second aim examined acculturation and cumulative substance use correlates in high school, as predictors of intimate partner violence perpetration and victimization classes in emerging adulthood. Average age of participants was 15.5 years in 10th grade and 22.7 years in emerging adulthood. We identified four distinct subgroups of intimate partner violence perpetration and victimization, with 22% of individuals identified in a violence perpetration and victimization subgroup. Cumulative heavy episodic drinking and marijuana use in high school predicted belonging to the psychological bidirectional intimate partner violence group rather than the group with no violence. Cumulative marijuana use in high school, predicted belonging to the sexual bidirectional partner violence group compared to the no violence group. Our study extends the literature across developmental periods among Latino youth. The findings have implications for early adolescent prevention strategies and promotion of healthy intimate relationships.

  15. Emergency information management needs and practices of older adults: A descriptive study.

    Science.gov (United States)

    Turner, Anne M; Osterhage, Katie; Loughran, Julie; Painter, Ian; Demiris, George; Hartzler, Andrea L; Phelan, Elizabeth A

    2018-03-01

    To better understand how older adults currently manage emergency information, the barriers and facilitators to planning and management of emergency information, as well as the potential role of information technology to facilitate emergency planning and management. Older adults face a much higher risk of sudden illness/injury and are the age group with the largest percentages of emergent and urgent healthcare visits. Emergency information (health information needed in an emergency situation such as emergency contact information, diagnoses, and advance directives) needs to be maintained and easily accessible to ensure older adults get appropriate care and treatment consistent with their wishes in emergency situations. Current health information technologies rarely take into consideration the emergency information needs of older adults, their caregivers, and emergency responders. As part of a larger study we performed in-depth interviews with 90 older adults living in a variety of residential settings (independent living, retirement communities, assisted living) regarding how they manage information about their health. Interview sessions included photos of important health information artifacts. Interviews were transcribed and coded. Analysis of in-depth interviews revealed that emergency information is a type of health information that older adults frequently manage. Participants differed in whether they practice emergency planning (e.g. the preparation and continued management of emergency information), and in whether they involve others in emergency information and emergency planning. Despite its importance, emergency information was often not up-to-date and not always kept in locations readily apparent to emergency responders. Emergency information, such as emergency contact information, diagnoses, and advance directives, is a type of health information that older adults manage. Considering emergency information in the design of health information technologies

  16. Prevention and treatment of emergencies in thyroid patients

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    Anatoliy Filippovich Romanchishen

    2015-03-01

    Full Text Available AimTo evaluate the surgical treatment outcomes for patients with acute complications of thyroid disease (compression syndrome, early postoperative complications - like bilateral recurrent laryngeal nerve injure, bleeding (PB in thyroid bed and others performed in the single medical center.Material and methodsAnaplastic Thyroid Cancer (243 patients, multiglandular retrosternal goiter (25 cases, and purulent acute thyroiditis (9 observations made heavy compression of neck and mediastinal aerodigestive organs and were the reason for emergent thyroid surgery. Were estimated intraoperative recurrent nerve (RLN injures consequences and postoperative bleeding, made necessary for reoperations after 25663 thyroid surgeries during 36 years of the Center practice.ResultsSurgical intervention for Anaplastic Thyroid Cancer in all of patients has got palliative character only. Postop. lethality rate made 21,0% after emergency interventions, and 2,5% - after routine procedure. Combinations of it with radiochemotherapy has prolonged survival rate up to 13 month in 25% of cases.Follow up results of thyroid surgery in 23777 patients has found unexpected and relevant unilateral RLN injures in 251 (1.0% and bilateral – in 91 (0.38% cases. Recurrent laryngeal nerves and larynges reconstruction surgery allow us to decanulate more that 75% those patients.Postoperative bleeding (PB and thyroid bad hematomas were found in 138 больных (0.58% patients. The most often PB happened in initial and recurrent DTG (1.07%, 0.94%, TC (0.82% patients. In most (65.5% of cases PB began during the first 6 hours. In case of PB we parted wound edges anywhere, intubated repeatedly trachea, inspected wound; performed hemostasis and drained wound. Main sources of PB were inferior (40.38% or superior (17.30% thyroid artery. Source was not found in 13.35%. PB prevention included: careful hemostasis with control lavage of the wound; fascia covering of the thyroid bed and high

  17. Incentivizing health care behaviors in emerging adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Yu CH

    2016-03-01

    Full Text Available Catherine H Yu,1,2 Giuliana Guarna,1 Pamela Tsao,3 Jude R Jesuthasan,1 Adrian NC Lau,3,4 Ferhan S Siddiqi,1 Julie Anne Gilmour,3 Danyal Ladha,1 Henry Halapy,5 Andrew Advani1–3 1Li Ka Shing Knowledge Institute, St Michael’s Hospital, 2Division of Endocrinology and Metabolism, Department of Medicine, St Michael’s Hospital, University of Toronto, 3Department of Medicine, Faculty of Medicine, University of Toronto, 4Division of Endocrinology, Department of Medicine, University Health Network, 5Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada Purpose: For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases.Methods: The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years with chronic medical conditions including addictions, were included.Results: A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated.Conclusion: While the majority of

  18. Potentially preventable use of emergency services: the role of low health literacy.

    Science.gov (United States)

    Schumacher, Jessica R; Hall, Allyson G; Davis, Terry C; Arnold, Connie L; Bennett, Robert D; Wolf, Michael S; Carden, Donna L

    2013-08-01

    Limited health literacy is a barrier for understanding health information and has been identified as a risk factor for overuse of the emergency department (ED). The association of health literacy with access to primary care services in patients presenting to the ED has not been fully explored. To examine the relationship between health literacy, access to primary care, and reasons for ED use among adults presenting for emergency care. Structured interviews that included health literacy assessment were performed involving 492 ED patients at one Southern academic medical center. Unadjusted and multivariable logistic regression models assessed the relationship between health literacy and (1) access to a personal physician; (2) doctor office visits; (3) ED visits; (4) hospitalizations; and (5) potentially preventable hospital admissions. After adjusting for sociodemographic and health status, those with limited health literacy reported fewer doctor office visits [odds ratio (OR)=0.6; 95% confidence interval (CI), 0.4-1.0], greater ED use, (OR=1.6; 95% CI, 1.0-2.4), and had more potentially preventable hospital admissions (OR=1.7; 95% CI, 1.0-2.7) than those with adequate health literacy. After further controlling for insurance and employment status, fewer doctor office visits remained significantly associated with patient health literacy (OR=0.5; 95% CI, 0.3-0.9). Patients with limited health literacy reported a preference for emergency care, as the services were perceived as better. Among ED patients, limited health literacy was independently associated with fewer doctor office visits and a preference for emergency care. Policies to reduce ED use should consider steps to limit barriers and improve attitudes toward primary care services.

  19. Prediction and Prevention of Emerging Zoonotic Diseases in Wildlife ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The emerging and re-emerging zoonotic diseases affecting Brazil today result from complex interactions between natural and human systems. Zoonotic diseases such as hantavirus pulmonary syndrome, rabies and leishmaniasis for example emerged as humans encroached on forested regions, bringing people into direct ...

  20. Clinical and Community Strategies to Prevent Falls and Fall-Related Injuries Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Taylor-Piliae, Ruth E; Peterson, Rachel; Mohler, Martha Jane

    2017-09-01

    Falls in older adults are the result of several risk factors across biological and behavioral aspects of the person, along with environmental factors. Falls can trigger a downward spiral in activities of daily living, independence, and overall health outcomes. Clinicians who care for older adults should screen them annually for falls. A multifactorial comprehensive clinical fall assessment coupled with tailored interventions can result in a dramatic public health impact, while improving older adult quality of life. For community-dwelling older adults, effective fall prevention has the potential to reduce serious fall-related injuries, emergency room visits, hospitalizations, institutionalization, and functional decline. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Manual for best practice for emergency response procedures, part 1: causes and prevention of inrushes, fires, explosions and other emergencies.

    CSIR Research Space (South Africa)

    Spencer, KC

    2000-02-01

    Full Text Available Executive Summary This project was designed to have the following outputs: • Recommendations for best practices to deal with coal mine emergencies, with emphasis on inrushes, fires and explosions. • Provide a document from which training staff can... and prevention of inrushes, fires, explosions and other emergencies. Part 2 The management of inrushes, fires, explosions and other emergencies. Part 3 A review of the Department of Minerals and Energy guidelines relevant to inrushes, fires, explosions...

  2. Advancing prevention research on child abuse, youth violence, and domestic violence: emerging strategies and issues.

    Science.gov (United States)

    Guterman, Neil B

    2004-03-01

    Prevention research on the related problems of child abuse, youth violence, and domestic violence has grown at an accelerating pace in recent years. In this context, a set of shared methodological issues has emerged as investigators seek to advance the interpersonal violence prevention knowledge base. This article considers some of the persistent methodological issues in these areas and points out emerging research strategies that are forging advances in garnering valid, rigorous, and useful knowledge to prevent interpersonal violence. Research issues and emerging strategies in three key domains of prevention research are considered, including complexities in validly conceptualizing and measuring varying forms of violence as specific targets for preventive intervention, research issues and strategies designed to reliably predict and identify future violence risk to be targeted by preventive intervention, and research issues and emerging strategies in the application of empirical methods to forge specific advances in preventive intervention strategies themselves.

  3. FORUM: Instructional Communication and Millennial Students: Teaching Communication to Emerging Adults

    Science.gov (United States)

    Tompkins, Paula S.

    2016-01-01

    The new developmental stage of emerging adulthood (age 18-25) offers a framework for thinking about younger millennials in our classrooms. Smith, Christoffersen, Davidson, and Herzog's (2011) profile of emerging adults, based on longitudinal study of over 3200 emerging adults and culminating in 230 in-depth interviews, parallels research of the…

  4. Emerging Adults Riding With Marijuana-, Alcohol-, or Illicit Drug-Impaired Peer and Older Drivers.

    Science.gov (United States)

    Li, Kaigang; Ochoa, Elizabeth; Vaca, Federico E; Simons-Morton, Bruce

    2018-03-01

    The purpose of this study was to examine the prevalence and covariates among emerging adults of riding with an impaired peer or older adult driver (RWI) because of marijuana (MJ), alcohol (ALC), or illicit drugs (ID). Data were from Waves 4 (W4, N = 2,085) and 5 (W5, N = 2,116) of the NEXT Generation Health Study, collected in 2013-2014, 1 and 2 years after high school. W5 RWI was specified for substance-specific impaired peer and older adult (peer/older adult) drivers. Multinomial logistic regressions estimated W5 association of substance-specific RWI with W4 RWI, and W5 heavy episodic drinking, MJ use, and school/residence/work status. At W5, 33% of the participants reported RWI in the past year, including riding with ALC- (21%), MJ- (17%), and ID- (5%) impaired peer drivers and ALC- (2%), MJ- (4%), and ID- (0.7%) impaired older adult drivers. W4 RWI was associated with W5 RWI with impaired peer/older adult drivers for ALC- (adjusted odds ratio [AOR] = 4.28, 2.69) and MJ-RWI (AOR = 2.34, 3.56). W5 heavy episodic drinking was positively associated with W5 peer ALC-related RWI (AOR = 2.16) and peer/older adult MJ-related RWI (AOR = 2.38, 5.45). W5 MJ use was positively associated with W5 peer ALC-related RWI (AOR = 2.23), peer/older adult MJ-related (AOR = 10.89, 2.98), and peer/older adult ID-related (AOR = 9.34, 4.26) RWI. ID-related RWI was higher among those not attending 4-year college (AOR = 3.38), attending technology school (AOR = 16.23), living on their own (AOR = 6.85), or living on campus (AOR = 11.50). The high prevalence of RWI among emerging adults occurred mostly with ALC- or MJ-impaired peer drivers. The findings support the need for precisely tailored programs to prevent impaired driving according to substance use and age.

  5. Humility, Forgiveness, and Emerging Adult Female Romantic Relationships.

    Science.gov (United States)

    Bell, Chance A; Fincham, Frank D

    2017-10-26

    Among a sample of emerging adult females (N = 152) we empirically examined the role of humility and forgiveness in romantic relationships. We specifically tested a model linking perceived humility to relationship satisfaction with self-forgiveness and partner-forgiveness. Participants in a romantic relationship completed measures of self-reported humility, self-forgiveness, partner-forgiveness, and relationship satisfaction. Serial mediation analyses were conducted using path analysis to test the following sequence, humility self-forgiveness partner-forgiveness relationship satisfaction. Findings indicate that humility was related to relationship satisfaction via a serially mediated path of self-forgiveness and partner-forgiveness, which was not reducible to impression management. We consider implications for research and clinical practice. © 2017 American Association for Marriage and Family Therapy.

  6. Triage in an adult emergency service: patient satisfaction

    Directory of Open Access Journals (Sweden)

    Pollyane Liliane Silva

    2016-06-01

    Full Text Available Abstract OBJECTIVE Assess the degree of patient satisfaction with triage in the adult emergency service of a public hospital. METHOD Exploratory, descriptive, cross-sectional study with a quantitative approach. Three hundred patients were interviewed and the data were analyzed using descriptive statistics based on sociodemographic variables and those related to patient satisfaction. RESULTS There was a predominance of women, with elementary education and a mean age of 41 years. Most of the interviewees reported being satisfied in regard to the following items: timely service, embracement, trust, environment (comfort, cleanliness and signage, humanization (courtesy, respect, and interest, timely referral/scheduling of appointments and care expectations. CONCLUSION There was a high level of patient satisfaction, evidenced by the strong association of user satisfaction with the items investigated.

  7. Cognitive Impairment among Older Adults in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Hirschman, Karen

    2011-02-01

    Full Text Available Background: Within the next 30 years, the number of visits older adults will make to emergency departments (EDs is expected to double from 16 million, or 14% of all visits, to 34 million and comprise nearly a quarter of all visits.Objective: The objectives of this study were to determine prevalence rates of cognitive impairment among older adults in the ED and to identify associations, if any, between environmental factors unique to the ED and rates of cognitive impairment.Methods: A cross-sectional observational study of adults 65 and older admitted to the ED of a large, urban, tertiary academic health center was conducted between September 2007 and May 2008. Patients were screened for cognitive impairment in orientation, recall and executive function using the Six-Item Screen (SIS and the CLOX1, clock drawing task. Cognitive impairment among this ED population was assessed and both patient demographics and ED characteristics (crowding, triage time, location of assessment, triage class were compared through adjusted generalized linear models.Results: Forty-two percent (350/829 of elderly patients presented with deficits in orientation and recall as assessed by the SIS. An additional 36% of elderly patients with no impairment in orientation or recall had deficits in executive function as assessed by the CLOX1. In full model adjusted analyses patients were more likely to screen deficits in orientation and recall (SIS if they were 85 years or older (Relative Risk [RR]=1.63, 95% Confidence Interval [95% CI]=1.3-2.07, black (RR=1.85, 95% CI=1.5-2.4 and male (RR=1.42, 95% CI=1.2-1.7. Only age was significantly associated with executive functioning deficits in the ED screened using the clock drawing task (CLOX1 (75-84 years: RR=1.35, 95% CI= 1.2-1.6; 85+ years: RR=1.69, 95% CI= 1.5-2.0.Conclusion: These findings have several implications for patients seen in the ED. The SIS coupled with a clock drawing task (CLOX1 provide a rapid and simple method for

  8. Chemical Emergency Preparedness and Prevention Advisory: Hydrogen Fluoride

    Science.gov (United States)

    This advisory recommends ways Local Emergency Planning Committees (LEPCs) and chemical facilities can reduce risks posed by the presence of hydrogen fluoride (HF), a strong inorganic acid used to manufacture CFCs, in their communities.

  9. Older Adult Knowledge and Behavior Change in the Stepping On Fall Prevention Program in a Community Setting

    OpenAIRE

    Jane Strommen; Sean E. Brotherson; Zhen Yang

    2017-01-01

    One out of every three Americans age 65 and over falls at least once annually. Fall-related injuries among older adults are a major public health concern, and prevention of falls has emerged as a key issue in avoiding the risks to mobility and health that exist due to falls. Stepping On is an evidence-based fall prevention program designed to help older adults take control of their fall risk factors, explore different behavioral steps, and reduce their fall risk. This study shares findings...

  10. Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame.

    Directory of Open Access Journals (Sweden)

    Margarita Pons-Salort

    2016-07-01

    Full Text Available Reversion and spread of vaccine-derived poliovirus (VDPV to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs. Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2 in April 2016. Supplementary immunisation activities (SIAs with trivalent OPV (tOPV in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2. Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]. We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population

  11. Freedom to explore the self: How emerging adults use leisure to develop identity.

    Science.gov (United States)

    Layland, Eric K; Hill, Brian J; Nelson, Larry J

    2018-01-01

    During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries ( M age =23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time.

  12. Freedom to explore the self: How emerging adults use leisure to develop identity

    Science.gov (United States)

    Layland, Eric K.; Hill, Brian J.; Nelson, Larry J.

    2017-01-01

    During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries (Mage=23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time. PMID:29276528

  13. Vitamin D supplementation for prevention of cancer in adults

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Gluud, Lise Lotte; Nikolova, Dimitrinka

    2014-01-01

    from substantial dropout of participants. Combined vitamin D₃ and calcium supplements increased nephrolithiasis, whereas it remains unclear from the included trials whether vitamin D₃, calcium, or both were responsible for this effect. We need more trials on vitamin D supplementation, assessing......BACKGROUND: The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory. OBJECTIVES: To assess the beneficial and harmful effects of vitamin D supplementation for prevention of cancer in adults. SEARCH METHODS: We searched the Cochrane Central Register...... included randomised trials that compared vitamin D at any dose, duration, and route of administration versus placebo or no intervention in adults who were healthy or were recruited among the general population, or diagnosed with a specific disease. Vitamin D could have been administered as supplemental...

  14. Consensus document for the prevention of respiratory infections in adults.

    Science.gov (United States)

    Froes, F; Diniz, A; Robalo Cordeiro, C; Serrado, M; Ramalho de Almeida, A

    2014-01-01

    Infectious diseases are one of the principle causes of morbidity, mortality and drain on health resources worldwide. In recent years there has been an increase in the impact of respiratory infections, particularly in the Portuguese population. It is for this reason that the Portuguese Respiratory Society has presented a series of recommendations for the prevention of respiratory infections in adults. These recommendations include both general measures and vaccinations for flu and pneumococcal pneumonia. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  15. Evidence-Based Practice Guideline: Fall Prevention for Older Adults.

    Science.gov (United States)

    Kruschke, Cheryl; Butcher, Howard K

    2017-11-01

    Falls are a major cause of injury and death annually for millions of individuals 65 and older. Older adults are at risk for falls for a variety of reasons regardless of where they live. Falls are defined as any sudden drop from one surface to a lower surface. The purpose of this fall prevention evidence-based practice guideline is to describe strategies that can identify individuals at risk for falls. A 10-step protocol including screening for falls, comprehensive fall assessment, gait and balance screening when necessary, and an individualized fall intervention program addressing specific fall risks is presented. Reassessing fall risk and fall prevention programs will ensure a proactive approach to reducing falls in the aging population. [Journal of Gerontological Nursing, 43(11), 15-21.]. Copyright 2017, SLACK Incorporated.

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

    Science.gov (United States)

    Hogan, Michael F; Grumet, Julie Goldstein

    2016-06-01

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

  17. Effectiveness and reliability of emergency measures for flood prevention

    NARCIS (Netherlands)

    Lendering, K.T.; Jonkman, S.N.; Kok, M.

    2014-01-01

    Floods in the summer of 2013 in Central Europe demonstrated once again that floods account for a large part of damage and loss of life caused by natural disasters. During flood threats emergency measures, such as sand bags and big bags, are often applied to strengthen the flood defences and attempt

  18. Is a European Practice of Mass Atrocity Prevention Emerging?

    DEFF Research Database (Denmark)

    de Franco, Chiara; Rodt, Annemarie Peen

    2015-01-01

    reactions to the 2011 Libyan crisis, we investigate whether a “European practice of mass atrocity prevention” is emerging and if so how this relates—or not—to R2P. We do this by investigating EU practices seeking to protect people from genocide, ethnic cleansing, war crimes and crimes against humanity...

  19. Factors limiting and preventing emerging farmers to progress to ...

    African Journals Online (AJOL)

    The findings demonstrated that the specific limiting factors emerging farmers face are poor physical infrastructure such as poor roads, lack of transportation to the markets from the farms, lack of marketing skills and information, poor market infrastructure, and high transaction costs, insufficient land availability to expand ...

  20. Prediction and Prevention of Emerging Zoonotic Diseases in Wildlife ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Zoonotic diseases such as hantavirus pulmonary syndrome, rabies and leishmaniasis for example emerged as humans encroached on forested regions, bringing ... of wild and domestic animal populations in the Atlantic Forest (Pontal do Paranapanema, Mata Atlantica) to detect pathogens that cause zoonotic diseases.

  1. Containment of ebola – steps to prevent spread of emerging ...

    African Journals Online (AJOL)

    Six response teams were deployed within the Emergency Operations Centre; 1) Epidemiology/ Surveillance, 2) Case Management/ Infection Control, 3) Social mobilization, 4) Laboratory Services, 5) Point of Entry and 6) Management / Coordination. The strategy group reviewed and approved all of the teams work and ...

  2. Predicting Homelessness among Emerging Adults Aging Out of Foster Care.

    Science.gov (United States)

    Shah, Melissa Ford; Liu, Qinghua; Mark Eddy, J; Barkan, Susan; Marshall, David; Mancuso, David; Lucenko, Barbara; Huber, Alice

    2017-09-01

    This study examines risk and protective factors associated with experiencing homelessness in the year after "aging out" of foster care. Using a state-level integrated administrative database, we identified 1,202 emerging adults in Washington State who exited foster care between July 2010 and June 2012. Initial bivariate analyses were conducted to assess the association between candidate predictive factors and an indicator of homelessness in a 12-month follow-up period. After deploying a stepwise regression process, the final logistic regression model included 15 predictive factors. Youth who were parents, who had recently experienced housing instability, or who were African American had approximately twice the odds of experiencing homelessness in the year after exiting foster care. In addition, youth who had experienced disrupted adoptions, had multiple foster care placements (especially in congregate care settings), or had been involved with the juvenile justice system were more likely to become homeless. In contrast, youth were less likely to experience homelessness if they had ever been placed with a relative while in foster care or had a high cumulative grade point average relative to their peers. © Society for Community Research and Action 2016.

  3. Young adult couples' decision making regarding emergency contraceptive pills.

    Science.gov (United States)

    Beaulieu, Richard; Kools, Susan M; Kennedy, Holly Powell; Humphreys, Janice

    2011-03-01

    Unintended pregnancy is a significant public health problem among young people worldwide. The purpose of this study was to explore and better understand the reasons for the apparent underuse of emergency contraceptive pills (ECP) in young people in coupled relationships. THEORETICAL RATIONAL: In postmodern explications of grounded theory, social construction of realities and the influence of subjectivities on the meanings of experiences lead to the development of partial truths that may change with time, context, and situation. Grounded theory methods guided semi-structured face-to-face interviews and data analysis. Twenty-two couples aged 18 to 25 years old were recruited through public notices. Four salient and interrelated conditions were constructed to help explain the complexities involved in young couples decision making regarding ECP use: (a) the shifting locus of responsibility for contraceptive decision making: in a perfect world versus biological reality; (b) relationship power: control-vulnerability continuum; (c) a woman's autonomy over her own body; and (d) conflicting views on ECP. Healthcare professionals whose practice includes young people need to be aware of possible couple dynamics when discussing contraception. Clients in supportive relationships should be encouraged to engage in open communication with their partners about their contraception needs, including possible ECP use. The results of this study contribute to the body of knowledge with regard to decision making related to ECP use in young adults. © 2011 Sigma Theta Tau International.

  4. Emerging Adults at Work and at Play: Leisure, Work Engagement, and Career Indecision

    Science.gov (United States)

    Konstam, Varda; Lehmann, Ilana S.

    2011-01-01

    To expand the understanding of how leisure and recreational activities can inform career indecision, this research examined the relationship between career indecision, work engagement, and leisure in emerging adults, 25-30 years of age. Independent sample t tests reveal that career indecisive emerging adults scored significantly lower on all three…

  5. "Family Comes First!" Relationships with family and friends in Italian emerging adults

    NARCIS (Netherlands)

    Crocetti, Elisabetta|info:eu-repo/dai/nl/371750946; Meeus, Wim|info:eu-repo/dai/nl/070442215

    2014-01-01

    We conducted two studies to examine relationships with family and friends in Italian emerging adults, paying attention to the potential moderating role of gender and occupational status. In Study I, we aimed at capturing emerging adults' perspective on interactions with both family and friends by

  6. Factors Contributing to the Uptake and Maintenance of Regular Exercise Behaviour in Emerging Adults

    Science.gov (United States)

    Langdon, Jody; Johnson, Chad; Melton, Bridget

    2017-01-01

    Objective: To identify the influence of parental autonomy support, basic need satisfaction and motivation on emerging adults' physical activity level and exercise behaviours. Design: Cross-sectional survey. Setting: This study convenience-sampled approximately 435 college students identified as emerging adults--aged 18-25 years, who did not have a…

  7. Relationship Duration Moderation of Identity Status Differences in Emerging Adults' Same-Sex Friendship Intimacy

    Science.gov (United States)

    Johnson, H. Durell

    2012-01-01

    Previous research has not yielded consistent identity and intimacy associations for female and male emerging adults. Intimacy varies with time spent in a relationship, and relationship duration may explain variations in the identity process association with intimacy. Data from 278 female and 156 male emerging adults revealed relationship duration…

  8. Perceived Stress and Avoidant Coping Moderate Disordered Gambling among Emerging Adults in Vietnam

    Science.gov (United States)

    Lostutter, Ty W.; Larimer, Mary E.; Neighbors, Clayton; Kaljee, Linda M.

    2013-01-01

    Gambling research conducted in Asia has been limited, despite a continued growth of the gambling industry within the region. Outside Asia, research suggests emerging adults have high rates of gambling behavior and experience serious consequences. The current study examines gambling behavior within an emerging adult (ages 16-24) population in…

  9. Domestic burns among children, adolescents and young adults: urgency and emergency cases

    Directory of Open Access Journals (Sweden)

    Jackeline Gonçalves Brito

    2016-03-01

    Full Text Available The objective of this study was to analyze domestic burns caused by the exposure to electric current/radiation/temperature, smoke/fire/flames and contact with a source of heat/hot substances, in children, adolescents and young adults treated at an urgency/emergency service of reference. A descriptive, cross-sectional study was conducted with victims (0 to 24 years of age of home burns treated at an urgency/emergency service of a capital city located in the center-west region of Brazil, in 2013. In total, 84 victims of home burns were studied, with prevalence of female victims (59.5% and age group of 1-4 years of age (27.4%. The most frequent burns were caused by contact with a source of heat/hot substances (82.1% and exposure to smoke/fire/flames (15.5%. The body areas most commonly affected by home burns were head, trunk, and upper and lower limbs (90.5%, with prevalence of second-degree burns (40.5%. Home burns significantly affect children, adolescents and young adults, particularly female subjects, highlighting the importance of providing preventive and educational activities to female victims.

  10. Older adults' perceptions of technologies aimed at falls prevention, detection or monitoring: a systematic review.

    Science.gov (United States)

    Hawley-Hague, Helen; Boulton, Elisabeth; Hall, Alex; Pfeiffer, Klaus; Todd, Chris

    2014-06-01

    Over recent years a number of Information and Communication Technologies (ICTs) have emerged aiming at falls prevention, falls detection and alarms for use in case of fall. There are also a range of ICT interventions, which have been created or adapted to be pro-active in preventing falls, such as those which provide strength and balance training to older adults in the prevention of falls. However, there are issues related to the adoption and continued use of these technologies by older adults. This review provides an overview of older adults' perceptions of falls technologies. We undertook systematic searches of MEDLINE, EMBASE, CINAHL and PsychINFO, COMPENDEX and the Cochrane database. Key search terms included 'older adults', 'seniors', 'preference', 'attitudes' and a wide range of technologies, they also included the key word 'fall*'. We considered all studies that included older adults aged 50 and above. Studies had to include technologies related specifically to falls prevention, detection or monitoring. The Joanna Briggs Institute (JBI) tool and the Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project (EPHPP) were used. We identified 76 potentially relevant papers. Some 21 studies were considered for quality review. Twelve qualitative studies, three quantitative studies and 6 mixed methods studies were included. The literature related to technologies aimed at predicting, monitoring and preventing falls suggest that intrinsic factors related to older adults' attitudes around control, independence and perceived need/requirements for safety are important for their motivation to use and continue using technologies. Extrinsic factors such as usability, feedback gained and costs are important elements which support these attitudes and perceptions. Positive messages about the benefits of falls technologies for promoting healthy active ageing and independence are critical, as is ensuring that the technologies are simple

  11. Older Adult Knowledge and Behavior Change in the Stepping On Fall Prevention Program in a Community Setting

    Directory of Open Access Journals (Sweden)

    Jane Strommen

    2017-10-01

    Full Text Available One out of every three Americans age 65 and over falls at least once annually. Fall-related injuries among older adults are a major public health concern, and prevention of falls has emerged as a key issue in avoiding the risks to mobility and health that exist due to falls. Stepping On is an evidence-based fall prevention program designed to help older adults take control of their fall risk factors, explore different behavioral steps, and reduce their fall risk. This study shares findings from evaluation efforts conducted with 182 older adult participants in Stepping On from 2013 to 2015. Older adults in the program demonstrated (1 high satisfaction with program quality; (2 positive impacts on knowledge related to fall risk factors and prevention; and (3 substantial followthrough on behavioral steps designed to minimize fall risk. Program participants also shared positive feedback on the program in response to open-ended questions. Implications of the findings for fall risk reduction and programs to enhance fall prevention among older adults are discussed. Programs designed to reduce fall risk factors and enhance quality of life can be a critical tool to assist older adults, educators, and community leaders in addressing this public health issue.

  12. The characters of emergency rescue and the measures to prevent accidents for nuclear-powered submarine

    International Nuclear Information System (INIS)

    Wang Yuexing

    1999-01-01

    The characteristics of emergency rescue and the measures for preventing and decreasing accidents in nuclear-powered submarine have been presented. The breakdown of equipment and human factors are the main reasons which lead to accidents. Four preventive measures are suggested: enhancing capabilities to take precautions against fire, seriously controlling the environmental factors which affect the health of the submariners, reinforcing the constitutions of the submariners, and working out emergency planning against serious accidents in advance

  13. The re-emergency and persistence of vaccine preventable diseases

    Directory of Open Access Journals (Sweden)

    RODRIGO C.N. BORBA

    2015-08-01

    Full Text Available The introduction of vaccination worldwide dramatically reduced the incidence of pathogenic bacterial and viral diseases. Despite the highly successful vaccination strategies, the number of cases among vaccine preventable diseases has increased in the last decade and several of those diseases are still endemic in different countries. Here we discuss some epidemiological aspects and possible arguments that may explain why ancient diseases such as, measles, polio, pertussis, diphtheria and tuberculosis are still with us.

  14. Public health and aging: nonfatal injuries among older adults treated in hospital emergency departments--United States, 2001.

    Science.gov (United States)

    2003-10-24

    Because injuries generally are considered a problem of the young, injuries among older adults (i.e., persons aged > or =65 years) have received little attention. However, injuries are the eighth leading cause of death among older adults in the United States. In 2001, approximately 2.7 million older adults were treated for nonfatal injuries in hospital emergency departments (EDs); the majority of these injuries were the result of falls. To characterize nonfatal injuries among older adults, CDC analyzed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP). This report summarizes the results of that analysis, which indicate differences in type and mechanism of injury by sex, suggesting that prevention programs should be designed and tailored differently for men and women.

  15. Prevention policies addressing packaging and packaging waste: Some emerging trends.

    Science.gov (United States)

    Tencati, Antonio; Pogutz, Stefano; Moda, Beatrice; Brambilla, Matteo; Cacia, Claudia

    2016-10-01

    Packaging waste is a major issue in several countries. Representing in industrialized countries around 30-35% of municipal solid waste yearly generated, this waste stream has steadily grown over the years even if, especially in Europe, specific recycling and recovery targets have been fixed. Therefore, an increasing attention starts to be devoted to prevention measures and interventions. Filling a gap in the current literature, this explorative paper is a first attempt to map the increasingly important phenomenon of prevention policies in the packaging sector. Through a theoretical sampling, 11 countries/states (7 in and 4 outside Europe) have been selected and analyzed by gathering and studying primary and secondary data. Results show evidence of three specific trends in packaging waste prevention policies: fostering the adoption of measures directed at improving packaging design and production through an extensive use of the life cycle assessment; raising the awareness of final consumers by increasing the accountability of firms; promoting collaborative efforts along the packaging supply chains. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. [Emergence of early childhood trauma in adult psychiatric symptomatology].

    Science.gov (United States)

    Bouras, G; Lazaratou, E

    2012-06-01

    DNA methylation and brain development. Supporting the family and break the silence that frequently covers the traumatic events and feelings, will give the opportunity for the elaboration of all these aspects which could capture and imprison the subject in a dramatic circle of psychopathology. Moreover, the effectiveness of early interventions and child psychotherapy is now a common ground, so we have to use all our clinical instruments (dialogue, symbolic play, drawing, storytelling) in order to help the child and have the best possible result. Finally, concerning clinical practice, the emergence of early childhood trauma in adult psychiatric symptomatology is so frequent that mental health experts should take it into serious account while developing an appropriate clinical treatment for such patients.

  17. Effectiveness of light paths coupled with personal emergency response systems in preventing functional decline among the elderly

    Directory of Open Access Journals (Sweden)

    Florent Lachal

    2016-08-01

    Full Text Available Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0 and at the end of the study (T12-month. Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5 at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54, p = 0.002. Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies.

  18. Indicated prevention of adult obesity: reference data for weight normalization in overweight children

    Science.gov (United States)

    Background: Pediatric obesity is a major risk factor for adult obesity. Indicated prevention--that is, helping overweight or obese youth attain non-overweight status--has been suggested to prevent adult obesity. This study aimed to support the notion of indicated prevention by demonstrating that rel...

  19. Advancing Prevention Research on Child Abuse, Youth Violence, and Domestic Violence: Emerging Strategies and Issues

    Science.gov (United States)

    Guterman, Neil B.

    2004-01-01

    Prevention research on the related problems of child abuse, youth violence, and domestic violence has grown at an accelerating pace in recent years. In this context, a set of shared methodological issues has emerged as investigators seek to advance the interpersonal violence prevention knowledge base. This article considers some of the persistent…

  20. Emerging concept: 'central benefit model' of exercise in falls prevention.

    Science.gov (United States)

    Liu-Ambrose, Teresa; Nagamatsu, Lindsay S; Hsu, Chun Liang; Bolandzadeh, Niousha

    2013-01-01

    Falls are a common geriatric syndrome and are the third leading cause of chonic disability worldwide. Falls are not random events and occur, at least in part, due to impaired physiological function, such as impaired balance, and cognitive impairment. The clinical syndrome of falls is important for Sports and Exercise Medicine Clinicians as there is Level 1 evidence that targeted exercise prescription is an effective intervention strategy. The widely accepted dogma is that improved physical function, balance and muscle strength, underlies the effectiveness of the exercise in reducing falls. However, findings from randomised controlled trials suggest that exercise reduce falls via mechanisms other than improved physiological function. The authors propose that improved cognitive function - specifically, executive functions - and associated functional plasticity may be an important yet underappreciated mechanism by which the exercise reduces falls in older adults.

  1. How do levonorgestrel-only emergency contraceptive pills prevent pregnancy? Some considerations.

    Science.gov (United States)

    Mozzanega, Bruno; Cosmi, Erich

    2011-06-01

    Controversial opinions exist about the possible mechanisms throughout emergency contraception prevents pregnancy. Recently, the International Federation of Gynaecology and Obstetrics and the International Consortium for Emergency Contraception released a Joint Statement declaring that 'inhibition or delay of ovulation should be their primary and possibly only mechanism of action'. They still added that 'Review of the evidence suggests that LNG-ECPs cannot prevent implantation'. Concerning levonorgestrel-only emergency contraceptive pills effects on ovulation, the Statement based on seven reference papers which considered a total of only 142 patients, divided into still different subgroups. Basing on their same references we got quite different conclusions.

  2. Unemployment and depression among emerging adults in 12 states, Behavioral Risk Factor Surveillance System, 2010.

    Science.gov (United States)

    McGee, Robin E; Thompson, Nancy J

    2015-03-19

    The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults. Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Responses to the Patient Health Questionnaire-8 provided data about the prevalence of depression. Bivariate relationships were assessed using χ(2) tests, and multivariable adjusted odds ratios were calculated with logistic regressions. Sociodemographic variables were sex, race/ethnicity, marital status, and education. In addition, logistic regression models adjusted for health insurance status, disability, smoking, and body mass index. The analyses were completed using SAS 9.3 survey procedures to account for the complex sampling design. Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults. The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health-focused interventions.

  3. Mother-Father Dyad Conflict Strategy Clusters: Implications for Emerging Adults.

    Science.gov (United States)

    McKinney, Cliff; Walker, Courtney S; Kwan, Janet W

    2016-12-01

    Research has examined the different parenting styles that are present during emerging adulthood; however, less is known about potential parental conflict strategies that emerging adults may be experiencing during this developmental time period. Conflict strategies are conceptualized in the current study as parents' efforts to regulate, correct, or enforce a consequence in response to their emerging adult child's behavior. Previous research on discipline during childhood and adolescence has suggested the use of harsh discipline (e.g., use of physical force) leads to negative outcomes for children. Despite evidence linking harsh discipline methods to harmful outcomes in various developmental periods and suggested influence of parents in emerging adulthood, very little is known about how parents handle conflict with their emerging adult children. Thus, the present study investigated parental conflict strategies and mental health outcomes of emerging adults. Results revealed a significant parent-child gender interaction for non-violent strategies and psychological aggression. Moreover, results indicated that emerging adult children of parents who utilize similar levels of aggressive methods reported greater psychological problems. The findings from the current study underscore parents' use of conflict strategies when interacting with their emerging adult children, and further emphasize the importance of future research in this area.

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

    Science.gov (United States)

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

    2017-09-01

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

  5. [Prevention of cardiovascular complications associated with diabetes mellitus: hospital emergency department involvement].

    Science.gov (United States)

    Agudo Villa, Teresa; Álvarez-Rodríguez, Esther; Caurel Sastre, Zaida; Martín Martínez, Alfonso; Merinero Palomares, Raúl; Alvarez Rodríguez, Virginia; Portero Sánchez, Isabel

    2015-06-01

    To analyze the risk profile of patients with diabetes who seek care from hospital emergency departments and emergency department involvement in preventing cardiovascular complications in these patients. Cross-sectional analysis of case series from 2 Spanish hospital emergency departments. We included all patients with a history or final diagnosis of diabetes mellitus who were treated in the emergency department between November 1, 2010, and June 30, 2011. Each patient's cardiovascular risk profile was analyzed. The main outcome was the appropriate of prescribed treatment to prevent cardiovascular complications according to the 2012 guidelines of the American Diabetes Association on the patient's discharge from emergency care. A total of 298 patients were included; 275 (92%) had type II diabetes. Ninety percent of the series (269 patients) had at least 1 cardiovascular risk factor and 147 (49%) had prior target organ damage; target organ damage was newly diagnosed in 41 (14%). Fifty-eight percent (172 patients) were discharged home from the emergency department. Although 215 patients (72%) were not adhering to at least 1 previously prescribed preventive treatment and 30 (10%) were not adhering to any prescribed treatment, drug prescriptions were modified only in 1.1% to 3.3% of patients and no follow-up was recommended in 42 cases (24%). Although diabetic patients treated in emergency departments are at high risk for cardiovascular complications, their visit is not used to optimize preventive treatment for these complications or ensure appropriate follow-up.

  6. Triage in an adult emergency service: patient satisfaction.

    Science.gov (United States)

    Silva, Pollyane Liliane; Paiva, Luciana; Faria, Veridiana Bernardes; Ohl, Rosali Isabel Barduchi; Chavaglia, Suzel Regina Ribeiro

    2016-01-01

    Assess the degree of patient satisfaction with triage in the adult emergency service of a public hospital. Exploratory, descriptive, cross-sectional study with a quantitative approach. Three hundred patients were interviewed and the data were analyzed using descriptive statistics based on sociodemographic variables and those related to patient satisfaction. There was a predominance of women, with elementary education and a mean age of 41 years. Most of the interviewees reported being satisfied in regard to the following items: timely service, embracement, trust, environment (comfort, cleanliness and signage), humanization (courtesy, respect, and interest), timely referral/scheduling of appointments and care expectations. There was a high level of patient satisfaction, evidenced by the strong association of user satisfaction with the items investigated. Avaliar o grau de satisfação dos usuários no setor de Acolhimento com Classificação de Risco do Pronto-Socorro Adulto de um hospital público. Pesquisa exploratória, descritiva e transversal com abordagem quantitativa. Foram entrevistados 300 usuários e os dados foram analisados por meio de estatística descritiva a partir de variáveis sociodemográficas e as relacionadas à satisfação do usuário. Houve predominância do sexo feminino, nível de escolaridade fundamental e idade média de 41 anos. A maioria dos entrevistados respondeu estar satisfeito em relação aos itens: agilidade no atendimento; acolhimento; confiança; ambiência (conforto, limpeza, sinalização), humanização (educação, respeito e interesse); agilidade no encaminhamento/agendamento de consulta e expectativa sobre o serviço. Verificou-se elevado grau de satisfação dos usuários, evidenciada pela forte associação da satisfação do usuário com os itens investigados.

  7. Consensus document for the prevention of respiratory infections in adults

    Directory of Open Access Journals (Sweden)

    F. Froes

    2014-03-01

    Full Text Available Infectious diseases are one of the principle causes of morbidity, mortality and drain on health resources worldwide. In recent years there has been an increase in the impact of respiratory infections, particularly in the Portuguese population. It is for this reason that the Portuguese Respiratory Society has presented a series of recommendations for the prevention of respiratory infections in adults. These recommendations include both general measures and vaccinations for flu and pneumococcal pneumonia. Resumo: As infeções respiratórias são uma das principais causas de morbilidade, mortalidade e consumo de recursos de saúde a nível global. Nos últimos anos tem-se assistido a um crescente impacto das infeções respiratórias, nomeadamente na população portuguesa. Assim, a Sociedade Portuguesa de Pneumologia apresenta um conjunto de recomendações para a prevenção das infeções respiratórias no adulto. Estas recomendações englobam medidas gerais e de vacinação antigripal e antipneumocócica. Keywords: Prevention, Respiratory infections, Pneumonia, Flu vaccination, Pneumococcal vaccination, Palavras-chave: Prevenção, Infeções respiratórias, Pneumonia, Vacina da gripe, Vacina pneumocócica

  8. Food safety: emerging trends in foodborne illness surveillance and prevention.

    Science.gov (United States)

    McCabe-Sellers, Beverly J; Beattie, Samuel E

    2004-11-01

    Between 250 and 350 million Americans are estimated to suffer acute gastroenteritis annually, with 25% to 30% thought to be caused by foodborne illnesses. Most vulnerable to foodborne diseases are elderly people, pregnant women, immune-compromised people, and children. While bacterial causes such as Salmonella are widely recognized and monitored as foodborne infections, other important bacterial causes such as Clostridium perfringens , Bacillus cereus , and Staphylococcus aureus are less well known. While the majority of cases of foodborne diseases are of unknown cause, bacteria and viruses are the most likely causative agents. Caliciviridae (Norwalk-like) virus cases are more difficult to identify, but represent the most common cause of known and probably unknown cases. Fresh produce has to be added to the traditional list of foods requiring careful selection and handling to prevent foodborne disease. To assess the disease burden in the United States, morbidity and mortality surveillance activities are done by several networks and systems with collaboration among federal agencies and health departments. Not all important causes are being equally monitored. Critical behaviors by food processors, food retailers, foodservice personnel, and consumers can reduce the risk of foodborne illness episodes. Dietetics professionals can more readily monitor new developments and update knowledge and practice through online resources.

  9. Personality disorders in older adults : emerging research issues

    NARCIS (Netherlands)

    van Alphen, S. P. J.; van Dijk, S. D. M.; Videler, A. C.; Rossi, G.; Dierckx, E.; Bouckaert, F.; Oude Voshaar, R. C.

    Empirical research focusing on personality disorders (PDs) among older adults is mainly limited to studies on psychometric properties of age-specific personality tests, the age neutrality of specific items/scales, and validation of personality inventories for older adults. We identified only two

  10. Personality disorders in older adults : Emerging research issues

    NARCIS (Netherlands)

    van Alphen, S.P.J.; van Dijk, S.D.M.; Videler, A.C.; Rossi, G.; Dierckx, E.; Bouckaert, F.; Oude Voshaar, R.C.

    2015-01-01

    Empirical research focusing on personality disorders (PDs) among older adults is mainly limited to studies on psychometric properties of age-specific personality tests, the age neutrality of specific items/scales, and validation of personality inventories for older adults. We identified only two

  11. Emergency Department Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

    Science.gov (United States)

    Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J.

    2016-01-01

    Background The rise in emergency department (ED) utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to positively impact the care of older adults. Symptoms have been associated with ED utilization, however, it remains unclear if symptoms are the primary reason for ED utilization. Purpose Describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department. Examine the differences in self-reported symptoms among those who utilized the emergency department, and those who did not. Procedures A prospective longitudinal design was used. The sample included 403 community-dwelling older adults 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Main Findings Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance, and fair/poor well-being were significantly associated with ED utilization. Conclusions Several symptoms were common among this cohort of older adults. However, there were no significant differences in the types of symptoms reported by older adults who utilized the emergency department compared to those who did not use the emergency department. Based on these findings, symptoms among community-dwelling older adults may not be the primary reason for ED utilization. PMID:28131350

  12. Diabetes care for emerging adults: transition from pediatric to adult diabetes care systems

    Directory of Open Access Journals (Sweden)

    Young Ah Lee

    2013-09-01

    Full Text Available With the increasing prevalence of diabetes mellitus in children, transitioning patients from childhood to adulthood are increasing. High-risk behaviors and poor glycemic control during the transition period increase the risk for hypoglycemia and hyperglycemia as well as chronic microvascular and macrovascular complications. Discussions regarding complications and preparations for transition must take place before the actual transition to adult care systems. Pediatric care providers should focus on diabetes self-management skills and prepare at least 1 year prior to the transfer. Pediatric providers should also provide a written summary about previous and current glycemic control, complications and the presence of mental health problems such as disordered eating behaviors and affective disorders. Transition care should be individualized, with an emphasis on diabetes self-management to prevent acute and long-term complications. Regular screening and management of complications should proceed according to pediatric and adult guidelines. Birth control, use of alcohol, smoking and driving should also be discussed. Barriers to self-management and care must be recognized and solutions sought. The goals of transitional care are to effectively transition the diabetic patient from the pediatric to adult care system with less elapsed time in between and to improve post-transition outcome. Previous studies regarding diabetes transitional care programs including patient education programs, medical coordinators and auxiliary service systems reported promising results. However, there is a lack of evidence regarding best practices in transition care. Further studies are needed to provide evidence based transitional care programs that take both medical and psychosocial aspects of diabetes care into consideration.

  13. Emergency contraception: Sources of information and perceptions of access among young adults.

    Science.gov (United States)

    Garrett, Kyla P; Widman, Laura; Francis, Diane B; Noar, Seth M

    2016-01-01

    Emergency contraception (EC) can prevent pregnancy for up to 5 days after unprotected sex. Although EC has become increasingly available, little is known about perceptions of young adults regarding access to EC or whether information sources about EC relate to perceived access among young adults. Over a 1-week period in November 2013, a self-report survey was administered to 352 college students (67% women) at the student union of a large, public university in the southeastern United States. The survey assessed three aspects of EC: perceived access, information sources, and prior use. Twenty-one percent of participants had used EC. Participants reported relatively high perceptions of access to EC, with females reporting higher perceptions of access than males. Prior to the study, 7.4% of students had never heard of EC; the remaining students had heard of EC from an average of four sources. Among women, hearing of EC from media, interpersonal, or health education sources was significantly associated with greater perceived access (ps sources were associated with perceived access (ps > .10). Future EC awareness efforts for women should leverage all three of these sources, while future research should examine specific sources to focus on the content, quality, and frequency of messages.

  14. Youth versus adult "weightlifting" injuries presenting to United States emergency rooms: accidental versus nonaccidental injury mechanisms.

    Science.gov (United States)

    Myer, Gregory D; Quatman, Carmen E; Khoury, Jane; Wall, Eric J; Hewett, Timothy E

    2009-10-01

    Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. We hypothesized that older athletes would sustain greater percentages of joint sprains and muscle strains, whereas younger athletes would sustain a greater percentage of accidental injuries that would result in an increased percentage of fractures in youths. The U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System was queried from 2002 to 2005 using the CPSC code for "Weightlifting." Subjects between the ages of 8 and 30 were grouped by age categories 8 to 13 (elementary/middle school age), 14 to 18 (high school), 19 to 22 (college), and 23 to 30 (adult). Injuries were classified as "accidental" if caused by dropped weight or improper equipment use. Multiple logistic regression was used to compare accidental injuries between age groups. The sample consisted of 4,111 patients. Accidental injuries decreased (p 14 to 18 > 19 to 22 years = 23 to 30 years. Conversely, sprain/strain injuries increased in each successive age group (p training-related joint sprains and muscle strains than adults. The majority of youth resistance training injuries are the result of accidents that are potentially preventable with increased supervision and stricter safety guidelines.

  15. The Adults in the Making program: long-term protective stabilizing effects on alcohol use and substance use problems for rural African American emerging adults.

    Science.gov (United States)

    Brody, Gene H; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M; Smith, Karen

    2012-02-01

    This report addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk. African American youths (M age, pretest = 17.7 years) were assigned randomly to the AIM (n = 174) or control (n = 173) group. Past 3-month alcohol use, past 6-month substance use problems, risk taking, and susceptibility cognitions were assessed at pretest and at 6.4, 16.6, and 27.5 months after pretest. Pretest assessments of parent-child conflict, affiliations with substance-using companions, and perceived racial discrimination were used to construct a contextual risk factor index. A protective stabilizing hypothesis was supported; the long-term efficacy of AIM in preventing escalation of alcohol use and substance use problems was greater for youths with higher pretest contextual risk scores. Consistent with a mediation-moderation hypothesis, AIM-induced reductions over time in risk taking and susceptibility cognitions were responsible for the AIM × contextual risk prevention effects on alcohol use and substance use problems. Training in developmentally appropriate protective parenting processes and self-regulatory skills during the transition from adolescence to emerging adulthood for rural African Americans may contribute to a self-sustaining decreased interest in alcohol use and a lower likelihood of developing substance use problems. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  16. Dyadic Qualitative Analysis of Condom Use Scripts Among Emerging Adult Gay Male Couples.

    Science.gov (United States)

    Starks, Tyrel J; Pawson, Mark; Stephenson, Rob; Sullivan, Patrick; Parsons, Jeffrey T

    2018-04-03

    Sexual risk reduction among gay male couples has received increasing attention in light of evidence that primary partners account for many-and possibly most-new HIV infections. This study examined the content of condom use scripts in interviews conducted with both members of 17 HIV-negative gay male couples. In each couple, at least one partner was an emerging adult (aged 18 to 29). Three scripts were identified: romantic love, unanticipated condomless anal intercourse (CAI), and negotiated safety. Scripts varied in their emphasis on emotional factors versus HIV risk reduction, the salience of sexual agreements, and the presence of an explicit communication goal. Results indicated that condom use may vary for couples as a result of script content and from the fluid adoption of scripts across contexts. Results highlighted potential tensions between emotional closeness and HIV prevention. Condom use cessation and sexual agreements-a potential mechanism for HIV risk reduction-may also serve as expressions of intimacy. This implies interventions that facilitate direct communication about sexual and relational goals-as well as those that expand couples' repertoires for expressing emotional closeness-may enhance sexual health for gay couples, particularly during the period of emerging adulthood.

  17. Intraosseous vascular access in adults using the EZ-IO in an emergency department.

    Science.gov (United States)

    Ngo, Adeline Su-Yin; Oh, Jen Jen; Chen, Yuming; Yong, David; Ong, Marcus Eng Hock

    2009-08-11

    Intraosseous (IO) access is an alternative to conventional intravenous access. We evaluate the use of the EZ-IO as an alternative vascular access for patients in the emergency department. A non-randomized, prospective, observational study was performed in adults using the EZ-IO powered drill device. Twenty-four patients were recruited. There were 35 intraosseous insertions, including 24 tibial and 11 humeral insertions. All EZ-IO insertions were achieved within 20 s and were successful at the first attempt except for one. Of the intraosseous insertions, 88.6% were reported to be easier than intravenous cannulation. We found flow rates to be significantly faster using a pressure bag. The seniority of operators did not affect the success of insertion. Complications included a glove being caught in the drill device and extravasation of fluid although they were easily preventable. The use of the EZ-IO provides a fast, easy and reliable alternative mode of venous access, especially in the resuscitation of patients with no venous vascular access in the emergency department. Flow rates may be improved by the use of pressure bags.

  18. 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, ...

  19. Parenting styles and emerging adult drug use in Cebu, the Philippines

    OpenAIRE

    Hock, Rebecca S.; Hindin, Michelle J.; Bass, Judith K.; Surkan, Pamela J.; Bradshaw, Catherine P.; Mendelson, Tamar

    2015-01-01

    Parenting style is a potent and malleable influence on emerging adult substance use. Most of the parenting-substance use literature has been conducted in Western populations and it is unknown whether findings are generalizable to other cultures and contexts. We extended the parenting-substance use literature to a cohort of emerging adults in the Philippines using the Cebu Longitudinal Health and Nutrition Survey. We assessed associations between mothers’ and fathers’ parenting styles (authori...

  20. Emergency Readiness for Older Adults and People with Disabilities

    Science.gov (United States)

    ... Preventing Abuse Research and Development Retirement Planning and Pension Support Support to Caregivers Support for People with ... less able to withstand periods of time without food, water, medication, and rest—and they may have ...

  1. Variables Affecting Emerging Adults' Self-Reported Risk and Reckless Behaviors

    Science.gov (United States)

    Duangpatra, Krisna N. K.; Bradley, Graham L.; Glendon, A. Ian

    2009-01-01

    Young adults' behaviors are frequently characterized by risk-taking and recklessness. Few studies have examined the correlates of risk and reckless behaviors in emerging adults. Drawing on theories emphasising multifactorial effects of personality, social, and cognitive variables, this study explores psychosocial factors contributing to risk and…

  2. Distinguishing Features of Emerging Adulthood: The Role of Self-Classification as an Adult

    Science.gov (United States)

    Nelson, Larry J.; Barry, Carolyn McNamara

    2005-01-01

    Research reveals that most 18- to 25-year-old individuals do not consider themselves to be adults. This time period between adolescence and adulthood has been newly defined as emerging adulthood. The purpose of this study was to (a) attempt to identify perceived adults and (b) explore whether differences in adulthood criteria, achievement of those…

  3. Adult surgical emergencies in a developing country: the experience of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.

    Science.gov (United States)

    Chianakwana, Gabriel U; Ihegihu, Chima C; Okafor, Pius I S; Anyanwu, Stanley N C; Mbonu, Okechukwu O

    2005-06-01

    The goal of this study was to examine the adult surgical emergencies seen at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, with a view to proffering preventive solutions where appropriate and improving outcome. From the register of patients seen at the Casualty department and from the operations register in the main operation room of NAUTH, names and hospital numbers of adult patients treated as emergencies over a 5-year period, from 7 September 1998 to 6 September 2003, were obtained. The hospital folders were then retrieved from the Records Department. From each folder, the following details about each patient were extracted: age, sex, diagnosis at presentation, causative factors, treatment given, and outcome. A total of 902 adult patients were treated during the period. The commonest emergency operation was appendectomy for acute appendicitis in 139 patients (97 women and 42 men), followed closely by road traffic accidents (RTAs) involving 137 patients (103 men and 34 women). Gunshot injuries, which resulted mainly from armed robbery attacks, accounted for 127 cases. More men (113) sustained gunshot injuries than women (14). Of the 92 cases of acute intestinal obstruction seen, 62 occurred in women and 30 in men. Some 126 men presented with acute urinary retention, and two others presented with priapism. Governments at various levels should provide modern diagnostic tools for the accurate preoperative diagnosis of surgical emergencies in hospitals. Governments should also inculcate strict discipline into drivers using the highways, particularly in relation to abuse of alcohol and drugs. Good roads and adequate security should be provided for the people. The need for Pre-Hospital Care for the efficient evacuation of accident victims is emphasized. These measures will help to improve the management and outcome of surgical emergencies, and decrease the number of surgical emergencies resulting from RTAs and gunshot wounds.

  4. Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

    Science.gov (United States)

    Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

    2012-01-01

    Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

  5. Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

    Science.gov (United States)

    Harris, Sion K; Aalsma, Matthew C; Weitzman, Elissa R; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E; Santelli, John; Park, M Jane; Ozer, Elizabeth M

    2017-03-01

    We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Gender role models in fictional novels for emerging adult lesbians.

    Science.gov (United States)

    Cook, Jennifer R; Rostosky, Sharon S; Riggle, Ellen D B

    2013-01-01

    Novels provide role models for young adult lesbians and thus may influence their identity development. This study focused on 16 lesbian protagonists identified in 11 young adult novels that received 2011 Lambda Literary Award nominations. Content analyses revealed six themes. Three themes defied traditional gender stereotypes: Asserting Oneself, Pursuing Intimacy with Another Woman, and Breaking Free of Constraints to Authentic Self-Expression. Three themes reinforced gender stereotypes: Negative Emotional Experiences Associated with Lesbian Identity, Traditional Masculine Gender Expression, and Traditional Gender Role-Based Sexual Scripts. Each theme is discussed in light of its possible contribution to lesbian identity development.

  7. Double diabetes: an emerging disease in children and young adults ...

    African Journals Online (AJOL)

    However, with increasing obesity the incidence of type 2 diabetes resulting from insulin resistance was high in children and young adults. Most patients with double diabetes were established type 1 diabetics, who while on insulin and on hypercaloric diet developed obesity especially during puberty and hence associated ...

  8. Sex Differences in the Manifestation of ADHD in Emerging Adults

    Science.gov (United States)

    Fedele, David A.; Lefler, Elizabeth K.; Hartung, Cynthia M.; Canu, Will H.

    2012-01-01

    Objective: Given the mixed literature in the area, the aim of the current study was to determine whether sex differences exist in inattention, hyperactivity, and impairment in college adults with ADHD. Method: Individuals from three universities were recruited for the study. Participants with (n = 164) and without ADHD (n = 710) completed on-line…

  9. Manual for best practice for emergency response procedures, part 4: a checklist of best practice requirements for the prevention and management of inrushes, fires, explosions and other emergencies.

    CSIR Research Space (South Africa)

    Spencer, KC

    2000-02-01

    Full Text Available PRACTICE FOR EMERGENCY RESPONSE PROCEDURES PART 4 A CHECKLIST OF BEST PRACTICE REQUIREMENTS FOR THE PREVENTION AND MANAGEMENT OF INRUSHES, FIRES, EXPLOSIONS AND OTHER EMERGENCIES Authors: K C Spencer, D M Walters, T P T Page and A G du Plessis... CHECKLIST FOR BEST PRACTICES PAGE 1 Part 1 Prevention of inrushes, fires, explosions and other emergencies Ref. ISSUE Y/N/? ACTION 1 Control mechanism for administration of CoPs, procedures & standards. 2 Introduction of hazards...

  10. Surgical and Gynaecological Abdominal Emergencies in Adults: The ...

    African Journals Online (AJOL)

    Ectopic gestation is the commonest indication for emergency exploratory laparotomy in our centre and should be considered in the diagnosis of acute abdomen in females. Early elective surgery for external hernia and prompt surgical treatment of acute appendicitis may decrease the burden of intestinal obstruction and ...

  11. Assessment of hospital-based adult triage at emergency receiving ...

    African Journals Online (AJOL)

    Background: Limited health service resources must be used in a manner which does “the most for the most”. This is partly achieved through the use of a triage system. Whereas efforts have been made to introduce paediatric triage in Uganda such as Emergency Triage Assessment and Treatment Plus (ETAT+), it is not clear ...

  12. Psychological Benefits of Regular Physical Activity: Evidence from Emerging Adults

    Science.gov (United States)

    Cekin, Resul

    2015-01-01

    Emerging adulthood is a transitional stage between late adolescence and young adulthood in life-span development that requires significant changes in people's lives. Therefore, identifying protective factors for this population is crucial. This study investigated the effects of regular physical activity on self-esteem, optimism, and happiness in…

  13. The Relationship Between Child Maltreatment and Substance Abuse Treatment Outcomes Among Emerging Adults and Adolescents

    Science.gov (United States)

    Garner, Bryan R.; Hunter, Brooke D.; Smith, Douglas C.; Smith, Jane Ellen; Godley, Mark D.

    2015-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. PMID:25125233

  14. The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents.

    Science.gov (United States)

    Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D

    2014-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. © The Author(s) 2014.

  15. Are mothers' and fathers' parenting characteristics associated with emerging adults' academic engagement?

    Science.gov (United States)

    Waterman, Emily A; Lefkowitz, Eva S

    2017-06-01

    Although parenting is clearly linked to academic engagement in adolescence, less is known about links between parenting and academic engagement in emerging adulthood. A diverse sample of college students ( N = 633; 53.1% female, 45.7% White/European American, 28.3% Asian American/Hawaiian/Pacific Islander, 26.4% Hispanic/Latino American, 21.6% Black/African American, and 2.8% Native American/American Indian) answered surveys about mothers' and fathers' parenting style, parent-offspring relationship quality, academic attitudes, academic behaviors, and academic performance. Emerging adults with more permissive mothers viewed grades as less important than emerging adults with less permissive mothers. Mothers' authoritarian parenting, mothers' permissive parenting, and relationship quality with father were differentially related to academic engagement depending on emerging adults' gender. Both mothers' and fathers' parenting characteristics may impact the academic engagement of emerging adults via past parenting behaviors and current quality of the parent-offspring relationship, despite decreased physical proximity of emerging adults and their parents.

  16. Recruitment of older adults to three preventative lifestyle improvement studies.

    Science.gov (United States)

    Chatters, Robin; Newbould, Louise; Sprange, Kirsty; Hind, Daniel; Mountain, Gail; Shortland, Katy; Powell, Lauren; Gossage-Worrall, Rebecca; Chater, Tim; Keetharuth, Anju; Lee, Ellen; Woods, Bob

    2018-02-20

    Recruiting isolated older adults to clinical trials is complex, time-consuming and difficult. Previous studies have suggested querying existing databases to identify appropriate potential participants. We aim to compare recruitment techniques (general practitioner (GP) mail-outs, community engagement and clinician referrals) used in three randomised controlled trial (RCT) studies assessing the feasibility or effectiveness of two preventative interventions in isolated older adults (the Lifestyle Matters and Putting Life In Years interventions). During the three studies (the Lifestyle Matters feasibility study, the Lifestyle Matters RCT, the Putting Life In Years RCT) data were collected about how participants were recruited. The number of letters sent by GP surgeries for each study was recorded. In the Lifestyle Matters RCT, we qualitatively interviewed participants and intervention facilitators at 6 months post randomisation to seek their thoughts on the recruitment process. Referrals were planned to be the main source of recruitment in the Lifestyle Matters feasibility study, but due to a lack of engagement from district nurses, community engagement was the main source of recruitment. District nurse referrals and community engagement were also utilised in the Lifestyle Matters and Putting Life In Years RCTs; both mechanisms yielded few participants. GP mail-outs were the main source of recruitment in both the RCTs, but of those contacted, recruiting yield was low (recruited. Participants recommended that direct contact with health professionals would be the most beneficial way to recruit. Recruitment to the Lifestyle Matters RCT did not mirror recruitment to the feasibility study of the same intervention. Direct district nurse referrals were not effective at recruiting participants. The majority of participants were recruited via GP mail-outs, which may have led to isolated individuals not being recruited to the trials. Further research is required into

  17. Personality and well-being in Black and White South African emerging adults

    Directory of Open Access Journals (Sweden)

    Jan Alewyn Nel

    2016-12-01

    Full Text Available Background In the last ten years, the South African Personality Inventory (SAPI has been developed as an indigenous measurement of personality for the multi-cultural environment of South Africa. The aim of the SAPI is to assess personality in an unbiased and equivalent way. For the purpose of this study, we used an 82-item version of the SAPI which measures nine factors (Conscientiousness, Emotional Stability, Extraversion, Facilitating, Integrity, Intellect, Openness, Relationship Harmony and Soft-heartedness. Participants and procedure A cross-sectional survey was conducted using the SAPI, the General Health Questionnaire and the Brief Multidimensional Student Life Satisfaction Scale. A purposive sample was drawn from Black and White emerging adults (N = 990. We assessed the relationship between personality aspects and well-being across groups in a multiple group structural equation model (SEM using the SPSS and AMOS programs. Results Black emerging adults showed evidence of more individualistic-inclined personality features, while the White emerging adults seem to demonstrate more collectivistic features. In terms of health, the White emerging adults experience more life satisfaction than their Black counterparts. Conscientiousness, emotional stability, extraversion, facilitating and openness predict well-being among emerging adults. Conclusions This study contributes to expanding the nomological network of the SAPI, and it enhances knowledge pertaining to the link between personality and well-being of emerging adults in South Africa. Understanding which factors contribute to poor mental health and lack of life satisfaction may lead to innovation programmes for emerging adults to assist them in dealing with negative health outcomes possibly associated with living in multicultural contexts.

  18. Military-civilian cooperative emergency response to infectious disease prevention and control in China.

    Science.gov (United States)

    Ma, Hui; Dong, Ji-Ping; Zhou, Na; Pu, Wei

    2016-01-01

    In recent years, the incidence of severe infectious diseases has increased, and the number of emerging infectious diseases continues to increase. The Chinese government and military forces have paid a great deal of attention to infectious disease prevention and control, and using military-civilian cooperation, they have successfully prevented numerous severe epidemic situations, such as severe acute respiratory syndrome (SARS), influenza A (H1N1), avian influenza H5N1 and H7N9, and Ebola hemorrhagic fever, while actively maintained public health, economic development, and national construction. This paper focuses on the mechanisms of the military-cooperative emergency response to infectious diseases--the joint working mechanism, the information-sharing mechanism, the research collaboration mechanism, and the joint disposal mechanism--and presents a sorted summary of the practices and experiences of cooperative emergency responses to infectious diseases. In the future, the Chinese military and the civilian sector will further strengthen the cooperative joint command system and emergency rescue force and will reinforce their collaborative information-sharing platform and technical equipment system to further improve military-civilian collaborative emergency infectious diseases disposal, advance the level of infectious disease prevention and control, and maintain public health.

  19. Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes.

    Science.gov (United States)

    Garrow, Donald; Egede, Leonard E

    2006-01-01

    To assess the association between complementary and alternative medicine (CAM) use, preventive care practices, and use of conventional medical services among adults with diabetes. We analyzed data on 2,474 adults with diabetes. We created an overall CAM-use category based on use of any of the following: diets, herbs, chiropractic care, yoga, relaxation, acupuncture, ayuverda, biofeedback, chelation, energy healing, Reiki therapy, hypnosis, massage, naturopathy, and homeopathy. We used multiple logistic regression to assess the effect of CAM use on preventive care practices (receipt of influenza and pneumonia vaccines) and use of conventional medical services (number of primary care and emergency department visits). STATA was used for statistical analysis to account for the complex survey design. A total of 48% of adults with diabetes used some form of CAM. CAM use was independently associated with receipt of pneumonia vaccination (odds ratio 1.56 [95% CI 1.26-1.94]) but not significantly associated with receipt of influenza vaccination (1.17 [0.92-1.48]). CAM use was independently associated with visiting the emergency department (1.34 [1.06-1.70]), having six or more primary care visits (1.44 [1.14-1.83]), and having eight or more primary care visits (1.66 [1.22-2.25]). In contrast to the findings of previous studies, CAM use appears to be associated with increased likelihood of receipt of preventive care services and increased emergency department and primary care visits. CAM use may not be a barrier to use of conventional medical services in adults with diabetes.

  20. Intertemporal choice behavior in emerging adults and adults: effects of age interact with alcohol use and family history status

    Directory of Open Access Journals (Sweden)

    Christopher T. Smith

    2015-11-01

    Full Text Available Adults with alcohol use disorders (AUDs show marked immediate reward selection (or Now bias in intertemporal choice tasks. This Now bias persists long into abstinence, suggesting an irreversible consequence of chronic alcohol abuse or a pre-existing AUD intermediate phenotype. However, some data show substantial Now bias among emerging adults (18-25, regardless of drinking behavior, suggesting age-dependent effects on Now bias. The objectives of the present study were to determine 1 whether Now bias is greater among emerging adults relative to adults, 2 whether any such age effect on Now bias is diminished in sub-clinical heavy alcohol users, and 3 whether having a problem drinking first degree relative is independently associated with elevated Now bias. To achieve these objectives, we used an intertemporal choice task to quantify Now bias in n=237 healthy participants (ages 18-40; 50% female, and a wide range of non-zero alcohol use, based on the Alcohol Use Disorders Identification Test (AUDIT. We found that among non-heavy drinkers, Now bias inversely correlated with age; this relationship was not present among heavy drinkers. We found no significant relationship between AUDIT score and Now bias among emerging adults, but AUDIT scores and Now bias were positively correlated among 26-40 year olds.

  1. Suicide Prevention in an Emergency Department Population: The ED-SAFE Study.

    Science.gov (United States)

    Miller, Ivan W; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Jones, Richard; Hasegawa, Kohei; Boudreaux, Edwin D

    2017-06-01

    Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013. Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk. The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed. A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts

  2. Mosquito Surveillance for Prevention and Control of Emerging Mosquito-Borne Diseases in Portugal — 2008–2014

    Science.gov (United States)

    Osório, Hugo C.; Zé-Zé, Líbia; Amaro, Fátima; Alves, Maria J.

    2014-01-01

    Mosquito surveillance in Europe is essential for early detection of invasive species with public health importance and prevention and control of emerging pathogens. In Portugal, a vector surveillance national program—REVIVE (REde de VIgilância de VEctores)—has been operating since 2008 under the custody of Portuguese Ministry of Health. The REVIVE is responsible for the nationwide surveillance of hematophagous arthropods. Surveillance for West Nile virus (WNV) and other flaviviruses in adult mosquitoes is continuously performed. Adult mosquitoes—collected mainly with Centre for Disease Control light traps baited with CO2—and larvae were systematically collected from a wide range of habitats in 20 subregions (NUTS III). Around 500,000 mosquitoes were trapped in more than 3,000 trap nights and 3,500 positive larvae surveys, in which 24 species were recorded. The viral activity detected in mosquito populations in these years has been limited to insect specific flaviviruses (ISFs) non-pathogenic to humans. Rather than emergency response, REVIVE allows timely detection of changes in abundance and species diversity providing valuable knowledge to health authorities, which may take control measures of vector populations reducing its impact on public health. This work aims to present the REVIVE operation and to expose data regarding mosquito species composition and detected ISFs. PMID:25396768

  3. Mosquito surveillance for prevention and control of emerging mosquito-borne diseases in Portugal - 2008-2014.

    Science.gov (United States)

    Osório, Hugo C; Zé-Zé, Líbia; Amaro, Fátima; Alves, Maria J

    2014-11-12

    Mosquito surveillance in Europe is essential for early detection of invasive species with public health importance and prevention and control of emerging pathogens. In Portugal, a vector surveillance national program-REVIVE (REde de VIgilância de VEctores)-has been operating since 2008 under the custody of Portuguese Ministry of Health. The REVIVE is responsible for the nationwide surveillance of hematophagous arthropods. Surveillance for West Nile virus (WNV) and other flaviviruses in adult mosquitoes is continuously performed. Adult mosquitoes-collected mainly with Centre for Disease Control light traps baited with CO2-and larvae were systematically collected from a wide range of habitats in 20 subregions (NUTS III). Around 500,000 mosquitoes were trapped in more than 3,000 trap nights and 3,500 positive larvae surveys, in which 24 species were recorded. The viral activity detected in mosquito populations in these years has been limited to insect specific flaviviruses (ISFs) non-pathogenic to humans. Rather than emergency response, REVIVE allows timely detection of changes in abundance and species diversity providing valuable knowledge to health authorities, which may take control measures of vector populations reducing its impact on public health. This work aims to present the REVIVE operation and to expose data regarding mosquito species composition and detected ISFs.

  4. Mosquito Surveillance for Prevention and Control of Emerging Mosquito-Borne Diseases in Portugal — 2008–2014

    Directory of Open Access Journals (Sweden)

    Hugo C. Osório

    2014-11-01

    Full Text Available Mosquito surveillance in Europe is essential for early detection of invasive species with public health importance and prevention and control of emerging pathogens. In Portugal, a vector surveillance national program—REVIVE (REde de VIgilância de VEctores—has been operating since 2008 under the custody of Portuguese Ministry of Health. The REVIVE is responsible for the nationwide surveillance of hematophagous arthropods. Surveillance for West Nile virus (WNV and other flaviviruses in adult mosquitoes is continuously performed. Adult mosquitoes—collected mainly with Centre for Disease Control light traps baited with CO2—and larvae were systematically collected from a wide range of habitats in 20 subregions (NUTS III. Around 500,000 mosquitoes were trapped in more than 3,000 trap nights and 3,500 positive larvae surveys, in which 24 species were recorded. The viral activity detected in mosquito populations in these years has been limited to insect specific flaviviruses (ISFs non-pathogenic to humans. Rather than emergency response, REVIVE allows timely detection of changes in abundance and species diversity providing valuable knowledge to health authorities, which may take control measures of vector populations reducing its impact on public health. This work aims to present the REVIVE operation and to expose data regarding mosquito species composition and detected ISFs.

  5. Gender Differences in Longitudinal Links between Neighborhood Fear, Parental Support, and Depression among African American Emerging Adults

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2015-03-01

    Full Text Available The transition to adulthood is a developmental period marked by increased stress, especially among African Americans. In addition to stress related to emerging adulthood, neighborhood fear may contribute to depressive symptoms for African Americans. We examined gender differences in longitudinal associations between changes in perceived neighborhood fear, parental support, and depressive symptoms among African American youth who were in transition to adulthood. Five hundred and thirteen African American youths (235 males and 278 females were included in the study. An increase in perceived neighborhood fear was associated with an increase in depressive symptoms, and change in perceived maternal support was predictive of depressive symptoms among males, but not females. The findings suggest that policies and programs should help parents provide support to young adult children who live in violent neighborhoods as a strategy to prevent depressive symptoms during emerging adulthood.

  6. Sex Differences in Virtual Network Characteristics and Sexual Risk Behavior among Emerging Adults.

    Science.gov (United States)

    Cook, Stephanie H; Bauermeister, José A; Zimmerman, Marc A

    2016-08-01

    Emerging adults (EAs)ages 18 to 24 account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased influence of online media on decision-making, we examined how EA online networks were associated with sexual risk behaviors. We used egocentric network data collected from EAs aged 18 to 24 years old across the United States (N=1,687) to examine how online norms (e.g., acceptance of HIV infections, other STIs, and pregnancy) and network characteristics (i.e., network size and density; ties' closeness, race, age, and sex similarities) were associated with participants' unprotected vaginal intercourse (UVI) in the last 30 days. Findings suggested that in male EAs, there was a strong association between sexual norms, structural characteristics, and sexual risk behavior compared to females. Researchers and practitioners may wish to address online peer norms and EAs' online network composition when developing online sexual risk prevention tools.

  7. What are we missing? Risk behaviors among Arab-American adolescents and emerging adults.

    Science.gov (United States)

    Munro-Kramer, Michelle L; Fava, Nicole M; Saftner, Melissa A; Darling-Fisher, Cynthia S; Tate, Nutrena H; Stoddard, Sarah A; Martyn, Kristy K

    2016-09-01

    Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. ©2016 American Association of Nurse Practitioners.

  8. The COX-2 inhibitor meloxicam prevents pregnancy when administered as an emergency contraceptive to nonhuman primates.

    Science.gov (United States)

    McCann, Nicole C; Lynch, Terrie J; Kim, Soon Ok; Duffy, Diane M

    2013-12-01

    Cyclooxygenase-2 (COX-2) inhibitors reduce prostaglandin synthesis and disrupt essential reproductive processes. Ultrasound studies in women demonstrated that oral COX-2 inhibitors can delay or prevent follicle collapse associated with ovulation. The goal of this study was to determine if oral administration of a COX-2 inhibitor can inhibit reproductive function with sufficient efficacy to prevent pregnancy in primates. The COX-2 inhibitor meloxicam (or vehicle) was administered orally to proven fertile female cynomolgus macaques using one emergency contraceptive model and three monthly contraceptive models. In the emergency contraceptive model, females were bred with a proven fertile male once 2±1 days before ovulation, returned to the females' home cage, and then received 5 days of meloxicam treatment. In the monthly contraceptive models, females were co-caged for breeding with a proven fertile male for a total of 5 days beginning 2±1 days before ovulation. Animals received meloxicam treatment (1) cycle days 5-22, or (2) every day, or (3) each day of the 5-day breeding period. Female were then assessed for pregnancy. The pregnancy rate with meloxicam administration using the emergency contraception model was 6.5%, significantly lower than the pregnancy rate of 33.3% when vehicle without meloxicam was administered. Pregnancy rates with the three monthly contraceptive models (75%-100%) were not consistent with preventing pregnancy. Oral COX-2 inhibitor administration can prevent pregnancy after a single instance of breeding in primates. While meloxicam may be ineffective for regular contraception, pharmacological inhibition of COX-2 may be an effective method of emergency contraception for women. COX-2 inhibitors can interfere with ovulation, but the contraceptive efficacy of drugs of this class has not been directly tested. This study, conducted in nonhuman primates, is the first to suggest that a COX-2 inhibitor may be effective as an emergency contraceptive.

  9. Centers for Disease Control and Prevention Public Health Response to Humanitarian Emergencies, 2007-2016.

    Science.gov (United States)

    Boyd, Andrew T; Cookson, Susan T; Anderson, Mark; Bilukha, Oleg O; Brennan, Muireann; Handzel, Thomas; Hardy, Colleen; Husain, Farah; Cardozo, Barbara Lopes; Colorado, Carlos Navarro; Shahpar, Cyrus; Talley, Leisel; Toole, Michael; Gerber, Michael

    2017-12-01

    Humanitarian emergencies, including complex emergencies associated with fragile states or areas of conflict, affect millions of persons worldwide. Such emergencies threaten global health security and have complicated but predictable effects on public health. The Centers for Disease Control and Prevention (CDC) Emergency Response and Recovery Branch (ERRB) (Division of Global Health Protection, Center for Global Health) contributes to public health emergency responses by providing epidemiologic support for humanitarian health interventions. To capture the extent of this emergency response work for the past decade, we conducted a retrospective review of ERRB's responses during 2007-2016. Responses were conducted across the world and in collaboration with national and international partners. Lessons from this work include the need to develop epidemiologic tools for use in resource-limited contexts, build local capacity for response and health systems recovery, and adapt responses to changing public health threats in fragile states. Through ERRB's multisector expertise and ability to respond quickly, CDC guides humanitarian response to protect emergency-affected populations.

  10. Older adults and the emerging digital service delivery

    DEFF Research Database (Denmark)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were...... associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use...... it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability....

  11. Eosinophilic Esophagitis: an Emerging Clinicopathologic Disease of Children and Adults

    Science.gov (United States)

    Straumann, Alex

    2006-01-01

    Eosinophililc esophagitis is a clinicopathologic disease characterized clinically by dysphagia and food impaction in adults and nonspecific symptoms of gastroesophageal reflux disease in children, and histologically by large numbers of eosinophils in the proximal and distal esophageal epithelium. Importantly, these symptoms and histologic abnormalities appear to be unresponsive to proton pump inhibition. Recent clinical and basic studies suggest an allergic etiology but the precise allergen remains unknown and is likely unique for each patient. Endoscopic features suggest ongoing inflammation and range from linear furrowing with whitish exudation to long-segment stricture formation, to a fragile, crepe paper–like mucosa that is easily split open. Treatments include nutritional restrictions, medical management with topical steroids, and, in stenotic circumstances, esophageal dilation. The long-term outcome is still not certain. PMID:28289340

  12. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

    Science.gov (United States)

    Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

  13. Pregaming among Latina/o emerging adults: Do acculturation and gender matter?

    Science.gov (United States)

    Perrotte, Jessica K; Zamboanga, Byron L; Lui, P Priscilla; Piña-Watson, Brandy

    2018-01-24

    Among ethnic minority groups, Latina/o emerging adults are most likely to engage in pregaming, a risky drinking practice. This study examined how U.S. acculturation and enculturation are associated with pregaming and the extent to which gender moderates this relation in a sample of 312 Latina/o emerging adults (18 - 25 years of age). Results indicated that men consumed more alcohol when pregaming than women, but there were no gender differences in pregaming frequency. Results also showed that lower levels of U.S. acculturation were associated with greater alcohol consumption while pregaming for men, but not women. Gender did not moderate the association between acculturation and pregaming frequency. This study highlights the need to account for gender when examining sociocultural determinants of high risk drinking behaviors such as pregaming among Latina/o emerging adults.

  14. Willingness and appropriateness of peers participating in emerging adults' substance misuse treatment.

    Science.gov (United States)

    Smith, Douglas C; Cleeland, Leah; Middleton, Ashley; Godley, Mark D

    2013-07-01

    This study investigates the feasibility of adapting empirically-supported family treatments for emerging adult peer dyads. Data were collected (n=84) from emerging adults and their peers. Peers completed measures of substance use, willingness to participate in their friends' treatments, and an adapted version of the Significant Other Behavior Questionnaire (SBQ), which measures concerned significant others' (CSO) responses to another's use such a punishing, supporting, or withdrawing from the user. Peers were more likely to support sobriety or enable use, versus punishing use or withdrawing from their friends. Overall, peers were quite willing to assist in treatment, but heavily using peers were less enthusiastic. For some emerging adults, their current peers may represent untapped resources to integrate into treatment, and providing peer-enhanced treatments may expand the reach of services to non-treatment seeking populations. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Dying online: live broadcasts of Chinese emerging adult suicides and crisis response behaviors.

    Science.gov (United States)

    Ma, Jing; Zhang, Wei; Harris, Keith; Chen, Qiang; Xu, Xiaolin

    2016-08-11

    Social media and online environments are becoming increasingly popular and integral to modern lives. The online presentation of suicidal behaviors is an example of the importance of communication technologies, and the need for professionals to respond to a changing world. These types of behaviors, however, have rarely been scientifically analyzed. This study aimed to examine the behaviors of both suicide broadcasters and their audience, with attention on prevention/crisis opportunities. Multiple case studies were employed to explore live-broadcast suicide by Chinese emerging adults (aged 18-25 years). Six cases were selected (four males, two females; aged 19-24, M = 21.60, SD = 2.25), retrieved from 190 public documents (case range = 5 to 32; M = 11.50, SD = 10.37). A qualitative study based on grounded theory was adopted. Information on case background, stages, participants and their behaviors were collected. (1) Five stages of blogcast suicide incidents were revealed, including: Signaling, Initial reactions, Live blogcast of suicide attempts, Crisis responses, and Final outcomes. (2) Common behavioral trends (e.g., comforting, verbal abuse) were identified from the blogcast participants (e.g., active audience, peers, parents and police). (3) Suicide blogcasters exhibited tendencies to communicated signs of pain and cries for help. This multi-case study found live presentations of suicidal behaviors offered unique opportunities to respond to suicidal crises, and also to learn more about the relationships between suicidal people and potential help sources. Findings showed many audience members wanted to be helpful but lacked appropriate skills or knowledge. Others engaged in suicide cyberbullying. The social media is an environment in the making. This study revealed that increasing knowledge and skills for crisis response and suicide prevention is needed. Such efforts could lead to empowered netizens and a more hospitable online world.

  16. Dying online: live broadcasts of Chinese emerging adult suicides and crisis response behaviors

    Directory of Open Access Journals (Sweden)

    Jing Ma

    2016-08-01

    Full Text Available Abstract Background Social media and online environments are becoming increasingly popular and integral to modern lives. The online presentation of suicidal behaviors is an example of the importance of communication technologies, and the need for professionals to respond to a changing world. These types of behaviors, however, have rarely been scientifically analyzed. This study aimed to examine the behaviors of both suicide broadcasters and their audience, with attention on prevention/crisis opportunities. Methods Multiple case studies were employed to explore live-broadcast suicide by Chinese emerging adults (aged 18-25 years. Six cases were selected (four males, two females; aged 19-24, M = 21.60, SD = 2.25, retrieved from 190 public documents (case range = 5 to 32; M = 11.50, SD = 10.37. A qualitative study based on grounded theory was adopted. Information on case background, stages, participants and their behaviors were collected. Results (1 Five stages of blogcast suicide incidents were revealed, including: Signaling, Initial reactions, Live blogcast of suicide attempts, Crisis responses, and Final outcomes. (2 Common behavioral trends (e.g., comforting, verbal abuse were identified from the blogcast participants (e.g., active audience, peers, parents and police. (3 Suicide blogcasters exhibited tendencies to communicated signs of pain and cries for help. Conclusions This multi-case study found live presentations of suicidal behaviors offered unique opportunities to respond to suicidal crises, and also to learn more about the relationships between suicidal people and potential help sources. Findings showed many audience members wanted to be helpful but lacked appropriate skills or knowledge. Others engaged in suicide cyberbullying. The social media is an environment in the making. This study revealed that increasing knowledge and skills for crisis response and suicide prevention is needed. Such efforts could lead to

  17. Emergency department management of smoke inhalation injury in adults [digest].

    Science.gov (United States)

    Otterness, Karalynn; Ahn, Christine; Nusbaum, Jeffrey; Gupta, Nachi

    2018-03-01

    Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests. Treatment includes airway and respiratory support, lung protective ventilation, 100% oxygen or hyperbaric oxygen therapy for carbon monoxide poisoning, and hydroxocobalamin for cyanide toxicity. Due to its progressive nature, many patients with smoke inhalation injury warrant close monitoring for development of airway compromise. [Points & Pearls is a digest of Emergency Medicine Practice.].

  18. The uptake of secondary prevention by adults with intellectual and developmental disabilities.

    Science.gov (United States)

    Ouellette-Kuntz, H; Cobigo, V; Balogh, R; Wilton, A; Lunsky, Y

    2015-01-01

    Secondary prevention involves the early detection of disease while it is asymptomatic to prevent its progression. For adults with intellectual and developmental disabilities, secondary prevention is critical as they may not have the ability to recognize the early signs and symptoms of disease or lack accessible information about these. Linked administrative health and social service data were used to document uptake related to four secondary prevention guidelines among adults with intellectual and developmental disabilities. Rates were compared to those from a general population sample representing the same age ranges. Of 22% of adults with intellectual and developmental disabilities had a periodic health examination in a two-year period (compared to 26.4% of adults without intellectual and developmental disabilities). Adults with intellectual and developmental disabilities were less likely to undergo recommended age and gender-specific screening for the three types of cancer studied (colorectal, breast and cervical). Adults with intellectual and developmental disabilities in Ontario experience disparities in secondary prevention. As changes to primary care delivery and secondary prevention recommendations in the province and elsewhere continue to evolve, close monitoring of the impacts on adults with intellectual and developmental disabilities combined with dedicated efforts to increase access is warranted. © 2014 John Wiley & Sons Ltd.

  19. A comprehensive fracture prevention strategy in older adults

    DEFF Research Database (Denmark)

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

    2016-01-01

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS...... of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people....

  20. Newly Emerging Feeding Difficulties in a 33-Year-Old Adult With CHARGE Syndrome

    OpenAIRE

    Hudson, Alexandra; Blake, Kim

    2015-01-01

    Feeding and swallowing difficulties are common among individuals with CHARGE syndrome. Many children require gastrostomy tube feeding in their early years and often undergo a delay in feeding and oral-motor skill development. There is little information available on adults with CHARGE syndrome, and the feeding difficulties they face. The present case describes newly emerging mouth over-stuffing feeding behaviors and feeding difficulties in a 33-year-old adult with CHARGE syndrome who had not ...

  1. The role of romantic relationship status in pathways of risk for emerging adult alcohol use

    OpenAIRE

    Salvatore, Jessica E.; Thomas, Nathaniel S.; Cho, Seung Bin; Adkins, Amy; Kendler, Kenneth S.; Dick, Danielle M.

    2016-01-01

    Dating several people in emerging adulthood has been associated with higher alcohol use compared to being single or being in an exclusive relationship. As a follow-up to that report, we examined whether romantic relationship status is part of a pathway of risk between antecedent alcohol use risk factors and subsequent alcohol outcomes. Participants were 4,410 emerging adults assessed at two time-points during their first year of college. We found that a parental history of alcohol problems wa...

  2. Financial Policies and the Prevention of Financial Crises in Emerging Market Countries

    OpenAIRE

    Frederic S. Mishkin

    2001-01-01

    This paper outlines a set of financial policies that can help make financial crises less likely in emerging market countries. To justify these policies, the paper first explains what a financial crisis is, the factors that promote a financial crisis and the dynamics of a financial crisis. It then examines twelve basic areas of financial policies to prevent financial crises: 1) prudential supervision, 2) accounting and disclosure requirements, 3) legal and judicial systems, 4) market-based dis...

  3. Prevention of urinary tract infections by antibiotic cycling in spinal cord injury patients and low emergence of multidrug resistant bacteria.

    Science.gov (United States)

    Poirier, C; Dinh, A; Salomon, J; Grall, N; Andremont, A; Bernard, L

    2016-09-01

    Urinary tract infections (UTIs) are a major recurrent problem for spinal cord injury (SCI) patients. Repeated antibiotic treatments contribute to the emergence of multidrug-resistant bacteria (MDRB). We evaluated the use of weekly oral cycling antibiotics (WOCA) in the prevention of UTIs over a mean follow-up period of 53 months (median follow-up period: 57 months) and analyzed the risk of MDRB emergence. We conducted a cross-sectional study of adult SCI patients with neurogenic bladder who were receiving the WOCA regimen. We included 50 patients, mainly men (60%), with a mean age of 51±13.5 years. Overall, 66% of patients had been paraplegic or tetraplegic for 19.4±14.3 years; 92% underwent intermittent catheterization; and 36% had no postvoid residual. The number of febrile and non-febrile UTIs significantly reduced after WOCA initiation (9.45 non-febrile UTIs before WOCA initiation vs. 1.57 after; 2.25 febrile UTIs before WOCA initiation vs. 0.18 after; P=0.0001). Only one adverse event was reported during the follow-up period. The number of MDRB-colonized patients decreased from 9/50 to 4/50 during the follow-up period. WOCA is an effective and safe strategy to prevent UTIs in SCI patients with neurogenic bladder. WOCA does not lead to the emergence of MDRB resistance and even seems to reduce MDRB carriage. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan.

    Science.gov (United States)

    Yen, Suh-May; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen

    2014-06-12

    This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services. Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services.

  5. Beyond treatment effects: predicting emerging adult alcohol and marijuana use among substance-abusing delinquents.

    Science.gov (United States)

    Clingempeel, W Glenn; Henggeler, Scott W; Pickrel, Susan G; Brondino, Michael J; Randall, Jeff

    2005-10-01

    Secondary analyses of a randomized clinical trial examined the effects of 4 putative risk factors and 2 protective factors in predicting drug use among 80 emerging adults treated 5 years earlier for delinquency and alcohol and/or marijuana use disorders. Frequency of marijuana use and the number of comorbid psychiatric disorders in adolescence predicted cannabis use in emerging adulthood. Increasing academic competence at high levels of social competence predicted less marijuana use. At emerging adulthood, greater use of alcohol and marijuana were associated with both criminality and psychopathology.

  6. Organizing your practice for screening and secondary prevention among adults.

    Science.gov (United States)

    Knierim, Kyle E; Fernald, Douglas H; Staton, Elizabeth W; Nease, Donald E

    2014-06-01

    Prevention plays an important role in achieving the triple aim of decreasing per capita health care costs, improving the health of populations, and bettering the patient experience. Primary care is uniquely positioned to provide preventive services. External forces are aligning to support the transition of primary care from traditional models focused on disease-specific, acute episodes of care to new ways of organizing that are more patient centered, team based, and quality driven. By aligning leadership, building change capacity, and selectively choosing relevant processes to change, those practicing primary care can successfully organize their practice environment to deliver preventive services. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Key considerations for preventing suicide in older adults: consensus opinions of an expert panel

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Nordentoft, Merete; Conwell, Yeates

    2011-01-01

    The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide....

  8. How Can Older Adults Prevent Falls? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... on. Feature: Falls and Older Adults How Can Older Adults Prevent Falls? Past Issues / Winter 2014 Table of Contents Falls are not inevitable, even as we age. But a trip on a rug or slip on a wet floor ... a bone. For older people, breaks can lead to more serious problems. ...

  9. Are Older Adults Receiving Evidence-Based Advice to Prevent Falls Post-Discharge from Hospital?

    Science.gov (United States)

    Lee, Den-Ching A.; Brown, Ted; Stolwyk, Rene; O'Connor, Daniel W.; Haines, Terry P.

    2016-01-01

    Background: Older adults experience a high rate of falls when they transition to community-living following discharge from hospital. Objectives: To describe the proportion of older adults who could recall having discussed falls and falls prevention strategies with a health professional within 6 months following discharge from hospital. To describe…

  10. Outcomes of an HIV Prevention Peer Group Intervention for Rural Adults in Malawi

    Science.gov (United States)

    Kaponda, Chrissie P. N.; Norr, Kathleen F.; Crittenden, Kathleen S.; Norr, James L.; McCreary, Linda L.; Kachingwe, Sitingawawo I.; Mbeba, Mary M.; Jere, Diana L. N.; Dancy, Barbara L.

    2011-01-01

    This study used a quasi-experimental design to evaluate a six-session peer group intervention for HIV prevention among rural adults in Malawi. Two rural districts were randomly assigned to intervention and control conditions. Independent random samples of community adults compared the districts at baseline and at 6 and 18 months postintervention.…

  11. Preventing interpersonal violence in emergency departments: practical applications of criminology theory.

    Science.gov (United States)

    Henson, Billy

    2010-01-01

    Over the past two decades, rates of violence in the workplace have grown significantly. Such growth has been more prevalent in some fields than others, however. Research shows that rates of violence against healthcare workers are continuously among the highest of any career field. Within the healthcare field, the overwhelming majority of victims of workplace violence are hospital employees, with those working in emergency departments (EDs) experiencing the lion's share of violent victimization. Though this fact is well-known by medical researchers and practitioners, it has received relatively little attention from criminal justice researchers or practitioners. Unfortunately, this oversight has severely limited the use of effective crime prevention techniques in hospital EDs. The goal of this analysis is to utilize techniques of situational crime prevention to develop an effective and easily applicable crime prevention strategy for hospital EDs.

  12. Factors associated with preventive care practice among adults with diabetes.

    Science.gov (United States)

    Yuen, Hon K

    2012-04-01

    Adherence to annual preventive care (foot, eye, and dental examinations) in this group of study participants with diabetes (n=253) was suboptimal. Participants were 2.6-5.8 times more likely to have a specific preventive care in the past 12 months if they were told to do so by a health care professional. Copyright © 2011 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  13. Religiosity, Discrimination, and Community Engagement: Gendered Pathways of Muslim American Emerging Adults

    Science.gov (United States)

    Sirin, Selcuk R.; Katsiaficas, Dalal

    2011-01-01

    The attacks on September 11, 2001, changed the lives of all Americans. For many immigrant Muslims in the United States this meant dealing with an elevated amount of discrimination. This study investigated how perceived discrimination influenced levels of community engagement among Muslim American emerging adults and whether it varied by gender.…

  14. Perceived Parental Relationships and Health-Risk Behaviors in College-Attending Emerging Adults

    Science.gov (United States)

    Schwartz, Seth J.; Zamboanga, Byron L.; Ravert, Russell D.; Kim, Su Yeong; Weisskirch, Robert S.; Williams, Michelle K.; Bersamin, Melina; Finley, Gordon E.

    2009-01-01

    The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of…

  15. Exploring Dual Identification among Muslim-American Emerging Adults: A Mixed Methods Study

    Science.gov (United States)

    Sirin, Selcuk R.; Bikmen, Nida; Mir, Madeeha; Fine, Michelle; Zaal, Mayida; Katsiaficas, Dalal

    2008-01-01

    This mixed methods study explored dual identification among Muslim-American emerging adults of immigrant origin. A closer look was taken at the relationship between American and Muslim identifications and how this relationship was influenced by experiences of discrimination, acculturative and religious practices, and whether it varied by gender.…

  16. Career Pursuit Pathways among Emerging Adult Men and Women: Psychosocial Correlates and Precursors

    Science.gov (United States)

    Shulman, Shmuel; Barr, Tamuz; Livneh, Yaara; Nurmi, Jari-Erik; Vasalampi, Kati; Pratt, Michael

    2015-01-01

    The present study examined career pursuit pathways in 100 Israeli emerging adults (54 men) who were followed from age 22 to 29. Employing a semi-structured interview at the age of 29, participants were asked about current work and educational status, work and educational goals and status changes in recent years, and to reflect on the meaning of…

  17. Sexting and Sexuality in Romantic Relationships among Latina/o Emerging Adults

    Science.gov (United States)

    Castañeda, Donna Marie

    2017-01-01

    In a sample of 114 Latina/o emerging adults, ages 18 to 29, this study investigated the frequency of sexting, and gender differences in this behavior, and if sexting was related to a range of sexuality variables, including sexual satisfaction, sexual experience, sexual pleasure, and sexual permissiveness. Results show that a total of 63 (55.26%)…

  18. Perspectives on Adult Education, Human Resource Development, and the Emergence of Workforce Development

    Science.gov (United States)

    Jacobs, Ronald L.

    2014-01-01

    This article presents a perspective on the relationship between adult education and human resource development of the past two decades and the subsequent emergence of workforce development. The lesson taken from the article should be more than simply a recounting of events related to these fields of study. Instead, the more general lesson may be…

  19. Emerging Adults' Stress and Health: The Role of Parent Behaviors and Cognitions

    Science.gov (United States)

    Donnelly, Reesa; Renk, Kimberly; McKinney, Cliff

    2013-01-01

    Although parent behaviors and cognitions are important for stress/health outcomes throughout development, little research examines whether cognitions mediate the relationship between parent behaviors and stress/health outcomes. As a result, the current study examined the reports of 160 emerging adults regarding their mothers' and fathers'…

  20. Self-Presentation and Interaction in Blogs of Adolescents and Young Emerging Adults

    Science.gov (United States)

    Mazur, Elizabeth; Kozarian, Lauri

    2010-01-01

    This article analyzed 124 blogs, chronological, journal-type entries published on public hosting Web sites, as new and popular places for adolescents and emerging adults aged 15 to 19 to play openly with their self-presentation, an important aspect of identity exploration. Findings indicate that most young persons write emotionally toned entries;…

  1. Identity configurations across love and work in emerging adults in romantic relationships

    NARCIS (Netherlands)

    Luyckx, Koen; Seiffge-Krenke, Inge; Schwartz, Seth J.; Crocetti, Elisabetta; Klimstra, Theo A.

    2014-01-01

    Love and work constitute two life-defining identity domains for emerging adults. The present study utilized a five-dimensional identity model and examined identity configurations across these two domains, capturing the degree to which identity statuses correspond across domains. A sample of German

  2. Mental Health Literacy in Emerging Adults in a University Setting: Distinctions between Symptom Awareness and Appraisal

    Science.gov (United States)

    Gagnon, Michelle M.; Gelinas, Bethany L.; Friesen, Lindsay N.

    2017-01-01

    Despite the high prevalence of mental health concerns in university populations, students are unlikely to seek formal help. The current study examined help-seeking behaviors among emerging adults in a university setting using a mental health literacy framework. Responses from 122 university undergraduates were examined. Students ranged in age from…

  3. Associations between Online Friendship and Internet Addiction among Adolescents and Emerging Adults

    Science.gov (United States)

    Smahel, David; Brown, B. Bradford; Blinka, Lukas

    2012-01-01

    The past decades have witnessed a dramatic increase in the number of youths using the Internet, especially for communicating with peers. Online activity can widen and strengthen the social networks of adolescents and emerging adults (Subrahmanyam & Smahel, 2011), but it also increases the risk of Internet addiction. Using a framework derived from…

  4. Medication errors in the adult emergency unit of a tertiary care teaching hospital in Addis Ababa

    Directory of Open Access Journals (Sweden)

    Gediwon Negash

    2013-01-01

    Conclusion: Incidence and types of medication errors committed in Tikur Anbesa Specialized Hospital Adult Emergency Unit were substantiated; moreover, necessary information on factors within the healthcare delivery system that predispose healthcare professionals to commit errors have been pointed, which should be addressed by healthcare professionals through multidisciplinary efforts and involvement of decision makers at national level.

  5. Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

    Science.gov (United States)

    Blackmer, Rachel; Hayes-Harb, Rachel

    2016-01-01

    We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

  6. Parenting styles and emerging adult drug use in Cebu, the Philippines.

    Science.gov (United States)

    Hock, Rebecca S; Hindin, Michelle J; Bass, Judith K; Surkan, Pamela J; Bradshaw, Catherine P; Mendelson, Tamar

    Parenting style is a potent and malleable influence on emerging adult substance use. Most of the parenting-substance use literature has been conducted in Western populations and it is unknown whether findings are generalizable to other cultures and contexts. We extended the parenting-substance use literature to a cohort of emerging adults in the Philippines using the Cebu Longitudinal Health and Nutrition Survey. We assessed associations between mothers' and fathers' parenting styles (authoritative, permissive, authoritarian, and neglectful) reported by offspring at age 18 and odds of offspring-reported drug use three years later, adjusted for a range of offspring- and parent/household-level characteristics. Females were dropped from analyses due to low prevalence of drug users. We found that many emerging adults in Cebu reported having used drugs, particularly methamphetamine-a dangerous drug with high abuse potential. Authoritative (warm, firm) mothering was significantly associated with sons' reduced odds of drug use and neglectful fathering was related at a trend level with sons' increased odds of having tried drugs. Findings underscore the relation of parenting styles to emerging adults' drug use and add to the literature on cross-cultural variability in parenting styles.

  7. How Private Is the Relation with God? Religiosity and Family Religious Socialization in Romanian Emerging Adults

    Science.gov (United States)

    Negru, Oana; Haragâs, Cosmina; Mustea, Anca

    2014-01-01

    This qualitative study explores the dynamics of religious cognitions, behaviors, and emotions in emerging adult discourse in a sample of Romanian youth of heterogeneous socioeconomic, denominational (Orthodox Christian, Roman Catholic, Neo-protestant), and educational background. Also, from a parent-child dyad perspective, we investigate the role…

  8. Subjective Social Status and Positive Indicators of Well-Being among Emerging Adult College Students

    Science.gov (United States)

    Zorotovich, Jennifer; Johnson, Elizabeth I.; Linn, Rebekah

    2016-01-01

    The current study extends research on social status and well-being among young people by examining whether subjective social status (SSS) is related to life satisfaction and happiness. Emerging adults (n = 383) between 18 and 29 provided data on demographic characteristics, SSS, life satisfaction, and happiness via an online survey. Regression…

  9. Cell Phone Use While Driving: Prospective Association with Emerging Adult Use.

    Science.gov (United States)

    Trivedi, Neha; Haynie, Denise; Bible, Joe; Liu, Danping; Simons-Morton, Bruce

    2017-09-01

    Secondary task engagement such as cell phone use while driving is a common behavior among adolescents and emerging adults. Texting and other distracting cell phone use in this population contributes to the high rate of fatal car crashes. Peer engagement in similar risky driving behaviors, such as texting, could socially influence driver phone use behavior. The present study investigates the prospective association between peer and emerging adult texting while driving the first year after high school. Surveys were conducted with a national sample of emerging adults and their nominated peers. Binomial logistic regression analyses, adjusting for gender, race/ethnicity, parental education, and family affluence, showed that participants (n=212) with peers (n=675) who reported frequently texting while driving, were significantly more likely to text while driving the following year (odds ratio, 3.01; 95% CI, 1.19-7.59; P=0.05). The findings are consistent with the idea that peer texting behavior influences the prevalence of texting while driving among emerging adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Effects of MON810 Bt field corn on adult emergence of Helicoverpa zea (Lepidoptera: Noctuidae).

    Science.gov (United States)

    Horner, T A; Dively, G P; Herbert, D A

    2003-06-01

    A 3-yr study (1996-1998) was conducted to evaluate the effects of MON810 Bt corn on Helicoverpa zea (Boddie) emergence and to determine whether delayed larval development as a result of Bt intoxication results in higher levels of diapause induction and pupal mortality. In the 1997 study, there was no difference in prepupal mortality between corn types, although significantly more prepupae from Bt plots than from non-Bt plots died in emergence buckets before constructing pupal chambers in 1998. In all years, significantly fewer moths emerged from prepupae collected from Bt plots, suggesting that effects of the expressed Cry1Ab extended to the prepupal and pupal stages. Late plantings of corn showed the greatest reductions in moth emergence from Bt corn because environmental conditions were more conducive to trigger diapause at the time H. zea was developing in these plantings. This was supported by a significantly greater proportion of diapausing pupae remaining in the ground in the late plantings of both Bt and non-Bt corn. For April and early May plantings, larval feeding on Bt corn delayed the time to pupation, although there was no significant difference in moth emergence between corn types for those larvae that successfully pupated. Although Bt expression had less impact on the proportion of moths emerging, the actual number of moths emerging from Bt corn was significantly reduced because fewer larvae reached pupation. Delays in adult emergence, along with significant reductions in adult emergence from MON810 Bt corn, should reduce the rates of colonization in soybean and other late host crops but may also result in asynchrony of mating between individuals emerging from Bt and non-Bt corn. This, in turn, may contribute to the evolution of resistance to Bt corn.

  11. Young Adults in the Workplace: A Multisite Initiative of Substance Use Prevention Programs. RTI Press Book

    Science.gov (United States)

    Bray, Jeremy W., Ed.; Galvin, Deborah M., Ed.; Cluff, Laurie A., Ed.

    2011-01-01

    Although higher rates of substance use among young adults aged 16 to 24 are well-established (OAS, 2010), existing workplace substance use prevention and early intervention programs primarily target older workers. These data suggest that workplaces need substance abuse prevention and early intervention programs that are proven to be efficacious…

  12. Relations with parents and identity statuses in the relational domain in emerging adults

    Directory of Open Access Journals (Sweden)

    Justyna Michałek

    2016-09-01

    Full Text Available Background Emerging adulthood is a core developmental period in which individuals can develop a meaningful identity in the relational domain (with a romantic partner. The aim of the study was to examine relationships between relations with parents and identity statuses in the relational domain in emerging adults. Participants and procedure Participants were 266 (47.30% males emerging adults (M = 22.50, SD = 1.73. They completed self-report measures of relations with parents and identity. Results More than half of the participants were in the moratorium status or were not involved in a romantic relationship (35% and 29%, respectively. Relations with parents were linked to identity statuses in the relational domain. Particularly, the perception of low autonomy given by the father was related to less mature identity statuses. Conclusions This study highlighted that transition from singleness to stable partnerships seems to be challenging. Therefore, it is important to examine correlates of identity statuses in this domain.

  13. Qualitative analysis of emergency department reports applied to a pilot project for the prevention of pediatric burns.

    Science.gov (United States)

    Longo, E; Masellis, M; Fondi, G; Cedri, C; Debbia, C; Pitidis, A

    2015-12-31

    Accidents and burns are a major problem in Italy and in industrialized countries, due to the consequences they have on health, especially in children aged 0-4 years. In Italy, about 400 people die each year from burns, with over 70% of these occurring in the home. In the European Union, burns are one of the top five causes of death from accidents, accounting for 3% of all deaths from accidents and violence in those age groups. One percent of all deaths in children are due to burns. In this paper, we illustrate the results of qualitative analysis, conducted according to the methodology of content analysis, on narratives included in the anamnesis of clinical papers at the ED in 738 cases of burns in children (0-14 years) observed in a sample of Emergency Departments in the years 2005-2009. The results of content analysis show that the most frequent mechanism that leads to burns is contact with hot liquids and heating surfaces. Much of preventive action should be directed at controlling the child. The accidental event descriptions for the younger age group (0-4 years) reveal an unequivocal responsibility of the parents. The qualitative analysis of narratives was carried out to produce scientific evidence to identify the more frequent and severe burn accidents for specific target/age groups and to establish specific preventive measures. The study of qualitative analysis of burns observed at the ED was introductory to the pilot project PRIUS (Preventing burns among school-aged children). The objective of PRIUS is to increase awareness of the risks of burns in children and adults through a learning path tailored towards their prevention, and the promotion of appropriate standards of personal safe behaviour and first aid actions.

  14. Knowledge of Emergency Medicine Residents in Relation to Prevention of Tetanus

    Directory of Open Access Journals (Sweden)

    Hojjat Derakhshanfar

    2014-03-01

    Full Text Available Introduction: Knowledge of emergency medicine residents about the management of patients suspected of having tetanus favoring wounds is very important due to their responsibility for the treatment of such patients. The aim of the present study was to evaluate this knowledge and making sure of the adequacy of instructions they have received in relation to prevention of tetanus.  Methods: A reliable and reproducible questionnaire was used to evaluate knowledge of all the emergency medicine residents in Imam Hussein Hospital in Tehran, Iran, about conditions favoring tetanus (9 questions and proper interventions in such conditions (12 questions. The questionnaires were completed and scored as poor and good. The Mann-Whitney U test was used to analyze data. Statistical significance was set at P<0.05. Results: In the present study, 73 emergency medicine residents were evaluated (45.2% male. Knowledge of 31 (42.5% residents in relation to conditions favoring tetanus and 41 (56.2% residents in correct therapeutic interventions was in good level. The most frequent incorrect answer was related to diabetic ulcers and wounds in patients with sepsis. There was an increase in scores of conditions favoring tetanus (P<0.001 and correct therapeutic interventions (P=0.001 with an increase in educational years. However, age (P=0.64, gender (P=0.31, job experience (P=0.38 and participation in educational courses (P=0.67 had no effect on the knowledge level of emergency medicine residents. Conclusion: According to the findings of the present study, the knowledge of emergency medicine residents about correct management of patients suspected of tetanus was low, which emphasizes the necessity of providing further instructions on prevention of tetanus in wound management. 

  15. Efficacy of a new spot-on formulation of selamectin plus sarolaner for cats against adult Ctenocephalides felis, flea egg production and adult flea emergence.

    Science.gov (United States)

    Vatta, Adriano F; Everett, William R; Holzmer, Susan J; Cherni, Judith A; King, Vickie L; Rugg, Douglas; Geurden, Thomas

    2017-04-01

    A new spot-on formulation of selamectin plus sarolaner was evaluated against fleas for adulticidal efficacy, and for the effect on egg production and hatching when applied to flea-infested cats. Ten male and ten female adult domestic shorthair cats were randomly assigned to one of two treatment groups based on pre-treatment flea counts. Cats received topical treatment on Day 0 in a single spot to the dorsal scapular area with either a placebo formulation or with the combination formulation at the minimal dose of 6.0mg selamectin plus 1.0mg sarolaner per kg bodyweight. On Days -1, 5, 12, 19, 26 and 33, cats were infested with approximately 100 (±5) unfed Ctenocephalides felis fleas. At 24h after treatment or 48h after subsequent flea infestation, cats were housed for a 20-h period in a cage to allow collection of flea eggs. At the end of this period, flea eggs were collected from the cages and cats were combed to remove and count live fleas. Emerged viable larvae and emerged adult fleas were counted 3days and 35days, respectively, after egg collection. The new spot-on formulation of selamectin plus sarolaner provided 100% efficacy against adult fleas up to Day 36 following a single application. Fleas on placebo-treated cats produced large numbers of eggs throughout the study, with individual counts ranging from 110 to 1256 eggs. Following treatment, four flea eggs were collected from a single selamectin/sarolaner-treated cat on Day 29, but there were no eggs collected from any other selamectin/sarolaner-treated animal during the study. No larvae or adult fleas developed from these four eggs. From the eggs collected from the placebo-treated cats, the mean percentage of live larvae and adults that emerged ranged from 67.3% to 84.2% and from 50.7% to 81.8%, respectively. A single topical treatment with a new spot-on formulation of selamectin plus sarolaner at the minimum label dose thus controlled fleas on cats and was 100% effective in preventing flea reproduction

  16. A Comprehensive Fracture Prevention Strategy in Older Adults

    DEFF Research Database (Denmark)

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

    2016-01-01

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS......), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its...

  17. Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003-2010.

    Science.gov (United States)

    Shankar, Kalpana N; Liu, Shan W; Ganz, David A

    2017-08-01

    One third of older adults fall each year, and falls are costly to both the patient in terms of morbidity and mortality and to the health system. Given that falls are a preventable cause of injury, our objective was to understand the characteristics and trends of emergency department (ED) fall-related visits among older adults. We hypothesize that falls among older adults are increasing and examine potential factors associated with this rise, such as race, ethnicity, gender, insurance and geography. We conducted a secondary analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine fall trends over time by examining changes in ED visit rates for falls in the United States between 2003 and 2010, detailing differences by gender, sociodemographic characteristics and geographic region. Between 2003 and 2010, the visit rate for falls and fall-related injuries among people age ≥ 65 increased from 60.4 (95% confidence interval [CI][51.9-68.8]) to 68.8 (95% CI [57.8-79.8]) per 1,000 population (p=0.03 for annual trend). Among subgroups, visits by patients aged 75-84 years increased from 56.2 to 82.1 per 1,000 (P falls are increasing over time. There is a national movement to increase falls awareness and prevention. EDs are in a unique position to engage patients on future fall prevention and should consider ways they can also partake in such initiatives in a manner that is feasible and appropriate for the ED setting.

  18. Educating and Engaging Older Adults in the Sure Steps® Fall Prevention Program.

    Science.gov (United States)

    Ciance, Karin L

    Falls are the leading cause of fatal and nonfatal injuries among adults 65 years and older. Each year, one in three older adults experiences a fall, and people who fall are more likely to fall again. According to the National Council on Aging (2017), instituting evidence-based falls prevention programs can significantly decrease falls. The purpose of this article is to describe a pilot study that examined the impact of the Sure Steps Fall Prevention Program on incidence of falls among adults 65 and older living in their home. A convenience sample of 10 community-dwelling participants aged 65 and older was recruited. After the Sure Steps Fall Prevention Program was implemented, participants were contacted by telephone monthly for 1 year. None of the participants reported falls during that time. Based on the findings of this pilot study, the Visiting Nurse Association implemented the Sure Steps Fall Prevention Program into their other four clinical sites.

  19. Community-Dwelling Older Adults' Adherence to Environmental Fall Prevention Recommendations.

    Science.gov (United States)

    Taylor, Suzänne F; Coogle, Constance L; Cotter, James J; Welleford, E Ayn; Copolillo, Al

    2017-08-01

    This study examined the impact of personalized versus generalized education about environmental fall prevention recommendations on older adults' adherence with recommendations. Secondary aims focused on the impact of recent falls and perceived susceptibility of future falls on adherence with recommendations. Twenty-four community-dwelling older adults aged 65 to 89 years were randomized into two groups to receive either personalized or generalized education intervention on environmental fall prevention recommendations. A significant difference was found in the mean total percentage of adherence with recommendations of those receiving personalized education (69%) compared with those receiving generalized education (37%). No statistically significant relationship was found between sustaining recent falls, nor perceived susceptibility to future falls, and their extent of adherence with environmental fall prevention recommendations. Providing personalized education for environmental fall prevention recommendations may improve older adults' adherence with the recommendations given.

  20. Management and educational status of adult anaphylaxis patients at emergency department.

    Science.gov (United States)

    Kim, Mi-Yeong; Park, Chan Sun; Jeong, Jae-Won

    2017-12-28

    We evaluated the management and educational status of adult anaphylaxis patients at emergency departments (EDs). Anaphylaxis patients who visited ED from 2011 to 2013 were enrolled from three hospitals. We analyzed clinical features, prior history of anaphylaxis, management and provided education for etiology and/or prevention. For analyzing associated factors with epinephrine injection, Pearson chi-square test was used by SPSS version 21 (IBM Co.). A total of 194 anaphylaxis patients were enrolled. Ninety-nine patients (51%) visited ED by themselves. Time interval from symptom onset to ED visit was 62 ± 70.5 minutes. Drug (56.2%) was the most frequent cause of anaphylaxis. Forty-seven patients (24.2%) had prior history of anaphylaxis and 33 patients had same suspicious cause with current anaphylaxis. Cutaneous (88.7%) and respiratory (72.7%) symptoms were frequent. Hypotension was presented in 114 patients (58.8%). Mean observation time in ED was 12 ± 25.7 hours and epinephrine was injected in 114 patients (62%). In 68 patients, epinephrine was injected intramuscularly with mean dose of 0.3 ± 0.10 mg. Associated factor with epinephrine injection was hypotension (p = 0.000). Twenty-three patients (13%) were educated about avoidance of suspicious agent. Epinephrine auto-injectors were prescribed only in five patients. Only 34 (19%) and 72 (40%) patients were consulted to allergist at ED and outpatient allergy department respectively. We suggested that management and education of anaphylaxis were not fully carried out in ED. An education and promotion program on anaphylaxis is needed for medical staff.

  1. "You're Always First a Girl": Emerging Adult Women, Gender, and Sexuality in the Israeli Army

    Science.gov (United States)

    Levin, Dana S.

    2011-01-01

    The Israeli army drafts both men and women, and most Israelis complete their military service during their emerging adulthood years. This study examined Israeli women's experiences as soldiers in the army. Twenty-three women (18 emerging adults, 5 young adults) were recruited using purposive sampling and interviewed about how they experienced…

  2. Do I Really Need Someone in Order to become an Adult?: Romantic Relationships during Emerging Adulthood in Italy

    Science.gov (United States)

    Lanz, Margherita; Tagliabue, Semira

    2007-01-01

    Italian emerging adults stay at home with their parents until they marry. Being involved in a romantic relationship may be considered one precursor of the success of the transition to adulthood. In this study, 92 dating and 84 nondating emerging adults were compared on when they left the parental home and their future plans. They were also…

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

    African Journals Online (AJOL)

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

  4. A Prospective Study of Adolescents' Sexual Partnerships on Emerging Adults' Relationship Satisfaction and Intimate Partner Aggression.

    Science.gov (United States)

    Longmore, Monica A; Manning, Wendy D; Copp, Jennifer E; Giordano, Peggy C

    2016-12-01

    We examined whether the influence of adolescents' sexual partnerships, both dating and casual, carried over to affect emerging adults' relationship satisfaction and experiences of intimate partner aggression. Analyses of longitudinal data from the Toledo Adolescent Relationships Study (n = 294) showed that net of control variables (delinquency, depression, family violence, relational and sociodemographic characteristics), adolescents' number of dating, but not casual, sexual partners led to greater odds of intimate partner aggression during emerging adulthood. Further, relationship churning (breaking-up and getting back together) and sexual non-exclusivity during emerging adulthood mediated the influence of adolescents' number of dating sexual partnerships on intimate partner aggression. The positive effect of dating sexual partnerships on intimate partner aggression was stronger for women compared with men. These findings confirm the long reach of adolescent experiences into emerging adulthood.

  5. Better Strength, Better Balance! Partnering to deliver a fall prevention program for older adults.

    Science.gov (United States)

    Taing, Darcie; McKay, Kelly

    2017-09-14

    Falls incur significant health and economic costs, particularly among older adults. Physical activity has been found to be the single most important fall prevention behaviour an older adult can do. This manuscript describes Ottawa Public Health's (OPH) experience implementing the Better Strength, Better Balance! (BSBB) program, a fall prevention exercise program for older adults, through an innovative partnership with the local Recreation, Cultural & Facility Services (RCFS) Department. BSBB aims to reach 1300 community-dwelling adults (aged 65 years and older) per year through approximately 86-130 exercise programs. Designed as a universal program, BSBB addresses participation barriers such as transportation, cost and location. BSBB was enabled with funding from the Champlain Local Health Integration Network, and coincided with the implementation of an Older Adult Plan for the City of Ottawa. BSBB is a beginner-level, fall prevention exercise and education program that takes place twice a week, over 12 weeks. Certified RCFS instructors delivered the exercise components of the program and OPH staff incorporated fall prevention messaging and conducted the evaluation. The formative evaluation indicated that participants experienced improved strength and balance, decreased fear of falling and the intent to adopt new fall prevention behaviours following the program. The partnership between OPH and RCFS allowed both partners to leverage their unique and mutual strengths to continually improve the program. Improving access to strength and balance programming is an important public health strategy to reduce falls. The recreation sector is an ideal partner to help public health in this pursuit.

  6. Preventive dental care among Medicaid-enrolled senior adults: from community to nursing facility residence.

    Science.gov (United States)

    Kelly, Mary C; Caplan, Daniel J; Bern-Klug, Mercedes; Cowen, Howard J; Cunningham-Ford, Marsha A; Marchini, Leonardo; Momany, Elizabeth T

    2018-12-01

    The primary objective of this study was to determine whether the utilization rate of preventive oral health care services while senior adults were community-dwelling differed from the rate after those same senior adults were admitted to nursing facilities. A secondary objective was to evaluate other significant predictors of receipt of preventive oral health procedures after nursing facility entry. Iowa Medicaid claims from 2007-2014 were accessed for adults who were 68+ years upon entry to a nursing facility and continuously enrolled in Medicaid for at least three years before and at least two years after admission (n = 874). Univariate, bivariate and multivariable analyses were conducted. During the five years that subjects were followed, 52.8% never received a dental exam and 75.9% never received a dental hygiene procedure. More Medicaid-enrolled senior adults received ≥1 preventive dental procedure in the two years while residing in a nursing facility compared to the three years before entry. In multivariable analyses, the strongest predictor of preventive oral health care utilization after entry was the receipt of preventive oral health services before entry (p senior adult establishing a source of dental care while community-dwelling. © 2017 American Association of Public Health Dentistry.

  7. Lethal means restriction for suicide prevention: beliefs and behaviors of emergency department providers.

    Science.gov (United States)

    Betz, Marian E; Miller, Matthew; Barber, Catherine; Miller, Ivan; Sullivan, Ashley F; Camargo, Carlos A; Boudreaux, Edwin D

    2013-10-01

    We sought to examine the beliefs and behaviors of emergency department (ED) providers related to preventing suicide by reducing suicidal patients' access to lethal methods (means restriction) and identify characteristics associated with asking patients about firearm access. Physicians and nurses at eight EDs completed a confidential, voluntary survey. The response rate was 79% (n = 631); 57% of respondents were females and 49% were nurses. Less than half believed, "most" or "all" suicides are preventable. More nurses (67%) than physicians (44%) thought "most" or "all" firearm suicide decedents would have died by another method had a firearm been unavailable (P suicidal patients about firearm access varied across five patient scenarios: suicidal with firearm suicide plan (64%), suicidal with no suicide plan (22%), suicidal with nonfirearm plan (21%), suicidal in past month but not today (16%), and overdosed but no longer suicidal (9%). In multivariable logistic regression, physicians were more likely than nurses to "almost always" or "often" ask about a firearm across all five scenarios, as were older providers and those who believed their own provider type was responsible for assessing firearm access. Many ED providers are skeptical about the preventability of suicide and the effectiveness of means restriction, and most do not assess suicidal patients' firearm access except when a patient has a firearm suicide plan. These findings suggest the need for targeted staff education concerning means restriction for suicide prevention. © 2013 Wiley Periodicals, Inc.

  8. Designing an Internet Intervention for Emerging Adults Who Experience Troubled Relationships.

    Science.gov (United States)

    Draucker, Claire Burke; Martsolf, Donna S; Crane, Stacey; Romero, Lindsey; McCord, Allison Leigh

    2017-06-01

    This article describes how the Internet Intervention Model (IIM) was used as an organizing framework to design a theoretically based Internet intervention for emerging adults who experience troubled intimate partner relationships. In the design process, the team addressed six fundamental questions related to the several components of the IIM. Decisions made regarding the design of the intervention based on the six questions are described. We focus in particular on how the intervention is based on the Theory of Emerging Adulthood and the Theory of Narrative Identity. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. [Recognition, care and prevention of suicidal behaviour in adults].

    Science.gov (United States)

    Rihmer, Zoltán; Németh, Attila; Kurimay, Tamás; Perczel-Forintos, Dóra; Purebl, György; Döme, Péter

    2017-01-01

    Suicide is a major public health problem everywhere in the world and in the WHO European Region suicide accounts for over 120,000 deaths per year. 1. Recognition and diagnosis: An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential. 2. Treatment and care: Acute intervention should start immediately in order to keep the patient alive. Existing evidence supports the efficacy of pharmacological treatment and cognitive behavioural therapy (including dialectical behavior therapy and problem-solving therapy) in preventing suicidal behaviour. Some other psychological treatments are promising, but the supporting evidence is currently insufficient. Studies show that antidepressant and mood stabilizer treatments decrease the risk for suicidality among responders in mood disorder patients. However, the risk of suicidal behaviour in depressed patients treated with antidepressants exists during the first 10-14 days of treatment, which requires careful monitoring. Short-term supplementary medication with anxiolytics and hypnotics in the case of anxiety and insomnia is recommended. Treatment with antidepressants of children and adolescents should only be given under supervision of a specialist. Long-term treatment with lithium has been shown to be very effective in preventing both suicide and attempted suicide in patients with unipolar and bipolar depression. Treatment with clozapine is effective in reducing suicidal behaviour in patients with schizophrenia. Other atypical antipsychotics are promising but more evidence is required. 3. Family and social support: The suicidal person should always be motivated to involve family in the treatment. Psychosocial treatment and support is recommended, as the

  10. Cortisol Awakening Response, Internalizing Symptoms, and Life Satisfaction in Emerging Adults

    Directory of Open Access Journals (Sweden)

    Li Shen Chong

    2017-11-01

    Full Text Available The cortisol awakening response (CAR has been associated with depression and a broader range of internalizing problems. Emerging adulthood is characterized by numerous stressful transitional life events. Furthermore, the functioning of the neurobiological stress system changes across development. These considerations underscore the importance of evaluating the physiological stress system in emerging adults in identifying the extent to which cortisol levels vary with risk and protective factors for mental health. The present study evaluated the association between internalizing symptoms and perceived life satisfaction with CAR in 32 young adults. Three saliva samples were collected to measure cortisol levels upon awakening and participants completed the Depression Anxiety Stress Scale (DASS and Satisfaction with Life Scale (SWLS. Results show a significant positive correlation between area under the curve for CAR with internalizing symptoms (DASS total and the DASS-depression subscale, but not with life satisfaction. Study limitations, implications, and future directions for these finding were discussed.

  11. Emerging Adults' Text Message Use and Sleep Characteristics: A Multimethod, Naturalistic Study.

    Science.gov (United States)

    Murdock, Karla Klein; Horissian, Mikael; Crichlow-Ball, Caroline

    2017-01-01

    Emerging adults use text messaging as a principal form of social communication, day and night, and this may compromise their sleep. In this study, a hypothetical model was tested linking daytime and nighttime text message use with multiple sleep characteristics. Subjective and objective measures of texting and sleep were utilized to assess 83 college students over a seven-day period during an academic term. Greater number of daily texts, awareness of nighttime cell phone notifications, and compulsion to check nighttime notifications were significantly associated with poorer subjective sleep quality. Awareness of nighttime notifications was significantly associated with higher self-reported global sleep problems and more sleep disruptions. Results suggest potential benefits of targeting nighttime texting habits in health promotion efforts for emerging adults.

  12. Distress Severity Following a Romantic Breakup is Associated with Positive Relationship Memories among Emerging Adults

    DEFF Research Database (Denmark)

    del Palacio Gonzalez, Adriana; Clark, David; O'Sullivan, Lucia

    2017-01-01

    Romantic relationship loss is associated with significant psychological distress for emerging adults. Intrusive memories of stressful events are typically associated with symptom severity; however, whether spontaneous positive memories of a relationship breakup may also be related to psychological...... symptoms has received little attention. We examined links between breakup-specific distress, depressive symptoms, and relationship memories of different valence. Ninety-one emerging adults (Mage = 20.13) who had experienced a recent romantic breakup recorded the frequency of positive and negative...... spontaneous relationship memories in a four-day online memory diary. Control memories were also recorded. Positive memories were specifically related to breakup distress, whereas negative memories were related to both breakup distress and depression. No such associations were found for the control memories...

  13. Friendship and Romantic Relationships Among Emerging Adults With and Without Type 1 Diabetes

    Science.gov (United States)

    Mascatelli, Katilyn; Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2015-01-01

    Objective To examine whether friendship and romantic relationships of emerging adults with type 1 diabetes differed from those of a comparison group, and to determine whether these relationships were associated with psychological and diabetes health outcomes. Methods High school seniors with (n = 122) and without (n = 118) type 1 diabetes were assessed annually for 3 years. Friend and romantic relationship variables, psychological distress, life satisfaction, eating disturbances, and, for those with diabetes, diabetes outcomes were assessed. Results Those with diabetes reported less friend support but similar friend conflict compared with controls. Aspects of romantic relationships and friend relationships were associated with health outcomes, but there were more effects involving romantic relationships. On some indices, romantic support was more beneficial for controls and romantic conflict was more troublesome for those with diabetes. Conclusions Both friendship and romantic relationships were associated with psychological and diabetes outcomes among emerging adults. PMID:25157071

  14. Carbetocin versus oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery.

    Science.gov (United States)

    El Behery, Manal M; El Sayed, Gamal Abbas; El Hameed, Azza A Abd; Soliman, Badeea S; Abdelsalam, Walid A; Bahaa, Abeer

    2016-01-01

    To assess and compare the effectiveness and safety of single IV polus dose of carbetocin, versus IV oxytocin infusion in the prevention of PPH in obese nulliparous women undergoing emergency Cesarean Delivery. A double-blinded randomized-controlled trial was conducted on 180 pregnant women with BMI >30. Women were randomized to receive either oxytocin or carbetocin during C.S. The primary outcome measure was major primary PPH >1000 ml within 24 h of delivery as per the definition of PPH by the World Health Organization Secondary outcome measures were hemoglobin and hematocrit changes pre- and post-delivery, use of further ecobolics, uterine tone 2 and 12-h postpartum and adverse effects. A significant difference in the amount of estimated blood loss or the incidence of primary postpartum haemorrhage (>1000 ml) in both groups. Haemoglobin levels before and 24-h postpartum was similar. None from the carbetocin group versus 71.5% in oxytocin group needed additional utrotonics (p postpartum (p oxytocin infusion for maintaining adequate uterine tone and preventing postpartum bleeding in obese nulliparous women undergoing emergency cesarean delivery, both has similar safety profile and minor hemodynamic effect.

  15. Older Adults' Opinions on Fall Prevention in Relation to Physical Activity Level.

    Science.gov (United States)

    Tuvemo Johnson, Susanna; Martin, Cathrin; Anens, Elisabeth; Johansson, Ann-Christin; Hellström, Karin

    2018-01-01

    The purpose of this study was to explore and describe older adults' opinions regarding actions to prevent falls and to analyze differences in the opinions of highly versus less physically active older adults. An open-ended question was answered by 262 individuals aged 75 to 98 years living in the community. The answers were analyzed using qualitative content analysis, and differences in the categories were compared between highly and less physically active persons. Physical activity was measured according to a five-level scale. The content analysis resulted in eight categories: assistive devices, avoiding hazards, behavioral adaptive strategies, being physically active, healthy lifestyle, indoor modifications, outdoor modifications, and seeking assistance. Behavioral adaptive strategies were mentioned to a greater extent by highly active people, and indoor modifications were more often mentioned by less active older adults. Support for active self-directed behavioral strategies might be important for fall prevention among less physically active older adults.

  16. Clinical feasibility trial of a motion detection system for fall prevention in hospitalized older adult patients.

    Science.gov (United States)

    Ferrari, Marisa; Harrison, Barbara; Rawashdeh, Osamah; Hammond, Robert; Avery, Yvonne; Rawashdeh, Muawea; Sa'deh, Waseem; Maddens, Michael

    2012-01-01

    The purpose of this pilot study was to test the feasibility of a wireless 5-sensor, motion detection system (5S-MDS) with hospitalized older adults. Interventions to prevent hospital-based falls in older adults are important to reduce morbidity, mortality, and health care costs. Wearable motion sensors, which track and wirelessly transmit body movements, may identify human movement patterns that immediately precede falls, thus allowing early prevention. Descriptive feasibility study in which 5 hospitalized older adults were recruited to wear the 5S-MDS for 4 hours. Measurement included assessment of participant acceptance, skin integrity, and sensor accuracy. All 5 participants (mean age, 90.2 years) agreed that sensors were acceptable and skin integrity was maintained. The sensor data accurately reflected the patient movements. The 5S-MDS was feasible for 4 hours' use with hospitalized older adults. It has potential as an early warning system for falls. Copyright © 2012 Mosby, Inc. All rights reserved.

  17. Emergency care staff experiences of lay presence during adult cardiopulmonary resuscitation: a phenomenological study.

    Science.gov (United States)

    Walker, Wendy Marina

    2014-06-01

    Public support in favour of family presence during an adult cardiopulmonary resuscitation (CPR) attempt is a contentious issue among providers of emergency care. Researchers have mostly relied on attitudinal surveys to elicit staff views, leaving the life-world of those who have experienced this phenomenon, largely unexplored. To explore the lived experience of lay presence during an adult CPR attempt in primary (out-of-hospital) and secondary (inhospital) environments of care. Hermeneutical phenomenological study. Semistructured, face-to-face interviews with 8 ambulance staff and 12 registered nurses. The interviews were audio-recorded and subjected to thematic analysis. Participants provided insight into situations where lay presence during adult CPR came about either spontaneously or as a planned event. Their accounts portrayed a mixture of benefits and concerns. Familiarity of working in the presence of lay people, practical experience in emergency care and personal confidence were important antecedents. Divergent practices within and across the contexts of care were revealed. The concept of exposure emerged as the essence of this phenomenon. Overall, the study findings serve to challenge some of the previously reported attitudes and opinions of emergency care staff. Improved intraprofessional and interprofessional collaboration is essential to overcoming the barriers associated with lay presence during adult CPR. The future of this practice is dependent on initiatives that seek to bring about attitudinal change. Priority should be given to further exploring this phenomenon in the context of patient and family centred end-of-life care. 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.

  18. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    OpenAIRE

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-01-01

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 201...

  19. REDUCTIONS IN CANNABIS USE ARE ASSOCIATED WITH MOOD IMPROVEMENT IN FEMALE EMERGING ADULTS.

    Science.gov (United States)

    Moitra, Ethan; Anderson, Bradley J; Stein, Michael D

    2016-04-01

    Cannabis use and the development of depression symptoms have been linked in prospective research. However, no research has examined how depression symptoms might change relative to reductions in cannabis use. One group at risk for comorbid cannabis-use disorders and clinical depression is female emerging adults (those aged 18-25 years old) as cannabis use peaks during this period, depression is the most common psychiatric disorder among emerging adults, and females are at increased risk for depression relative to males. This study examined the longitudinal association between reductions in cannabis use and existing depression symptoms. Secondary analyses from a cannabis intervention trial for 332 female emerging adults were conducted. Changes in depression symptoms (categorized as minimal, mild, and moderate or more severe depression) were assessed in relation to changes in cannabis use at 3- and 6-months postbaseline assessment. After controlling for alcohol use, the association between change in cannabis-use frequency and change in depression (measured by Beck Depression Inventory-II) was significantly stronger for those with mild depression (b = -0.26; 95% CI: -0.44, -0.08; P = .004), and for those with moderate or more severe depression (b = -0.50; 95% CI: -0.68, -0.33; P depression. These results indicate a relationship between reductions in cannabis use and reductions in depression symptoms among female emerging adults who report at least mild depression symptoms. This represents a clinically meaningful effect for clinicians treating patients with co-occurring cannabis use and depressive disorders. © 2015 Wiley Periodicals, Inc.

  20. Impact of lifetime evaluated need on mental health service use among African American emerging adults.

    Science.gov (United States)

    Williams, Sha-Lai L; Cabrera-Nguyen, E Peter

    2016-04-01

    This study investigated the association between evaluated need and mental health service use among African-American emerging adults, when controlling for other predictor variables. Secondary analysis of data from the National Survey of American Life (2001-2003) was conducted. A nationally representative sample of African-American emerging adults, ages 18 to 29 years (N = 806), was assessed with the Composite International Diagnostic Interview. The sample included females and males with a mean age of 23 years. Evaluated need was determined by endorsement of mood, anxiety, substance use, or impulse control diagnoses. Respondents who reported ever voluntarily using mental health or general medical services to address these problems were considered to have used services. Forty-seven percent of the sample demonstrated an evaluated need for services, whereas a quarter of the sample used services in their lifetime. Respondents who were females, had received religious/spiritual support, and who had an evaluated need for services were significantly more likely to have used services in their lifetime compared with males, those who had not received religious/spiritual support, and those without a need for services. Literature indicates that evaluated need is a strong predictor of mental health service use, yet research examining its impact on service use among African American emerging adults is limited. This study found that along with having an evaluated need, this population was more likely to use services when supported by a religious/spiritual leader. Mental health outreach and education that incorporates the informal support systems identified by African American emerging adults, particularly males, is needed. (c) 2016 APA, all rights reserved).

  1. Youth Versus Adult “Weightlifting” Injuries Presenting to United States Emergency Rooms: Accidental Versus Nonaccidental Injury Mechanisms

    Science.gov (United States)

    Myer, Gregory D.; Quatman, Carmen E.; Khoury, Jane; Wall, Eric J.; Hewett, Timothy E.

    2014-01-01

    Myer, GD, Quatman, CE, Khoury, J, Wall, EJ, and Hewett, TE. Youth versus adult “weightlifting” injuries presenting to united states emergency rooms: accidental versus nonaccidental injury mechanisms. J Strength Cond Res 23(7): 2054–2060, 2009—Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. We hypothesized that older athletes would sustain greater percentages of joint sprains and muscle strains, whereas younger athletes would sustain a greater percentage of accidental injuries that would result in an increased percentage of fractures in youths. The U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System was queried from 2002 to 2005 using the CPSC code for “Weightlifting.” Subjects between the ages of 8 and 30 were grouped by age categories 8 to 13 (elementary/middle school age), 14 to 18 (high school), 19 to 22 (college), and 23 to 30 (adult). Injuries were classified as “accidental” if caused by dropped weight or improper equipment use. Multiple logistic regression was used to compare accidental injuries between age groups. The sample consisted of 4, 111 patients. Accidental injuries decreased (p 14 to 18 > 19 to 22 years = 23 to 30 years. Conversely, sprain/strain injuries increased in each successive age group (p training-related joint sprains and muscle strains than adults. The majority of youth resistance training injuries are the result of accidents that are potentially preventable with increased supervision and stricter safety guidelines. PMID:19855330

  2. Vulnerability of Older Adults in Disasters: Emergency Department Utilization by Geriatric Patients After Hurricane Sandy.

    Science.gov (United States)

    Malik, Sidrah; Lee, David C; Doran, Kelly M; Grudzen, Corita R; Worthing, Justin; Portelli, Ian; Goldfrank, Lewis R; Smith, Silas W

    2017-08-02

    Older adults are a potentially medically vulnerable population with increased mortality rates during and after disasters. To evaluate the impact of a natural disaster on this population, we performed a temporal and geospatial analysis of emergency department (ED) use by adults aged 65 years and older in New York City (NYC) following Hurricane Sandy's landfall. We used an all-payer claims database to analyze demographics, insurance status, geographic distribution, and health conditions for post-disaster ED visits among older adults. We compared ED patterns of use in the weeks before and after Hurricane Sandy throughout NYC and the most afflicted evacuation zones. We found significant increases in ED utilization by older adults (and disproportionately higher in those aged ≥85 years) in the 3 weeks after Hurricane Sandy, especially in NYC evacuation zone one. Primary diagnoses with notable increases included dialysis, electrolyte disorders, and prescription refills. Secondary diagnoses highlighted homelessness and care access issues. Older adults display heightened risk for worse health outcomes with increased ED visits after a disaster. Our findings suggest the need for dedicated resources and planning for older adults following a natural disaster by ensuring access to medical facilities, prescriptions, dialysis, and safe housing and by optimizing health care delivery needs to reduce the burden of chronic disease. (Disaster Med Public Health Preparedness. 2017;page 1 of 10).

  3. Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

    Science.gov (United States)

    Davis, Maryann; Sheidow, Ashli J.; McCart, Michael R.

    2014-01-01

    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n=41) were aged 17–20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post analyses revealed significant reductions in participants’ MH symptoms, justice-system involvement, and associations with antisocial peers. PMID:25023764

  4. Emerging Adult Religiosity and Spirituality: Linking Beliefs, Values, and Ethical Decision-Making

    Directory of Open Access Journals (Sweden)

    Patricia Snell Herzog

    2018-03-01

    Full Text Available This paper challenges the “spiritual but not religious” (SBNR category as a methodological artifact caused by interacting two closed-ended survey items into binary combinations. Employing a theoretically rich approach, this study maps the multiple ways in which the religious and the spiritual combine for emerging adults. Results indicate that most emerging adults have a tacit sense of morality, displaying limited cognitive access to how moral reasoning relates to religious and spiritual orientations. This longitudinal study investigates efforts to raise moral awareness through: exposure to diverse religious and spiritual orientations, personal reflection, and collective discussion. Relative to control groups, emerging adults in this study display increases in moral awareness. We combine the results of these studies to formulate a theoretical framework for the ways in which beliefs, values, and ethical decision-making connect in expressing plural combinations of religiosity and spirituality. The implication is that direct attention to religiosity and spirituality — not avoidance of — appears to facilitate ethical decision-making.

  5. I Want Your Sext: Sexting and Sexual Risk in Emerging Adult Minority Men.

    Science.gov (United States)

    Davis, Mikaela Jessica; Powell, Adeya; Gordon, Derrick; Kershaw, Trace

    2016-04-01

    Sexting, sending, or receiving sexually suggestive or explicit messages/photos/videos, have not been studied extensively. The aims of this study is to understand factors associated with sexting among minority (e.g., African- American, Hispanic) emerging adult males and the association between sexting and sexual risk. We recruited 119 emerging adult heterosexual males and assessed sexting and sexual risk behaviors. Fifty-four percent of participants sent a sext, and 70% received a sext. Participants were more likely to sext with casual partners than with steady partners. Multiple regression analyses showed that participants who sent sexts to steady partners had significantly more unprotected vaginal intercourse and oral sex. Participants who sent sexts to casual partners had significantly more partners, and participants who received sexts from casual partners had significantly more unprotected oral sex and sex while on substances. We found that sexting is a frequent and reciprocal behavior among emerging adults, and there were different patterns of significance for sexts with casual and steady partners.

  6. Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients

    OpenAIRE

    Israel, Salomon; Moffitt, Terrie E.; Belsky, Daniel W.; Hancox, Robert J.; Poulton, Richie; Roberts, Brent; Thomson, W. Murray; Caspi, Avshalom

    2014-01-01

    The rising number of newly insured young adults brought on by healthcare reform will soon increase demands on primary-care physicians. Physicians will face more young-adult patients which presents an opportunity for more prevention-oriented care. In the current study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the Dunedin Study cohort of 1,000 indivi...

  7. Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation

    Directory of Open Access Journals (Sweden)

    Paul Schvaneveldt

    2016-09-01

    Full Text Available This article presents the results from a study into international humanitarian service-learning experiences on young adult volunteers. Specifically, the service-learning experiences of emerging adults who had served in orphanages in Latin America were assessed, in a pre- and post-test design, for their development in areas of social competency such as identity, self-efficacy, self-esteem and ethnocentric attitudes. A mixed-methods design using both qualitative and quantitative measures was used. Both qualitative and quantitative results identified significant and important impacts on the development of the social competencies of these emerging adults. In addition, several qualitative themes illustrated that longer term international service-learning experiences have a profound impact on the social competence of emerging adults. Keywords: International humanitarian service, service-learning, emerging adult competency

  8. The context of condom use among young adults in the Philippines: Implications for HIV prevention

    Science.gov (United States)

    Lucea, Marguerite B.; Hindin, Michelle J.; Gultiano, Socorro; Kub, Joan; Rose, Linda

    2012-01-01

    We examine current perceptions and constraints surrounding condom use among young adults in the Philippines to garner a deeper contextual understanding of this aspect of HIV prevention within Filipino society. Through thematic analysis of focus group data, we found three broad themes, all of which included societal and individual barriers to using condoms. The findings may provide insight for similar settings that have strong religious influences on society. To strengthen HIV prevention efforts in such settings, we suggest that the development of strategies to address these constraints in the cultural setting and promote sexual health of young adults is essential. PMID:23394323

  9. Disease screening and prevention for transgender and gender-diverse adults.

    Science.gov (United States)

    Schmidt, Elizabeth; Rizzolo, Denise

    2017-10-01

    Primary care clinicians have an important role in the health and wellness of transgender and gender-diverse (TGD) adults and need to know best practices of health maintenance and disease prevention interventions. This article focuses on how exogenous use of sex steroids provided as hormone therapy and gender-affirming procedures affect screening and prevention. Hormone therapy can affect the heart, liver, lipids, bones, brain, skin, and reproductive organs; likewise, behaviors and gender-affirming procedures may alter the risks, prevalence, and screening techniques of sexually transmitted infections. Where applicable, modifications accounting for those differences should be incorporated into the primary care of TGD adults.

  10. Road Accident Prevention with Instant Emergency Warning Message Dissemination in Vehicular Ad-Hoc Network.

    Directory of Open Access Journals (Sweden)

    P Gokulakrishnan

    Full Text Available A Road Accident Prevention (RAP scheme based on Vehicular Backbone Network (VBN structure is proposed in this paper for Vehicular Ad-hoc Network (VANET. The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities: (i the Road Side Unit (RSU constructs a Prediction Report (PR based on the status of the vehicles and traffic in the highway roads, (ii the RSU generates an Emergency Warning Message (EWM based on an abnormal PR, (iii the RSU forms a VBN structure and (iv the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF and travels in High Risk Zone (HRZ. These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure. The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

  11. Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

    Science.gov (United States)

    Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, pwellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

    Directory of Open Access Journals (Sweden)

    Leonor Pássaro

    2016-11-01

    Full Text Available Abstract Background Pneumonia is one of the leading hospital-acquired infections worldwide and has an important impact. Although preventive measures for ventilator-associated pneumonia (VAP are well known, less is known about appropriate measures for prevention of hospital-acquired pneumonia (HAP. Aim The purpose of this narrative review is to provide an overview of the current standards for preventing HAP in non-ventilated adult patients. Methods A search of the literature up to May 2015 was conducted using Medline for guidelines published by national professional societies or professional medical associations. In addition, a comprehensive search for the following preventive measures was performed: hand hygiene, oral care, bed position, mobilization, diagnosis and treatment of dysphagia, aspiration prevention, viral infections and stress bleeding prophylaxis. Findings Regarding international guidelines, several measures were recommended for VAP, whilst no specific recommendations for HAP prevention in non-ventilated patients are available. There is reasonable evidence available that oral care is associated with a reduction in HAP. Early mobilization interventions, swift diagnosis and treatment of dysphagia, and multimodal programmes for the prevention of nosocomial influenza cross-infection, have a positive impact on HAP reduction. The impact of bed position and stress bleeding prophylaxis remains uncertain. Systematic antibiotic prophylaxis for HAP prevention should be avoided. Conclusion Scant literature and little guidance is available for the prevention of HAP among non-ventilated adult patients. In addition, the criteria used for the diagnosis of HAP and the populations targeted in the studies selected are heterogeneous. Oral care was the most studied measure and was commonly associated with a decrease in HAP rate, although a broad range of interventions are proposed. No robust evidence is available for other measures. Further high

  13. Tackling Communication Barriers Between Long-Term Care Facility and Emergency Department Transfers to Improve Medication Safety in Older Adults.

    Science.gov (United States)

    Callinan, Stephanie M; Brandt, Nicole J

    2015-07-01

    In 2013, the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine created geriatric emergency department guidelines, making recommendations for staffing/administration, follow up and transitions of care, education, quality improvement, equipment/supplies, and other policies, procedures, and protocols to be implemented. Awareness of these guidelines, as well as communication barriers, can help improve the delivery of care for older adults during transitions in care, particularly regarding medication safety. Copyright 2015, SLACK Incorporated.

  14. Major depressive disorder, suicidal behaviour, bipolar disorder, and generalised anxiety disorder among emerging adults with and without chronic health conditions.

    Science.gov (United States)

    Ferro, M A

    2016-10-01

    disability and pain mediate the association between chronic health conditions and mental disorder. Physical and mental comorbidity is prevalent among emerging adults and this relationship is not augmented, but may be mediated, by the level of disability or pain. Findings point to the integration and coordination of public sectors - health, education and social services - to facilitate the prevention and reduction of mental disorder among emerging adults with chronic health conditions.

  15. Equity in disease prevention: Vaccines for the older adults - a national workshop, Australia 2014.

    Science.gov (United States)

    Raina MacIntyre, C; Menzies, Robert; Kpozehouen, Elizabeth; Chapman, Michael; Travaglia, Joanne; Woodward, Michael; Jackson Pulver, Lisa; Poulos, Christopher J; Gronow, David; Adair, Timothy

    2016-11-04

    On the 20th June, 2014 the National Health and Medical Research Council's Centre for Research Excellence in Population Health "Immunisation in under Studied and Special Risk Populations", in collaboration with the Public Health Association of Australia, hosted a workshop "Equity in disease prevention: vaccines for the older adults". The workshop featured international and national speakers on ageing and vaccinology. The workshop was attended by health service providers, stakeholders in immunisation, ageing, primary care, researchers, government and non-government organisations, community representatives, and advocacy groups. The aims of the workshop were to: provide an update on the latest evidence around immunisation for the older adults; address barriers for prevention of infection in the older adults; and identify immunisation needs of these groups and provide recommendations to inform policy. There is a gap in immunisation coverage of funded vaccines between adults and infants. The workshop reviewed provider misconceptions, lack of Randomised Control Trials (RCT) and cost-effectiveness data in the frail elderly, loss of autonomy, value judgements and ageism in health care and the need for an adult vaccination register. Workshop recommendations included recognising the right of elderly people to prevention, the need for promotion in the community and amongst healthcare workers of the high burden of vaccine preventable diseases and the need to achieve high levels of vaccination coverage, in older adults and in health workers involved in their care. Research into new vaccine strategies for older adults which address poor coverage, provider attitudes and immunosenescence is a priority. A well designed national register for tracking vaccinations in older adults is a vital and basic requirement for a successful adult immunisation program. Eliminating financial barriers, by addressing inequities in the mechanisms for funding and subsidising vaccines for the older

  16. 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

  17. Sleep problems and pain: a longitudinal cohort study in emerging adults.

    Science.gov (United States)

    Bonvanie, Irma J; Oldehinkel, Albertine J; Rosmalen, Judith G M; Janssens, Karin A M

    2016-04-01

    Sleep and pain are thought to be bidirectional related on a daily basis in adolescents with chronic pain complaints. In addition, sleep problems have been shown to predict the long-term onset of musculoskeletal pain in middle-aged adults. Yet, the long-term effects of sleep problems on pain duration and different types of pain severity in emerging adults (age: 18-25) are unknown. This study investigated the cross-sectional and longitudinal relationship between sleep problems and chronic pain, and musculoskeletal pain, headache, and abdominal pain severity in a general population of emerging adults. We studied whether these relationships were moderated by sex and whether symptoms of anxiety and depression, fatigue, or physical inactivity mediated these effects. Data of participants from the longitudinal Dutch TRacking Adolescents' Individual Lives Survey were used. Follow-up data were collected in 1753 participants who participated in the fourth (N = 1668, mean age: 19.0 years [SD = 0.6]) and/or fifth (N = 1501, mean age: 22.3 years [SD = 0.6]) assessment wave. Autoregressive cross-lagged models were used for analyses. Sleep problems were associated with chronic pain, musculoskeletal pain, headache and abdominal pain severity, and predicted chronic pain and an increase in musculoskeletal pain severity at 3 years of follow-up. This prospective effect was stronger in females than in males and was mediated by fatigue but not by symptoms of anxiety and depression or physical inactivity. Only abdominal pain had a small long-term effect on sleep problems. Our results suggest that sleep problems may be an additional target for treatment in female emerging adults with musculoskeletal pain complaints.

  18. Perceptions of South African Emerging Adult FET College Students on Sexual Practices in Relation to Religion.

    Science.gov (United States)

    Moodley, Colleen Gail

    2017-10-01

    HIV and AIDS are rapidly spreading amongst the world's 15- to 24-year age group, particularly in sub-Saharan Africa. Despite vigorous government interventions and campaigns, 10 % of South African youth in the age cohort 15-24 are infected with HIV and AIDS. Furthermore, for the first time in history the world has its largest number of individuals under the age of 30 years. Researchers are desperately seeking a solution and have found religion to play an important role in moderating risky sexual behaviour amongst youth. This exploratory qualitative study aims to increase our understanding of emerging adult Further Education and Training (FET) students' perceptions of the role of religion and religious beliefs in their sexual decision-making and practices. The qualitative data emerged from five focus group discussions, each consisting of 12 heterosexual emerging adult FET college students aged 18-24 years, selected using random sampling. Participants were representative of all the major South African racial groups (Blacks, Whites, Coloured and Indians) as well as different religious and cultural groupings. Secularisation theory was used as a theoretical framework for this study. These focus group discussions revealed the following themes: Theme 1-religious institutions need to embrace change in order to become effective social agents of change. Theme 2-a need for open discussion and communication concerning current issues related to young people's sexual health (by religious institutions/religious leaders). Theme 3-perceptions of religion's negative sanctions towards sexual behaviour. Theme 4-religious leaders' indifference and abdication of responsibility to the problems that youth face. Theme 5-religion and condom-related beliefs. Theme 6-perceptions of religious leaders as role models. Theme 7-emerging adults general concern for the moral decay of society. Theme 8-perceptions of whether religion has an influence on young people's sexual decision-making and

  19. Characteristics of Emergency Department Visits by Older Versus Younger Homeless Adults in the United States

    Science.gov (United States)

    Steinman, Michael A.

    2013-01-01

    Objectives. We compared the characteristics of emergency department (ED) visits of older versus younger homeless adults. Methods. We analyzed 2005–2009 data from the National Hospital Ambulatory Medical Care Survey, a nationally representative survey of visits to hospitals and EDs, and used sampling weights, strata, and clustering variables to obtain nationally representative estimates. Results. The ED visits of homeless adults aged 50 years and older accounted for 36% of annual visits by homeless patients. Although demographic characteristics of ED visits were similar in older and younger homeless adults, clinical and health services characteristics differed. Older homeless adults had fewer discharge diagnoses related to psychiatric conditions (10% vs 20%; P = .002) and drug abuse (7% vs 15%; P = .003) but more diagnoses related to alcohol abuse (31% vs 23%; P = .03) and were more likely to arrive by ambulance (48% vs 36%; P = .02) and to be admitted to the hospital (20% vs 11%; P = .003). Conclusions. Older homeless adults’ patterns of ED care differ from those of younger homeless adults. Health care systems need to account for these differences to meet the needs of the aging homeless population. PMID:23597348

  20. Predicting and preventing peripheral intravenous cannula insertion failure in the emergency department: Clinician 'gestalt' wins again.

    Science.gov (United States)

    Rippey, James Cr; Carr, Peter J; Cooke, Marie; Higgins, Niall; Rickard, Claire M

    2016-12-01

    Failed attempts at peripheral i.v. cannula (PIVC) insertion in the ED are common. The psychological, physical and economic impact of these failures is significant. We sought to explore whether clinicians of differing experience levels can predict their own likelihood (clinician 'gestalt') of first-time cannula insertion success on any given patient. Data analyses from a prospective self-reported study assessing risk factors for first-time insertion success in a tertiary adult ED. We constructed and compared two simple theoretical clinical decision algorithms in an attempt to improve first-time PIVC insertion success rates. This best algorithm identified a subgroup of 18% of the total PIVC population at higher risk of failure. This 18% comprised 57% of all PIVC failures, and implementation would result in a relative risk reduction of PIVC failure by 31%. When applied to our sample population, an algorithm relying on clinician gestalt to identify patients at high risk of PIVC failure had the greatest potential impact. These patients would be referred to expert PIVC inserters prior to, rather than after, failed attempts. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  1. Information Vaccine: Using Graphic Novels as an HIV/AIDS Prevention Resource for Young Adults

    Science.gov (United States)

    Albright, Kendra S.; Gavigan, Karen

    2014-01-01

    HIV/AIDS infections are growing at an alarming rate for young adults. In 2009, youth, ages 13-29, accounted for 39% of all new HIV infections in the U.S. (Division of HIV/ AIDS Prevention, Centers for Disease Control (CDC), 2011). South Carolina ranks eighth in the nation for new HIV cases, while the capital city of Columbia ranks seventh…

  2. Pressure Ulcers in Adults: Prediction and Prevention. Clinical Practice Guideline Number 3.

    Science.gov (United States)

    Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD.

    This package includes a clinical practice guideline, quick reference guide for clinicians, and patient's guide to predicting and preventing pressure ulcers in adults. The clinical practice guideline includes the following: overview of the incidence and prevalence of pressure ulcers; clinical practice guideline (introduction, risk assessment tools…

  3. Recommendations for the diagnosis, treatment and prevention of the pneumonia acquired in the community in adults

    International Nuclear Information System (INIS)

    2003-01-01

    The pneumonia acquired in the community in adults, is the acute infection of the pulmonary parenchyma that is developed away from the hospital environment, it is manifested in the first 48 hours from the entrance to the hospital or after seven days of having left. The supplement includes clinical square, epidemiology, etiology classification, diagnostic, treatment and prevention among others

  4. Interventions for preventing and treating incontinence-associated dermatitis in adults

    NARCIS (Netherlands)

    Beeckman, D.; Damme, N. Van; Schoonhoven, L.; Lancker, A. Van; Kottner, J.; Beele, H.; Gray, M.; Woodward, S.; Fader, M.; Bussche, K. Van den; Hecke, A. Van; Meyer, D.; Verhaeghe, S.

    2016-01-01

    BACKGROUND: Incontinence-associated dermatitis (IAD) is one of the most common skin problems in adults who are incontinent for urine, stool, or both. In practice, products and procedures are the same for both prevention and treatment of IAD. OBJECTIVES: The objective of this review was to assess the

  5. Injury prevention for adult male soccer players. Blessure preventie voor volwassen, mannelijke voetballers

    NARCIS (Netherlands)

    Beijsterveldt, A.M.C. van

    2013-01-01

    Soccer causes the largest number of injuries each year (18% of all sports injuries) in the Netherlands. The aim of this dissertation is to contribute to the body of evidence on injury prevention for adult male soccer players. Chapter 1 is a general introduction and presents the “sequence of

  6. Teaching adults-best practices that leverage the emerging understanding of the neurobiology of learning.

    Science.gov (United States)

    Mahan, John D; Stein, David S

    2014-07-01

    It is important in teaching adults to recognize the essential characteristics of adult learners and how these characteristics define their learning priorities and activities. The seven key premises and practices for teaching adults provide a good guide for those interested in helping adults learn. The emerging science of the neurobiology of learning provides powerful new insights into how learning occurs in the complex integrated neural network that characterizes the adult. Differentiation of the two types of thinking: System 1 (fast, intuitive, and, often, emotional) and System 2 (slower, deliberate, and logical). System 1 thinking helps explain the basis for quick decisions and reliance of humans on heuristics (or rules of thumb) that leads to the type of convenient thinking associated with errors of thinking and judgment. We now know that the learning experience has an objective location-in the temporal and parietal lobes-as persistent dynamic networks of neurons and neuronal connections. Learning is initially stored in transient working memory (relatively limited capacity and time frame) and then moved under the right conditions to more long-lasting/stable memory (with larger capacity) that is stored for future access and development. It is clear that memories are not static and are not destined, once developed, to forever remain as stable constructs; rather, memories are dynamic, always available for modulation and alteration, and heavily invested with context, emotion, and other operant factors. The framework for such neural networks involves new neuronal connections, enhanced neuronal synaptic transmission, and neuron generation. Ten key teaching and learning concepts derived from recent neurobiology studies on learning and memory are presented. As the neurobiology of learning is better defined, the basis for how adults best learn, and even the preferences they display, can be employed as the physiological foundation for our best methods to effectively teach

  7. 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.

  8. Management of older adults with dementia who present to emergency services with neuropsychiatric symptoms.

    Science.gov (United States)

    Silwanowicz, Ryan M; Maust, Donovan T; Seyfried, Lisa S; Chiang, Claire; Stano, Claire; Kales, Helen C

    2017-12-01

    Our aim is to evaluate if and how neuropsychiatric symptoms (NPS) of dementia influence the management and disposition of older adults who present to emergency care settings. This is a retrospective cohort study that involved the medical and psychiatric emergency departments of a tertiary academic medical center. Participants included patients ≥65 years of age with dementia who presented between 1 February 2012 and 16 July 2014 (n = 347). Subjects with documented NPS (n = 78) were compared with a group of subjects without documented NPS (n = 78) randomly selected from the overall group with dementia. The groups with and without NPS were compared on demographic, clinical, management, and disposition characteristics. Patients with NPS were more likely to have additional diagnostic testing performed and receive psychotropic medications including benzodiazepines and antipsychotics. Significantly fewer patients with NPS (59.0%) returned to their original setting from the emergency department than patients without NPS (76.9%). Among patients with NPS, those who had a motor disturbance were more likely to receive psychotropic medications than patients who did not have a motor disturbance. Depression/dysphoria, anxiety, disinhibition, irritability/lability, and motor disturbance were all associated with transfer from medical to psychiatric emergency department. Patients with depression/dysphoria or anxiety were more likely to be psychiatrically hospitalized. There are significant differences in the management of dementia with and without NPS in the emergency room setting. Developing and implementing successful methods to manage NPS in the emergency department and outpatient setting could potentially lead to less emergent psychotropic administration and reduce hospitalizations. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Awareness among adults of vaccine-preventable diseases and recommended vaccinations, United States, 2015.

    Science.gov (United States)

    Lu, Peng-Jun; O'Halloran, Alissa; Kennedy, Erin D; Williams, Walter W; Kim, David; Fiebelkorn, Amy Parker; Donahue, Sara; Bridges, Carolyn B

    2017-05-25

    Adults are recommended to receive select vaccinations based on their age, underlying medical conditions, lifestyle, and other considerations. Factors associated with awareness of vaccine-preventable diseases and recommended vaccines among adults in the United States have not been explored. Data from a 2015 internet panel survey of a nationally representative sample of U.S. adults aged ≥19years were analyzed to assess awareness of selected vaccine-preventable diseases and recommended vaccines for adults. A multivariable logistic regression model with a predictive marginal approach was used to identify factors independently associated with awareness of selected vaccine-preventable infections/diseases and corresponding vaccines. Among the surveyed population, from 24.6 to 72.1% reported vaccination for recommended vaccines. Awareness of vaccine-preventable diseases among adults aged ≥19years ranged from 63.4% to 94.0% (63.4% reported awareness of HPV, 71.5% reported awareness of tetanus, 72.0% reported awareness of pertussis, 75.4% reported awareness of HZ, 75.8% reported awareness of hepatitis B, 83.1% reported awareness of pneumonia, and 94.0% reported awareness of influenza). Awareness of the corresponding vaccines among adults aged ≥19years ranged from 59.3% to 94.1% (59.3% HZ vaccine, 59.6% HPV vaccine, 64.3% hepatitis B vaccine, 66.2% pneumococcal vaccine, 86.3% tetanus vaccines, and 94.1% influenza vaccine). In multivariable analysis, being female and being a college graduate were significantly associated with a higher level of awareness for majority of vaccine-preventable diseases, and being female, being a college graduate, and working as a health care provider were significantly associated with a higher level of awareness for majority of corresponding vaccines. Although adults in this survey reported high levels of awareness for most vaccines recommended for adults, self-reported vaccination coverage was not optimal. Combining interventions known to

  10. Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 ...

    Science.gov (United States)

    ... 2013 Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 Increased between 2005 and 2011 Central nervous system (CNS) stimulants include prescription drugs, like those used ...

  11. Demographic and socioeconomic risk factors of adult violent victimization from an accident and emergency department and forensic medicine perspective

    DEFF Research Database (Denmark)

    Faergemann, Christian; Lauritsen, Jens; Brink, Ole

    2009-01-01

    To describe demographic and socioeconomic risk factors of adult violent victimization leading to contact with an emergency department and/or an institute of forensic medicine based on a case-control study design....

  12. Adherence decision making in the everyday lives of emerging adults with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Pyatak EA

    2013-07-01

    Full Text Available Elizabeth A Pyatak,1 Daniella Florindez,1 Marc J Weigensberg2 1Division of Occupational Science and Occupational Therapy, University of Southern California, 2Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA Purpose: The purpose of this study was to explore motivations underlying nonadherent treatment decisions made by young adults with type 1 diabetes. Methods: Eight emerging adults each completed a series of semi-structured interviews concerning their approaches to diabetes care, relationships with clinicians, and everyday activities and routines. A narrative thematic analysis was used to develop initial themes and refine them through continued data collection and review of the research literature. Results: Five themes were identified as motivating nonadherence: (1 efforts to mislead health care providers, (2 adherence to alternative standards, (3 treatment fatigue and burnout, (4 social support problems, and (5 emotional and self-efficacy problems. Conclusion: Instances of nonadherence generally involved a combination of the five identified themes. Participants reporting nonadherence also described difficulties communicating with care providers regarding their treatment. Nonjudgmental communication between providers and emerging adults may be particularly important in promoting positive health outcomes in this population. Keywords: compliance, health behavior, nonadherence, motivations

  13. Falls prevention education between older adults and healthcare providers during transition from hospital to community-living

    OpenAIRE

    Lee, Den-Ching Angel

    2017-01-01

    Background: Falls are a problem for older adults. In particular, older hospitalised adults and those recently discharged from hospital have been shown to be at an increased risk of falls compared to older adults living in the community. Falls impact negatively on the physical and psychosocial well-being of older adults. They increase the burden of care for their family, caregivers and the healthcare system. However, many falls in older adults are preventable. Cochrane reviews demonstrated man...

  14. The role of romantic relationship status in pathways of risk for emerging adult alcohol use.

    Science.gov (United States)

    Salvatore, Jessica E; Thomas, Nathaniel S; Cho, Seung Bin; Adkins, Amy; Kendler, Kenneth S; Dick, Danielle M

    2016-05-01

    Dating several people in emerging adulthood has been associated with higher alcohol use compared with being single or being in an exclusive relationship. As a follow-up to that report, we examined whether romantic relationship status is part of a pathway of risk between antecedent alcohol use risk factors and subsequent alcohol outcomes. Participants were 4,410 emerging adults assessed at 2 time-points during their first year of college. We found that a parental history of alcohol problems was indirectly related to dating several people via 2 modestly correlated pathways. The first pathway was through conduct problems. The second pathway was through positive urgency (i.e., a positive emotion-based predisposition to rash action). In turn, dating several people was associated with higher alcohol use. Our results suggest that these familial and individual-level alcohol risk factors are related to emerging adults' selection into subsequent romantic relationship experiences that are associated with higher alcohol use. These findings have implications for how romantic relationship experiences may fit into developmental models of the etiology of alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. The role of romantic relationship status in pathways of risk for emerging adult alcohol use

    Science.gov (United States)

    Salvatore, Jessica E.; Thomas, Nathaniel S.; Cho, Seung Bin; Adkins, Amy; Kendler, Kenneth S.; Dick, Danielle M.

    2015-01-01

    Dating several people in emerging adulthood has been associated with higher alcohol use compared to being single or being in an exclusive relationship. As a follow-up to that report, we examined whether romantic relationship status is part of a pathway of risk between antecedent alcohol use risk factors and subsequent alcohol outcomes. Participants were 4,410 emerging adults assessed at two time-points during their first year of college. We found that a parental history of alcohol problems was indirectly related to dating several people via two modestly correlated pathways. The first pathway was through conduct problems. The second pathway was through positive urgency (i.e., a positive emotion-based predisposition to rash action). In turn, dating several people was associated with higher alcohol use. Our results suggest that these familial and individual-level alcohol risk factors are related to emerging adults' selection into subsequent romantic relationship experiences that are associated with higher alcohol use. These findings have implications for how romantic relationship experiences may fit into developmental models of the etiology of alcohol use. PMID:27214170

  16. The influence of pornography on sexual scripts and hooking up among emerging adults in college.

    Science.gov (United States)

    Braithwaite, Scott R; Coulson, Gwen; Keddington, Krista; Fincham, Frank D

    2015-01-01

    The explosive growth in access to the Internet has led to a commensurate increase in the availability, anonymity, and affordability of pornography. An emerging body of research has shown associations between pornography and certain behaviors and attitudes; yet, how pornography actually influences these outcomes has not been documented. In two studies (Study 1 N = 969; Study 2 N = 992) we examined the hypothesis that pornography influences potentially risky sexual behavior (hooking up) among emerging adults via sexual scripts. Our results demonstrate that more frequent viewing of pornography is associated with a higher incidence of hooking up and a higher number of unique hook up partners. We replicated these effects both cross-sectionally and longitudinally while accounting for the stability of hook ups over the course of an academic semester. We also demonstrated that more frequent viewing of pornography is associated with having had more previous sexual partners of all types, more one occasion sexual partners ("one night stands"), and plans to have a higher number of sexual partners in the future. Finally, we provided evidence that more permissive sexual scripts mediated the association between more frequent pornography viewing and hooking up. We discuss these findings with an eye toward mitigating potential personal and public health risks among emerging adults.

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

    Science.gov (United States)

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

    2016-08-01

    To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

    Science.gov (United States)

    Delgado, Carmen; Sánchez-Prada, Andrés; Parra-Vidales, Esther; de Leo, Diego; Franco-Martín, Manuel

    2018-01-01

    Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ

  19. Patient satisfaction, preventive services, and emergency room use among African-Americans with type 2 diabetes.

    Science.gov (United States)

    Gary, Tiffany L; Maiese, Eric M; Batts-Turner, Marian; Wang, Nae-Yuh; Brancati, Fredrick L

    2005-12-01

    The aim of this study was to determine the relationship between patient satisfaction and diabetes- related preventive health care and emergency room (ER) use. We studied 542 urban African-Americans with type 2 diabetes aged > or =25 years who were enrolled in a primary carebased intervention trial to improve diabetes control and reduce adverse health events; 73% female, mean age 58 years, 35% had yearly household incomes of Consumer Assessment of Health Plans Survey (CAHPS) and use of diabetes-related preventive health care and ER were assessed by self-report. We then followed participants for 12 months to determine ER use prospectively. In general, participants gave favorable ratings of their care; over 70% reported that they had no problem getting care, over 60% reported the highest ratings on the communication and courtesy domains, and mean ratings (0-10 scale) for personal doctor and overall health care were high (8.8 and 8.4, respectively). Using poisson regression models adjusted for age, education, and self-reported rating of health, several aspects of patient satisfaction were associated with subsequent ER use. Participants who reported that medical staff were usually helpful or that doctors and nurses usually spent enough time were 0.49 and 0.37 times, respectively, less likely to use the ER (all p < 0.05). However, few aspects of patient satisfaction were associated with better preventive services. These data suggest that greater patient satisfaction was associated with lower ER use in urban African-Americans. Whether measures to improve patient satisfaction would reduce ER use requires further prospective study.

  20. Causes and prevention of violence toward emergency personnel by patients and their relatives in a province in Turkey.

    Science.gov (United States)

    Cebeci, Fatma; Sucu, Gülten; Karazeybek, Ebru

    2009-03-23

    STUDY OBJECTIVE: This research was conducted to determine the opinions of the emergency department's personnel about the causes and prevention of violence directed at them by patients and their relatives. METHODS: This research was conducted between 3 February and 15 June, 2006, in Antalya, a province in southern Turkey, with a total of 216 emergency department personnel who work in the emergency departments of three hospitals. A questionnaire developed by researchers was used to collect data for the purpose of determining what kind of violence is directed at emergency personnel by patients and their relatives and the personnel's socio-demographic characteristics and opinions. Pearson's chi and Fisher's exact test were used in the analysis of the data. RESULTS: Almost all (94.4%) of the participating emergency personnel had been exposed to verbal violence and 59.7% to physical violence. Only 24.5% of those exposed to violence reported the violence. The majority of the personnel (72.5%) thought that individuals' personality tendencies are the primary cause of violence. Their primary recommendation for preventing violence was to increase security measures. Statistically significant differences were found between emergency personnel's place of work and physical violence, between gender and physical violence, and between level of education and reporting violence. CONCLUSION: On the basis of the research results, it is recommended that emergency personnel be trained on the subject of violence, a documentation system be developed for recording and reporting violence, and corrections be made to prevent violence based on the personnel's opinions.

  1. Regional and international approaches on prevention and control of animal transboundary and emerging diseases.

    Science.gov (United States)

    Domenech, J; Lubroth, J; Eddi, C; Martin, V; Roger, F

    2006-10-01

    Transboundary animal diseases pose a serious risk to the world animal agriculture and food security and jeopardize international trade. The world has been facing devastating economic losses from major outbreaks of transboundary animal diseases (TADs) such as foot-and-mouth disease, classical swine fever, rinderpest, peste des petits ruminants (PPR), and Rift Valley fever. Lately the highly pathogenic avian influenza (HPAI) due to H5N1 virus, has become an international crisis as all regions around the world can be considered at risk. In the past decades, public health authorities within industrialized countries have been faced with an increasing number of food safety issues. The situation is equally serious in developing countries. The globalization of food (and feed) trade, facilitated by the liberalization of world trade, while offering many benefits and opportunities, also represents new risks. The GF-TADs Global Secretariat has carried out several regional consultations for the identification of priority diseases and best ways for their administration, prevention and control. In the questionnaires carried out and through the consultative process, it was noted that globally, FMD was ranked as the first and foremost priority. Rift Valley fever, and today highly pathogenic avian influenza, are defined as major animal diseases which also affect human health. PPR and CBPP, a disease which is particularly serious in Africa and finally, African swine fever (ASF) and classical swine fever (CSF) are also regionally recognised as top priorities on which the Framework is determined to work. The FAO philosophy--shared by the OIE--embraces the need to prevent and control TADs and emerging diseases at their source, which is most of the time in developing countries. Regional and international approaches have to be followed, and the FAO and OIE GF-TADs initiative provides the appropriate concepts and objectives as well as an organizational framework to link international and

  2. Sleep problems: predictor or outcome of media use among emerging adults at university?

    Science.gov (United States)

    Tavernier, Royette; Willoughby, Teena

    2014-08-01

    The pervasiveness of media use in our society has raised concerns about its potential impact on important lifestyle behaviours, including sleep. Although a number of studies have modelled poor sleep as a negative outcome of media use, a critical assessment of the literature indicates two important gaps: (i) studies have almost exclusively relied on concurrent data, and thus have not been able to assess the direction of effects; and (ii) studies have largely been conducted with children and adolescents. The purpose of the present 3-year longitudinal study, therefore, was to examine whether both sleep duration and sleep problems would be predictors or outcomes of two forms of media use (i.e. television and online social networking) among a sample of emerging adults. Participants were 942 (71.5% female) university students (M = 19.01 years, SD = 0.90) at Time 1. Survey measures, which were assessed for three consecutive years starting in the first year of university, included demographics, sleep duration, sleep problems, television and online social networking use. Results of a cross-lagged model indicated that the association between sleep problems and media use was statistically significant: sleep problems predicted longer time spent watching television and on social networking websites, but not vice versa. Contrary to our hypotheses, sleep duration was not associated with media use. Our findings indicate no negative effects of media use on sleep among emerging adults, but instead suggest that emerging adults appear to seek out media as a means of coping with their sleep problems. © 2014 European Sleep Research Society.

  3. Gender roles and binge drinking among Latino emerging adults: a latent class regression analysis.

    Science.gov (United States)

    Vaughan, Ellen L; Wong, Y Joel; Middendorf, Katharine G

    2014-09-01

    Gender roles are often cited as a culturally specific predictor of drinking among Latino populations. This study used latent class regression to test the relationships between gender roles and binge drinking in a sample of Latino emerging adults. Participants were Latino emerging adults who participated in Wave III of the National Longitudinal Study of Adolescent Health (N = 2,442). A subsample of these participants (n = 660) completed the Bem Sex Role Inventory--Short. We conducted latent class regression using 3 dimensions of gender roles (femininity, social masculinity, and personal masculinity) to predict binge drinking. Results indicated a 3-class solution. In Class 1, the protective personal masculinity class, personal masculinity (e.g., being a leader, defending one's own beliefs) was associated with a reduction in the odds of binge drinking. In Class 2, the nonsignificant class, gender roles were not related to binge drinking. In Class 3, the mixed masculinity class, personal masculinity was associated with a reduction in the odds of binge drinking, whereas social masculinity (e.g., forceful, dominant) was associated with an increase in the odds of binge drinking. Post hoc analyses found that females, those born outside the United States, and those with greater English language usage were at greater odds of being in Class 1 (vs. Class 2). Males, those born outside the United States, and those with greater Spanish language usage were at greater odds of being in Class 3 (vs. Class 2). Directions for future research and implications for practice with Latino emerging adults are discussed.

  4. Assessment of hospital-based adult triage at emergency receiving areas in hospitals in Northern Uganda.

    Science.gov (United States)

    Opiro, Keneth; Wallis, Lee; Ogwang, Martin

    2017-06-01

    Limited health service resources must be used in a manner which does "the most for the most". This is partly achieved through the use of a triage system. Whereas efforts have been made to introduce paediatric triage in Uganda such as Emergency Triage Assessment and Treatment Plus (ETAT+), it is not clear if hospitals have local protocols for adult triage being used in each setting. To determine the presence of existing hospital triage systems, the cadre of staff undertaking triage and barriers to development/improvement of formal triage systems. This was a descriptive cross-sectional study. Acholi sub-region was randomly selected for the study among the three sub-regions in Northern Uganda. The study was conducted in 6 of the 7 hospitals in the region. It was a written self-administered questionnaire. Thirty-three participants from 6 hospitals consented and participated in the study. Only one hospital (16.7%) of the 6 hospitals surveyed had a formal hospital-based adult triage protocol in place. Only 2 (33.3%) hospitals had an allocated emergency department, the rest receive emergency patients/perform triage from OPD and wards. Lack of training, variation of triage protocols from hospital to another, shortage of staff on duty, absence of national guidelines on triage and poor administrative support were the major barriers to improvement/development of formal triage in all these hospitals. Formal adult hospital-based triage is widely lacking in Northern Uganda and staff do perform subjective "eyeball" judgments to make triage decisions.

  5. Emergency Department Visits by Older Adults with Mental Illness in North Carolina

    Directory of Open Access Journals (Sweden)

    Anne M. Hakenewerth

    2015-12-01

    Full Text Available Introduction: We analyzed emergency department (ED visits by patients with mental health disorders (MHDs in North Carolina from 2008-2010 to determine frequencies and characteristics of ED visits by older adults with MHDs. Methods: We extracted ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT. We defined mental health visits as visits with a mental health ICD-9-CM diagnostic code, and organized MHDs into clinically similar groups for analysis. Results: Those ≥65 with MHDs accounted for 27.3% of all MHD ED visits, and 51.2% were admitted. The most common MHD diagnoses for this age group were psychosis, and stress/anxiety/depression. Conclusion: Older adults with MHDs account for over one-quarter of ED patients with MHDs, and their numbers will continue to increase as the “boomer” population ages. We must anticipate and prepare for the MHD-related needs of the elderly.

  6. Haematological emergencies managing hypercalcaemia in adults and children with haematological disorders.

    LENUS (Irish Health Repository)

    Sargent, Jeremy T S

    2012-02-01

    Hypercalcaemia is a common metabolic complication of malignant disease often requiring emergency intervention. Although it is more frequently associated with solid tumours, malignancy-associated hypercalcaemia (MAH) is seen in a significant number of patients with blood diseases. Its association with myeloma and adult T-cell leukaemia\\/lymphoma is well recognized but the incidence of hypercalcaemia in other haematological neoplasms, affecting adults and children, is less clearly defined. Haematologists need to be familiar with the clinical manifestations of, the differential diagnosis to be considered and the most effective management strategies that are currently available for MAH. The key components of management of MAH include aggressive rehydration, specific therapy to inhibit bone resorption and, crucially, treatment of the underlying malignancy. Bisphosphonates have revolutionized the management of MAH over the last 20 years, however the elucidation of molecular pathways implicated in MAH is facilitating the development of more targeted approaches to treatment.

  7. The interplay of frequency of volunteering and prosocial motivation on purpose in life in emerging adults.

    Science.gov (United States)

    Okun, Morris A; Kim, Ga Young

    2016-01-01

    One developmental task in emerging adulthood is finding meaning and purpose in life. Volunteering has been touted as one role that fosters purpose in life. We examined whether the association between frequency of volunteering and purpose in life varies with pleasure-based prosocial motivation and pressure-based prosocial motivation in a sample of 576 undergraduates, ages 18-22 years old. In a regression analysis predicting purpose in life, the frequency of volunteering by pleasure-based prosocial motivation by pressure-based prosocial motivation interaction effect was significant (p = .042). Simple slopes analyses revealed that frequency of volunteering was not significantly (p = .478) related to purpose in life among college students who were low in both pleasure-based and pressure-based prosocial motivation. The findings of the present study highlight the importance of prosocial motivation for understanding whether emerging adults' purpose in life will be enhanced by volunteering.

  8. Family cultural socialization practices and ethnic identity in college-going emerging adults.

    Science.gov (United States)

    Juang, Linda; Syed, Moin

    2010-06-01

    We examined how family cultural socialization related to the ethnic identity of Asian American, Latino, White, and Mixed-Ethnic emerging adults (N=225). Greater family cultural socialization was related to greater ethnic identity exploration and commitment. Ethnic minority students reported higher levels of family cultural socialization and ethnic identity compared to White students. The family cultural socialization-ethnic identity link was more pronounced for females compared to males, and for White compared to ethnic minority students. The findings highlight the importance of the family for identity development beyond adolescence.

  9. Are Older Adults Prepared to Ensure Food Safety during Extended Power Outages and Other Emergencies?: Findings from a National Survey

    Science.gov (United States)

    Kosa, Katherine M.; Cates, Sheryl C.; Karns, Shawn; Godwin, Sandria L.; Coppings, Richard J.

    2012-01-01

    Natural disasters and other emergencies can cause an increased risk of foodborne illness. We conducted a nationally representative survey to understand consumers' knowledge and use of recommended practices during/after extended power outages and other emergencies. Because older adults are at an increased risk for foodborne illness, this paper…

  10. Patterns and predictors of state adult obesity prevention legislation enactment in US states: 2010-2013.

    Science.gov (United States)

    Donaldson, Elisabeth A; Cohen, Joanna E; Villanti, Andrea C; Kanarek, Norma F; Barry, Colleen L; Rutkow, Lainie

    2015-05-01

    This study examined bill- and state-level factors associated with enactment of adult obesity prevention legislation in US states. A review of bills in the Rudd Center for Food Policy and Obesity's legislative database identified 487 adult obesity prevention bills, or proposed legislation, introduced between 2010 and 2013. Multilevel models were constructed to examine bill- and state-level characteristics associated with enactment. From 2010 to 2013, 81 (17%) of obesity prevention bills introduced were enacted across 35 states and the District of Columbia. Bills introduced in 2010 were more likely to be enacted than in 2013 (OR=9.49; 95% CI: 2.61-34.5). Bills focused on access to healthy food, physical activity, general and educational programs, as well as modifying rules and procedures (e.g., preemption) had greater odds of enactment relative to food and beverage taxes (OR=8.18; 95% CI: 2.85-23.4 healthy food; OR=17.3; 95% CI: 4.55-65.7 physical activity; OR=15.2; 95% CI: 4.80-47.9 general; OR=13.7; 95% CI: 3.07-61.5 rules). The year of bill introduction and overall bill enactment rate were related to adult obesity prevention legislation enactment in states. This study highlights the importance of a bill's topic area for enactment and provides insights for advocates and policymakers trying to address enactment barriers. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Using commercial video games for falls prevention in older adults: the way for the future?

    Science.gov (United States)

    Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

    2014-01-01

    Falls in older adults are an increasingly costly public health issue. There are many fall prevention strategies that are effective. However, with an increasing population of older people and ever-decreasing availability of health practitioners and health funding, novel modes of intervention are being developed, including those relying on computer technologies.The aim of this article was to review the literature on the use of exergaming to prevent falls in older adult persons living in the community. The Cochrane, Medline, and Embase databases were searched using prespecified search terms. To be included, studies had to investigate the effect of using commercially available consoles and video games on outcome measures such as a decrease in falls, improvements in balance control or gait parameters, decreased fear of falling, and attitude to exercise in older adult persons living in the community. All study designs with the exception of single-person case studies were included. Articles had to be published in peer-reviewed journals in the English language. Nineteen studies fulfilled the inclusion criteria. The following outcomes were observed: (1) using computer-based virtual reality gaming for balance training in older adults was feasible; (2) the majority of studies showed a positive effect of exergaming on balance control; (3) some studies showed a positive effect on balance confidence and gait parameters; (4) the effect was seen across the age and sex spectrum of older adults, including those with and without balance impairment. There is as yet no evidence that using virtual reality games will prevent falls, but there is an indication that their use in balance training may improve balance control, which in turn may lead to falls prevention.

  12. Factors associated with free adult preventive health care utilization among physically disabled people in Taiwan: nationwide population-based study.

    Science.gov (United States)

    Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

    2014-12-05

    Few previous studies have specifically addressed the health care utilization situation of the physically disabled. This study aimed to investigate the utilization of free adult preventive health care for physically disabled people and its' affecting factors. The data was obtained from three nationwide databases from 2006 to 2008. This study comprised 329,264 physically disabled people in Taiwan above the age of 40 who had eligible health checks during 2008. We employed descriptive statistics to analyze the use and rate of free preventive health care use by physically disabled adults. Logistic regression analysis was used to explore the factors that affect physically disabled adults' use of free adult preventive health care. 16.37% of the physically disabled adults used free adult preventive health care. Women (17.66%), married (17.16%), a junior high education level (17.89%), and mildly disabled adults (18.77%) had the highest use rate among various participant subgroups. The variables that significantly influenced the use of free adult preventive health care by the physically disabled included gender, age, education, marital status, urbanization of the residence areas, monthly payroll, aboriginal status, catastrophic illnesses status, relevant chronic diseases, and severity of disability. Physically disabled using preventive health care tend to be low. Governments should use the media to reinforce propagation and education of these services to specific, low-utilization groups, and encourage doctors to actively provide preventive health care to communities.

  13. Awareness regarding preventive measures of avian influenza among the adult people of Thimi Municipality, Nepal.

    Science.gov (United States)

    Manandhar, K; Chataut, J; Khanal, K; Shrestha, A; Shrestha, S; Shrestha, S

    2013-01-01

    Avian influenza is considered as a threat to global public health. Prevention and control depends on the awareness of the general population as well as high risk-groups. The avian influenza should be viewed more seriously because it may lead to pandemic influenza when the virus mutates its strain with the common human influenza. Thus, this study aims to explore the awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. The objective of this study was to explore awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. It is a cross-sectional, population based study. It was carried out in Thimi Municipality from May 15 to June 15, 2012. Pre tested structured questionnaire was used for face to face interview with randomly selected 250 subjects. Out of 250 subjects, 123 (49.2 %) were males. The mean age of subjects was 36 ± 11.8 year. Among total subjects, 94.4 percent had heard about avian influenza. The main source of information was television (94.1%). Majority of subjects (84.9 %) thought that keeping infected birds and poultry as the mode of transmission followed by eating not well cooked poultry meat (82.8 %). Out of total study subjects, 165 (66.0 percent) mentioned fever and 138 (55.2 percent) thought fatigue as the signs and symptoms. As for knowledge about preventive measures, majority (85.6%) stated that cleaning the surfaces that had come in contact with the poultry could prevent the disease and 83.2 % had knowledge that the infection could be prevented by washing hands with soap and water after poultry handling. Awareness regarding preventive measures was found significantly low in females, middle adults, illiterates, and house wives. The awareness regarding avian influenza was quite satisfactory among the adult people of Thimi Municipality. However level of awareness was seen lower in female, illiterate and middle adult. So that along with large

  14. System factors to explain H1N1 state vaccination rates for adults in US emergency response to pandemic.

    Science.gov (United States)

    Davila-Payan, Carlo; Swann, Julie; Wortley, Pascale M

    2014-05-23

    During the 2009-2010 H1N1 pandemic, vaccine in short supply was allocated to states pro rata by population, yet the vaccination rates of adults differed by state. States also differed in their campaign processes and decisions. Analyzing the campaign provides an opportunity to identify specific approaches that may result in higher vaccine uptake in a future event of this nature. To determine supply chain and system factors associated with higher state H1N1 vaccination coverage for adults in a system where vaccine was in short supply. Regression analysis of factors predicting state-specific H1N1 vaccination coverage in adults. Independent variables included state campaign information, demographics, preventive or health-seeking behavior, preparedness funding, providers, state characteristics, and H1N1-specific state data. The best model explained the variation in state-specific adult vaccination coverage with an adjusted R-squared of 0.76. We found that higher H1N1 coverage of adults is associated with program aspects including shorter lead-times (i.e., the number of days between when doses were allocated to a state and were shipped, including the time for states to order the doses) and less vaccine directed to specialist locations. Higher vaccination coverage is also positively associated with the maximum number of ship-to locations, past seasonal influenza vaccination coverage, the percentage of women with a Pap smear, the percentage of the population that is Hispanic, and negatively associated with a long duration of the epidemic peak. Long lead-times may be a function of system structure or of efficiency and may suggest monitoring or redesign of distribution processes. Sending vaccine to sites with broad access could be useful when covering a general population. Existing infrastructure may be reflected in the maximum number of ship-to locations, so strengthening routine influenza vaccination programs may help during emergency vaccinations also. Future research

  15. A randomized controlled trial of Koru: a mindfulness program for college students and other emerging adults.

    Science.gov (United States)

    Greeson, Jeffrey M; Juberg, Michael K; Maytan, Margaret; James, Kiera; Rogers, Holly

    2014-01-01

    To evaluate the effectiveness of Koru, a mindfulness training program for college students and other emerging adults. Ninety students (66% female, 62% white, 71% graduate students) participated between Fall 2012 and Spring 2013. Randomized controlled trial. It was hypothesized that Koru, compared with a wait-list control group, would reduce perceived stress and sleep problems, and increase mindfulness, self-compassion, and gratitude. As hypothesized, results showed significant Group (Koru, Wait-List)×Time (Pre, Post) interactions for improvements in perceived stress (F[1, 76.40]=4.50, p=.037, d=.45), sleep problems (F [1, 79.49]=4.71, p=.033, d=.52), mindfulness (F [1, 79.09]=26.80, p<.001, d=95), and self-compassion (F[1, 74.77]=18.08, p<.001, d=.75). All significant effects were replicated in the wait-list group. Significant correlations were observed among changes in perceived stress, sleep problems, mindfulness, and self-compassion. Results support the effectiveness of the Koru program for emerging adults in the university setting.

  16. 'Hello, you're not supposed to be here': homeless emerging adults' experiences negotiating food access.

    Science.gov (United States)

    Bowen, Elizabeth A; Irish, Andrew

    2018-03-05

    We aimed to examine the food-seeking experiences of homeless emerging adults (age 18-24 years) in a US urban context. The study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews. Emerging themes were confirmed and refined through member checking. Buffalo, a mid-sized city in the Northeastern USA. A sample of thirty participants was recruited through community-based methods. Eligibility criteria specified that participants were aged 18-24 years and did not have a stable place to live. The sample was demographically diverse and included participants who were couch-surfing, staying on the streets and/or using shelters. Participants' food access strategies varied across their living circumstances. Common strategies included purchasing food with cash or benefits (reported by 77 %), using free meal programmes (70 %) and eating at friends' or relatives' homes (47 %). Although 70 % of participants received Supplemental Nutrition Assistance Program benefits, several reported access barriers, including initial denials of eligibility due to being listed on a parent's application even when the participant no longer resided in the household. Participants described a stigma associated with using food pantries and free meal programmes and expressed preference for less institutionalized programmes such as Food Not Bombs. Given endemic levels of food insecurity among homeless youth and young adults, policy modifications and service interventions are needed to improve food access for this population.

  17. The Youth Psychopathic Traits Inventory-Short Version in a general population sample of emerging adults.

    Science.gov (United States)

    Colins, Olivier F; Andershed, Henrik

    2016-05-01

    Prior studies with children and adolescents have shown that Youth Psychopathic Traits Inventory-Short Version (YPI-S) scores are internally consistent and manifest expected relations with external variables of interest. In the present study, the factor structure and the internal consistency of YPI-S scores, and the convergent validity of the interpretation of YPI-S scores were tested in a sample of 2,500 emerging adults from the general population in Sweden (aged 20-24 years; 52.6% women). Results of exploratory and confirmatory factor analyses support a 3-factor structure among both men and women that is similar to prior YPI-S studies conducted with children and adolescents. The YPI-S total score and the 3 factor scores were internally consistent. Correlations with external variables, including aggression and delinquency, support the convergent validity of the interpretation of YPI-S scores. Finally, the strength of these zero-order and partial correlations, overall, was not significantly different across gender. In conclusion, this study provides initial evidence that the YPI-S may hold promise as a brief and time-effective self-report tool for assessing psychopathic traits in emerging adults. The present findings also suggest that the YPI-S performs in a consistent manner across gender. Recommendations for future research with the YPI-S are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Friendship and romantic relationships among emerging adults with and without type 1 diabetes.

    Science.gov (United States)

    Helgeson, Vicki S; Mascatelli, Katilyn; Reynolds, Kerry A; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2015-04-01

    To examine whether friendship and romantic relationships of emerging adults with type 1 diabetes differed from those of a comparison group, and to determine whether these relationships were associated with psychological and diabetes health outcomes. High school seniors with (n = 122) and without (n = 118) type 1 diabetes were assessed annually for 3 years. Friend and romantic relationship variables, psychological distress, life satisfaction, eating disturbances, and, for those with diabetes, diabetes outcomes were assessed. Those with diabetes reported less friend support but similar friend conflict compared with controls. Aspects of romantic relationships and friend relationships were associated with health outcomes, but there were more effects involving romantic relationships. On some indices, romantic support was more beneficial for controls and romantic conflict was more troublesome for those with diabetes. Both friendship and romantic relationships were associated with psychological and diabetes outcomes among emerging adults. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Religious Attachment and the Sense of Life Purpose among Emerging Adults

    Directory of Open Access Journals (Sweden)

    Julian Culver

    2017-12-01

    Full Text Available The salubrious association between religious involvement and well-being is evident among the general population of religious individuals. In particular, the sense of attachment to a deity is linked to promoting healthy behavior and positive well-being. The link between religious attachment and well-being is particularly salient for emerging adults during a life stage where they are developing their own sense of self while also renegotiating religious commitments. The current study uses OLS regression and a lagged dependent variable model to analyze how perceived closeness to God is linked to the sense of life purpose among a diverse, national sample of emerging adults. We find that relative to those perceiving closeness to God, those who reported feeling neutral or did not believe in God experienced lower levels of life purpose. Respondents who reported feeling distant from God had the lowest scores on the Life Purpose Index. The findings are examined within the framework of religion and attachment theory literature. The study encourages researchers to consider attachment to a deity as an important link in explaining well-being outcomes, especially among religious individuals.

  20. Factors Related to Weight Gain/Loss among Emerging Adults with Obesity.

    Science.gov (United States)

    Johnson, Ping H; Annesi, James J

    2018-05-01

    We examined the reasons for weight gain and barriers to weight loss among emerging adults with obesity. Eighty-one female undergraduate students with obesity completed 4-open ended questions in 2015-2016. Qualitative responses were analyzed using NVivo 11 Pro software. Most participants experienced weight gain prior to attending college. The most commonly reported reasons for weight gain include a lack of ability to control one's behaviors or overcome barriers (ie, poor eating habits, lack of physical activity, lack of time, easy access to food), emotional/mental health issues, physical health, and influence of significant others. Nearly half reported having a weight loss goal. Most reported having used one or more weight loss methods. Few reached short-term weight loss but quickly regained the lost weight. Major reported barriers reflect a lack of self-regulation skills, negative mood and stress, and lack of self-efficacy for healthy eating or physical activity. Results suggest that the perceived ability to control one's behaviors and overcome barriers, self-efficacy, and mood are important in weight-related behaviors, weight, and weight loss success among emerging adults, especially those enrolled in college.

  1. Harsh Parenting and Food Insecurity in Adolescence: The Association With Emerging Adult Obesity.

    Science.gov (United States)

    Lohman, Brenda J; Gillette, Meghan T; Neppl, Tricia K

    2016-07-01

    As the first study of its kind, the overall purpose of this article was to examine the relationships and interactions between harsh parenting (HP) and food insecurity (FI) in adolescence on the development of overweight/obesity (OW/OB) in emerging adulthood. Data came from the Iowa Youth and Families Project, a longitudinal study of 451 adolescent youth and their families that began in 1989 in the rural Midwest. Adolescents were aged 13 years at the initial assessment, and weight status in emerging adulthood was measured 10 years later at age 23. Experiencing HP in adolescence predicted greater odds of OW/OB at 23 years old. Higher body mass indexes of the adolescent and his or her father in adolescence also increased the odds of being OW/OB at 23 years. Having parents with higher levels of education lowered the odds of being OW/OB in emerging adulthood. Finally, females who experienced high levels of FI and HP in adolescence had higher odds of OW/OB at 23 years in comparison to males. HP, in combination with FI in adolescence, predicted OW/OB for females in emerging adulthood but not for males. This study contributes to an understanding of the interplay between multiple influences in adolescence: namely, parenting and economic influences. Assessing antecedents to OW/OB in emerging adulthood via multiple pathways provides a more complex understanding of how and why adolescents turn into OW/OB adults. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Reducing preventable emergency department utilization and costs by using community health workers as patient navigators.

    Science.gov (United States)

    Enard, Kimberly R; Ganelin, Deborah M

    2013-01-01

    Primary care-related emergency department (PCR-ED) utilization, including for conditions that are preventable or treatable with appropriate primary care, is associated with decreased efficiency of and increased costs to the health system. Many PCR-ED users experience actual or perceived problems accessing appropriate, ongoing sources of medical care. Patient navigation, an intervention used most often in the cancer care continuum, may help to address these barriers among medically underserved populations, such as those who are low income, uninsured, publicly insured, or recent U.S. immigrants. We examined a patient navigation program designed to promote appropriate primary care utilization and prevent or reduce PCR-ED use at Memorial Hermann Health System in Houston, Texas. The intervention is facilitated by bilingual, state-certified community health workers (CHWs) who are trained in peer-to-peer counseling and connect medically underserved patients with medical homes and related support services. The CHWs provide education about the importance of primary care, assist with appointment scheduling, and follow up with patients to monitor and address additional barriers. Our study found that the patient navigation intervention was associated with decreased odds of returning to the ED among less frequent PCR-ED users. Among patients who returned to the ED for PCR reasons, the pre/post mean visits declined significantly over a 12-month pre/post-observation period but not over a 24-month period. The savings associated with reduced PCR-ED visits were greater than the cost to implement the navigation program. Our findings suggest that an ED-based patient navigation program led by CHWs should be further evaluated as a tool to help reduce PCR-ED visits among vulnerable populations.

  3. Journey to a safe environment: fall prevention in an emergency department at a level I trauma center.

    Science.gov (United States)

    Alexander, Danette; Kinsley, Terry L; Waszinski, Christine

    2013-07-01

    Predicting which patients will fall is a challenging task, especially in the often unpredictable setting of an emergency department of a Level I Trauma Center. Unfortunately, there is a great potential for falls to occur in this environment. Fall risk assessment tools used in inpatient settings do not adequately capture the risk factors of patients presenting to the emergency department. The ability to accurately identify patients at risk for falling at the point of entry is the first step toward preventing patient harm. Once patients are identified as at risk for a fall, the next challenge is to be sure that they do not fall. We created the KINDER1 Fall Risk Assessment Tool for use in the emergency department. This instrument was specifically designed for the rapid identification of patients at risk for a fall as well as the re-evaluation of patients for fall risk throughout their stay in the emergency department. Once we had an appropriate assessment tool, our next challenge was for staff to consistently apply fall prevention interventions. Performing a mini-root cause analysis on each fall showed trends and in turn led to the design and implementation of specific fall prevention interventions to motivate the nursing staff to focus on fall prevention that the ED nursing leadership used to select change strategies. With improved identification of fall risk patients and consistent application of innovative prevention strategies, we were able to show a trend toward reduction of falls and fall-related injuries in our emergency department. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  4. Dynamic transitions between marijuana use and cigarette smoking among US adolescents and emerging adults.

    Science.gov (United States)

    Yu, Bin; Chen, Xinguang; Wang, Yan

    2018-03-07

    Marijuana and tobacco are considered two closely related substances. It is of great significance to understand the mutual impact of marijuana and cigarette use when more states in the US have legalized marijuana use. This study aims to investigate the transitions between marijuana and cigarette use among adolescents and emerging adults. Guided by the probabilistic discrete events systems (PDES) theory, a five-stage model with 21 transition paths was constructed to quantify dynamic transitions between marijuana and cigarette use. The five stages were NU: Never-user, MU: Current marijuana user, CU: Current cigarette user, MCU: Current marijuana-cigarette user, and FU: Former-user. The proposed five-stage PDES model was tested using the 2013 National Survey on Drug Use and Health data (N = 26,665, 50.45% male). Transition probabilities were estimated using the Moore-Penrose generalized inverse matrix method. Among the adolescents, 51.14% of the CUs transited to use marijuana (MCU/MU), higher than the proportion of those who first used marijuana and then transferred to cigarettes (MCU/CU) (41.66%). The quitting rates for MUs, CUs and MCUs were 29.38%, 25.93% and 27.76%, respectively. Of the total FUs, 31.90% transited to MUs, 17.06% to CUs, and 17.39% to MCUs. Among the young adults, more people progressed from MUs to CUs. Transition probabilities by single year of age were also estimated. This is the first study to quantify marijuana-cigarette transitions. Study findings indicate more cigarette-to-marijuana transitions for adolescents and more marijuana-to-cigarette transitions for emerging adults. Future intervention programs should consider this age-related difference in marijuana-cigarette use transitions.

  5. Cortical thinness and volume differences associated with marijuana abuse in emerging adults.

    Science.gov (United States)

    Mashhoon, Y; Sava, S; Sneider, J T; Nickerson, L D; Silveri, M M

    2015-10-01

    The prevalence of marijuana (MJ) use among youth and its legalization for medical or recreational use has intensified public health endeavors of understanding MJ effects on brain structure and function. Studies indicate that MJ use is related to impaired cognitive performance, and altered functional brain activation and chemistry in adolescents and adults, but MJ effects on brain morphology in emerging adults are less understood. Fifteen MJ users (age 21.8±3.6, 2 females) and 15 non-user (NU) participants (age 22.3±3.5, 2 females) were included, demographically matched on age, education and alcohol use. High-resolution structural MR images were acquired at 3Tesla. Cortical thickness (CT) and volumetric analyses were performed using Freesurfer. A priori regions of interest (ROI) included orbitofrontal and cingulate cortices, amygdala, hippocampus and thalamus. Whole brain CT analysis did not result in significant group differences in a priori ROIs but revealed MJ users had significantly less CT (i.e., thinness) in right fusiform gyrus (rFG) compared to NU (p<0.05). Thalamic volume was significantly smaller in MJ users compared to NU (right, p=0.05; left, p=0.01) and associated with greater non-planning (p<0.01) and overall impulsivity (p=0.04). There were no other group differences. RFG cortical thinness and smaller thalamic volume in emerging adults is associated with MJ abuse. Furthermore, smaller thalamic volume associated with greater impulsivity contributes to growing evidence that the thalamus is neurobiologically perturbed by MJ use. Collectively, altered thalamic and rFG structural integrity may interfere with their known roles in regulating visuoperceptual and object information processing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Generation Validation: The Role of Social Comparison in Use of Instagram Among Emerging Adults.

    Science.gov (United States)

    Stapleton, Peta; Luiz, Gabriella; Chatwin, Hannah

    2017-03-01

    Social networking sites (SNSs) provide emerging adults with extreme and unprecedented transparency, exposing them to a plethora of opportunities for social comparison. In light of the growing use of the popular SNS, Instagram, among emerging adults, the purpose of this study was to examine the impact of exposure to social media-based social comparison information on self-esteem. The study recruited 237 participants through social media. The sample was narrowed to young adults aged 18-29 years. The study used a correlational nonexperimental approach to investigate two mediation models proposed in the literature. First, the study investigated the mediating role of social comparison on Instagram in the relationship between intensity of Instagram use and self-esteem. Second, the study examined the mediating role of social comparison in the relationship between self-worth contingent on approval from others and self-esteem. Although the first model was found to be nonsignificant, results observed a significant indirect pathway that confirmed the second model. Thus, social comparison on Instagram mediated the relationship between contingent self-worth and self-esteem. Furthermore, moderation analyses found that self-worth contingent on approval from others moderated the relationship between intensity of Instagram use and social comparison on Instagram. Thus, although Instagram did not directly affect self-esteem, the significant moderation suggested that intensity of Instagram use is influential when the young person's self-worth is contingent on approval from others. Overall, the findings are consistent with previous research and enhance our understanding of the mechanisms that link SNS use to low self-esteem.

  7. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    Science.gov (United States)

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-01-01

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments. PMID:28208748

  8. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    Directory of Open Access Journals (Sweden)

    Sungmin Lee

    2017-02-01

    Full Text Available Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS. Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA were analyzed at the census tract level (n = 264. Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

  9. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers.

    Science.gov (United States)

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-02-08

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

  10. Voices not heard: a systematic review of adolescents' and emerging adults' perspectives of health care transition.

    Science.gov (United States)

    Betz, Cecily L; Lobo, Marie L; Nehring, Wendy M; Bui, Kim

    2013-01-01

    A better understanding of the needs of adolescents and emerging adults with special health care needs (AEA-SHCNs) is essential to provide health care transition services that represent best practices. The purpose of this systematic review was to evaluate the research on health care transition for AEA-SHCNs from their perspectives. A comprehensive literature review of research publications since 2005 was performed using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and EBSCO databases. Thirty-five studies met the final review criteria. The process of transition from child to adult for AEA-SHCNs is complex. Individuals experiencing the transition desire to be a part of the process and want providers who will listen and be sensitive to their needs, which are often different from others receiving health care at the same facility. More research that considers the voice of the AEA-SHCNs related to transition from pediatric to adult care is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Older Adults' Perceptions of Clinical Fall Prevention Programs: A Qualitative Study

    OpenAIRE

    Calhoun, Rebecca; Meischke, Hendrika; Hammerback, Kristen; Bohl, Alex; Poe, Pamela; Williams, Barbara; Phelan, Elizabeth A.

    2011-01-01

    Objective. To investigate motivational factors and barriers to participating in fall risk assessment and management programs among diverse, low-income, community-dwelling older adults who had experienced a fall. Methods. Face-to-face interviews with 20 elderly who had accepted and 19 who had not accepted an invitation to an assessment by one of two fall prevention programs. Interviews covered healthy aging, core values, attributions/consequences of the fall, and barriers/benefits of fall prev...

  12. Relationships and health among emerging adults with and without Type 1 diabetes.

    Science.gov (United States)

    Helgeson, Vicki S; Palladino, Dianne K; Reynolds, Kerry A; Becker, Dorothy J; Escobar, Oscar; Siminerio, Linda

    2014-10-01

    The study's goal was to examine the impact of parent and peer relationships on health behaviors and psychological well-being of those with and without Type 1 diabetes over the transition to emerging adulthood. Emerging adulthood is an understudied developmental period and a high-risk period--especially for those with Type 1 diabetes. Youth with (n = 117) and without Type 1 diabetes (n = 122) completed questionnaires during their senior year of high school and 1 year later. Measures included supportive and problematic aspects of parent and peer relationships, health behaviors, psychological well-being, and, for those with diabetes, self-care behavior and glycemic control. Prospective multiple and logistic regression analysis revealed that friend conflict was a more potent predictor than friend support of changes in health behaviors and psychological well-being. Parent support was associated with positive changes in psychological well-being and decreases in smoking, whereas parent control was related to increases in smoking and depressive symptoms. There was some evidence of cross-domain buffering such that supportive relationships in one domain buffered adverse effects of problematic relationships in the other domain on health outcomes. This longitudinal study showed that parent relationships remain an important influence on, and peer relationships continue to influence, the health behaviors and psychological well-being of emerging adults with and without Type 1 diabetes. Parent relationships also have the potential to buffer the adverse effects of difficulties with peers.

  13. 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.

  14. Comprehensive services delivery and emergency department use among chronically homeless adults.

    Science.gov (United States)

    Moore, David T; Rosenheck, Robert A

    2017-05-01

    Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites. Multiple imputation was used to account for missing data and differential rates of attrition between the cohorts. Longitudinal models were constructed to compare ED use between the 2 groups during the first year after initiation of CICH services. A mediation analysis was performed to determine the relative contributions of being housed, the receipt of outpatient services, and health status to group differences in ED utilization. Participants receiving CICH services were significantly less likely to report ED use (odds ratio = 0.78, 95% confidence interval [0.65, 0.93]) in the year after program entry. Decreased ED use was primarily mediated by decreased homelessness-not by increased access to other services or health status. This suggests that becoming housed is a key driver of reduced ED utilization and that efforts to provide housing for homeless adults may result in significantly decreased ED use. Further research is needed to determine the long-term effects of housing on health status and to develop services to improve health outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Identity as a moderator of gender differences in the emotional closeness of emerging adults' same- and cross-sex friendships.

    Science.gov (United States)

    Johnson, H Durell; Brady, Evelyn; McNair, Renae; Congdon, Darcy; Niznik, Jamie; Anderson, Samantha

    2007-01-01

    Closeness is an integral aspect of friendships, and males and females differ in their closeness experiences within these relationships. However, identity development and friendship type (e.g., same-sex versus cross-sex friendships) may moderate these gender differences. In an attempt to clarify the relationships among gender, identity, and friendship closeness, the current study examined gender and identity associations with reported emotional closeness in emerging adults' same- and cross-sex friendships. Responses from 181 college undergraduates (89 males and 92 females) indicated similar levels of emotional closeness reported for same- and cross-sex friendships. Results also indicated overall identity commitment and friendship identity commitment associations with same-sex friendship closeness. Examination of closeness reports for cross-sex friends revealed a significant association with overall identity commitment for emerging adult males. A significant association was not indicated for emerging adult females. The associations between identity and emotional closeness in same-sex friendships and male cross-sex friendships support previous studies that report differences in the role of these relationships for emerging adult males and females. Findings are discussed in terms of understanding the gender and identity differences in emerging adults' reports of friendship closeness.

  16. Coping-motivated marijuana use correlates with DSM-5 cannabis use disorder and psychological distress among emerging adults.

    Science.gov (United States)

    Moitra, Ethan; Christopher, Paul P; Anderson, Bradley J; Stein, Michael D

    2015-09-01

    Compared to other age cohorts, emerging adults, ages 18-25 years, have the highest rates of marijuana (MJ) use. We examined the relationship of using MJ to cope with negative emotions, relative to using MJ for enhancement or social purposes, to MJ-associated problems and psychological distress among emerging adults. Participants were 288 community-dwelling emerging adults who reported current MJ use as part of a "Health Behaviors" study. Linear and logistic regressions were used to evaluate the adjusted association of coping-motivated MJ use with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) cannabis use disorder, MJ-related problem severity, depressive symptoms, and perceived stress. After adjusting for other variables in the regression model, using MJ to cope was positively associated with having DSM-5 cannabis use disorder (OR = 1.85, 95% CI [1.31, 2.62], p depression (b = .36, 95% CI [.23, .49], p < .01), and perceived stress (b = .37, 95% CI [.22, .51], p < .01). Using MJ for enhancement purposes or for social reasons was not associated significantly with any of the dependent variables. Using MJ to cope with negative emotions in emerging adults is associated with MJ-related problems and psychological distress. Assessment of MJ use motivation may be clinically important among emerging adults. (c) 2015 APA, all rights reserved).

  17. Does smart home technology prevent falls in community-dwelling older adults: a literature review.

    Science.gov (United States)

    Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

    2014-01-01

    Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies. The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly. Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of 'snowballing'. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants' fear of falling and attitudes towards monitoring technology were included. Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1) older adults' attitudes towards fall detectors and smart home technology are generally positive; (2) privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3) unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology. So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults' confidence and sense of security, thus possibly enabling aging in place.

  18. Evaluating antibiotic therapies prescribed to adult patients in the emergency department.

    Science.gov (United States)

    Grenet, J; Davido, B; Bouchand, F; Sivadon-Tardy, V; Beauchet, A; Tritz, T; Guyot, C; Perronne, C; Gaillard, J-L; Salomon, J; Beaune, S; Dinh, A

    2016-06-01

    The proper use of antibiotics is a public health priority to preserve their effectiveness. Little data is available on outpatient antibiotic prescriptions, especially in the emergency department. We aimed to assess the quality of outpatient antibiotic prescriptions in our hospital. Retrospective monocentric study of antibiotic prescriptions written to adult patients managed at the emergency department without hospitalization (November 15th, 2012-November 15th, 2013). Prescriptions were evaluated by an infectious disease specialist and an emergency physician on the basis of local recommendations compiled from national and international guidelines. A total of 760 prescriptions were reviewed. The most frequent indications were urinary tract infections (n=263; 34.6%), cutaneous infections (n=198; 26.05%), respiratory tract infections (n=101; 13.28%), and ENT infections (n=62; 8.15%). The most frequently prescribed antibiotics were fluoroquinolones (n=314; 40.83%) and amoxicillin-clavulanic acid (n=245; 31.85%). Overall, 455 prescriptions (59.86%) did not comply with guidelines. The main reasons for inadequacy were the absence of an indication for antibiotic therapy (n=197; 40.7%), an inadequate spectrum of activity, i.e. too broad, (n=95; 19.62%), and excessive treatment duration (n=87; 17.97%). Rates of inadequate prescriptions were 82.26% for ENT infections, 71.2% for cutaneous infections, 46.53% for respiratory tract infections, and 38.4% for urinary tract infections. Antibiotic prescriptions written to outpatients in the emergency department are often inadequate. Enhancing prescribers' training and handing out guidelines is therefore necessary. The quality of these prescriptions should then be re-assessed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

    Science.gov (United States)

    Günthard, Huldrych F.; Saag, Michael S.; Benson, Constance A.; del Rio, Carlos; Eron, Joseph J.; Gallant, Joel E.; Hoy, Jennifer F.; Mugavero, Michael J.; Sax, Paul E.; Thompson, Melanie A.; Gandhi, Rajesh T.; Landovitz, Raphael J.; Smith, Davey M.; Jacobsen, Donna M.; Volberding, Paul A.

    2016-01-01

    IMPORTANCE New data and therapeutic options warrant updated recommendations for the use of antiretroviral drugs (ARVs) to treat or to prevent HIV infection in adults. OBJECTIVE To provide updated recommendations for the use of antiretroviral therapy in adults (aged ≥18 years) with established HIV infection, including when to start treatment, initial regimens, and changing regimens, along with recommendations for using ARVs for preventing HIV among those at risk, including preexposure and postexposure prophylaxis. EVIDENCE REVIEW A panel of experts in HIV research and patient care convened by the International Antiviral Society-USA reviewed data published in peer-reviewed journals, presented by regulatory agencies, or presented as conference abstracts at peer-reviewed scientific conferences since the 2014 report, for new data or evidence that would change previous recommendations or their ratings. Comprehensive literature searches were conducted in the PubMed and EMBASE databases through April 2016. Recommendations were by consensus, and each recommendation was rated by strength and quality of the evidence. FINDINGS Newer data support the widely accepted recommendation that antiretroviral therapy should be started in all individuals with HIV infection with detectable viremia regardless of CD4 cell count. Recommended optimal initial regimens for most patients are 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (InSTI). Other effective regimens include nonnucleoside reverse transcriptase inhibitors or boosted protease inhibitors with 2 NRTIs. Recommendations for special populations and in the settings of opportunistic infections and concomitant conditions are provided. Reasons for switching therapy include convenience, tolerability, simplification, anticipation of potential new drug interactions, pregnancy or plans for pregnancy, elimination of food restrictions, virologic failure, or drug toxicities. Laboratory

  20. Effectiveness of bedrails in preventing falls among hospitalized older adults: a systematic review.

    Science.gov (United States)

    Marques, Paulo; Queirós, Carmen; Apóstolo, João; Cardoso, Daniela

    2017-10-01

    Falls are a major problem today affecting adults of any age, but the elderly are a population that is more susceptible to falls. Falls are the leading cause of injury or death among older adults. Hospitalized older people are particularly vulnerable to falls. Falls cause direct injuries (minor injuries, severe wounds of the soft tissues and bone fractures) to patients and increased length of stay. The prevention of falls is commonly considered an indicator of the quality of care. Therefore, health institutions and professionals treat the identification and implementation of strategies to prevent or minimize their effects as a high priority. Fall prevention interventions involving physical restraints are still common and considered a primary preventative measure, despite controversy in their use. One of the most frequently used restraint interventions is bedrails. The question of the effectiveness of bedrails in preventing falls cuts across all societies and cultures and has with significant implications for the clinical practice of nurses. The objective of this review was to identify the effectiveness of the use of bedrails in preventing falls among hospitalized older adults when compared with no use of bedrails or any type of physical restraints. The current review considered studies that included hospitalized adults (female and male), 65 years and over with any clinical condition in a non-intensive care unit (ICU). The current review considered studies that evaluated the use of bedrails as a restraint to prevent falls among older adults in non-ICUs compared to no use of bedrails or any type of physical restraints, for example, bedrails versus no bedrails, and bedrails versus no wrist or ankle ties. The current review considered any randomized controlled trials (RCTs). In the absence of RCTs, other research designs such as non-RCTs, before and after studies, cohort studies, case-control studies, descriptive studies, case series/reports and expert-opinion were

  1. Relapse prevention medications in community treatment for young adults with opioid addiction.

    Science.gov (United States)

    Vo, Hoa T; Robbins, Erika; Westwood, Meghan; Lezama, Debra; Fishman, Marc

    2016-01-01

    Despite the well-known effectiveness and widespread use of relapse prevention medications such as extended release naltrexone (XR-NTX) and buprenorphine for opioid addiction in adults, less is known about their use in younger populations. This was a naturalistic study using retrospective chart review of N = 56 serial admissions into a specialty community treatment program that featured the use of relapse prevention medications for young adults (19-26 years old) with opioid use disorders. Treatment outcomes over 24 weeks included retention and weekly opioid-negative urine tests. Patients were of mean age 23.1, 70% male, 86% Caucasian, 82% with history of injection heroin use, and treated with either buprenorphine (77%) or XR-NTX (23%). The mean number of XR-NTX doses received was 4.1. Retention was approximately 65% at 12 weeks and 40% at 24 weeks, and rates of opioid-negative urine were 50% at 12 weeks and 39% at 24 weeks, with missing samples imputed as positive. There were no statistically significant differences in retention (t = 1.87, P = .06) or in rates of weekly opioid-negative urine tests (t = 1.96, P = .06) between medication groups, over the course of 24 weeks. The XR-NTX group had higher rates of weekly negative urine drug tests for other nonopioid substances (t = 2.83, P buprenorphine group. Males were retained in treatment longer and had higher rates of opioid-negative weeks compared with females. These results suggest that relapse prevention medications including both buprenorphine and XR-NTX can be effectively incorporated into standard community treatment for opioid addiction in young adults with good results. Specialty programming focused on opioid addiction in young adults may provide a promising model for further treatment development.

  2. Relationship maintenance across platonic and non-platonic cross-sex friendships in emerging adults.

    Science.gov (United States)

    Weger, Harry; Cole, Megan; Akbulut, Valerie

    2018-02-13

    Prior research examining maintenance in cross-sex friendships focuses heavily on platonic (i.e., nonsexually active) friendships with limited research examining sexually involved cross-sex friendships (i.e., "friends with benefits relationships"). In this study, we investigated differences in relational maintenance behaviors between sexually and nonsexually active cross-sex friendships types. In an online survey, 531 emerging adult participants from large southwestern and southeastern universities identified either a friends with benefits or platonic opposite sex friendship and then completed items asking them to report the frequency with which they enacted each of 36 relationship maintenance behaviors. Overall, participants involved in casual sex friendships engaged in the least, and those who transitioned from a friends-with-benefits relationship to a romantic relationship engaged in the most frequent relationship maintenance. Platonic friendships employed more frequent maintenance than casual-sex friendships but less than either true friends with benefits or participants who transitioned to a romantic relationship.

  3. Too close and too far: counseling emerging adults in a technological age.

    Science.gov (United States)

    Tao, Karen W

    2014-03-01

    Individuals increasingly connect with others via social media (e.g., blogs, social networking, chatrooms), a phenomenon that is likely to impact psychological well-being and development. As such, therapists play an important role in assisting their clients to identify how virtual and in-person relationships influence their sense of self, interpersonal communication, and how they engage in meaningful relationships. In this article, I describe 3 examples related to working with emerging adults that take into consideration how this population "does relationships" in this technological era. Specifically, 3 clinical exchanges illustrate ways to (a) enhance interpersonal skills, (b) develop self-awareness about emotions, and (c) gain a clearer understanding of the intersections of social identity. (c) 2014 APA, all rights reserved.

  4. Emotional health across the transition to first and second unions among emerging adults.

    Science.gov (United States)

    Mernitz, Sara E; Dush, Claire Kamp

    2016-03-01

    The link between romantic relationships and emotional health has been extensively examined and suggests that marriage provides more emotional health benefits than cohabiting or dating relationships. However, the contemporary context of intimate relationships has changed and these associations warrant reexamination among emerging adults in the 2000s. We examined the change in emotional health across the entrance into first and second unions, including cohabiting unions, direct marriage (marriage without premarital cohabitation), and marriage preceded by cohabitation. Using the National Longitudinal Survey of Youth, 1997, a nationally representative panel study of youth born between 1980 and 1984 in the United States, pooled fixed-effects regression models indicated that entrance into first cohabiting unions and direct marriages, and all second unions, were significantly associated with reduced emotional distress. Gender differences were found for first unions only; for men, only direct marriage was associated with an emotional health benefit, while both direct marriage and cohabitation benefited women's emotional health. (c) 2016 APA, all rights reserved).

  5. Differential Effects of Family Structure on Religion and Spirituality of Emerging Adult Males and Females.

    Science.gov (United States)

    Handal, Paul J; Lace, John W

    2017-08-01

    This study examined measures of religion and spirituality in a sample of male and female emerging adult college students whose parents were either divorced or intact using the Personal Religious Inventory, the Duke University Religion Index, the Daily Spiritual Experiences Scale, the Spiritual Transcendence Scale, and the Spiritual Involvement and Beliefs Scale. Data were collected online, and 66% of participants received extra credit for participating. A main effect of sex was found, as females reported significantly higher scores than men on all but one measure of religion and spirituality, and the dataset was separated by sex. No differences were found between males from divorced and intact families. However, females from intact families scored significantly higher on all religion and spirituality measures than females from divorced families. This study suggests that females may respond differently than males to their parents' divorce in the context of religion and spirituality, and discusses possible reasons.

  6. [Mild head injury in children and adults. Diagnostic challenges in the emergency department].

    Science.gov (United States)

    Leidel, B A; Lindner, T; Wolf, S; Bogner, V; Steinbeck, A; Börner, N; Peiser, C; Audebert, H J; Biberthaler, P; Kanz, K-G

    2015-01-01

    Mild head injuries are one of the most frequent reasons for attending emergency departments and are particularly challenging in different ways. While clinically important injuries are infrequent, delayed or missed injuries may lead to fatal consequences. The initial mostly inconspicuous appearance may not reflect the degree of intracranial injury and computed tomography (CT) is necessary to rule out covert injuries. Furthermore, infants and young children with a lack of or rudimentary cognitive and language development are challenging, especially for those examiners not familiar with pediatric care. Established check lists of clinical risk factors for children and adults regarding traumatic brain injuries allow specific and rational decision-making for cranial CT imaging. Clinically important intracranial injuries can be reliably detected and unnecessary radiation exposure avoided at the same time.

  7. [Mild head injury in children and adults: Diagnostic challenges in the emergency department].

    Science.gov (United States)

    Leidel, B A; Lindner, T; Wolf, S; Bogner, V; Steinbeck, A; Börner, N; Peiser, C; Audebert, H J; Biberthaler, P; Kanz, K-G

    2015-06-01

    Mild head injuries are one of the most frequent reasons for attending emergency departments and are particularly challenging in different ways. While clinically important injuries are infrequent, delayed or missed injuries may lead to fatal consequences. The initial mostly inconspicuous appearance may not reflect the degree of intracranial injury and computed tomography (CT) is necessary to rule out covert injuries. Furthermore, infants and young children with a lack of or rudimentary cognitive and language development are challenging, especially for those examiners not familiar with pediatric care. Established check lists of clinical risk factors for children and adults regarding traumatic brain injuries allow specific and rational decision-making for cranial CT imaging. Clinically important intracranial injuries can be reliably detected and unnecessary radiation exposure avoided at the same time.

  8. Emotion Reactivity, Comfort Expressing Emotions, and Future Suicidal Ideation in Emerging Adults.

    Science.gov (United States)

    Polanco-Roman, Lillian; Moore, Alyssa; Tsypes, Aliona; Jacobson, Colleen; Miranda, Regina

    2018-01-01

    Emotion reactivity and difficulties in expressing emotions have been implicated in risk for suicidal behavior. This study examined comfort in expressing emotions (positive vs. negative) and depressive symptoms as mediators of the prospective relation between emotion reactivity and suicidal ideation. Emerging adults (N = 143; 72% female; 28% White) completed measures of emotion reactivity, comfort expressing emotions, and suicidal ideation at baseline and of depressive symptoms and suicidal ideation 12 months later. Emotion reactivity predicted suicidal ideation at follow-up through depressive symptoms. Difficulty expressing love-but not happiness, sadness, and anger-partially mediated the relationship between emotion reactivity and suicidal ideation at follow-up before but not after adjusting for baseline ideation. The relation between high emotion reactivity and suicidal ideation may be explained by discomfort in the expression of positive emotions and by depressive symptoms. Promotion of comfort in positive emotion expression may reduce vulnerability to suicidal ideation. © 2017 Wiley Periodicals, Inc.

  9. Structure emerges faster during cultural transmission in children than in adults.

    Science.gov (United States)

    Kempe, Vera; Gauvrit, Nicolas; Forsyth, Douglas

    2015-03-01

    How does children's limited processing capacity affect cultural transmission of complex information? We show that over the course of iterated reproduction of two-dimensional random dot patterns transmission accuracy increased to a similar extent in 5- to 8-year-old children and adults whereas algorithmic complexity decreased faster in children. Thus, children require more structure to render complex inputs learnable. In line with the Less-Is-More hypothesis, we interpret this as evidence that children's processing limitations affecting working memory capacity and executive control constrain the ability to represent and generate complexity, which, in turn, facilitates emergence of structure. This underscores the importance of investigating the role of children in the transmission of complex cultural traits. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Associations between low back pain and depression and somatization in a Canadian emerging adult population

    Science.gov (United States)

    Robertson, David; Kumbhare, Dinesh; Nolet, Paul; Srbely, John; Newton, Genevieve

    2017-01-01

    Introduction The association between depression, somatization and low back pain has been minimally investigated in a Canadian emerging adult population. Methods 1013 first year Canadian university students completed the Modified Zung Depression Index, the Modified Somatic Perception Questionnaire, and a survey about low back pain frequency and intensity. Multinomial logistic regression was used to measure associations between low back pain and depression and somatization, both independently and co-occurring. Results Over 50% of subjects reported low back pain across grades, and both depression and somatization were significantly positively associated with low back pain. Several positive associations between the cooccurrence of somatization and depression with various grades of low back pain were observed. Discussion These results suggest that low back pain, depression and somatization are relatively common at the onset of adulthood, and should be considered an important focus of public health. PMID:28928493

  11. Intergenerational Solidarity and Satisfaction With Life: Mediation Effects With Emerging Adults

    Directory of Open Access Journals (Sweden)

    Susana Coimbra

    2013-05-01

    Full Text Available The increasing dependency of emerging adults (EA on their family of origin and their lower future expectations challenge intergenerational family support exchanges and may affect their impact on satisfaction with life. This study aims to examine the mediation effect of familism, filial maturity, and relationship satisfaction between different directions of support (received, given and anticipated between both and satisfaction with life. Data was collected through the administration of self-report questionnaires to a convenience sample of 243 EA (18-30 years old of both genders, students and workers, of different socioeconomic statuses. Results corroborate the mediation effect of the study variables and suggest that the magnitude of this impact depends on the direction of the support: partial mediations are observed for the received support, whereas total mediations are observed for the given support.

  12. Social networks and substance use among at-risk emerging adults living in disadvantaged urban areas in the southern United States: a cross-sectional naturalistic study.

    Science.gov (United States)

    Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Crawford, Scott M; Simpson, Cathy A

    2015-09-01

    Substance use and risk-taking are common during emerging adulthood, a transitional period when peer influences often increase and family influences decrease. Investigating relationships between social network features and substance use can inform community-based prevention programs. This study investigated whether substance use among emerging adults living in disadvantaged urban areas was influenced by peer and family social network messages that variously encouraged and discouraged substance use. Cross-sectional, naturalistic field study. Lower-income neighborhoods in Birmingham, Alabama, USA with 344 participants (110 males, 234 females, ages 15-25 years; mean = 18.86 years), recruited via respondent-driven sampling. During structured interviews conducted in community locations, the Alcohol, Smoking and Substance Involvement Screening Test assessed substance use and related problems. Predictor variables were network characteristics, including presence of substance-using peers, messages from friends and family members about substance use and network sources for health information. Higher substance involvement was associated with friend and family encouragement of use and having close peer network members who used substances (Ps Social networks appear to be important in both promoting and preventing substance use in disadvantaged young adults in the United States. © 2015 Society for the Study of Addiction.

  13. Self-esteem and fear of negative evaluation as mediators between family socioeconomic status and social anxiety in Chinese emerging adults.

    Science.gov (United States)

    Cheng, Gang; Zhang, Dajun; Ding, Fangyuan

    2015-09-01

    The social causation hypothesis suggests that the stress in connection with a depressing social position results in the development of mental disorders. This study examines the psychological mechanisms underlying the link between family socioeconomic status (SES) and social anxiety in Chinese emerging adults. A self-administered questionnaire was given to a representative sample (N = 717) of undergraduate students (17-23 years old) at three universities in China. Correlational and structural equation modeling analyses were employed to test the hypothesized three-path effect of self-esteem and fear of negative evaluation (FNE) as mediators between family SES and social anxiety. Findings suggest the following: (1) the emerging adults belonging to families with low SES are at an increased risk of social anxiety, and (2) lower family SES caused lower self-esteem, which, in turn, serves to enhance the levels of FNE, thereby increasing social anxiety. In addressing the prevention and treatment of social anxiety, we conclude that preventive efforts toward improving self-esteem may help reduce social anxiety in individuals with low family SES. © The Author(s) 2014.

  14. Lifestyle risk factors and utilization of preventive services in disabled elderly adults in the community.

    Science.gov (United States)

    Kim, Dae Hyun; Sagar, Utpal N; Adams, Suzanne; Whellan, David J

    2009-10-01

    Lifestyle risk factor counseling and preventive health services are important to disabled elderly adults to prevent adverse health outcomes. We aimed to examine the prevalence of lifestyle risk factors and utilization of preventive health services in community-dwelling 2,982 adults, aged 60 years or older, with or without disability, in Southeastern Pennsylvania in 2004. The severity of disability was classified as no [independent activities of daily living (ADL) and instrumental activities of daily living (IADL)], some (independent ADL, dependent IADL), and severe limitation (dependent ADL). The prevalence of lifestyle risk factors (cigarette smoking, obesity, binge alcohol use, unhealthy diet, and physical inactivity) and utilization rate of a comprehensive list of preventive health services (risk factor counseling, disease management, vaccination, and cancer screening) were measured, across the disability categories. The prevalence of disability was 14.6% for some limitation and 10.3% for severe limitation. As disability increases, participants with unhealthy diet, physical inactivity, and obesity became more prevalent (8.8, 15.7, and 25.2% for no, some, and severe limitation, respectively) and fewer osteoporosis screenings were performed (51.5, 38.8, and 37.8%). Utilization of other services did not vary significantly across the disability categories, but participants with some or severe limitation were less likely than those without to receive needed health services overall (19.3% or 16.2 vs. 24.2%; P for trend = .047). In conclusion, disabled elderly adults have more undesirable lifestyle risk factors, but are less likely to receive needed health services than nondisabled counterparts. More attention is needed to this vulnerable population.

  15. Reaching Adolescents for Prevention: The Role of Pediatric Emergency Department Health Promotion Advocates.

    Science.gov (United States)

    Bernstein, Judith; Dorfman, David; Lunstead, Julie; Topp, Deric; Mamata, Hosana; Jaffer, Sara; Bernstein, Edward

    2017-04-01

    Almost 200,000 adolescents visit US emergency departments (EDs) yearly for conditions involving underage drinking but receive no follow-up referral. Other health risk behaviors resulting in sexually transmitted infections, car crashes, and assault-related injury are common among adolescents. A pediatric ED (PED) visit presents an opportunity to discuss and promote prevention. We report here on implementation of a new PED navigator/extender role, the Health Promotion Advocate (HPA). Health Promotion Advocates surveyed patients to identify health risks, stresses, and needs. A positive screen triggered a brief conversation containing the following elements: permission to discuss risks/needs; exploration of context (a typical day in your life); brief feedback (information and norms); exploration of benefits and consequences of risk behaviors; assessment of readiness to change; calling up assets, instilling hope; discussing challenges of change; negotiating a menu of options and prescription for change; referrals to primary care, community resources; and treatment services as indicated. During 2009-2013, HPAs screened 2149 PED patients aged 14 to 21 years and referred 834 for an array of services (eg, primary care, mental health, insurance, personal safety, human immunodeficiency virus testing, general education diploma (GED), employment, housing, and food pantries) to address reported health risks; 785 screened positive for at-risk substance use (53% female, 36% without primary care). Among them, 636 received a brief intervention; 546 were referred to specialized substance abuse treatment. Two case studies are presented to illustrate the engagement and referral process. Health Promotion Advocates working as PED team members can extend PED services beyond the scope of the presenting complaint.

  16. Attention-deficit/hyperactivity disorder (ADHD) symptoms, anxiety symptoms, and executive functioning in emerging adults.

    Science.gov (United States)

    Jarrett, Matthew A

    2016-02-01

    The current study examined attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms in relation to self-reported executive functioning deficits in emerging adults. College students (N = 421; ages 17-25; 73.1% female) completed self-reports of ADHD, anxiety, and executive functioning in a laboratory setting. Structural equation modeling analyses revealed that self-reported executive functioning deficits were significantly related to all 3 symptom domains. Executive functioning deficits were most strongly related to inattention followed by hyperactivity/impulsivity and anxiety. Analyses based on clinical groups revealed that groups with ADHD and comorbid anxiety showed greater deficits on self-regulation of emotion and self-organization/problem solving than those with ADHD only or anxiety only. Groups with ADHD showed greater deficits with self-motivation and self-restraint than those with anxiety only. All clinical groups differed from a control group on executive functioning deficits. Overall, anxiety symptoms appear to be associated with college students' self-reported executive functioning deficits above and beyond relationships with ADHD symptomatology. Further, those with ADHD and anxiety appear to show increased difficulties with self-regulation of emotion and self-organization/problem solving, a domain which appears to overlap substantially with working memory. Future studies should seek to replicate our findings with a clinical population, utilize both report-based and laboratory task measures of executive functioning, and integrate both state and trait anxiety indices into study designs. Finally, future studies should seek to determine how executive functioning deficits can be best ameliorated in emerging adults with ADHD and anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Relationship Between Continuity of Ambulatory Care and Risk of Emergency Department Episodes Among Older Adults.

    Science.gov (United States)

    Nyweide, David J; Bynum, Julie P W

    2017-04-01

    We determine whether visit patterns indicative of higher continuity are related to a lower risk of presenting at the emergency department (ED) among older adults. This study was a survival analysis between 2011 and 2013 of a 20% random sample of fee-for-service Medicare beneficiaries aged 66 years or older. Ambulatory visit patterns were measured starting in 2011 for up to 24 months using 2 continuity metrics measured on a 0 to 1 scale-Continuity of Care (COC) score and the Usual Provider Continuity (UPC) score. The composite outcome of an ED episode was defined as occurrence of an ED visit with discharge home, an observation stay, or hospital admission. Time-dependent Cox proportional hazards regression models controlled for patient demographic characteristics, comorbidities, previous use, and regional factors, with censoring for death or occurrence of the composite outcome. In a secondary analysis, continuity was measured in the 12 months preceding an ED episode to test whether it was associated with type of ED episode. The relative rate of ED episodes decreased approximately 1% for every 0.1-point increase in the COC score (adjusted hazard ratio 0.99; 95% confidence interval 0.99 to 0.99; Pcontinuity was associated with a 1% lower risk of observation stay but a 3% to 4% higher risk of hospital admission relative to an ED visit with discharge home. Ambulatory visit patterns exhibiting more continuity were associated with a lower rate of ED utilization for older adults with fee-for-service Medicare coverage. The association of higher continuity with lower risk of ED use but differences in outcome when an ED visit does occur may reflect more appropriate referral to the ED when outpatient management is no longer adequate. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  18. Alcohol use trajectories after high school graduation among emerging adults with type 1 diabetes.

    Science.gov (United States)

    Hanna, Kathleen M; Stupiansky, Nathan W; Weaver, Michael T; Slaven, James E; Stump, Timothy E

    2014-08-01

    To explore alcohol involvement trajectories and associated factors during the year post-high school (HS) graduation among emerging adults with type 1 diabetes. Youth (N = 181) self-reported alcohol use at baseline and every 3 months for 1 year post-HS graduation. Data were also collected on parent-youth conflict, diabetes self-efficacy, major life events, living and educational situations, diabetes management, marijuana use, cigarette smoking, and glycemic control. Trajectories of alcohol use were modeled using latent class growth analysis. Associations between trajectory class and specific salient variables were examined using analysis of variance, chi square, or generalized linear mixed model, as appropriate. Identified alcohol involvement trajectory classes were labeled as (1) consistent involvement group (n = 25, 13.8%) with stable, high use relative to other groups over the 12 months; (2) growing involvement group (n = 55, 30.4%) with increasing use throughout the 12 months; and (3) minimal involvement group (n = 101, 55.8%) with essentially no involvement until the ninth month. Those with minimal involvement had the best diabetes management and better diabetes self-efficacy than those with consistent involvement. In comparison with those minimally involved, those with growing involvement were more likely to live independently of parents; those consistently involved had more major life events; and both the growing and consistent involvement groups were more likely to have tried marijuana and cigarettes. This sample of emerging adults with type 1 diabetes has three unique patterns of alcohol use during the first year after HS. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Role of impulsivity in the relationship between depression and alcohol problems among emerging adult college drinkers.

    Science.gov (United States)

    Gonzalez, Vivian M; Reynolds, Brady; Skewes, Monica C

    2011-08-01

    Depression is common among college students and higher levels of depression are associated with greater alcohol-related problems. However, depression is frequently not found to be directly associated with more alcohol use. This study examined whether various aspects of impulsivity (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and delay discounting) and drinking to cope with negative affect help to account for the relationship between depression and alcohol problems among emerging adult college drinkers who reported at least a minimal level of depressive symptoms. In this cross-sectional study, 143 emerging adult (between 18 and 25 years old) female (69.9%, n = 100) and male (30.1%, n = 43) college drinkers with at least minimal depressive symptoms completed measures of depression, alcohol use and problems, drinking to cope, and impulsivity. A multiple mediation analysis revealed that only negative urgency and drinking to cope partially mediated the depression-alcohol problems relationship. Moderated mediation analyses revealed that impulsivity-related constructs did not significantly interact with drinking to cope to increase alcohol problems. It appears that alcohol use is particularly problematic for students with elevated depression, and this is partly attributable to depression's association with negative urgency, in addition to its association with drinking to cope. Our findings suggest that students who suffer from depression may engage in problematic drinking behavior in part because negative affect is detrimental to their short-term impulse control and decision making, independent of maladaptive attempts to regulate affect through drinking to cope. (c) 2011 APA, all rights reserved.

  20. A daily analysis of physical activity and satisfaction with life in emerging adults.

    Science.gov (United States)

    Maher, Jaclyn P; Doerksen, Shawna E; Elavsky, Steriani; Hyde, Amanda L; Pincus, Aaron L; Ram, Nilam; Conroy, David E

    2013-06-01

    Subjective well-being has well-established positive health consequences. During emerging adulthood, from ages 18 to 25 years, people's global evaluations of their well-being (i.e., satisfaction with life [SWL]) appear to worsen more than any other time in the adult life span, indicating that this population would benefit from strategies to enhance SWL. In these studies, we investigated top-down (i.e., time-invariant, trait-like) and bottom-up (i.e., time-varying, state-like) influences of physical activity (PA) on daily SWL. Two daily diary studies lasting 8 days (N = 190) and 14 days (N = 63) were conducted with samples of emerging adults enrolled in college to evaluate relations between daily PA and SWL while controlling for established and plausible top-down and bottom-up influences on SWL. In both studies, multilevel models indicated that people reported greater SWL on days when they were more active (a within-person, bottom-up effect). Top-down effects of PA were not significant in either study. These findings were robust when we controlled for competing top-down influences (e.g., sex, personality traits, self-esteem, body mass index, mental health symptoms, fatigue) and bottom-up influences (e.g., daily self-esteem, daily mental health symptoms, daily fatigue). We concluded that SWL was impacted by people's daily PA rather than their trait level of PA over time. These findings extend evidence that PA is a health behavior with important consequences for daily well-being and should be considered when developing national policies to enhance SWL. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  1. Efficacy and feasibility of antidepressants for the prevention of migraine in adults: a meta-analysis.

    Science.gov (United States)

    Xu, X-M; Yang, C; Liu, Y; Dong, M-X; Zou, D-Z; Wei, Y-D

    2017-08-01

    Migraine has greatly impacted the quality of life for migraineurs and was ranked as the seventh highest specific cause of disability worldwide in 2012. Because of the role of serotonin in migraine mechanisms, antidepressants have been used in the prevention of migraine. However, the role of antidepressants for migraine prophylaxis in adults has not been completely established. Our aim was systematically to assess the efficacy and feasibility of antidepressants for the prevention of migraine in adults based on currently available literature. A comprehensive search of databases was conducted including the Cochrane, PubMed, Web of Science and Embase databases from inception to July 2016. Randomized controlled trials that assigned adults with a clinical diagnosis of migraine to antidepressant or placebo treatment were included. The primary outcome was the reduction of migraine frequency or index. Overall, 16 randomized controlled trials including 1082 participants were identified. Antidepressants had a significant advantage over placebo in reducing the migraine frequency or index of adults with a standardized mean difference of -0.79 [95% confidence interval (CI) -1.13 to -0.45, P antidepressant therapy were more likely to experience an at least 50% reduction of headache burden than those receiving placebo (28.9% vs. 20.2%; risk ratio 1.40; 95% CI 0.97-2.02; P = 0.07). However, antidepressants were less well tolerated than placebo because of some adverse events (risk ratio 1.74, 95% CI 1.05-2.89, P = 0.03). Antidepressants are effective in the prophylaxis of migraine in adults, but the level of evidence for antidepressants except for amitriptyline seems to be quite shaky. © 2017 EAN.

  2. Effects of a community disability prevention program for frail older adults at 48-month follow up.

    Science.gov (United States)

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutumimoto, Kota; Yoshida, Daisuke; Suzuki, Takao

    2017-12-01

    The present prospective study was carried out to determine whether participation in community-based intervention studies exerted a positive impact on disability prevention in older adults with physical frailty. A total of 514 community-dwelling older adults (aged ≥65 years) with physical frailty who had undergone baseline assessment and participated in community-based intervention studies (participants) or did not (non-participants) were included in the present study. Non-participants were selected through propensity score matching, to balance potential covariates at baseline. Disability incidence was followed up at 48 months as a main outcome. Demographic data (age, sex and medical history), global cognitive function, grip strength, walking speed, and blood test results including serum albumin and brain-derived neurotrophic factor at baseline were included as covariates. Disability incidence rates differed significantly between participants (11.3%) and non-participants (19.8%) of community-based intervention studies during the 48-month follow-up period (P = 0.007). Participation in community-based intervention studies (hazard ratio 0.55, 95% confidence interval 0.35-0.88) was significantly associated with the incidence of disability in older adults with physical frailty. Participation in community-based intervention studies could reduce the incidence of disability in older adults with physical frailty. Thus, strategies designed to increase the number of participants in community-based intervention programs should be considered in community-based approaches for the prevention of disability in older adults with physical frailty. Geriatr Gerontol Int 2017; 17: 2347-2353. © 2017 Japan Geriatrics Society.

  3. Associations between the patient-centered medical home and preventive care and healthcare quality for non-elderly adults with mental illness: A surveillance study analysis.

    Science.gov (United States)

    Bowdoin, Jennifer J; Rodriguez-Monguio, Rosa; Puleo, Elaine; Keller, David; Roche, Joan

    2016-08-24

    Patient-centered medical homes (PCMHs) may improve outcomes for non-elderly adults with mental illness, but the extent to which PCMHs are associated with preventive care and healthcare quality for this population is largely unknown. Our study addresses this gap by assessing the associations between receipt of care consistent with the PCMH and preventive care and healthcare quality for non-elderly adults with mental illness. This surveillance study used self-reported data for 6,908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey. Preventive care and healthcare quality measures included: participant rating of all healthcare; cervical, breast, and colorectal cancer screening; current smoking; smoking cessation advice; flu shot; foot exam and eye exam for people with diabetes; and follow-up after emergency room visit for mental illness. Multiple logistic regression models were developed to compare the odds of meeting preventive care and healthcare quality measures for participants without a usual source of care, participants with a non-PCMH usual source of care, and participants who received care consistent with the PCMH. Compared to participants without a usual source of care, those with a non-PCMH usual source of care had better odds of meeting almost all measures examined, while those who received care consistent with the PCMH had better odds of meeting most measures. Participants who received care consistent with the PCMH had better odds of meeting only one measure compared to participants with a non-PCMH usual source of care. Compared with having a non-PCMH usual source of care, receipt of care consistent with the PCMH does not appear to be associated with most preventive care or healthcare quality measures. These findings raise concerns about the potential value of the PCMH for non-elderly adults with mental illness and suggest that alternative models of primary care are needed to improve outcomes and address

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

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    Michael D Parkins

    2009-01-01

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

  5. A Personality-Based Latent Class Analysis of Emerging Adult Gamblers.

    Science.gov (United States)

    Tackett, Jennifer L; Rodriguez, Lindsey M; Rinker, Dipali V; Neighbors, Clayton

    2015-12-01

    Increases in access to gambling venues have been accompanied by increased gambling behavior among young adults. The present research examined associations among Five Factor Model personality traits, motives for gambling, and gambling behavior and problems using latent class analysis. College students (N = 220) completed online measures of personality and gambling behavior as part of a larger intervention trial. Agreeableness and conscientiousness were negatively associated with indicators of gambling behavior. Low agreeableness and high neuroticism were associated with gambling-specific motives, particularly for less frequently endorsed motives. Personality-based latent class analyses of emerging adult gamblers revealed support for three distinct groups reflecting a resilient personality group, a normative personality group, and a vulnerable personality group, which were further differentiated by gambling behaviors and gambling-specific motives. Associations between personality traits and gambling-specific motives highlight potential heterogeneity among college students who gamble. Together, findings suggest that the correlational and latent class-based analyses, as well as the personality and motivation analyses, present complementary information with respect to the attributes of college student gamblers. Implications and future research directions are discussed.

  6. The association between developmental assets and sexual enjoyment among emerging adults.

    Science.gov (United States)

    Galinsky, Adena M; Sonenstein, Freya L

    2011-06-01

    To examine the associations between three key developmental assets and an aspect of sexual health, sexual enjoyment, which has rarely been studied in young adults, although its importance is stressed in all recent sexual health policy statements. Using data from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health, and multiple logistic and ordered logistic regression, we explored the associations between sexual pleasure and autonomy, self-esteem, and empathy among 3,237 respondents aged 18-26 years in heterosexual relationships of ≥ 3-month duration. We also examined the distribution of sexual pleasure across various socio-demographic groups. Compared with young women, young men reported more regular orgasms and more enjoyment of two kinds of partnered sexual behavior. Sexual enjoyment was not associated with age, race/ethnicity, or socioeconomic status. Among women, autonomy, self-esteem, and empathy co-varied positively with all three sexual enjoyment measures. Among men, all associations were in the same direction, but not all were statistically significant. A substantial gender difference in enjoyment of partnered sexual behavior exists among emerging adults in the United States. This study is the first to use a representative population sample to find a relationship between developmental assets and a positive aspect of sexual health - sexual pleasure. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Being in-between: A model of cultural identity negotiation for emerging adult immigrants.

    Science.gov (United States)

    Cohen, Julie A; Kassan, Anusha

    2018-03-01

    This qualitative study explored the cultural identity negotiation of young adult immigrants. Using a grounded theory research design, 10 semistructured interviews were conducted with emerging adult immigrants (EAI), ages 19-27. Results yielded a substantive model of cultural identity negotiation (MCIN) for EAI and posited that One's Motivation and Sense of Agency to Negotiate Cultural Identity is at the core of how participants navigate their cultural identities. This model included 6 major categories: (a) Family Cultural Rigidity ; (b) Connections Specific to Canada ; (c) Connection to a Same Cultured Community ; (d) Sense of Permanency ; (e) Desire to Preserve Culture of Origin ; (f) Desire to Fit in to Canadian Culture , as well as 2 overarching factors ( Dimension of Time and Dimension of Age ), which were found to be influential on participants' cultural identity negotiation. The model also included the identification of 4 approaches to cultural identity negotiation: (a) Blended; (b) Dual; (c) Disconnected; and (d) Intermediate. The MCIN for EAI is discussed in terms of the current literature on cultural identity formation as well as implications for counseling psychology training and practice. Recommendations for further research are also suggested. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Two Prospective Studies of Changes in Stress Generation across Depressive Episodes in Adolescents and Emerging Adults

    Science.gov (United States)

    Morris, Matthew C.; Kouros, Chrystyna D.; Hellman, Natalie; Rao, Uma; Garber, Judy

    2014-01-01

    The stress generation hypothesis was tested in two different longitudinal studies examining relations between weekly depression symptom ratings and stress levels in adolescents and emerging adults at varied risk for depression. Participants in Study 1 included 240 adolescents who differed with regard to their mother’s history of depressive disorders. Youth were assessed annually across 6 years (Grades 6 through 12). Consistent with the depression autonomy model, higher numbers of prior major depressive episodes (MDEs) were associated with weaker stress generation effects, such that higher levels of depressive symptoms predicted increases in levels of dependent stressors for adolescents with ≤ 2 prior MDEs, but depressive symptoms were not significantly related to dependent stress levels for youth with ≥ 3 prior MDEs. In Study 2, participants were 32 remitted-depressed and 36 never-depressed young adults who completed a psychosocial stress task to determine cortisol reactivity and were re-assessed for depression and stress approximately eight months later. Stress generation effects were moderated by cortisol responses to a laboratory psychosocial stressor, such that individuals with higher cortisol responses exhibited a pattern consistent with the depression autonomy model, whereas individuals with lower cortisol responses showed a pattern more consistent with the depression sensitization model. Finally, comparing across the two samples, stress generation effects were weaker for older participants and for those with more prior MDEs. The complex, multi-factorial relation between stress and depression is discussed. PMID:25422968

  9. Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct

    Science.gov (United States)

    Duan-Porter, Wei; Schmader, Kenneth E.; Morey, Miriam C.; Cohen, Harvey J.; Colón-Emeric, Cathleen S.

    2016-01-01

    Background. Resilience has been described in the psychosocial literature as the capacity to maintain or regain well-being during or after adversity. Physical resilience is a newer concept that is highly relevant to successful aging. Our objective was to characterize the emerging construct of resilience as it pertains to physical health in older adults, and to identify gaps and opportunities to advance research in this area. Methods. We conducted a systematic review to identify English language papers published through January 2015 that apply the term “resilience” in relation to physical health in older adults. We applied a modified framework analysis to characterize themes in implicit or explicit definitions of physical resilience. Results. Of 1,078 abstracts identified, 49 articles met criteria for inclusion. Sixteen were letters or concept papers, and only one was an intervention study. Definitions of physical resilience spanned cellular to whole-person levels, incorporated many outcome measures, and represented three conceptual themes: resilience as a trait, trajectory, or characteristic/capacity. Conclusions. Current biomedical literature lacks consensus on how to define and measure physical resilience. We propose a working definition of physical resilience at the whole person level: a characteristic which determines one’s ability to resist or recover from functional decline following health stressor(s). We present a conceptual framework that encompasses the related construct of physiologic reserve. We discuss gaps and opportunities in measurement, interactions across contributors to physical resilience, and points of intervention. PMID:26718984

  10. Injection drug use and hepatitis C virus infection in young adult injectors: using evidence to inform comprehensive prevention

    NARCIS (Netherlands)

    Page, Kimberly; Morris, Meghan D.; Hahn, Judith A.; Maher, Lisa; Prins, Maria

    2013-01-01

    The hepatitis C virus (HCV) virus epidemic is ongoing in the United States and globally. Incidence rates remain high, especially in young adult injection drug users. New outbreaks of HCV in the United States among young adults, in predominantly suburban and rural areas, have emerged and may be

  11. Risk factors for alcohol use among male adolescents and emerging adults in Haiti.

    Science.gov (United States)

    Gage, Anastasia J; Suzuki, Chiho

    2006-04-01

    This study examined risk factors associated with alcohol use in the past 3 months among young men aged 15-24 in Haiti using data from the 2000 Enquête Mortalité, Morbidité et Utilization des Services. Findings indicate that life-time smoking, multiple sexual partnerships, witnessing inter-parental conflict in childhood, disruption of parental monitoring, and residing in communities with high levels of youth drinking differentiated experimenters from abstainers. Youth out-of-school employment and co-residence with adults who had a history of drunkenness were among risk factors associated with regular alcohol use. The greater was the number of risk factors to which a young man was exposed, the higher were the probabilities of alcohol experimentation and regular use. The findings call for prevention strategies at the family and community levels and for initiatives that focus on sexual and non-sexual individual behaviour change.

  12. CAREER AND SELF-CONSTRUCTION OF EMERGING ADULTS: THE VALUE OF LIFE DESIGNING

    Directory of Open Access Journals (Sweden)

    Jacobus Gideon Maree

    2016-01-01

    Full Text Available This article describes a potential way of counselling emerging adults from a life design perspective to construct a self that could enable them to be agents of both their own development and the development of others. Theoretical issues relating to a dynamic, developmental and systems framework of the understanding of wellbeing are described and the process involved is delineated. The research design was qualitative and comprised case studies. Six participants who subscribed to the definition of ‘emerging adults’ and were comparatively representative of the ethnic diversity of South Africa, were selected purposively from a group of individuals who applied for career counselling in a private practice context. The intervention involved life design counselling and occurred over a period of six weeks. Information related to participants’ self-construction was gathered using qualitative techniques, including the Career Interest Profile, the Career Construction Interview, a timeline, video clips, a collage, and semi-structured interviews. Following the intervention, the participants revealed heightened insights with regard to aspects of their sense of a relational-moral self. Results indicated that life design counselling could enhance elaborative personal development (enhancing self-awareness and reaping the benefits of developing an improved relational-moral self and the promotion of an awareness of the importance to promote social justice in work-related contexts.

  13. Alcohol Use Severity Among Hispanic Emerging Adults in Higher Education: Understanding the Effect of Cultural Congruity.

    Science.gov (United States)

    Cano, Miguel Ángel; Vaughan, Ellen L; de Dios, Marcel A; Castro, Yessenia; Roncancio, Angelica M; Ojeda, Lizette

    2015-01-01

    Identifying and understanding determinants of alcohol use behavior among Hispanic college students is an increasingly important public health issue, particularly during emerging adulthood. Studies examining ethnocultural determinants of alcohol use behavior among Hispanic college students have focused on direct associations with cultural orientation (e.g., acculturation and enculturation); yet there is a need for research that accounts for the complex interplay of other culturally relevant sociocultural factors. This study examined associations of behavioral acculturation, behavioral enculturation, and cultural congruity (perception of cultural fit between the values of the academic environment and the student's personal values) with alcohol use severity (AUS); and tested if gender moderated those associations. A hierarchical linear regression and moderation analysis were conducted on a sample of 167 Hispanic emerging adults (ages 18-25) enrolled in college. All predictor variables entered in the regression model accounted for 20.9% of the variance in AUS. After controlling for demographic variables and depressive symptoms, behavioral acculturation and enculturation did not have a statistically significant association with AUS. Further, gender did not moderate either of these associations. Conversely, greater cultural congruity was associated with lower reports of AUS. A moderation analysis suggested that cultural congruity predicted lower reports of AUS among men, but not among women. This was the first known study to examine the association of cultural congruity with alcohol use. Findings highlight the value of examining contextual factors of culture and moving beyond reductive measures of cultural orientation.

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

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    William A. Satariano

    2017-08-01

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

  15. Effectiveness of Different Preventive Programs in Cariogram Parameters of Young Adults at High Caries Risk

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    Said Karabekiroğlu

    2017-01-01

    Full Text Available Objective. To evaluate the effectiveness of different preventive programs in young adults at high caries risk using Cariogram software. Methods. Sixty-six young adults with high caries risk were evaluated. Dental caries risk for all subjects was determined according to WHO criteria. Subjects were divided into three different preventive groups (control: OH, fluoride varnish: FV, and chlorhexidine varnish: CV. They were followed for 12 weeks (baseline: T0, 1 week: T1, 4 weeks: T2, and 12 weeks: T3. Plaque index, diet frequency, and salivary chairside tests (to record the flow rate, buffer capacity, and mutans streptococci and lactobacillus counts were performed at each visit. Based on these data, ten caries-related variables were collected and inserted into the Cariogram software to calculate the predicted chance of avoiding caries for each subject. Results. Significant changes were obtained about the Cariogram parameters (diet, bacteria, susceptibility, circumstances, and Cariogram risk group. No significant differences were found between the three methods regarding mean Cariogram scores after 3 months (p>0.05. Conclusions. The regular and effective short-term (three months use of 1450 ppm fluoridated toothpaste, one visit application of fluoride, and chlorhexidine varnishes were effective for reducing caries risk in young adults, which can be clearly demonstrated using Cariogram software.

  16. Validation of educational booklet for HIV/Aids prevention in older adults

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    Luana Ibiapina Cordeiro

    Full Text Available ABSTRACT Objective: To describe the process of manufacturing and validation of an educational booklet for HIV/Aids prevention in older adults Methods: Methodological study developed in two phases - manufacturing of the booklet and validation of the educational material by judges. The manufacturing process involved a situational diagnosis with older adults, and its result indicated gaps in the knowledge with respect to HIV/Aids. The validation process was performed by nine judges, selected by convenience. It was considered an agreement index of at least 0.80, analyzed through the content validity index. Results: We opted for a dialogue between two older adults divided into three categories: myths and taboos; ignorance; and prevention and importance of diagnosis. The average of the items was 0.90. The suggestions made by the judges were observed and modified for the final version. Conclusion: The material had relevant content for the judges, in addition to being able to be used by health professionals in the education and clarification of issues on the subject.

  17. Alcohol Use as Risk Factors for Older Adults' Emergency Department Visits: A Latent Class Analysis.

    Science.gov (United States)

    Choi, Namkee G; Marti, C Nate Nathan; DiNitto, Diana M; Choi, Bryan Y

    2015-12-01

    Late middle-aged and older adults' share of emergency department (ED) visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Data came from the 2013 National Health Interview Survey's Sample Adult file (n=15,713). Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA) modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/moderate drinkers, and current heavy drinkers), chronic health and mental health status, and past-year ED visits as indicators. LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group) were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/mental health problems; Class 2 (21%; low-risk group) consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group) was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group) included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Alcohol nonuse/use (and quantity of use) and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex-drinkers improve chronic illnesses self-management.

  18. EMERGENCY BRAKING IN ADULTS VERSUS NOVICE TEEN DRIVERS: RESPONSE TO SIMULATED SUDDEN DRIVING EVENTS.

    Science.gov (United States)

    Loeb, Helen S; Kandadai, Venk; McDonald, Catherine C; Winston, Flaura K

    Motor vehicle crashes remain the leading cause of death in teens in the United States. Newly licensed drivers are the group most at risk for crashes. Their driving skills are very new, still very often untested, so that their ability to properly react in an emergency situation remains a research question. Since it is impossible to expose human subjects to critical life threatening driving scenarios, researchers have been increasingly using driving simulators to assess driving skills. This paper summarizes the results of a driving scenario in a study comparing the driving performance of novice teen drivers (n=21) 16-17 year olds with 90 days of provisional licensure with that of experienced adult drivers (n=17) 25-50 year olds with at least 5 years of PA licensure, at least 100 miles driven per week and no self-reported collisions in the previous 3 years. As part of a 30 to 35 simulated drive that encompassed the most common scenarios that result in serious crashes, participants were exposed to a sudden car event. As the participant drove on a suburban road, a car surged from a driveway hidden by a fence on the right side of the road. To avoid the crash, participants must hard brake, exhibiting dynamic control over both attentional and motor resources. The results showed strong differences between the experienced adult and novice teen drivers in the brake pressure applied. When placed in the same situation, the novice teens decelerated on average 50% less than the experienced adults (p<0.01).

  19. Impact of childhood cancer on emerging adult survivors' romantic relationships: a qualitative account.

    Science.gov (United States)

    Thompson, Amanda L; Long, Kristin A; Marsland, Anna L

    2013-02-01

    Research focusing on the long-term sequelae of diagnosis and treatment for childhood cancer suggests that although the majority of survivors are not at increased risk for psychopathology, many experience persistent problems in other domains that greatly affect quality of life (QoL). One such domain is social functioning. To date, little is known about the impact of childhood cancer on social functioning and related QoL during emerging adulthood, the developmental period that spans the late teens and early twenties and is characterized, in part, by explorations in love and romantic relationships. To document emerging adult survivors' perceptions of their romantic relationships through a descriptive qualitative study. Recurrent themes from interviews were extracted via qualitative content-based analysis. Eighteen female survivors of childhood cancer, ages 18-25, participated in a phone interview focused on past and present romantic partnerships. Themes from coded transcripts included redefined life priorities and perspective, concerns with disclosure of cancer history and emotions, negative body image as a result of illness and treatment side effects, and worries about fertility and health of future children. Survivors related these concerns to their histories of childhood cancer and discussed the impact on the development and maintenance of romantic relationships. Overall, survivors reported a number of relationship concerns that have the potential to interfere with their ability to move toward emotional and physical intimacy in relationships, a key task of emerging adulthood. These findings suggest a number of testable hypotheses for future research, have the potential to inform the construction of new measures that more accurately evaluate social functioning of childhood cancer survivors, and emphasize the importance of ongoing assessment by health care providers of developmentally salient issues like love/romance. © 2012 International Society for Sexual Medicine.

  20. Prevention of alcohol and other drug use using motivational interviewing among young adults in the Ukraine

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    Svitlana Polshkova

    2016-10-01

    Full Text Available Background: World Health Organization data shows alarming rates of alcohol consumption among those ages 15 and older in the Ukraine. This study examined the feasibility and initial efficacy of a brief intervention to reduce risky drinking among emerging adults (ages 18-25 in the Ukraine. Methods: Emerging adults presenting to two settings were screened for risky drinking (Railway Clinical Hospital and Bogomolets National Medical University, with those screening positive on the AUDIT-C (>5 enrolled in the study: 59 participants from the hospital setting (mean age = 22.6 (2.1, 55.9%% male and 61 participants from the university setting (mean age = 20.1(2.3, 55.7% male.  After self-administering a computerized baseline assessment, participants were randomized to receive an in-person brief intervention with telephone booster or to a control condition; participants self-administered a computerized follow-up at 3 months. Results: Regression analyses were conducted, separately for each setting, predicting alcohol outcomes (alcohol consumption and consequences; models controlled for baseline alcohol levels and condition assignment (brief intervention or control. In both settings, the brief intervention group showed significantly less alcohol consumption and consequences at 3-months as compared to the control group (p<.001; however, the groups did not significantly differ  on other drug use (DAST-10 score. Conclusions: Findings suggest that brief motivational interventions are promising for reducing risky drinking among emerging adults in the Ukraine in both inpatient hospital and university settings. Future studies are needed to replicate these findings and extend these effects to reduce other drug use among young people in the Ukraine.

  1. Prevalence of Exposure to Risk Factors for Violence among Young Adults Seen in an Inner-City Emergency Department

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    Abigail Hankin

    2013-08-01

    Full Text Available Introduction: To assess the prevalence of risk factors for violent injury among young adults treated at an urban emergency department (ED.Methods: This study is a cross-sectional analysis of data collected as part of a longitudinal study. Enrollment took place in an urban ED in a Level 1 trauma center, June through December 2010. All patients aged 18–24 years were eligible. Patients were excluded if they were incarcerated, critically ill, or unable to read English. Study participants completed a 10-minute multiple-choice questionnaire using previously validated scales: a aggression, b perceived likelihood of violence, c recent violent behavior, d peer behavior, and e community exposure to violence.Results: 403 eligible patients were approached, of whom 365 (90.1% consented to participate. Average age was 21.1 (95% confidence interval: 20.9, 21.3 years, and participants were 57.2% female, 85.7% African American, and 82.2% were educated at the high school level or beyond. Among study participants, rates of high-risk exposure to individual risk factors ranged from 7.4% (recent violent behavior to 24.5% (exposure to community violence, with 32.3% of patients showing high exposure to at least one risk factor. When comparing participants by ethnicity, no significant differences were found between White, African-American, and Hispanic participants. Males and females differed significantly only on 1 of the scales – community violence, (20.4% of males vs. 30.3% of females, p¼0.03. Selfreported hostile/aggressive feelings were independently associated with initial presentation for injury associated complaint after controlling for age, sex, and race (odds ratio 3.48 (1.49-8.13.Conclusion: Over 30% of young adults presenting to an urban ED reported high exposure to risk factors for violent injury. The high prevalence of these risk factors among ED patients highlights the potential benefit of a survey instrument to identify youth who might benefit from

  2. Use of Online Health Information by Geriatric and Adult Emergency Department Patients: Access, Understanding, and Trust.

    Science.gov (United States)

    Scott, Grant; McCarthy, Danielle M; Aldeen, Amer Z; Czerniak, Alyssa; Courtney, D Mark; Dresden, Scott M

    2017-07-01

    The objective was to characterize geriatric patients' use of online health information (OHI) relative to younger adults and assess their comfort ith OHI compared to health information (HI) from their physician. This was a prospective cross-sectional survey study of adult emergency department (ED) patients. The survey assessed patients' self-reported use of OHI in the past year and immediately prior to ED visit and analyzed differences across four age groups: 18-39, 40-64, 65-74, and 75+. Patients' ability to access, understand, and trust OHI was assessed using a 7-point Likert scale and compared to parallel questions regarding HI obtained from their doctor. Patient use of OHI was compared across age groups. Comfort with OHI and HI obtained from a doctor was compared across age groups using the Kruskal-Wallis test. Comparisons between sources of HI were made within age groups using the Wilcoxon signed-rank test. Of 889 patients who were approached for study inclusion, 723 patients (81.3%) completed the survey. The majority of patients had used OHI in the past year in all age groups, but older patients were less likely to have used OHI: age 18-39, 90.3%; 40-64, 85.3%; 65-74, 76.4%; and 75+, 50.7% (p accessible from their doctor than the Internet, while the youngest patients found HI more accessible on the Internet than from their doctor. Regardless of age, patients noted that information from their physician was both easier to understand and more trustworthy than information found on the Internet. Although many older patients used OHI, they were less likely than younger adults to use the Internet immediately prior to an ED visit. Despite often using OHI, patients of all age groups found healthcare information from their doctor easier to understand and more trustworthy than information from the Internet. As health systems work to efficiently provide information to patients, addressing these perceived deficiencies may be necessary to build effective OHI programs.

  3. Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection.

    Science.gov (United States)

    Singer, Adam J; Ng, Jennifer; Thode, Henry C; Spiegel, Rory; Weingart, Scott

    2017-04-01

    The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes in adult emergency department (ED) patients with and without suspected infection. We performed a single-site, retrospective review of adult ED patients between January 2014 and March 2015. Patients triaged to fast-track, dentistry, psychiatry, and labor and delivery were excluded. qSOFA scores were calculated with simultaneous vital signs and Modified Early Warning System scores. Patients receiving intravenous antibiotics were presumed to have suspected infection. Univariate and multivariate analyses were performed to explore the association between qSOFA scores and inpatient mortality, admission, and length of stay. Receiver operating characteristics curve analysis and c statistics were also calculated for ICU admission and mortality. We included 22,530 patients. Mean age was 54 years (SD 21 years), 53% were women, 45% were admitted, and mortality rate was 1.6%. qSOFA scores were associated with mortality (0 [0.6%], 1 [2.8%], 2 [12.8%], and 3 [25.0%]), ICU admission (0 [5.1%], 1 [10.5%], 2 [20.8%], and 3 [27.4%]), and hospital length of stay (0 [123 hours], 1 [163 hours], 2 [225 hours], and 3 [237 hours]). Adjusted rates were also associated with qSOFA. The c statistics for mortality in patients with and without suspected infection were similarly high (0.75 [95% confidence interval 0.71 to 0.78) and 0.70 (95% confidence interval 0.65 to 0.74), respectively. qSOFA scores were associated with inpatient mortality, admission, ICU admission, and hospital length of stay in adult ED patients likely to be admitted both with and without suspected infection and may be useful in predicting outcomes. Copyright © 2016 American College of Emergency Physicians. Published by

  4. 40 CFR Appendix L to Part 51 - Example Regulations for Prevention of Air Pollution Emergency Episodes

    Science.gov (United States)

    2010-07-01

    .... Maximum reduction of air contaminants from manufacturing operations by, if necessary, assuming reasonable... which must proceed to avoid emergent physical harm. c. All manufacturing establishments except those...

  5. EFFECTS OF MOVEABLE PLATFORM TRAINING IN PREVENTING SLIP-INDUCED FALLS IN OLDER ADULTS

    Science.gov (United States)

    Parijat, Prakriti; Lockhart, Thurmon E

    2011-01-01

    Identifying effective interventions is vitalin preventing slip-induced fall accidents in older adults. The purpose of the current study was to evaluate the efficacy of moveable platform training in improving recovery reactions and reducing fall frequency in older adults. Twenty-four older adults were recruited and randomly assigned to two groups (training and control). Both groups underwent three sessions including baseline slip, training, and transfer of training on a slippery surface. Both groups experienced two slips on a slippery surface, one during the baseline and the other (after two weeks) during the transfer of training session. In the training session, the training group underwent twelve simulated slips using a moveable platform while the control group performed normal walking trials. Kinematic, kinetic, and EMG data were collected during all the sessions. Results indicated a reduced incidence of falls in the training group during the transfer of training trial as compared to the control group. The training group was able to transfer proactive and reactive control strategies learned during training to the second slip trial. The proactive adjustments include increased center-of-mass velocity and transitional acceleration after training. Reactive adjustments include reduction in muscle onset and time to peak activations of knee flexors and ankle plantarflexors, reduced ankle and knee coactivation, reduced slip displacement, and reduced time to peak knee flexion, trunk flexion, and hip flexion velocities. In general, the results indicated a beneficial effect of perturbation training in reducing slip severity and recovery kinematics in healthy older adults. PMID:22134467

  6. Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review.

    Science.gov (United States)

    Lach, Helen W; Harrison, Barbara E; Phongphanngam, Sutthida

    2017-05-01

    Older adults with mild cognitive impairment (MCI) and early-stage dementia have an increased risk of falling, with risks to their health and quality of life. The purpose of the current integrative review was to evaluate evidence on fall risk and fall prevention in this population. Studies were included if they examined falls or fall risk factors in older adults with MCI or early-stage dementia, or reported interventions in this population; 40 studies met criteria. Evidence supports the increased risk of falls in individuals even in the early stages of dementia or MCI, and changes in gait, balance, and fear of falling that may be related to this increased fall risk. Interventions included exercise and multifactorial interventions that demonstrated some potential to reduce falls in this population. Few studies had strong designs to provide evidence for recommendations. Further study in this area is warranted. [Res Gerontol Nurs. 2017; 10(03):139-148.]. Copyright 2016, SLACK Incorporated.

  7. Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention.

    Science.gov (United States)

    Garpestad, Erik; Devlin, John W

    2017-05-01

    Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults. Discussed are clinician strategies on how to recognize and reduce medication-associated delirium and recommendations that help prevent polypharmacy when interventions to reduce the burden of delirium in this vulnerable population are being formulated. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Effectiveness of an injury prevention programme for adult male amateur soccer players: A cluster-randomised controlled trial

    NARCIS (Netherlands)

    Beijsterveldt, A.M.C. van; Port, I.G.L. van de; Krist, M.R.; Schmikli, S.L.; Stubbe, J.H.; Frederiks, J.E.; Backx, F.J.G.

    2012-01-01

    The incidence rate of soccer injuries is among the highest in sports, particularly for adult male soccer players. Purpose To investigate the effect of the 'The11' injury prevention programme on injury incidence and injury severity in adult male amateur soccer players. Study design Cluster-randomised

  9. Effectiveness of an injury prevention programme for adult male amateur soccer players: A cluster-randomised controlled trial

    NARCIS (Netherlands)

    Beijsterveldt, A.M.C. van; Port, I.G.L. van de; Krist, M.R.; Schmikli, S.L.; Stubbe, J.H.; Frederiks, J.E.; Backx, F.J.G.

    2012-01-01

    Background The incidence rate of soccer injuries is among the highest in sports, particularly for adult male soccer players. Purpose To investigate the effect of the 'The11' injury prevention programme on injury incidence and injury severity in adult male amateur soccer players. Study design

  10. Short stick exercises for fall prevention among older adults: a cluster randomized trial.

    Science.gov (United States)

    Yokoi, Katsushi; Yoshimasu, Kouichi; Takemura, Shigeki; Fukumoto, Jin; Kurasawa, Shigeki; Miyashita, Kazuhisa

    2015-01-01

    To investigate the effects of short stick exercise (SSEs) on fall prevention and improvement of physical function in older adults. A cluster randomized trial was conducted in five residential care facilities. The intervention group (n = 51) practiced SSEs for six months, followed by routine care for six more months. The control group (n = 54) received ordinary care for 12 months. The primary outcome measure was the number of fallers, taking into account the time to first fall using the Kaplan-Meier method. The secondary outcome measures were physical and mental functions. The number of fallers was significantly lower in the intervention group (n = 6) than in the control group (n = 16) during the 12 months. The adjusted hazard ratio for a first fall in the intervention group compared with the control group was 0.15 (CI, 0.03 to 0.74, p = 0.02). The fall-free period was significantly longer in the intervention group than in controls (mean ± SD, 10.1 ± 3.0 versus 9.0 ± 4.1 months, p = 0.027). The functional reach and sit and reach tests were significantly improved at three and six months. The SSEs appeared effective for fall prevention and improvement of physical function in older adults. Implications for Rehabilitation The newly developed short stick exercises appear an effective means of reducing falls among older adults in residential care facilities. The short stick exercises seem to have an immediate effect on improving physical functions. Effects gained by performing the short stick exercises, such as static balance, flexibility and agility may last for six months. The short stick exercises were found to be easy for older adults to practice continuously in residential care facilities.

  11. Edivoxetine compared to placebo as adjunctive therapy to selective serotonin reuptake inhibitors in the prevention of symptom re-emergence in major depressive disorder.

    Science.gov (United States)

    Oakes, Tina M; Dellva, Mary Anne; Waterman, Karen; Greenbaum, Michael; Poppe, Christopher; Goldberger, Celine; Ahl, Jonna; Perahia, David G

    2015-06-01

    When patients with major depressive disorder (MDD) are partial responders to antidepressant therapy, adjunctive treatment with an agent that has a different mode of action may provide additional benefit. We investigated the efficacy of edivoxetine, a highly selective norepinephrine reuptake inhibitor (NRI), as adjunctive treatment to selective serotonin reuptake inhibitors (SSRIs) in the prevention of re-emergence of depressive symptoms in patients with MDD (ClinicalTrials.gov identifier: NCT01299272). Adult outpatients with MDD who were partial responders to SSRI treatment (N = 1249) entered an open-label 8 week flexibly dosed (12-18 mg/day) adjunctive edivoxetine period. Patients who achieved remission (Montgomery-Åsberg Depression Rating Scale total score ≤10 at week 8) entered a 12 week open-label fixed-dose (12 mg or 18 mg/day) stabilization period, and those still in remission at each of weeks 18, 19, and 20 were randomized to continue treatment at the same dose of edivoxetine or switch to placebo for a 24 week double-blind withdrawal period. All patients remained on SSRI therapy throughout the study. The primary outcome was time to re-emergence of depressive symptoms during double-blind withdrawal. Two hundred and ninety-four patients were randomized to continue adjunctive edivoxetine and 292 were switched to adjunctive placebo. Comparing adjunctive edivoxetine with adjunctive placebo, differences were not significant for time to re-emergence of symptoms (Kaplan-Meier log-rank p = 0.485), rates of symptom re-emergence (9.9% vs 8.2%, p = 0.565) or rates of sustained remission (75.4% vs 76.7%, p = 0.771). Treatment-emergent adverse events were consistent with the noradrenergic mechanism of action. Edivoxetine failed to demonstrate superiority vs placebo as adjunctive treatment in the prevention of symptom re-emergence during maintenance treatment in SSRI partial responders with MDD. While no selective NRIs are approved for adjunctive

  12. Prescribing Physical Activity for the Prevention and Treatment of Osteoporosis in Older Adults

    Directory of Open Access Journals (Sweden)

    Lachlan B. McMillan

    2017-11-01

    Full Text Available Osteoporosis is an age-related disease, characterised by low bone mineral density (BMD and compromised bone geometry and microarchitecture, leading to reduced bone strength. Physical activity (PA has potential as a therapy for osteoporosis, yet different modalities of PA have varying influences on bone health. This review explores current evidence for the benefits of PA, and targeted exercise regimes for the prevention and treatment of osteoporosis in older adults. In particular, the outcomes of interventions involving resistance training, low- and high-impact weight bearing activities, and whole-body vibration therapy are discussed. Finally, we present recommendations for future research that may maximise the potential of exercise in primary and secondary prevention of osteoporosis in the ageing population.

  13. Virtual Reality and Serious Games in Neurorehabilitation of Children and Adults: Prevention, Plasticity, and Participation.

    Science.gov (United States)

    Deutsch, Judith E; Westcott McCoy, Sarah

    2017-07-01

    Use of virtual reality (VR) and serious games (SGs) interventions within rehabilitation as motivating tools for task specific training for individuals with neurological conditions are fast-developing. Within this perspective paper we use the framework of the IV STEP conference to summarize the literature on VR and SG for children and adults by three topics: Prevention; Outcomes: Body-Function-Structure, Activity and Participation; and Plasticity. Overall the literature in this area offers support for use of VR and SGs to improve body functions and to some extent activity domain outcomes. Critical analysis of clients' goals and selective evaluation of VR and SGs are necessary to appropriately take advantage of these tools within intervention. Further research on prevention, participation, and plasticity is warranted. We offer suggestions for bridging the gap between research and practice integrating VR and SGs into physical therapist education and practice.

  14. Targeted preventive care may be needed for adults with congenital spine anomalies.

    Science.gov (United States)

    Wilson, Richard; Lewis, Steven A; Dicianno, Brad E

    2011-08-01

    To compare hospitalizations caused by spina bifida-sensitive conditions, ambulatory care-sensitive conditions in adults with spina bifida and in the general population, our aim was to provide information about whether preventive health efforts already underway in the hospitalized general population are adequate for preventive care in spina bifida and congenital spine anomalies. Retrospective secondary data analysis. Records of hospitalized individuals who were 18 years of age and older. Comparison between individuals hospitalized with spina bifida and the general population using data from the California State Inpatient Database from the Healthcare Cost and Utilization Project for 2004 of adults. Prevalence of spina bifida-sensitive conditions and ambulatory care-sensitive conditions as reason for hospitalization and 30-day readmission. As compared with the general population, persons with spina bifida who were hospitalized in 2004 had a significantly greater number of hospitalizations, number of hospitalizations associated with both spina bifida-sensitive conditions and ambulatory care-sensitive conditions, and number of 30-day readmissions. Stratification by age shows that the admissions for spina bifida sensitive conditions were greater in persons with spina bifida than in the general population for all age groups. In contrast, only in the youngest age group did those with spina bifida experience greater hospitalizations for ambulatory care-sensitive conditions. This study provides further evidence that persons with spina bifida have hospitalizations that are beyond what the general population experiences. These conditions may be potentially preventable with appropriate ambulatory care. This group also had a greater risk for readmission within 30 days of discharge from their last hospitalization. More research is needed on the efficacy of programs aimed at prevention of these conditions. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation

  15. Knowledge, attitudes, and preventive practices about colorectal cancer among adults in an area of Southern Italy.

    Science.gov (United States)

    Sessa, Alessandra; Abbate, Rossella; Di Giuseppe, Gabriella; Marinelli, Paolo; Angelillo, Italo F

    2008-06-11

    Colorectal cancer (CRC) is the second most commonly diagnosed cancer for both sexes in developed countries. This study assessed the knowledge, attitudes, and preventive practices regarding CRC of adults in Italy. A random sample of 1165 adults received a self-administered questionnaire on socio-demographic characteristics; knowledge regarding definition, risk factors, and screening; attitudes regarding perceived risk of contracting CRC and utility of screening tests; health-related behaviors and health care use; source of information. Only 18.5% knew the two main modifiable risk factors (low physical activity, high caloric intake from fat) and this knowledge was significantly associated with higher educational level, performing physical activity, modification of dietary habits and physical activity for fear of contracting CRC, and lower risk perception of contracting CRC. Half of respondents identified fecal occult blood testing (FOBT) as main test for CRC prevention and were more knowledgeable those unmarried, more educated, who knew the main risk factors of CRC, and have received advice by physician of performing FOBT. Personal opinion that screening is useful for CRC prevention was high with a mean score of 8.3 and it was predicted by respondents' lower education, beliefs that CRC can be prevented, higher personal perceived risk of contracting CRC, and information received by physician about CRC. An appropriate behavior of performing FOBT if eligible or not performing if not eligible was significantly higher in female, younger, more educated, in those who have been recommended by physician for undergo or not undergo FOBT, and who have not personal history of precancerous lesions and familial history of precancerous lesions or CRC. Linkages between health care and educational systems are needed to improve the levels of knowledge and to raise CRC screening adherence.

  16. Knowledge, attitudes, and preventive practices about colorectal cancer among adults in an area of Southern Italy

    Directory of Open Access Journals (Sweden)

    Marinelli Paolo

    2008-06-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second most commonly diagnosed cancer for both sexes in developed countries. This study assessed the knowledge, attitudes, and preventive practices regarding CRC of adults in Italy. Methods A random sample of 1165 adults received a self-administered questionnaire on socio-demographic characteristics; knowledge regarding definition, risk factors, and screening; attitudes regarding perceived risk of contracting CRC and utility of screening tests; health-related behaviors and health care use; source of information. Results Only 18.5% knew the two main modifiable risk factors (low physical activity, high caloric intake from fat and this knowledge was significantly associated with higher educational level, performing physical activity, modification of dietary habits and physical activity for fear of contracting CRC, and lower risk perception of contracting CRC. Half of respondents identified fecal occult blood testing (FOBT as main test for CRC prevention and were more knowledgeable those unmarried, more educated, who knew the main risk factors of CRC, and have received advice by physician of performing FOBT. Personal opinion that screening is useful for CRC prevention was high with a mean score of 8.3 and it was predicted by respondents' lower education, beliefs that CRC can be prevented, higher personal perceived risk of contracting CRC, and information received by physician about CRC. An appropriate behavior of performing FOBT if eligible or not performing if not eligible was significantly higher in female, younger, more educated, in those who have been recommended by physician for undergo or not undergo FOBT, and who have not personal history of precancerous lesions and familial history of precancerous lesions or CRC. Conclusion Linkages between health care and educational systems are needed to improve the levels of knowledge and to raise CRC screening adherence.

  17. Adherence with isoniazid for prevention of tuberculosis among HIV-infected adults in South Africa

    Directory of Open Access Journals (Sweden)

    Muller F James

    2006-06-01

    Full Text Available Abstract Background Tuberculosis (TB is the most common opportunistic infection in HIV-infected adults in developing countries. Isoniazid (INH is recommended for treatment of latent TB infection, however non-adherence is common. The purpose of this study was to apply in-house prepared isoniazid (INH urine test strips in a clinical setting, and identify predictors of positive test results in an adherence questionnaire in HIV-infected adults taking INH for prevention of TB. Methods Cross-sectional study of adherence using a questionnaire and urine test strips for detection of INH metabolites at two hospitals in Pietermaritzburg, South Africa. Participants were aged at least 18 years, HIV positive, and receiving INH for prevention of tuberculosis disease. Univariate and multivariate analyses are used to identify factors relevant to adherence. Results 301 consecutive patients were recruited. 28% of participants had negative urine tests. 32 (37.2%, 95% CI25.4, 45.0 of the 86 patients who received INH from peripheral pharmacies said the pharmacy had run out of INH at some time, compared with central hospital pharmacies (p = 0.0001. In univariate analysis, a negative test was associated with self-reported missed INH doses (p = 0.043. Each 12-hour increment since last reported dose increased the likelihood of a negative test by 34% (p = 0.0007. Belief in INH safety was associated with a positive test (p = 0.021. In multivariate analysis, patients who believed INH is important for prevention of TB disease were more likely to be negative (p = 0.0086. Conclusion Adequate drug availability at peripheral pharmacies remains an important intervention for TB prevention. Key questions may identify potentially non-adherent patients. In-house prepared urine tests strips are an effective and cheap method of objectively assessing INH adherence, and could be used an important tool in TB control programs.

  18. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences.

    Science.gov (United States)

    Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

    2017-02-01

    Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome measures of functional reach, perceived health status, fear of fall were included. Quality of the included articles was rated using Physiotherapy Evidence Database (PEDro) scale and the pooled effect of SSE was obtained by Review Manager (RevMan5) software. Significant effect of SSE was detected over walking or no treatment to improve balance as well to prevent fear of fall and improve perceived health status. The results of this systematic review proposed that SSE significantly better than walking or no treatment to prevent fall, prevent fear of fall and improve perceived health status.

  19. Early emergence of adult-like fear renewal in the developing rat after chronic corticosterone treatment of the dam or the pups.

    Science.gov (United States)

    Callaghan, Bridget L; Richardson, Rick

    2014-10-01

    Early adversity increases the risk of nearly all mental health disorders. Although tractable animal models exist to probe the psychobiology of early adversity, the empirical research has focused largely on adult outcomes. In the current studies we examined how early exposure to the stress hormone corticosterone (CORT) affects the maturation of fear extinction in infant rats. Whereas juvenile and adult rodents exhibit extinction learning that is relapse-prone (i.e., they show renewal and reinstatement of extinguished fear), under typical rearing conditions the extinction system in infant rats appears to be relapse-resistant (i.e., extinction leads to a permanent reduction in conditioned fear). In the current studies we tested the hypothesis that chronically exposing infant rats to CORT, either indirectly (through maternal drinking water) or directly (via insertion of an osmotic pump), leads to an early transition into the adult-like extinction system (i.e., evidence of the renewal effect). Although some differences were observed between the 2 methods of CORT exposure, the data showed that infants exposed to CORT via either method exhibited premature emergence of adult-like extinction learning (i.e., they exhibited the renewal effect). The theoretical implications of these findings for typical and abnormal development of emotion learning systems, as well as their practical applications in the context of prevention and treatment of mental health disorders, are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. THE ROLE OF PHARMACISTS IN PREVENTING FALLS AMONG AMERICA’S OLDER ADULTS

    Directory of Open Access Journals (Sweden)

    Mamta V Karani

    2016-11-01

    Full Text Available Falls are the leading cause of both fatal and nonfatal injuries in people aged 65 and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient centered team-based approach, pharmacists can collaborate with primary care providers to reduce fall risk. They can screen for fall risk, review and optimize medication therapy, recommend vitamin D, and educate patients and caregivers about ways to prevent falls. To help health care providers implement fall prevention, the Centers for Disease Control and Prevention (CDC developed the STEADI (Stopping Elderly Accidents, Death and Injuries initiative. Based on established clinical guidelines, STEADI provides members of the health care team, including pharmacists, with the tools and resources they need to manage their older patients’ fall risk. These tools are being adapted to specifically advance the roles of pharmacists in: reviewing medications, identifying those that increase fall risk, and communicating those risks with patients’ primary care providers. Through a multidisciplinary approach, pharmacists along with other members of the health care team can better meet the needs of America’s growing older adult population and reduce falls.

  1. The Role of Pharmacists in Preventing Falls among America's Older Adults.

    Science.gov (United States)

    Karani, Mamta V; Haddad, Yara; Lee, Robin

    2016-01-01

    Falls are the leading cause of both fatal and non-fatal injuries in people aged 65 years and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient-centered team-based approach, pharmacists can collaborate with the primary care providers to reduce fall risk. They can screen for fall risk, review and optimize medication therapy, recommend vitamin D, and educate patients and caregivers about ways to prevent falls. To help health-care providers implement fall prevention, the Centers for Disease Control and Prevention developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. Based on the established clinical guidelines, STEADI provides members of the health-care team, including pharmacists, with the tools and resources they need to manage their older patients' fall risk. These tools are being adapted to specifically advance the roles of pharmacists in reviewing medications, identifying those that increase fall risk, and communicating those risks with patients' primary care providers. Through a multidisciplinary approach, pharmacists along with other members of the health-care team can better meet the needs of America's growing older adult population and reduce falls.

  2. Recommendations for Methicillin-Resistant Staphylococcus aureus Prevention in Adult ICUs: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Whittington, Melanie D; Atherly, Adam J; Curtis, Donna J; Lindrooth, Richard C; Bradley, Cathy J; Campbell, Jonathan D

    2017-08-01

    Patients in the ICU are at the greatest risk of contracting healthcare-associated infections like methicillin-resistant Staphylococcus aureus. This study calculates the cost-effectiveness of methicillin-resistant S aureus prevention strategies and recommends specific strategies based on screening test implementation. A cost-effectiveness analysis using a Markov model from the hospital perspective was conducted to determine if the implementation costs of methicillin-resistant S aureus prevention strategies are justified by associated reductions in methicillin-resistant S aureus infections and improvements in quality-adjusted life years. Univariate and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness. ICU. Hypothetical cohort of adults admitted to the ICU. Three prevention strategies were evaluated, including universal decolonization, targeted decolonization, and screening and isolation. Because prevention strategies have a screening component, the screening test in the model was varied to reflect commonly used screening test categories, including conventional culture, chromogenic agar, and polymerase chain reaction. Universal and targeted decolonization are less costly and more effective than screening and isolation. This is consistent for all screening tests. When compared with targeted decolonization, universal decolonization is cost-saving to cost-effective, with maximum cost savings occurring when a hospital uses more expensive screening tests like polymerase chain reaction. Results were robust to sensitivity analyses. As compared with screening and isolation, the current standard practice in ICUs, targeted decolonization, and universal decolonization are less costly and more effective. This supports updating the standard practice to a decolonization approach.

  3. Demystifying a Black Box: A Grounded Theory of How Travel Experiences Impact the Jewish Identity Development of Jewish Emerging Adults

    Science.gov (United States)

    Aaron, Scott

    2015-01-01

    The positive impact on the Jewish Identity Development of Jewish Emerging Adults of both the 10 day trips to Israel popularly known as Birthright trips and the service learning trips commonly known as Alternative Spring Breaks has been well-documented. However, the mechanics of how this positive impact occurs has not been well-understood. This…

  4. Measurement Invariance of the Brief Multidimensional Student's Life Satisfaction Scale among Adolescents and Emerging Adults across 23 Cultural Contexts

    Science.gov (United States)

    Abubakar, Amina; van de Vijver, Fons; Alonso-Arbiol, Itziar; He, Jia; Adams, Byron; Aldhafri, Said; Aydinli-Karakulak, Arzu; Arasa, Josephine; Boer, Diana; Celenk, Ozgur; Dimitrova, Radosveta; Ferreira, Maria Cristina; Fischer, Ronald; Mbebeb, Fomba Emmanuel; Frías, María Teresa; Fresno, Andrés; Gillath, Omri; Harb, Charles; Handani, Penny; Hapunda, Given; Kamble, Shanmukh; Kosic, Marianna; Looh, Joseph Lah; Mazrui, Lubna; Mendia, Rafael Emilio; Murugami, Margaret; Mason-Li, Mei; Pandia, Weny Savitry; Perdomo, Cristina; Schachner, Maja; Sim, Samantha; Spencer, Rosario; Suryani, Angela; Tair, Ergyul

    2016-01-01

    There is hardly any cross-cultural research on the measurement invariance of the Brief Multidimensional Students' Life Satisfaction Scales (BMSLSS). The current article evaluates the measurement invariance of the BMSLSS across cultural contexts. This cross-sectional study sampled 7,739 adolescents and emerging adults in 23 countries. A multi-group…

  5. Using Oral Language Skills to Build on the Emerging Literacy of Adult English Learners. CAELA Network Brief

    Science.gov (United States)

    Vinogradov, Patsy; Bigelow, Martha

    2010-01-01

    In addition to learning to read and write for the first time, adult English language learners with limited or emerging literacy skills must acquire oral English. Often, learners with limited print literacy in their first language have oral skills in English that exceed their English literacy skills (Geva & Zadeh, 2006). While this mismatch of oral…

  6. Marriage (In)equality: The Perspectives of Adolescents and Emerging Adults with Lesbian, Gay, and Bisexual Parents

    Science.gov (United States)

    Goldberg, Abbie E.; Kuvalanka, Katherine A.

    2012-01-01

    The debate over whether same-sex couples should be allowed to enter into civil marriages continues in the United States. Forty-nine adolescents and emerging adults (ages 14-29) with lesbian, gay, and bisexual parents were interviewed for the current exploratory study, which examined how individuals perceived themselves and their families as being…

  7. Drug-Intake Methods and Social Identity: The Use of Marijuana in Blunts among Southeast Asian Adolescents and Emerging Adults

    Science.gov (United States)

    Soller, Brian; Lee, Juliet P.

    2010-01-01

    This article examines why Southeast Asian American adolescents and emerging adults in two urban settings prefer to use "blunts," or hollowed-out cigars filled with marijuana, over other methods of drug intake. Rationales for preferring blunts were both instrumental and social. Blunts allowed users to more easily share marijuana, the preferred drug…

  8. "It Felt Good but Weird at the Same Time": Emerging Adults' First Experiences of Six Different Sexual Behaviors

    Science.gov (United States)

    Vasilenko, Sara A.; Maas, Megan K.; Lefkowitz, Eva S.

    2015-01-01

    Although sexual behavior is multidimensional, little research has focused on the experience of nonintercourse behaviors for adolescents and emerging adults. This article uses open-ended coded data from a longitudinal study of college students (N = 346; M age = 18.5, 52% female, 27% Hispanic/Latino [HL], 25% non-HL European American, 23% non-HL…

  9. Age of First Use as a Predictor of Current Alcohol and Marijuana Use among College-Bound Emerging Adults

    Science.gov (United States)

    Bergen-Cico, Dessa K.; Lape, Megan E.

    2013-01-01

    Background: Alcohol and marijuana are the most commonly used psychoactive substances; however, the sequencing and relationship between age of first use and continued current problematic use among college-bound emerging adults is not well understood. Methods: This is a cross-sectional study of current and historical alcohol and marijuana use among…

  10. Exploring Relationships among Strengths Use, Spirituality, Religion and Positive Mental Health of College-Attending Emerging Adults

    Science.gov (United States)

    Rankin, Wendy M.

    2015-01-01

    This exploratory study examined the relationships among strengths use, spirituality, religion, and positive mental health of 109 traditional undergraduate, college-attending emerging adults in a public university in the southern region of the United States, often referred to as the Bible-Belt. Constructs of the study were guided by a student…

  11. The Relationship between Spirituality and Religiosity on Psychological Outcomes in Adolescents and Emerging Adults: A Meta-Analytic Review

    Science.gov (United States)

    Yonker, Julie E.; Schnabelrauch, Chelsea A.; DeHaan, Laura G.

    2012-01-01

    The present study used meta-analytic techniques to examine the association between spirituality and religiosity (S/R) and psychological outcomes in adolescents and emerging adults. The outcome measures of risk behavior, depression, well-being, self-esteem, and personality were examined with respect to the influence of S/R across 75 independent…

  12. Self-Study as an Emergent Methodology in Career and Technical Education, Adult Education and Technology: An Invitation to Inquiry

    Science.gov (United States)

    Hawley, Todd S.; Hostetler, Andrew L.

    2017-01-01

    In this manuscript, the authors explore self-study as an emerging research methodology with the potential to open up spaces of inquiry for researchers, graduate students, and teachers in a broad array of fields. They argue that the fields of career and technical education (CTE), adult education and technology can leverage self-study methodology in…

  13. Physician Attitudes Toward Adult Vaccines and Other Preventive Practices, United States, 2012.

    Science.gov (United States)

    Hurley, Laura P; Bridges, Carolyn B; Harpaz, Rafael; Allison, Mandy A; O' Leary, Sean T; Crane, Lori A; Brtnikova, Michaela; Stokley, Shannon; Beaty, Brenda L; Jimenez-Zambrano, Andrea; Kempe, Allison

    2016-01-01

    We described the following among U.S. primary care physicians: (1) perceived importance of vaccines recommended by the Advisory Committee on Immunization Practices relative to U.S. Preventive Services Task Force (USPSTF) preventive services, (2) attitudes toward the U.S. adult immunization schedule, and (3) awareness and use of Medicare preventive service visits. We conducted an Internet and mail survey from March to June 2012 among national networks of general internists and family physicians. We received responses from 352 of 445 (79%) general internists and 255 of 409 (62%) family physicians. For a 67-year-old hypothetical patient, 540/606 (89%, 95% confidence interval [CI] 87, 92) of physicians ranked seasonal influenza vaccine and 487/607 (80%, 95% CI 77, 83) ranked pneumococcal vaccine as very important, whereas 381/604 (63%, 95% CI 59, 67) ranked Tdap/Td vaccine and 288/607 (47%, 95% CI 43, 51) ranked herpes zoster vaccine as very important (pimportant than Tdap/Td and herpes zoster vaccines. For the hypothetical patient aged 30 years, the number and percentage of physicians who reported that the Tdap/Td vaccine (377/604; 62%, 95% CI 59, 66) is very important was greater than the number and percentage who reported that the seasonal influenza vaccine (263/605; 43%, 95% CI 40, 47) is very important (pimportant than was any vaccine. A total of 172 of 587 physicians (29%) found aspects of the adult immunization schedule confusing. Among physicians aware of "Welcome to Medicare" and annual wellness visits, 492/514 (96%, 95% CI 94, 97) and 329/496 (66%, 95% CI 62, 70), respectively, reported having conducted fewer than 10 such visits in the previous month. Despite lack of prioritization of vaccines by ACIP, physicians are prioritizing some vaccines over others and ranking some vaccines below other preventive services. These attitudes and confusion about the immunization schedule may result in missed opportunities for vaccination. Medicare preventive visits are not

  14. Emerging adults in substance misuse intervention: preintervention characteristics and responses to a motivation-enhancing program

    Directory of Open Access Journals (Sweden)

    Blair Beadnell

    2016-11-01

    Full Text Available Abstract Background Emerging adulthood is an age of particularly risky behavior. Substance misuse during this phase of life can be the beginning of longer-term problems, making intervention programs particularly important. This study’s purposes were to identify alcohol use profile subgroups, describe the preintervention characteristics of each, and assess how many participants transitioned to lower-risk profiles during the course of the intervention. Methods We used latent transition analyses to categorize 1183 people court ordered to attend Prime For Life® (PFL, a motivation-enhancing program, into preintervention and postintervention profiles. We then assessed how many made transitions between these profiles during the course of the intervention. Results Profiles included two low-risk statuses (abstinence and light drinking and two high-risk statuses (occasional heavy drinking and frequent heavy drinking. We found that people in profile subgroups that reflected heavier 90-day preintervention drinking were likely to transition to profiles reflecting postintervention intentions for lower-risk drinking in the subsequent 90 days. In contrast, the likelihood of transitioning from a lower-risk to a higher-risk profile was extremely low. These positive changes were found for people of both sexes and for those above versus below the legal drinking age, albeit for more women than men in the heaviest drinking group. Conclusions Findings showed positive changes during intervention for many emerging adult participants attending PFL. Further research is needed that include comparison conditions, as well as examine longer-term outcomes in this population.

  15. Current practices related to family presence during acute deterioration in adult emergency department patients.

    Science.gov (United States)

    Youngson, Megan J; Currey, Judy; Considine, Julie

    2017-11-01

    To explore the characteristics of and interactions between clinicians, patients and family members during management of the deteriorating adult patient in the emergency department. Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over the last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite the decrease in cardiac arrests, research related to family presence continues to focus on care during resuscitation rather than care during acute deterioration. Descriptive exploratory study using nonparticipatory observation. Five clinical deterioration episodes were observed within a 50-bed, urban, Australian emergency department. Field notes were taken using a semistructured tool to allow for thematic analysis. Presence, roles and engagement describe the interactions between clinicians, family members and patients while family are present during a patient's episode of deterioration. Presence was classified as no presence, physical presence and therapeutic presence. Clinicians and family members moved through primary, secondary and tertiary roles during patients' deterioration episode. Engagement was observed to be superficial or deep. There was a complex interplay between presence, roles and engagement with each influencing which form the other could take. Current practices of managing family during episodes of acute deterioration are complex and multifaceted. There is fluid interplay between presence, roles and engagement during a patient's episode of deterioration. This study will contribute to best practice, provide a strong foundation for clinician education and present opportunities for future research. © 2017 John Wiley & Sons Ltd.

  16. Emotional Intelligence: An Untapped Resource for Alcohol and Other Drug Related Prevention among Adolescents and Adults

    Directory of Open Access Journals (Sweden)

    Ken Russell Coelho

    2012-01-01

    Full Text Available Alcohol and Other Drug abuse in adolescents and adults continues to be a major public health problem in the United States. Care in intervention programs aimed at high risk populations identified occurs after the maladaptive behavioral delinquency has occurred, and only then is an individual afforded the opportunity to join an intervention program. The focus of this paper is to illustrate and highlight the value of prevention programs which emphasize altering maladaptive behavior before the behavior becomes problematic. Emotional Intelligence is not only an indicator of alcohol and other drug abuse, but is linked to emotional competence, social and emotional learning, the development of healthy and life promoting behavior, and has been proven to reduce some of the risk factors associated with alcohol and other drug abuse in adolescents and adults. This paper seeks to recognize the significance of Emotional Intelligence as a desirable health promoting attribute and to establish the importance of its conceptual use in a prevention based model for reducing associated high risk behaviors.

  17. Efficacy of Alendronate for Preventing Collapse of Femoral Head in Adult Patients with Nontraumatic Osteonecrosis

    Directory of Open Access Journals (Sweden)

    Yu-Cai Hong

    2014-01-01

    Full Text Available The purpose of the current review was to determine the efficacy of alendronate for preventing collapse of femoral head in adult patients with nontraumatic avascular osteonecrosis of femoral head (ANFH. Five randomized controlled trials (RCTs involving 305 hips were included in this review, of which 3 studies investigated alendronate versus control/placebo and the other 2 studies compared the combination of alendronate and extracorporeal shockwave therapy (ESWT with ESWT alone. Our results suggested that even the patients with extensive necrosis encountered much less collapse in the alendronate group than control group. In these RCTs, their data also indicated a positive short- and middle-term efficacy of alendronate treatment in joint function improvement and hip pain diminishment. With the presence of the outlier study, only insignificant overall efficacy of alendronate could be observed with substantial heterogeneities. In addition, we did not find any additive benefits of alendronate in combination with ESWT for preventing collapse compared to ESWT alone. In conclusion, there is still lack of strong evidence for supporting application of alendronate in adult patients with nontraumatic ANFH, which justified that large scale, randomized, and double-blind studies should be developed to demonstrate the confirmed efficacies, detailed indication, and optimized strategy of alendronate treatment.

  18. Fear and Risk of Falling, Activities of Daily Living, and Quality of Life: Assessment When Older Adults Receive Emergency Department Care.

    Science.gov (United States)

    Çinarli, Tuğba; Koç, Zeliha

    Falls tend to create fear and concern in older adults who also seek care in emergency departments (EDs) at high rates. The purposes of this study were to (a) describe risk and fear of falling in older adults seeking care in the ED and (b) explore relationships between risk and fear of falling with activities of daily living and quality of life. The study was conducted in the ED of Ondokuz Mayis University Hospital in Samsun, Turkey. Data were collected for 7 months in 2013-2014. Adults aged 65 years and above who scored at least 20 on the Standardized Mini-Mental Test and who presented for care in the ED were eligible to take part. Patients self-reported demographic information and completed the Tinetti Falls Efficacy Scale, the Morse Fall Scale, the Nottingham Health Profile (NHP), and the Modified Barthel Index (MBI). A total of 151 older adults took part. Prevalence of falls was high (48.3%), as well as fear of falling (63.6%). Risk of falling (Morse Fall Scale scores) was negatively correlated with the ability to carry out activities of daily living (MBI scores; r = -.50, p falling (Falls Efficacy Scale scores) was negatively correlated with the ability to carry out activities of daily living (MBI scores; r = -.79, p Older adults seeking care in the ED who have a higher risk of falling are more dependent in daily living activities and experience lower quality of life. Care seeking in the ED offers an opportunity to assess fall risk and fear of falling and provide guidance on prevention and management of falls in older adults.

  19. Report: EPA Lacks Internal Controls to Prevent Misuse of Emergency Drinking Water Facilities

    Science.gov (United States)

    Report #11-P-0001, October 12, 2010. EPA cannot accurately assess the risk of public water systems delivering contaminated drinking water from emergency facilities because of limitations in Safe Drinking Water Information System (SDWIS) data management.

  20. A globalisation challenge: Preventing a clash between the middle classes of the developed and emerging economies

    OpenAIRE

    Ortega, Andrés; Otero-Iglesias, Miguel; Steinberg, Federico

    2017-01-01

    Tension is growing between the interests of the middle classes that are in decline in the mature economies and the rising ones in emerging markets. The aim of the public policies proposed in this paper is to impede such a clash by not threatening de-globalisation, avoiding protectionism, fostering inclusive technological innovation, compensating the losers of globalisation in developed economies and reassuring the winners in emerging economies. It argues that the G20 concept of "inclusive gro...

  1. Caste-fate determination primarily occurs after adult emergence in a primitively eusocial paper wasp: significance of the photoperiod during the adult stage

    Science.gov (United States)

    Yoshimura, Hideto; Yamada, Yoshihiro Y.

    2018-02-01

    Independent-founding paper wasps constitute a major group of primitively eusocial insects, and when caste-fate determination occurs in temperate species of these wasps, particularly regarding whether it occurs before or after emergence, remains unclear. No critical morphological differences occur between potential queens of the next generation (often called gynes) and workers in primitively eusocial insects. The gynes of temperate species are characterized by diapausing, and the nutrients available during the larval stage have often been believed to determine caste fate. Short days usually induce diapause in temperate nonsocial insects, although few investigations of the effects of day length on caste-fate determination in paper wasps have been conducted. By exposing individuals to different combinations of short and long days during the immature and adult stages, we show for the first time that short days during the adult stage (but not during the immature stage) facilitated caste-fate determination toward gynes in a paper wasp. Moreover, the decision to diapause partly depended on changes in the photoperiod during the pupal and adult stages. The size of the adult also affected caste-fate determination, with diapause more likely to occur in large adults, but this size effect did not occur when individuals were exposed to many short days during the pupal stage. In addition, all adults except for a small proportion of smaller individuals prepared for diapause under short days. These findings suggest that the photoperiod is a higher priority cue than adult size.

  2. Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.

    Science.gov (United States)

    Tayyib, Nahla; Coyer, Fiona

    2016-12-01

    Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.

  3. Probiotics, Prebiotics, and Synbiotics for the Treatment and Prevention of Adult Dermatological Diseases.

    Science.gov (United States)

    Notay, Manisha; Foolad, Negar; Vaughn, Alexandra R; Sivamani, Raja K

    2017-12-01

    Probiotic, prebiotic, and synbiotic supplementation is becoming more prevalent nowadays. Clinical studies have demonstrated some of the medical benefits of probiotics, prebiotics, and synbiotics within dermatology but an evidence-based review of their effects in adults is needed. The aim of this study was to identify evidence for the use of supplementation with probiotics, prebiotics, or synbiotics for the prevention and treatment of dermatological diseases in adults. We conducted a search of the Ovid MEDLINE, Cochrane Central Register of Controlled trials and EMBASE electronic databases from 1 January 1946 to 11 January 2017. Trials examining supplementation in the treatment of dermatological diseases using oral or topical probiotics, synbiotics, and prebiotics in adults over the age of 18 years were selected. Of 315 articles, 12 met the inclusion criteria. Nutritional supplementation with probiotics and prebiotics was shown to improve atopic dermatitis (AD) symptomatology, quality of life, or clinical severity in six of nine studies. One study in psoriasis was shown to improve inflammatory markers, and one study suggested that probiotics could be used as adjunctive therapy in the treatment of acne. Preliminary studies are optimistic for the use of some strains of probiotics for symptomatic and clinical improvement in AD, and as adjunctive treatment with antibiotics for acne. Further research is necessary to better assess how probiotics and prebiotics may be used within dermatology.

  4. Falls in Cognitively Impaired Older Adults: Implications for Risk Assessment And Prevention.

    Science.gov (United States)

    Montero-Odasso, Manuel; Speechley, Mark

    2018-02-01

    To provide an overview of the role of cognition in falls, with potential implications for managing and preventing falls in older adults. Review. Observational and interventional studies addressing the role of cognition on falls. Community-dwelling older adults (65 years and older). The relationship between gait and cognition in aging and neurodegeneration was reviewed in the medical literature to highlight the role of brain motor control deficits in fall risk. The benefits of dual-task gait assessments as a marker of fall risk were reviewed. Therapeutic approaches for reducing falls by improving certain aspects of cognition were appraised. Low performance in attention and executive function are associated with gait slowing, instability, and future falls. Drug-enhancement of cognition may reduce falls in Parkinson's disease, and cognitive training, dual-task training, and virtual reality modalities are promising to improve mobility in sedentary older adults and in those with cognitive impairment and dementia. Falls remain common in older people, with higher prevalence and morbidity in those who are cognitively impaired. Disentangling the mechanism and contribution of cognitive deficits in fall risk may open new treatment approaches. Mounting evidence supports that cognitive therapies help reduce falls. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  5. Patterns of perspectives on fall-prevention beliefs by community-dwelling older adults: a Q method investigation.

    Science.gov (United States)

    Chen, Shueh-Fen; Huang, Su-Fei; Lu, Li-Ting; Wang, Mei-Chuen; Liao, Jung-Yu; Guo, Jong-Long

    2016-07-07

    Falling has high incidence and reoccurrence rates and is an essential factor contributing to accidental injury or death for older adults. Enhancing the participation of community-dwelling older adults in fall-prevention programs is crucial. Understanding fall-prevention beliefs will be beneficial for developing a community-based fall-prevention program. The aim of the present study was to identify the distinct types of subjective views on the fall-prevention beliefs of community-dwelling older adults aged 80 years and older by applying the Q method. The Q method was adopted to investigate the pattern of perception on fall-prevention beliefs. Forty-two older adults aged 80 - 92 years from a community care center in Northern Taiwan were recruited and requested to complete a Q-sorting. A series of Q-sorts was performed by the participants to rank 30 statements into a normal distribution Q-sort grid. The Q-sorts were subjected to principal component analysis by using PQMethod software Version 2.35. Four statistically independent perspectives were derived from the analysis and reflected distinct viewpoints on beliefs related to fall prevention. Participants in the Considerate perspective believed that health problems caused by falling were serious and fall prevention could decrease the burden they place on their family. Participants in the Promising perspective believed that existing health problems could cause a fall and that fall prevention contributed to their well-being. Participants in the Adaptable perspective perceived low barriers to execute fall prevention and displayed self-confidence and independence in preventing falls. Participants in the Ignorance perspective believed that they could not prevent falls and perceived barriers to fall prevention. By combining theoretical constructs and the Q methodology approach, this study identified four distinct perspectives on fall prevention among community-dwelling older adults. Critical reflection on older adult

  6. Delirium prevention program in the surgical intensive care unit improved the outcomes of older adults.

    Science.gov (United States)

    Bryczkowski, Sarah B; Lopreiato, Maeve C; Yonclas, Peter P; Sacca, James J; Mosenthal, Anne C

    2014-07-01

    Hospital-acquired delirium is a known risk factor for negative outcomes in patients admitted to the surgical intensive care unit (SICU). Outcomes worsen as the duration of delirium increases. The purpose of this study was to evaluate the efficacy of a delirium prevention program and determine whether it decreased the incidence and duration of hospital-acquired delirium in older adults (age>50 y) admitted to the SICU. A prospective pre- or post-intervention cohort study was done at an academic level I trauma center. Older adults admitted to the SICU were enrolled in a delirium prevention program. Those with traumatic brain injury, dementia, or 0 d of obtainable delirium status were excluded from analysis. The intervention consisted of multidisciplinary education, a pharmacologic protocol to limit medications associated with delirium, and a nonpharmacologic sleep enhancement protocol. Primary outcomes were incidence of delirium and delirium-free days/30. Secondary outcomes were ventilator-free days/30, SICU length of stay (LOS), daily and cumulative doses of opioids (milligram, morphine equivalents) and benzodiazepines (milligram, lorazepam equivalents), and time spent in severe pain (greater than or equal to 6 on a scale of 1-10). Delirium was measured using the Confusion Assessment Method for the ICU. Data were analyzed using Chi-squared and Wilcoxon rank sum analysis. Of 624 patients admitted to the SICU, 123 met inclusion criteria: 57 preintervention (3/12-6/12) and 66 postintervention (7/12-3/13). Cohorts were similar in age, gender, ratio of trauma patients, and Injury Severity Score. Postintervention, older adults experienced delirium at the same incidence (pre 47% versus 58%, P=0.26), but for a significantly decreased duration as indicated by an increase in delirium-free days/30 (pre 24 versus 27, P=0.002). After intervention, older adults with delirium had more vent-free days (pre 21 versus 25, P=0.03), shorter SICU LOS (pre 13 [median 12] versus 7 [median 6

  7. Acute Alcohol Use, History of Homelessness, and Intent of Injury Among a Sample of Adult Emergency Department Patients.

    Science.gov (United States)

    Jetelina, Katelyn K; Reingle Gonzalez, Jennifer M; Brown, Carlos V R; Foreman, Michael L; Field, Craig

    2017-08-01

    The literature is clear that adults who are currently homeless also have higher rates of intentional injuries, such as assault and suicide attempts. No study has assessed whether intentional injuries are exacerbated because of substance use among adults with a history of homelessness. Data were obtained from a cohort of adults admitted to 3 urban emergency departments (EDs) in Texas from 2007 to 2010 (N = 596). Logistic regression analyses were used to determine whether a history of homelessness was associated with alcohol use at time of injury in intentional violent injuries (gunshot, stabbing, or injury consistent with assault). 39% adults with a history of homelessness who were treated at trauma centers for a violent injury. Bivariate analyses indicated that adults who had ever experienced homelessness have 1.67 increased odds, 95% confidence interval (CI) [1.11, 2.50], of any intentional violent injury and 1.95 increased odds (95% CI [1.12, 3.40]) of a stabbing injury than adults with no history of homelessness. Adults who experienced homelessness in their lifetime were more likely to visit EDs for violencerelated injuries. Given our limited knowledge of the injuries that prompt ED use by currently homeless populations, future studies are needed to understand the etiology of injuries, and substance-related injuries specifically, among adults with a history of homelessness.

  8. Passion, Intimacy, and Commitment in Casual Sexual Relationships in a Canadian Sample of Emerging Adults.

    Science.gov (United States)

    Rodrigue, Carl; Blais, Martin; Lavoie, Francine; Adam, Barry D; Goyer, Marie-France; Magontier, Céline

    2017-12-04

    Research on casual sexual relationships (CSRs) among emerging adults is prevalent, yet our empirical and theoretical knowledge of relationship processes involved in these relationships is limited. The present study's objective was to compare four CSR partner types (acquaintance, friend, non-dating partner, ex-romantic partner) on passion, intimacy, and commitment, the components of Sternberg's triangular theory of love. A total of 441 Canadians aged 18-25 years who were not in a romantic relationship, and who reported having had more than one sexual contact with their last CSR partner, completed an online survey. Across all partner types, passion was highest, followed by intimacy and commitment. Levels of passion, intimacy, and commitment generally increased with partner familiarity. However, CSR partner type differences on the three components were partially explained by CSR components (i.e., frequency of sexual activity, frequency of social activity, whether partners saw each other with the main goal of having sex, sexual exclusivity agreement, and hopes about the relationship). Results are consistent with CSRs' emphasis on sexuality, and, to a lesser extent, emotions. However, they challenge the mainstream and scientific conflation of CSRs with an absence of emotional bond, commitment, or love.

  9. Bridging Multidimensional Models of Ethnic-Racial and Gender Identity Among Ethnically Diverse Emerging Adults.

    Science.gov (United States)

    Wilson, Antoinette R; Leaper, Campbell

    2016-08-01

    The purpose of this study was to integrate and validate a multidimensional model of ethnic-racial identity and gender identity borrowing constructs and measures based on social identity and gender identity theories. Participants included 662 emerging adults (M age  = 19.86 years; 75 % female) who self-identified either as Asian American, Latino/a, or White European American. We assessed the following facets separately for ethnic-racial identity and gender identity: centrality, in-group affect, in-group ties, self-perceived typicality, and felt conformity pressure. Within each identity domain (gender or ethnicity/race), the five dimensions generally indicated small-to-moderate correlations with one another. Also, correlations between domains for each dimension (e.g., gender typicality and ethnic-racial typicality) were mostly moderate in magnitude. We also noted some group variations based on participants' ethnicity/race and gender in how strongly particular dimensions were associated with self-esteem. Finally, participants who scored positively on identity dimensions for both gender and ethnic-racial domains indicated higher self-esteem than those who scored high in only one domain or low in both domains. We recommend the application of multidimensional models to study social identities in multiple domains as they may relate to various outcomes during development.

  10. Associations among stress, gender, sources of social support, and health in emerging adults.

    Science.gov (United States)

    Lee, Chih-Yuan Steven; Dik, Bryan J

    2017-10-01

    This study aimed to examine how sources of social support intersect with stress and health by testing two theoretical models. Three relationship-specific sources of social support (family, friends, and romantic partners) and two health indicators (self-rated physical health and depressive symptoms) were investigated. The sample consisted of 636 emerging adults attending college (age range: 18-25). Results suggest that only support from family was a stress-buffer, in that it buffered the adverse association between stress and depressive symptoms. Holding stress constant, only support from family was related to self-rated physical health and only support from friends or romantic partners was associated with depressive symptoms. There were no gender differences in the mean levels of self-rated physical health and depressive symptoms. However, gender moderations were found, in that the positive relationship between friends support and physical health was observed only in women, that the association between friends support and depressive symptoms was greater in men than in women, and that family support buffered the negative relationship between stress and physical health only in men. Findings of this study suggest that the associations among stress, social support, and health vary by the sources of support, the health outcome, and gender. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Degree of agreement among sepsis diagnosis criteria in adult emergency room patients with infection

    Science.gov (United States)

    Sinto, R.; Chandra, A. T.; Lie, K. C.; Suwarto, S.

    2018-03-01

    The study on the degree of agreement among three established sepsis diagnosis criteria become the necessity to investigate the best sepsis diagnosis criteria in Indonesia further. A cross-sectional study of adult Emergency Room patients hospitalized with a diagnosis of infection in CiptoMangunkusumo Hospital, Indonesia was conducted during March and April 2017. We recorded diagnosis, gender, age, comorbidities, infection source, and origin. Every subject was classified into sepsis and non-sepsis based on 1991, 2001 and sepsis-3 criteria. Raw % and Kappa agreement coefficients (κ) were calculated according to previously established formula to measure the degree of agreement among three diagnostic criteria. As many as 278 subjects were included in this study. The raw % agreement and κ between 1991 and 2001 criteria is 69.07% and 0.34 respectively. The raw % agreement and κ between 2001 and sepsis-3 criteria is 56.12% and 0.15 respectively. The raw % agreement and κ between 1991 and sepsis-3 criteria is 48.19% and -0.02. In conclusions, there is afair agreement between 1991 and 2001 criteria, poor agreement between 2001 and sepsis-3 criteria, and poor disagreement between 1991 and sepsis-3 criteria. This necessitates further Indonesian study of the best diagnosis criteria to diagnose an infected patient with sepsis.

  12. Predictors of Adherence to Multiple Clinical Preventive Recommendations among Adults with Diabetes in Spain.

    Science.gov (United States)

    Jimenez-Trujillo, Isabel; Jiménez-García, Rodrigo; Esteban-Hernández, Jesus; Hernández-Barrera, Valentin; Carrasco Garrido, Pilar; Salinero-Fort, Miguel A; Cardenas-Valladolid, Juan; López-de-Andrés, Ana

    2015-01-01

    This study aims to describe adherence to seven clinical preventive services among Spanish adults with diabetes, to compare adherence with people without diabetes and to identify predictor of adherence to multiple practices among adults with diabetes. Cross-sectional study based on data obtained from the European Health Survey for Spain 2009 and the Spanish National Health Survey 2011. We analyzed those aged 40-69 years (n= 20,948). Diabetes status was self-reported. The study variables included adherence to blood pressure (BP) checkup, cholesterol measurement, influenza vaccination, dental examination, fecal occult blood test (FOBT), mammography and cytology. Independent variables included socio-demographic characteristics, variables related to health status and lifestyle factors. The study sample included 1,647 subjects with diabetes and 19,301 without. Over 90% had measured their BP and cholesterol in the last year, 44.4% received influenza immunization, 36.4% had a dental checkup within the year and only 8.1% underwent a FOBT. Among diabetic women 75.4% had received a mammography and 52.4% a cytology in the recommended periods. The adherence to BP and cholesterol measurements and influenza vaccination was significantly higher among those suffering diabetes and cytology and dental checkup were lower. Only 63.4% of people with diabetes had fulfilled half or more of the recommended practices. Female sex, higher educational level, being married or cohabiting, higher number of chronic conditions and number of physician visits increased the adherence to multiple preventive practices. For each unhealthy lifestyle reported the probability of having a higher adherence level decreased. Acceptable adherence is found for BP and cholesterol checkups and mammography. Unacceptably low rates were found for influenza vaccine, dental care, cytology and FOBT. Moreover, preventive services are provided neither equitably nor efficiently so future research needs to identify

  13. Predictors of Adherence to Multiple Clinical Preventive Recommendations among Adults with Diabetes in Spain.

    Directory of Open Access Journals (Sweden)

    Isabel Jimenez-Trujillo

    Full Text Available This study aims to describe adherence to seven clinical preventive services among Spanish adults with diabetes, to compare adherence with people without diabetes and to identify predictor of adherence to multiple practices among adults with diabetes.Cross-sectional study based on data obtained from the European Health Survey for Spain 2009 and the Spanish National Health Survey 2011. We analyzed those aged 40-69 years (n= 20,948. Diabetes status was self-reported. The study variables included adherence to blood pressure (BP checkup, cholesterol measurement, influenza vaccination, dental examination, fecal occult blood test (FOBT, mammography and cytology. Independent variables included socio-demographic characteristics, variables related to health status and lifestyle factors.The study sample included 1,647 subjects with diabetes and 19,301 without. Over 90% had measured their BP and cholesterol in the last year, 44.4% received influenza immunization, 36.4% had a dental checkup within the year and only 8.1% underwent a FOBT. Among diabetic women 75.4% had received a mammography and 52.4% a cytology in the recommended periods. The adherence to BP and cholesterol measurements and influenza vaccination was significantly higher among those suffering diabetes and cytology and dental checkup were lower. Only 63.4% of people with diabetes had fulfilled half or more of the recommended practices. Female sex, higher educational level, being married or cohabiting, higher number of chronic conditions and number of physician visits increased the adherence to multiple preventive practices. For each unhealthy lifestyle reported the probability of having a higher adherence level decreased.Acceptable adherence is found for BP and cholesterol checkups and mammography. Unacceptably low rates were found for influenza vaccine, dental care, cytology and FOBT. Moreover, preventive services are provided neither equitably nor efficiently so future research needs to

  14. Adults attending private physiotherapy practices seek diagnosis, pain relief, improved function, education and prevention: a survey.

    Science.gov (United States)

    McRae, Martin; Hancock, Mark J

    2017-10-01

    How important are different aspects of physiotherapy care to patients presenting to a primary care physiotherapist? Are patient factors (eg, age and gender) associated with how important different aspects of physiotherapy care are to individual patients? A cross-sectional survey with consecutive recruitment. A total of 500 adults aged≥18years who presented to a primary care physiotherapist. Participants were recruited from 10 private practices within the Sydney metropolitan area. Participants completed a survey assessing how important five aspects of physiotherapy care were in their initial decision to present to a primary care physiotherapist. These aspects were: diagnosis; information and education; treatment for pain relief; treatment to improve function; and prevention. The survey also collected characteristics of the patients and information about their presentation to the physiotherapist, to assess whether these factors were associated with the aspects of physiotherapy care that they considered most important. A total of 500 surveys were completed, with a response rate of 94%. All five aspects of physiotherapy care were considered either 'quite important' or 'extremely important' by most participants (diagnosis 65%; information and education 68%; pain relief 89%; improved function 93%; prevention 90%). Patient factors were associated with the participants' ratings of importance. Female participants and those with spinal pain more commonly rated pain relief as highly important. Participants with lower educational levels were more likely to rate diagnosis and information and education as important. This study demonstrated that most patients presenting to primary care physiotherapists value all aspects of physiotherapy care and do not simply want treatment for pain. Patient characteristics were associated with what individual patients considered the most important reason for presenting to a private primary care physiotherapist. [McRae M, Hancock MJ (2017

  15. Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall: a Rasch analysis.

    Science.gov (United States)

    Morris, Rebecca L; Soh, Sze-Ee; Hill, Keith D; Buchbinder, Rachelle; Lowthian, Judy A; Redfern, Julie; Etherton-Beer, Christopher D; Hill, Anne-Marie; Osborne, Richard H; Arendts, Glenn; Barker, Anna L

    2017-08-29

    Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).

  16. Development of a Just-in-Time Adaptive Intervention for Smoking Cessation Among Korean American Emerging Adults.

    Science.gov (United States)

    Cerrada, Christian Jules; Dzubur, Eldin; Blackman, Kacie C A; Mays, Vickie; Shoptaw, Steven; Huh, Jimi

    2017-10-01

    Cigarette smoking is a preventable risk factor that contributes to unnecessary lung cancer burden among Korean Americans and there is limited research on effective smoking cessation strategies for this population. Smartphone-based smoking cessation apps that leverage just-in-time adaptive interventions (JITAIs) hold promise for smokers attempting to quit. However, little is known about how to develop and tailor a smoking cessation JITAI for Korean American emerging adult (KAEA) smokers. This paper documents the development process of MyQuit USC according to design guidelines for JITAI. Our development process builds on findings from a prior ecological momentary assessment study by using qualitative research methods. Semi-structured interviews and a focus group were conducted to inform which intervention options to offer and the decision rules that dictate their delivery. Qualitative findings highlighted that (1) smoking episodes are highly context-driven and that (2) KAEA smokers believe they need personalized cessation strategies tailored to different contexts. Thus, MyQuit USC operates via decision rules that guide the delivery of personalized implementation intentions, which are contingent on dynamic factors, to be delivered "just in time" at user-scheduled, high-risk smoking situations. Through an iterative design process, informed by quantitative and qualitative formative research, we developed a smoking cessation JITAI tailored specifically for KAEA smokers. Further testing is under way to optimize future versions of the app with the most effective intervention strategies and decision rules. MyQuit USC has the potential to provide cessation support in real-world settings, when KAEAs need them the most.

  17. Can peer education improve beliefs, knowledge, motivation and intention to engage in falls prevention amongst community-dwelling older adults?

    Science.gov (United States)

    Khong, Linda A M; Berlach, Richard G; Hill, Keith D; Hill, Anne-Marie

    2017-09-01

    The aim of the study was to evaluate the effectiveness of delivering a contemporary peer-led falls prevention education presentation on community-dwelling older adults' beliefs, knowledge, motivation and intention to engage in falls prevention strategies. A two-group quasi-experimental pre-test-post-test study using a convenience sample was conducted. A new falls prevention training package for peer educators was developed, drawing on contemporary adult learning and behaviour change principles. A 1-h presentation was delivered to community-dwelling older adults by peer educators trained with the new package (intervention group). Control group participants received an existing, 1-h falls prevention presentation by trained peer educators who had not received the adult learning and behaviour change training. Participants in both groups completed a purpose-developed questionnaire at pre-presentation, immediately post-presentation and at one-month follow-up. Participants' levels of beliefs, knowledge, motivation and intention were compared across these three points of time. Generalised estimating equations models examined associations in the quantitative data, while deductive content analysis was used for qualitative data. Participants (control n  = 99; intervention n  = 133) in both groups showed significantly increased levels of beliefs and knowledge about falls prevention, and intention to engage in falls prevention strategies over time compared to baseline. The intervention group was significantly more likely to report a clear action plan to undertake falls prevention strategies compared to the control group. Peer-led falls prevention education is an effective approach for raising older adults' beliefs, knowledge and intention to engage in falls prevention strategies.

  18. Longitudinal changes in emerging adults' attachment preferences for their mother, father, friends, and romantic partner : Focusing on the start and end of romantic relationships

    NARCIS (Netherlands)

    Umemura, Tomo; Lacinova, Lenka; Macek, Petr; Kunnen, E. Saskia

    Only a few studies have longitudinally explored to whom emerging adults prefer to turn to seek closeness, comfort, and security (called attachment preferences), and previous studies on attachment preferences in emerging adults have focused only on the beginning of romantic relationships but not on

  19. Longitudinal Changes in Emerging Adults' Attachment Preferences for Their Mother, Father, Friends, and Romantic Partner: Focusing on the Start and End of Romantic Relationships

    Science.gov (United States)

    Umemura, Tomo; Lacinová, Lenka; Macek, Petr; Kunnen, E. Saskia

    2017-01-01

    Only a few studies have longitudinally explored to whom emerging adults prefer to turn to seek closeness, comfort, and security (called "attachment preferences"), and previous studies on attachment preferences in emerging adults have focused only on the beginning of romantic relationships but not on the end of relationships. Czech…

  20. Emerging science in the dietary control and prevention of dental caries.

    Science.gov (United States)

    Al-Dajani, Mahmoud; Limeback, Hardy

    2012-10-01

    The key environmental factor involved in caries incidence is fermentable carbohydrates. Because of the high costs of caries treatment, researchers continue to explore dietary control as a promising preventive method. While dietary change has been demonstrated to reduce Streptococcus mutans, a preventive role is expected for "functional foods" and dietary habit alterations. The authors consider how recent advances in the understanding of caries pathology can reveal dietary control as a valuable method in promoting a healthy dentition.

  1. Older Adults' Perceptions of Clinical Fall Prevention Programs: A Qualitative Study

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    Rebecca Calhoun

    2011-01-01

    Full Text Available Objective. To investigate motivational factors and barriers to participating in fall risk assessment and management programs among diverse, low-income, community-dwelling older adults who had experienced a fall. Methods. Face-to-face interviews with 20 elderly who had accepted and 19 who had not accepted an invitation to an assessment by one of two fall prevention programs. Interviews covered healthy aging, core values, attributions/consequences of the fall, and barriers/benefits of fall prevention strategies and programs. Results. Joiners and nonjoiners of fall prevention programs were similar in their experience of loss associated with aging, core values they expressed, and emotional response to falling. One difference was that those who participated endorsed that they “needed” the program, while those who did not participate expressed a lack of need. Conclusions. Interventions targeted at a high-risk group need to address individual beliefs as well as structural and social factors (transportation issues, social networks to enhance participation.

  2. Health of Older Adults in Assisted Living and Implications for Preventive Care.

    Science.gov (United States)

    Kistler, Christine E; Zimmerman, Sheryl; Ward, Kimberly T; Reed, David; Golin, Carol; Lewis, Carmen L

    2017-10-01

    Older adults in residential care and assisted living (RC/AL) are less healthy than the general elderly population, and some have needs similar to those in nursing homes, making this an important group in which to assess potential overuse or underuse of preventive services. We determined the health status of RC/AL residents and distinguished characteristics between those who may and may not benefit from preventive services requiring a life expectancy ≥5 years. Cross-sectional survey of a nationally representative sample of RC/AL residents using 2010 data from the National Survey of Residential Care Facilities. The primary outcome was the weighted frequency distribution of health states using three predictive mortality indices: Charlson Comorbidity Index, 4-year mortality index, and 9-year mortality index. A total of 666,700 of 733,300 (weighted) residents met criteria for inclusion. Based on the three indices, 10%-15% were in good health, 11%-70% in intermediate health, and 20%-76% in poor health. Using triangulation between 3 well-validated mortality indices, 10%-15% of RC/AL residents are in good health and highly likely to benefit from preventive services that require ≥5 year life expectancy. In addition, many residents have uncertain benefit and would benefit from shared decision making. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Turning frequency in adult bedridden patients to prevent hospital-acquired pressure ulcer: A scoping review.

    Science.gov (United States)

    Jocelyn Chew, H-S; Thiara, Emelia; Lopez, Violeta; Shorey, Shefaly

    2018-04-01

    The aim of this study was to identify current research on turning frequencies of adult bed-bound patients and inform future turning practices for hospitals based on evidence-based practice. We undertook a scoping review framework that provided a transparent and systematic methodology using 8 electronic databases (CINAHL, PubMed, Cochrane Library, ScienceDirect, PsycINFO, Scopus, ProQuest, and Web of Science) to identify articles published from 2000 to 2016. Articles were included if they focused on the prevention of hospital-acquired pressure ulcers related to the frequency of turning or repositioning of bed-bound patients. Literature search and data extraction were performed independently by 3 authors. The study followed the PRISMA guidelines. In total, 911 articles were identified, of which 10 were eligible. Of the eligible articles, 8 studies could not reach a conclusion on the effective frequency of turning and duration for repositioning patients to prevent the development of pressure ulcers. Only 2 studies found significant differences among the intervention and control groups. Results regarding turning and repositioning schedules are inconclusive; however, the topic needs further exploration to improve the outdated guidelines surrounding pressure ulcer prevention. This may, in turn, make the work of nurses more efficient and make treatment cost-effective for both the patients and the hospitals. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  4. Improving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Moineddin Rahim

    2006-07-01

    Full Text Available Abstract Background To determine the effectiveness of a single checklist reminder form to improve the delivery of preventive health services at adult health check-ups in a family practice setting. Methods A prospective cluster randomized controlled trial was conducted at four urban family practice clinics among 38 primary care physicians affiliated with the University of Toronto. Preventive Care Checklist Forms© were created to be used by family physicians at adult health check-ups over a five-month period. The sex-specific forms incorporate evidence-based recommendations on preventive health services and documentation space for routine procedures such as physical examination. The forms were used in two intervention clinics and two control clinics. Rates and relative risks (RR of the performance of 13 preventive health maneuvers at baseline and post-intervention and the percentage of up-to-date preventive health services delivered per patient were compared between the two groups. Results Randomly-selected charts were reviewed at baseline (n = 509 and post-intervention (n = 608. Baseline rates for provision of preventive health services ranged from 3% (fecal occult blood testing to 93% (blood pressure measurement, similar to other settings. The percentage of up-to-date preventive health services delivered per patient at the end of the intervention was 48.9% in the control group and 71.7% in the intervention group. This is an overall 22.8% absolute increase (p = 0.0001, and 46.6% relative increase in the delivery of preventive health services per patient in the intervention group compared to controls. Eight of thirteen preventive health services showed a statistically significant change (p Conclusion This simple, low cost, clinically relevant intervention improves the delivery of preventive health services by prompting physicians of evidence-based recommendations in a checklist format that incorporates existing practice patterns. Periodic updates

  5. The Impacts of Sexual Media Exposure on Adolescent and Emerging Adults' Dating and Sexual Violence Attitudes and Behaviors: A Critical Review of the Literature.

    Science.gov (United States)

    Rodenhizer, Kara Anne E; Edwards, Katie M

    2017-01-01

    Dating violence (DV) and sexual violence (SV) are widespread problems among adolescents and emerging adults. A growing body of literature demonstrates that exposure to sexually explicit media (SEM) and sexually violent media (SVM) may be risk factors for DV and SV. The purpose of this article is to provide a systematic and comprehensive literature review on the impact of exposure to SEM and SVM on DV and SV attitudes and behaviors. A total of 43 studies utilizing adolescent and emerging adult samples were reviewed, and collectively the findings suggest that (1) exposure to SEM and SVM is positively related to DV and SV myths and more accepting attitudes toward DV and SV; (2) exposure to SEM and SVM is positively related to actual and anticipated DV and SV victimization, perpetration, and bystander nonintervention; (3) SEM and SVM more strongly impact men's DV and SV attitudes and behaviors than women's DV and SV attitudes and behaviors; and (4) preexisting attitudes related to DV and SV and media preferences moderate the relationship between SEM and SVM exposure and DV and SV attitudes and behaviors. Future studies should strive to employ longitudinal and experimental designs, more closely examine the mediators and moderators of SEM and SVM exposure on DV and SV outcomes, focus on the impacts of SEM and SVM that extend beyond men's use of violence against women, and examine the extent to which media literacy programs could be used independently or in conjunction with existing DV and SV prevention programs to enhance effectiveness of these programming efforts.

  6. Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana.

    Science.gov (United States)

    Acheampong, Franklin; Tetteh, Ashalley Raymond; Anto, Berko Panyin

    2016-12-01

    This study determined the incidence, types, clinical significance, and potential causes of medication administration errors (MAEs) at the emergency department (ED) of a tertiary health care facility in Ghana. This study used a cross-sectional nonparticipant observational technique. Study participants (nurses) were observed preparing and administering medication at the ED of a 2000-bed tertiary care hospital in Accra, Ghana. The observations were then compared with patients' medication charts, and identified errors were clarified with staff for possible causes. Of the 1332 observations made, involving 338 patients and 49 nurses, 362 had errors, representing 27.2%. However, the error rate excluding "lack of drug availability" fell to 12.8%. Without wrong time error, the error rate was 22.8%. The 2 most frequent error types were omission (n = 281, 77.6%) and wrong time (n = 58, 16%) errors. Omission error was mainly due to unavailability of medicine, 48.9% (n = 177). Although only one of the errors was potentially fatal, 26.7% were definitely clinically severe. The common themes that dominated the probable causes of MAEs were unavailability, staff factors, patient factors, prescription, and communication problems. This study gives credence to similar studies in different settings that MAEs occur frequently in the ED of hospitals. Most of the errors identified were not potentially fatal; however, preventive strategies need to be used to make life-saving processes such as drug administration in such specialized units error-free.

  7. Accident and emergency staff opinion on the effects of family presence during adult resuscitation: critical literature review.

    Science.gov (United States)

    Walker, Wendy

    2008-02-01

    This paper is a report of a critical literature review to identify the positive and negative effects of family presence during adult resuscitation, as perceived by accident and emergency healthcare staff based in primary (out-of-hospital) and secondary (in-hospital) environments of care. The controversial practice of family presence during resuscitation of adults has stimulated debate over the past two decades, giving rise to a growing body of literature and the development of clinical guidelines for practice. A search was carried out for the period 1987-2007 using the Science Direct, CINAHL, Medline, EMBASE, psychINFO and BNI databases and the search terms resuscitation, witnessed resuscitation, family presence, relatives' presence, attitudes and opinions and accident and emergency. Eighteen studies were included in the critical review, primarily comprising retrospective survey research. The majority of studies were descriptive in design. A standardized approach to the appraisal process was achieved through the utilization of guidelines for critiquing self-reports. The findings revealed that accident and emergency healthcare staff perceive both positive and negative effects as a consequence of family presence during adult resuscitation and their opinions suggest that there are more risks than benefit. Further research is essential if family presence during resuscitation of adults is to be better defined and understood. Qualitative methods of enquiry are recommended as a way of gaining a deeper insight into and understanding of this practice.

  8. Preventing Absenteeism and Promoting Resilience Among Health Care Workers In Biological Emergencies

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    Lesperance, Ann M.; Miller, James S.

    2009-05-08

    The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studies of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.

  9. Developmental and ethnic issues experienced by emerging adult African American women related to developing a mature love relationship.

    Science.gov (United States)

    Tyson, Sheryl Y

    2012-01-01

    This qualitative study explored perspectives of emerging adult African American women on the development of mature love relationships. Inductive analysis of focus group interviews, conducted with a purposive sample of 31 African American women, yielded themes related to relationship goals and characteristics, and interpersonal and societal challenges to finding the right partner and developing a mature love relationship. Core categories that emerged from analysis of the discussions were (1) age and relationship goal differences within the emerging adult group, (2) mature love relationship goals and characteristics, (3) interpersonal obstacles to finding the right partner, and (4) societal obstacles to finding the right partner. Two approaches-black womanist/feminist thought (Collins, 2000 ; Walker, 1983 ) and relationship maturity theory (Paul & White, 1990 )-were then combined to explain the influence of historic and contemporary interpersonal and societal factors on developmental and ethnic issues that challenge positive gender identity formation, hasten intimacy maturity, and hinder the development of mature love relationships among emerging adult African American women. For these women, premature responsibility, especially early caregiver burden, was related to the early development of intimacy capacity and the desire for a mature love relationship, to be protected, and to have someone to help carry the load. Interracial dating, negative stereotypic images of African American women, and even positive images of enduring black love relationships posed difficult challenges to positive identity formation and intimacy maturity. A primary challenge was to counteract negative stereotypic images, so that they could develop their own self-identities as women and as relationship partners.

  10. A novel emergency department based prevention intervention program for people living with HIV: evaluation of early experiences

    Directory of Open Access Journals (Sweden)

    Trott Alexander T

    2007-10-01

    Full Text Available Abstract Background HIV prevention is increasingly focused on people living with HIV (PLWH and the role of healthcare settings in prevention. Emergency Departments (EDs frequently care for PLWH, but do not typically endorse a prevention mission. We conducted a pilot exploratory evaluation of the first reported ED program to address the prevention needs of PLWH. Methods This retrospective observational cohort evaluation reviewed program records to describe the first six months of participants and programmatic operation. Trained counselors provided a risk assessment and counseling intervention combined with three linkage interventions: i linkage to health care, ii linkage to case management, and iii linkage to partner counseling and referral. Results Of 81 self-identified PLWH who were approached, 55 initially agreed to participate. Of those completing risk assessment, 17/53 (32%, 95 CI 20% to 46% reported unprotected anal/vaginal intercourse or needle sharing in the past six months with a partner presumed to be HIV negative. Counseling was provided to 52/53 (98%. For those requesting services, 11/15 (73% were linked to healthcare, 4/23 (17% were coordinated with case management, and 1/4 (25% completed partner counseling and referral. Conclusion Given base resources of trained counselors, it was feasible to implement a program to address the prevention needs for persons living with HIV in an urban ED. ED patients with HIV often have unmet needs which might be addressed by improved linkage with existing community resources. Healthcare and prevention barriers for PLWH may be attenuated if EDs were to incorporate CDC recommended prevention measures for healthcare providers.

  11. Emerging Technologies to Prevent Pregnancy and Sexually Transmitted Infections in Women.

    Science.gov (United States)

    Seidman, Dominika; Hemmerling, Anke; Smith-McCune, Karen

    2016-05-01

    Worldwide, there continues to be a large unmet need for family planning and sexually transmitted infection (STI) prevention methods. Multipurpose prevention technology (MPT) is a general term encompassing any single prevention methodology targeting more than one STI (including HIV) and/or pregnancy. While innovation has been slow over the past several decades, recent scientific advances have resulted in new products entering clinical trials. This review focuses primarily on multipurpose technologies that are designed to prevent pregnancy and HIV. To examine the current state of MPTs, we outline key discoveries of biologic mechanisms that influence susceptibility of the female genital tract to HIV and STIs, and review the effects of hormonal contraception on HIV susceptibility. We discuss the state of currently available HIV prevention strategies for women, and their interactions with hormonal contraceptive products. Finally, we describe MPTs currently in preclinical and clinical trials and propose ongoing questions requiring research to help advance the field. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. A fall prevention guideline for older adults living in long-term care facilities.

    Science.gov (United States)

    Jung, D; Shin, S; Kim, H

    2014-12-01

    Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. © 2014 International Council of Nurses.

  13. Emergency department use and hospitalizations among homeless adults with substance dependence and mental disorders.

    Science.gov (United States)

    Cheung, Adrienne; Somers, Julian M; Moniruzzaman, Akm; Patterson, Michelle; Frankish, Charles J; Krausz, Michael; Palepu, Anita

    2015-08-05

    Homelessness, substance use, and mental disorders each have been associated with higher rates of emergency department (ED) use and hospitalization. We sought to understand the correlation between ED use, hospital admission, and substance dependence among homeless individuals with concurrent mental illness who participated in a 'Housing First' (HF) intervention trial. The Vancouver At Home study consisted of two randomized controlled trials addressing homeless individuals with mental disorders who have "high" or "moderate" levels of need. Substance dependence was determined at baseline prior to randomization, using the Mini International Neuropsychiatric Interview diagnostic tool, version 6.0. To assess health service use, we reviewed the number of ED visits and the number of hospital admissions based on administrative data for six urban hospitals. Negative binomial regression modeling was used to test the independent association between substance dependence and health service use (ED use and hospitalization), adjusting for HF intervention, age, gender, ethnicity, education, duration of lifetime homelessness, mental disorders, chronic health conditions, and other variables that were selected a priori to be potentially associated with use of ED services and hospital admission. Of the 497 homeless adults with mental disorders who were recruited, we included 381 participants in our analyses who had at least 1 year of follow-up and had a personal health number that could be linked to administrative health data. Of this group, 59% (n = 223) met criteria for substance dependence. We found no independent association between substance dependence and ED visits or hospital admissions [rate ratio (RR) = 0.85; 95% CI 0.62-1.17 and RR = 1.21; 95% CI 0.83-1.77, respectively]. The most responsible diagnoses (defined as the diagnosis that accounts for the length of stay) for hospital admissions were schizo-affective disorder, schizophrenia-related disorder, or bipolar affective

  14. What adult electrocardiogram (ECG) diagnoses and/or findings do residents in emergency medicine need to know?

    Science.gov (United States)

    Patocka, Catherine; Turner, Joel; Wiseman, Jeffrey

    2015-11-01

    There is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee. We developed a list of potentially important adult ECG diagnoses/findings and conducted a Delphi opinion-soliciting process. Participants used a 4-point Likert scale to rate the importance of each diagnosis for EM trainees. Consensus was defined as a minimum of 75% agreement at the second round or later. In the absence of consensus, stability was defined as a shift of 20% or less after successive rounds. A purposive sampling of 22 emergency physicians participated in the Delphi process, and 16 (72%) completed the process. Of those, 15 were from 11 different EM training programs across Canada and one was an expert in EM electrocardiography. Overall, 78 diagnoses reached consensus, 42 achieved stability and one diagnosis achieved neither consensus nor stability. Out of 121 potentially important adult ECG diagnoses, 53 (44%) were considered "must know" diagnoses, 61 (50%) "should know" diagnoses, and 7 (6%) "nice to know" diagnoses. We have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.

  15. Oral and Tympanic Membrane Temperatures are Inaccurate to Identify Fever in Emergency Department Adults

    Directory of Open Access Journals (Sweden)

    Robert Silverman

    2011-05-01

    Full Text Available Introduction: Identifying fever can influence management of the emergency department (ED patient, including diagnostic testing, treatment, and disposition. We set out to determine how well oral and tympanic membrane (TM temperatures compared with rectal measurements. Methods: A convenience sample of consecutively adult ED patients had oral, TM, and rectal temperatures performed within several minutes of each other. Descriptive statistics, Bland–Altman agreement matrices with 95% confidence interval (CI, and measures of test performance, including sensitivity, specificity, predictive values, and interval likelihood ratios were performed. Results: A total of 457 patients were enrolled with an average age of 64 years (standard deviation: 19 years. Mean temperatures were: oral (98.38F, TM (99.68F, and rectal (99.48F. The mean difference in rectal and oral temperatures was 1.18F, although there was considerable lack of agreement between oral and rectal temperatures, with the oral temperature as much as 2.918F lower or 0.748F higher than the rectal measurement (95% CI. Although the difference in mean temperature between right TM and rectal temperature was only 0.228F, the right TM was lower than rectal by up to 1.618F or greater by up to 2.058F (95% CI. Test performance varied as the positive predictive value of the oral temperature was 97% and for tympanic temperature was 55% (relative to a rectal temperature of 100.48F or higher. Comparative findings differed even at temperatures considered in the normal range; among patients with an oral temperature of 98.0 to 98.9, 38% (25/65 were found to have a rectal temperature of 100.4 or higher, while among patients with a TM of 98.0 to 98.9, only 7% (10/134 were found to have a rectal temperature of 100.4 or higher. Conclusion: In conclusion, the oral and tympanic temperature readings are not equivalent to rectal thermometry readings. Oral thermometry frequently underestimates the temperature relative to

  16. Effectiveness of Interventions to Decrease Emergency Department Visits by Adult Frequent Users: A Systematic Review.

    Science.gov (United States)

    Moe, Jessica; Kirkland, Scott W; Rawe, Erin; Ospina, Maria B; Vandermeer, Ben; Campbell, Sandy; Rowe, Brian H

    2017-01-01

    Frequent emergency department (ED) users are high-risk and high-resource-utilizing patients. This systematic review evaluates effectiveness of interventions targeting adult frequent ED users in reducing visit frequency and improving patient outcomes. An a priori protocol was published in PROSPERO. Two independent reviewers screened, selected, rated quality, and extracted data. Third-party adjudication resolved disagreements. Rate ratios of post- versus pre-intervention ED visits were calculated. Data sources were from a comprehensive search that included seven databases and the gray literature. Eligibility criteria for selecting studies included experimental studies assessing the effect of interventions on frequent users' ED visits and patient-oriented outcomes. A total of 6,865 citations were identified and 31 studies included. Designs were noncontrolled (n = 21) and controlled (n = 4) before-after studies and randomized controlled trials (n = 6). Frequent user definitions varied considerably and risk of bias was moderate to high. Studies examined general frequent users or those with psychiatric comorbidities, chronic disease, or low socioeconomic status or the elderly. Interventions included case management (n = 18), care plans (n = 8), diversion strategies (n = 3), printout case notes (n = 1), and social work visits (n = 1). Post- versus pre-intervention rate ratios were calculated for 25 studies and indicated a significant visit decrease in 21 (84%) of these studies. The median rate ratio was 0.63 (interquartile range = 0.41 to 0.71), indicating that the general effect of the interventions described was to decrease ED visits post-intervention. Significant visit decreases were found for a majority of studies in subgroup analyses based on 6- or 12-month follow-up, definition thresholds, clinical frequent user subgroups, and intervention types. Studies reporting homelessness found consistent improvements in stable housing. Overall, interstudy

  17. Strategies for preventing excess mortality after discharge from psychiatric emergency room

    DEFF Research Database (Denmark)

    Aagaard, Jørgen; Jensen, Mikkel

    2017-01-01

    AbstractPatients with severe mental illness have increased risk for severe physical diseases. In addition, there is evidence that this patient group is less likely to receive standard levels of care for most physical diseases, which may contribute to their shortened life expectancy. Further, illn.......  Keywords: Psychiatric emergency room; Crisis resolution; mortality; severe mental illness...

  18. Fast assessment of the effect of preventive wide area emergency control

    DEFF Research Database (Denmark)

    Dmitrova, Evgenia; Jóhannsson, Hjörtur; Nielsen, Arne Hejde

    2013-01-01

    to determine whether the suggested counteraction is sufficient to avoid system instability during severely critical operating conditions. The fast assessment of the effect that a countermeasure has on system stability provides an important decision support for the control room personnel in emergency situations....... The validity of the suggested approach is proved on the 8 bus test system and IEEE30 bus test system....

  19. Emerging Research Directions in Adult Congenital Heart Disease: A Report from a National Heart, Lung, and Blood Institute/Adult Congenital Heart Association Working Group

    Science.gov (United States)

    Gurvitz, Michelle; Burns, Kristin M.; Brindis, Ralph; Broberg, Craig S.; Daniels, Curt J.; Fuller, Stephanie M.P.N.; Honein, Margaret A.; Khairy, Paul; Kuehl, Karen S.; Landzberg, Michael J.; Mahle, William T.; Mann, Douglas L.; Marelli, Ariane; Newburger, Jane W.; Pearson, Gail D.; Starling, Randall C.; Tringali, Glenn R.; Valente, Anne Marie; Wu, Joseph C.; Califf, Robert M.

    2016-01-01

    Congenital heart disease (CHD) is the most common birth defect, affecting about 0.8% of live births. Advances in recent decades have allowed >85% of children with CHD to survive to adulthood, creating a growing population of adults with CHD. Little information exists regarding survival, demographics, late outcomes, and comorbidities in this emerging group, and multiple barriers impede research in adult CHD (ACHD). The National Heart, Lung, and Blood Institute and the Adult Congenital Heart Association convened a multidisciplinary Working Group to identify high-impact research questions in ACHD. This report summarizes the meeting discussions in the broad areas of CHD-related heart failure, vascular disease and multisystem complications. High-priority subtopics identified included heart failure in tetralogy of Fallot, mechanical circulatory support/transplantation, sudden cardiac death, vascular outcomes in coarctation of the aorta, late outcomes in single ventricle disease, cognitive and psychiatric issues, and pregnancy. PMID:27102511

  20. 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 ...

  1. Pathway from child sexual and physical abuse to risky sex among emerging adults: the role of trauma-related intrusions and alcohol problems.

    Science.gov (United States)

    Walsh, Kate; Latzman, Natasha E; Latzman, Robert D

    2014-04-01

    Some evidence suggests that risk reduction programming for sexual risk behaviors (SRB) has been minimally effective, which emphasized the need for research on etiological and mechanistic factors that can be addressed in prevention and intervention programming. Childhood sexual and physical abuse have been linked with SRB among older adolescents and emerging adults; however, pathways to SRB remain unclear. This study adds to the literature by testing a model specifying that traumatic intrusions after early abuse may increase risk for alcohol problems, which in turn may increase the likelihood of engaging in various types of SRB. Participants were 1,169 racially diverse college students (72.9% female, 37.6% black/African-American, and 33.6% white) who completed anonymous questionnaires assessing child abuse, traumatic intrusions, alcohol problems, and sexual risk behavior. The hypothesized path model specifying that traumatic intrusions and alcohol problems account for associations between child abuse and several aspects of SRB was a good fit for the data; however, for men, stronger associations emerged between physical abuse and traumatic intrusions and between traumatic intrusions and alcohol problems, whereas for women, alcohol problems were more strongly associated with intent to engage in risky sex. Findings highlight the role of traumatic intrusions and alcohol problems in explaining paths from childhood abuse to SRB in emerging adulthood, and suggest that risk reduction programs may benefit from an integrated focus on traumatic intrusions, alcohol problems, and SRB for individuals with abuse experiences. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  2. Fall Prevention Knowledge, Attitude, and Practices of Community Stakeholders and Older Adults

    Directory of Open Access Journals (Sweden)

    Sharon S. Laing

    2011-01-01

    Full Text Available We assessed knowledge, attitude, and provision of recommended fall prevention (FP practices by employees of senior-serving organization and participation in FP practices by at-risk elders. The Washington State Department of Health administered structured telephone surveys to 50 employees and 101 elders in Washington State. Only 38% of employees felt “very knowledgeable” about FP, and a majority of their organizations did not regularly offer FP services. Almost half (48% of seniors sustained a fall within the past 12 months; however, one-third perceived falling to be among their least important health concerns, and most had minimal working knowledge of proven FP practices. Seniors who perceived avoiding falls as important to their well-being were more likely to participate in practices about which they had the least knowledge (risk assessment, medication management. Increased awareness and availability of FP services might help engage older adults in FP practices and reduce the adverse effects of falls.

  3. Fall Prevention Knowledge, Attitude, and Practices of Community Stakeholders and Older Adults

    Science.gov (United States)

    Laing, Sharon S.; Silver, Ilene F.; York, Sally; Phelan, Elizabeth A.

    2011-01-01

    We assessed knowledge, attitude, and provision of recommended fall prevention (FP) practices by employees of senior-serving organization and participation in FP practices by at-risk elders. The Washington State Department of Health administered structured telephone surveys to 50 employees and 101 elders in Washington State. Only 38% of employees felt “very knowledgeable” about FP, and a majority of their organizations did not regularly offer FP services. Almost half (48%) of seniors sustained a fall within the past 12 months; however, one-third perceived falling to be among their least important health concerns, and most had minimal working knowledge of proven FP practices. Seniors who perceived avoiding falls as important to their well-being were more likely to participate in practices about which they had the least knowledge (risk assessment, medication management). Increased awareness and availability of FP services might help engage older adults in FP practices and reduce the adverse effects of falls. PMID:21915377

  4. The use of non-slip socks to prevent falls among hospitalized older adults: A literature review.

    Science.gov (United States)

    Hartung, Benjamin; Lalonde, Michelle

    Falls among hospitalized older adults are a growing concern. Hospitals are using non-slip socks as an alternative footwear to help prevent falls, however there is limited evidence to support their use. The aim of this article is to review the literature on the effectiveness of non-slip socks to determine if there is sufficient evidence to support their use in the prevention of falls among hospitalized older adults. A comprehensive literature search was conducted using Medline, CINAHL, Scopus, PubMed and the Cochrane Library. Six studies were included in this review. The results suggested that there is inconclusive evident to support the use of non-slip socks to prevent falls among hospitalized older adults. Non-slip socks do not possess the properties of adequate footwear and have the potential to spread infection. The patient's personal footwear from home is the safest footwear option while admitted into hospital. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Effects of marijuana use on prefrontal and parietal volumes and cognition in emerging adults.

    Science.gov (United States)

    Price, Jenessa S; McQueeny, Tim; Shollenbarger, Skyler; Browning, Erin L; Wieser, Jon; Lisdahl, Krista M

    2015-08-01

    Chronic marijuana (MJ) use among adolescents has been associated with structural and functional abnormalities, particularly in developing regions responsible for higher order cognition. This study investigated prefrontal (PFC) and parietal volumes and executive function in emerging adult MJ users and explored potential gender differences. Participants (ages 18-25) were 27 MJ users and 32 controls without neurologic or psychiatric disorders or heavy other drug use. A series of multiple regressions examined whether group status, past year MJ use, and their interactions with gender predicted ROI volumes. Post hoc analyses consisted of brain-behavior correlations between volumes and cognitive variables and Fisher's z tests to assess group differences. MJ users demonstrated significantly smaller medial orbitofrontal (mOFC; p = 0.004, FDR p = 0.024) and inferior parietal volumes (p = 0.04, FDR p = 0.12); follow-up regressions found that increased past year MJ use did not significantly dose-dependently predict smaller mOFC volume in a sub-sample of individuals with at least one past year MJ use. There were no significant gender interactions. There was a significant brain-behavior difference by group, such that smaller mOFC volumes were associated with poorer complex attention for MJ users (p < 0.05). Smaller mOFC volumes among MJ users suggest disruption of typical neurodevelopmental processes associated with regular MJ use for both genders. These results highlight the need for longitudinal, multi-modal imaging studies providing clearer information on timing of neurodevelopmental processes and neurocognitive impacts of youth MJ initiation.

  6. Malnutrition among Cognitively Intact, non-Critically Ill Older Adults in the Emergency Department

    Science.gov (United States)

    Pereira, Greg F.; Bulik, Cynthia M.; Weaver, Mark A.; Holland, Wesley C.; Platts-Mills, Timothy F.

    2014-01-01

    Objectives We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk. Methods We conducted a cross-sectional study with random time block sampling of cognitively intact patients aged 65 years and older. Nutrition was assessed using the Mini Nutritional Assessment Short-Form (0–14 scale) with malnutrition defined as a score of 7 or less and at-risk for malnutrition defined as a score of 8–11. The presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression-10 score of 4 or more (0–10 scale). Results Among 138 older adults, 16% (95% Confidence Interval [CI], 10%–22%) were malnourished and 60% (95% CI, 52%–69%) were either malnourished or at-risk for malnutrition. Seventeen of the 22 malnourished patients (77%) denied previously being diagnosed with malnutrition. The prevalence of malnutrition was not appreciably different between males and females, across levels of patient education, or between those living in urban and rural areas. However, the prevalence of malnutrition was higher among patients with depressive symptoms 52%, those residing in assisted living 50%, those with difficulty eating 38%, and those reporting difficulty buying groceries 33%. Conclusion Among a random sample of cognitively intact older ED patients, more than half were malnourished or at-risk for malnutrition, and the majority of malnourished patients had not previously been diagnosed. Higher rates of malnutrition among those with depression, difficulty eating, and difficulty buying groceries suggest the need to explore multifaceted interventions. PMID:25129819

  7. Cost Effectiveness of Field Trauma Triage among Injured Adults Served by Emergency Medical Services

    Science.gov (United States)

    Newgard, Craig D; Yang, Zhuo; Nishijima, Daniel; McConnell, K John; Trent, Stacy; Holmes, James F; Daya, Mohamud; Mann, N Clay; Hsia, Renee Y; Rea, Tom; Wang, N Ewen; Staudenmayer, Kristan; Delgado, M Kit

    2016-01-01

    Background The American College of Surgeons Committee on Trauma sets national targets for the accuracy of field trauma triage at ≥ 95% sensitivity and ≥ 65% specificity, yet the cost-effectiveness of realizing these goals is unknown. We evaluated the cost-effectiveness of current field trauma triage practices compared to triage strategies consistent with the national targets. Study Design This was a cost-effectiveness analysis using data from 79,937 injured adults transported by 48 emergency medical services (EMS) agencies to 105 trauma and non-trauma hospitals in 6 regions of the Western U.S. from 2006 through 2008. Incremental differences in survival, quality adjusted life years (QALYs), costs, and the incremental cost-effectiveness ratio (ICER; costs per QALY gained) were estimated for each triage strategy over a 1-year and lifetime horizon using a decision analytic Markov model. We considered an ICER threshold of less than $100,000 to be cost-effective. Results For these 6 regions, a high sensitivity triage strategy consistent with national trauma policy (sensitivity 98.6%, specificity 17.1%) would cost $1,317,333 per QALY gained, while current triage practices (sensitivity 87.2%, specificity 64.0%) cost $88,000 per QALY gained compared to a moderate sensitivity strategy (sensitivity 71.2%, specificity 66.5%). Refining EMS transport patterns by triage status improved cost-effectiveness. At the trauma system level, a high-sensitivity triage strategy would save 3.7 additional lives per year at a 1-year cost of $8.78 million, while a moderate sensitivity approach would cost 5.2 additional lives and save $781,616 each year. Conclusions A high-sensitivity approach to field triage consistent with national trauma policy is not cost effective. The most cost effective approach to field triage appears closely tied to triage specificity and adherence to triage-based EMS transport practices. PMID:27178369

  8. Prevention of alcohol and other drug use using motivational interviewing among young adults in the Ukraine

    Directory of Open Access Journals (Sweden)

    Svitlana Polshkova

    2016-10-01

    Full Text Available Background. World Health Organization data show alarming rates of alcohol consumption among those aged 15 and older in Ukraine. This study examined the feasibility and initial efficacy of a brief intervention to reduce risky drinking among adults (age between 18-25 in Ukraine. Methods. Adults were screened for risky drinking with the Alcohol Use Disorders Identification Test (AUDIT-C. Those with AUDIT-C score (>5 were enrolled in the study: 59 participants from the hospital setting (mean age = 22.6 (2.1, 55.9% male and 61 participants from the university setting (mean age = 20.1(2.3, 55.7% male. After self-administering a computerized baseline assessment, participants were randomized to receive an in-person brief intervention by telephone or to a control condition; participants underwent a computerized follow-up at 3 months. Results. Regression analyses for prediction of alcohol outcomes (alcohol consumption and consequences were conducted separately for each setting; models were controlled for baseline alcohol levels and assigned condition (brief intervention or control. In both settings, the brief intervention group showed significantly less alcohol consumption and consequences at 3-months as compared to the control group (p<.001; however, the groups did not significantly differ on other drug use (DAST-10 score. Conclusion. Findings suggest that brief motivational interventions are promising for reducing risky drinking among emerging adults in the Ukraine in both inpatient hospital and university settings. Future studies are needed to replicate these findings and extend these effects to reduce other drug use among young people in the Ukraine.

  9. Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients

    Science.gov (United States)

    Israel, Salomon; Moffitt, Terrie E.; Belsky, Daniel W.; Hancox, Robert J.; Poulton, Richie; Roberts, Brent; Thomson, W. Murray; Caspi, Avshalom

    2014-01-01

    The rising number of newly insured young adults brought on by healthcare reform will soon increase demands on primary-care physicians. Physicians will face more young-adult patients which presents an opportunity for more prevention-oriented care. In the current study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the Dunedin Study cohort of 1,000 individuals, we show that very brief measures of young adults’ personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness-to-Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health-risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for healthcare professionals to personalize preventive medicine. Adding personality information to existing healthcare electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor-patient communication, health service use, and patient outcomes. PMID:24588093

  10. Oral triiodothyronine for the prevention of thyroid hormone reduction in adult valvular cardiac surgery

    Directory of Open Access Journals (Sweden)

    A.P.A. Magalhães

    2006-07-01

    Full Text Available Treatment of non-thyroidal illness by intravenous triiodothyronine (T3 after cardiac surgery causes a disproportional elevation of hormone levels. The administration of oral T3, which has never been studied in this context, could cause physiological hormone levels. The aim of this study was to test oral T3 for the prevention of T3 reduction during the postoperative period of valvular cardiac surgery in adults. Eighteen patients who underwent cardiac surgery for valvular disease with invasive hemodynamic monitoring were randomly assigned to 2 groups: the T group received oral T3 (N = 8, 25 µg three times/day, initiated 24 h before surgery and maintained for 48 h and the NT group (N = 10 received placebo. Serum T3, thyroxine and thyrotropin were determined at baseline, 1 h before surgery, within 30 min of cardiopulmonary bypass and 6, 12, 24, and 48 h after removal of the aortic cross-clamp. Baseline T3 was similar in both groups (T: 119 ± 13; NT: 131 ± 9 ng/dL. Serum T3 increased during the first 24 h in the T group compared to the NT group (232 ± 18 vs 151 ± 13 ng/dL; P < 0.001. In the NT group, T3 was reduced by 24% (P = 0.007 6 h after removal of the aortic cross-clamp, confirming the non-thyroidal illness syndrome. There were no differences in clinical or hemodynamic parameters between groups. Administration of oral T3 prevented its serum reduction after valvular cardiac surgery in adults, with normal serum levels for 48 h without disproportional elevations.

  11. The analysis of Lower Silesian adult inhabitants’ lifestyles in the context of cardiovascular diseases (CVDs prevention

    Directory of Open Access Journals (Sweden)

    Janusz Muszyński

    2016-02-01

    Full Text Available Background . CVDs are considered to be the leading cause of demise and disability. The authors established cardiovascular risk factors and divided them into two groups: those subject and those not subject to modification. As prevention of risk factors, a population strategy and high-risk strategy, including secondary prevention were elaborated. The population strategy (recognized as the most effective method of combating CVD consists of modifying lifestyle risk factors. Objectives. The analysis of Lower Silesian adult inhabitants’ lifestyles as well as the attempt to estimate possible differences underlying the lifestyles of healthy individuals and ones who have been treated due to cardiovascular afflictions. Material and methods . 140 adult Lower Silesian inhabitants were divided into two groups: I – 74 healthy people; II – 66 people who have so far been treated due to cardiovascular afflictions. Michałków’s modification of the Personal Fitness Inventory, the questionnaire on physical fitness and lifestyle excogitated by San Lukas Hospital in USA , was used to make a diagnosis of the lifestyles. Results . The distinction between the lifestyles of healthy people and those who have been treated due to cardiovascular diseases was drawn. The lifestyle classified as a very good one was found among 8.11% of healthy individuals when compared to 0% among people treated due to CVDs. The lifestyle classified as a poor one was found among 7.58% (5 subjects of the afflicted patients while the ones unaffected constituted 0%. Conclusions . None of diagnosed with CVDs was evaluated with a good grade which may indicate that people suffering from CVDs don’t lead a healthy lifestyle. Accordingly, these patients do not attempt to maintain or enhance their physical fitness. Obesity and overweight are predominant as far as the BMI results are concerned. The affected don’t follow a sensible diet. Healthy individuals tend to deal with stress more

  12. Stop them at the door: should a pressure ulcer prevention protocol be implemented in the emergency department?

    Science.gov (United States)

    Denby, Abby; Rowlands, Aletha

    2010-01-01

    The purpose of this descriptive study was to determine the feasibility of implementing a Pressure Ulcer Prevention Protocol in the emergency department (ED). Using data abstraction, a descriptive analysis was conducted to examine the relationship between ED length of stay and hospital-acquired pressure ulcers for those patients who were directly admitted to the hospital from the ED. During 2006, 32,664 patients sought medical attention through the ED. Seventy-five percent of the total patient population admitted was admitted from the ED. One hundred twenty-five of those patients developed hospital-acquired pressure ulcers, 99.2% of which had an ED length of stay greater than 2 hours prior to hospital admission. Findings of this study suggest early nursing interventions are needed to prevent hospital-acquired pressure ulcers.

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

    Science.gov (United States)

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

    2016-02-01

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

  14. Screening for active tuberculosis before isoniazid preventive therapy among HIV-infected West African adults.

    Science.gov (United States)

    Moh, R; Badjé, A; N'takpé, J-B; Kouamé, G M; Gabillard, D; Ouassa, T; Ouattara, E; Le Carrou, J; Bohoussou, F; Messou, E; Eholié, S; Anglaret, X; Danel, C

    2017-12-01

    TEMPRANO was a multicentre, open-label trial in which human immunodeficiency virus (HIV) infected adults with high CD4 counts were randomised into early or deferred antiretroviral therapy (ART) arms with or without 6-month isoniazid preventive therapy (IPT) in a setting where the World Health Organization (WHO) recommends IPT in HIV-infected patients. Despite the WHO recommendation, IPT coverage remains low due to fear of the presence of undiagnosed active TB before prescribing IPT, and the related risk of drug resistance. To report the frequency of undiagnosed TB in patients enrolled for IPT and describe the results of a 1-month buffer period to avoid prescribing IPT for active TB cases. Patients were screened using a clinical algorithm and chest X-ray at Day 0 and started on isoniazid at Month 1 if no sign/symptom suggestive of TB appeared between Day 0 and Month 1. Of 1030 patients randomised into IPT arms. 10% never started IPT at Month 1. Of these, 23 had active TB, including 16 with prevalent TB. Among the 927 patients who started IPT, 6 had active TB, including 1 with prevalent TB. Only 1 patient with active TB received IPT due to the 1-month buffer period between Day 0 and IPT initiation. In this study, 1.6% of adults considered free of active TB based on clinical screening at pre-inclusion actually had active TB.

  15. Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis.

    Science.gov (United States)

    Witt, Katrina; Milner, Allison; Allisey, Amanda; Davenport, Lauren; LaMontagne, Anthony D

    2017-04-01

    This brief report summarizes the international literature on the effectiveness of suicide prevention programs for protective and emergency services employees. A systematic search of 11 electronic databases was undertaken until June 30, 2015. Quantitative meta-analysis was undertaken to investigate the effectiveness of these programs on suicide rates at post-intervention. Qualitative analyses were also used to identify program components that may be associated with reductions in suicide rates. A total of 13 studies were included. Only six reported sufficient information on suicide rates to enable inclusion in quantitative analyses, however. On average, these programs were associated with an approximate halving in suicide rates over an average follow-up period of 5.25 years (SD = 4.2; range: 1-11) (Incidence Rate Ratio 0.45, 95%CI 0.31-0.65; five studies; I 2 14.8%). Few programs integrated activities at the primary prevention level. A greater focus on the relatively neglected area of workplace primary prevention could further improve suicide prevention effectiveness. Am. J. Ind. Med. 60:394-407, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Preventing musculoskeletal injuries among recreational adult volleyball players: design of a randomised prospective controlled trial.

    Science.gov (United States)

    Gouttebarge, Vincent; Zwerver, Johannes; Verhagen, Evert

    2017-08-02

    Both acute and overuse injuries are common among recreational volleyball players, especially finger/wrist, ankle, shoulder and knee injuries. Consequently, an intervention ('VolleyVeilig') was developed to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational volleyball players. This article describes the design of a study evaluating the effectiveness of the developed intervention on the one-season occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational adult volleyball players. A randomized prospective controlled trial with a follow-up period of one volleyball season will be conducted. Participants will be healthy recreational adult volleyball players (18 years of age or older) practicing volleyball (training and/or match) at least twice a week. The intervention ('VolleyVeilig') consists of a warm-up program based on more than 50 distinct exercises (with different variations and levels). The effect of the intervention programme on the occurrence of injuries will be compared to volleyball as usual. Outcome measures will be incidence of acute injury (expressed as number of injuries per 1000 h of play) and prevalence of overuse injuries (expressed as percentage). This study will be one of the first randomized prospective controlled trials evaluating the effectiveness of an intervention on the occurrence of both acute and overuse injuries among recreational adult volleyball players. Outcome of this study could possibly lead to the nationwide implementation of the intervention in all volleyball clubs in The Netherlands, ultimately resulting in less injuries. Dutch Trial Registration NTR6202 , registered February 1st 2017. Version 3, February 2017.

  17. Mindfulness Based Relapse Prevention for Stimulant Dependent Adults: A Pilot Randomized Clinical Trial.

    Science.gov (United States)

    Glasner-Edwards, Suzette; Mooney, Larissa J; Ang, Alfonso; Garneau, Hélène Chokron; Hartwell, Emily; Brecht, Mary-Lynn; Rawson, Richard A

    2017-02-01

    In light of the known associations between stress, negative affect, and relapse, mindfulness strategies hold promise as a means of reducing relapse susceptibility. In a pilot randomized clinical trial, we evaluated the effects of Mindfulness Based Relapse Prevention (MBRP), relative to a health education control condition (HE) among stimulant dependent adults receiving contingency management. All participants received a 12-week contingency management (CM) intervention. Following a 4-week CM-only lead in phase, participants were randomly assigned to concurrently receive MBRP (n=31) or HE (n=32). Stimulant dependent adults age 18 and over. A university based clinical research center. The primary outcomes were stimulant use, measured by urine drug screens weekly during the intervention and at 1-month post-treatment, negative affect, measured by the Beck Depression Inventory and Beck Anxiety Inventory, and psychiatric severity, measured by the Addiction Severity Index. Medium effect sizes favoring MBRP were observed for negative affect and overall psychiatric severity outcomes. Depression severity changed differentially over time as a function of group, with MBRP participants reporting greater reductions through follow-up (p=0.03; Effect Size=0.58). Likewise, the MBRP group evidenced greater declines in psychiatric severity, (p=0.01; Effect Size=0.61 at follow-up). Among those with depressive and anxiety disorders, MBRP was associated with lower odds of stimulant use relative to the control condition (Odds Ratio= 0.78, p=0.03 and OR=0.68, p=0.04). MBRP effectively reduces negative affect and psychiatric impairment, and is particularly effective in reducing stimulant use among stimulant dependent adults with mood and anxiety disorders.

  18. Double-Edged Innovations: Preventing the Misuse of Emerging Biological/Chemical Technologies

    Science.gov (United States)

    2010-07-01

    discovery of two new peptide neurotransmitters, hypocretin and orexin, which are produced by cells in the hypothalamus .6 One of the functions of hypocretin...2009). 20 Committee on Military and Intelligence Methodology for Emergent Neurophysiological and Cognitive/Neural Science Research in the Next Two...Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996,” Electroencephalography and Clinical Neurophysiology , vol. 108 (1998), pp. 1

  19. The effectiveness of an educational program on preventing and treating compassion fatigue in emergency nurses.

    Science.gov (United States)

    Flarity, Kathleen; Gentry, J Eric; Mesnikoff, Nathan

    2013-01-01

    The purpose of this qualitative study was to examine the treatment effectiveness of a multifaceted education program to decrease compassion fatigue (CF) and burnout (BO) symptoms and increase compassion satisfaction of emergency nurses participating in the training. The goal of the CF multifaceted intervention program was to demonstrate a statistically significant improvement in the 3 CF subscales: an increase on the Compassion Satisfaction (CS) subscale and a decrease on the Secondary Traumatic Stress (STS) and BO subscales in the participants' pretest and posttest scores as measured by The Professional Quality of Life test (B. H. , ). The study sites were 2 emergency departments in Colorado Springs, CO. A convenience sample consisted of emergency nurses who self-selected to participate in the study. Univariate statistics were used, and data were examined for normalcy of distribution. Because these data were not distributed normally, Wilcoxon signed-rank tests were used to evaluate the differences between the baseline and postintervention groups. The multifaceted education program resulted in a statistically significant increase in CS (p = 0.004) and a decrease in BO (p = 0.001 or less) and STS (p = 0.001) symptoms.

  20. Steering Evolution with Sequential Therapy to Prevent the Emergence of Bacterial Antibiotic Resistance.

    Directory of Open Access Journals (Sweden)

    Daniel Nichol

    2015-09-01

    Full Text Available The increasing rate of antibiotic resistance and slowing discovery of novel antibiotic treatments presents a growing threat to public health. Here, we consider a simple model of evolution in asexually reproducing populations which considers adaptation as a biased random walk on a fitness landscape. This model associates the global properties of the fitness landscape with the algebraic properties of a Markov chain transition matrix and allows us to derive general results on the non-commutativity and irreversibility of natural selection as well as antibiotic cycling strategies. Using this formalism, we analyze 15 empirical fitness landscapes of E. coli under selection by different β-lactam antibiotics and demonstrate that the emergence of resistance to a given antibiotic can be either hindered or promoted by different sequences of drug application. Specifically, we demonstrate that the majority, approximately 70%, of sequential drug treatments with 2-4 drugs promote resistance to the final antibiotic. Further, we derive optimal drug application sequences with which we can probabilistically 'steer' the population through genotype space to avoid the emergence of resistance. This suggests a new strategy in the war against antibiotic-resistant organisms: drug sequencing to shepherd evolution through genotype space to states from which resistance cannot emerge and by which to maximize the chance of successful therapy.

  1. System factors to explain 2009 pandemic H1N1 state vaccination rates for children and high-risk adults in US emergency response to pandemic.

    Science.gov (United States)

    Davila-Payan, Carlo; Swann, Julie; Wortley, Pascale M

    2014-01-03

    During the 2009-2010 H1N1 pandemic, children and high-risk adults had priority for vaccination. Vaccine in short supply was allocated to states pro-rata by population, but vaccination rates as of January 2010 varied among states from 21.3% to 84.7% for children and 10.4% to 47.2% for high-risk adults. States had different campaign processes and decisions. To determine program and system factors associated with higher state pandemic vaccination coverage for children and high-risk adults during an emergency response with short supply of vaccine. Regression analysis of factors predicting state-specific H1N1 vaccination coverage in children and high-risk adults, including state campaign information, demographics, preventive or health-seeking behavior, preparedness funding, providers, state characteristics, and surveillance data. Our modeling explained variation in state-specific vaccination coverage with an adjusted R-squared of 0.82 for children and 0.78 for high-risk adults. We found that coverage of children was positively associated with programs focusing on school clinics and with a larger proportion of doses administered in public sites; negatively with the proportion of children in the population, and the proportion not visiting a doctor because of cost. The coverage for high-risk adults was positively associated with shipments of vaccine to "general access" locations, including pharmacy and retail, with the percentage of women with a Pap smear within the past 3 years and with past seasonal influenza vaccination. It was negatively associated with the expansion of vaccination to the general public by December 4, 2009. For children and high-risk adults, coverage was positively associated with the maximum number of ship-to-sites and negatively associated with the proportion of medically underserved population. Findings suggest that distribution and system decisions such as vaccination venues and providers targeted can positively impact vaccination rates for

  2. A cultural take on the links between religiosity, identity, and meaning in life in religious emerging adults.

    Science.gov (United States)

    Negru-Subtirica, Oana; Tiganasu, Alexandra; Dezutter, Jessie; Luyckx, Koen

    2017-03-01

    Identity and meaning in life are core developmental assets in emerging adulthood. We analysed how religiosity is related to these intentional strivings in emerging adults enrolled in theological education, by depicting (1) identity strivings and meaning in life accounts in faith narratives (Study 1) and (2) links between personal identity and meaning in life profiles and religious beliefs, behaviours, and subjective experiences (Study 2). Both studies highlighted that a Foreclosed status, with high personal commitment and reduced exploration, was dominant in faith narratives and personal identity profiles. Also, in narratives meaning in life was reflected by a strong focus on presence of meaning through religious insights. Nonetheless, global meaning in life profiles indicated that many emerging adults were searching for a meaning in their lives, while reporting lower levels of presence of meaning. Identity Achievement and High Presence-High Search profiles were linked to the highest levels of subjective, behavioural, and cognitive religiosity. We highlighted the multidimensionality of identity and meaning in life strivings in emerging adults attending theological schools. We pointed out that even in a somewhat foreclosed cultural context (e.g., Romanian Christian Orthodox theological schools), religion represents a dynamic social and ideological context for self-development. Statement of contribution What is already known on this subject? Religious beliefs increase in emerging adults, doubled by decreases in religious behaviours, linked to an adherence to a more personal approach to religion. Religious youth are more committed to their faith and also explore identity and life meaning in relation to their religious strivings. Youth religious exemplars report close links between their religious faith and strivings for meaningful life goals. What does this study add? We investigated Christian Orthodox theology students, for whom religion is a normative dimension of

  3. Prevalence of Exposure to Risk Factors for Violence among Young Adults Seen in an Inner-City Emergency Department

    OpenAIRE

    Hankin, Abigail; Meagley, Brittany; Wei, Stanley; Houry, Debra

    2013-01-01

    Introduction: To assess the prevalence of risk factors for violent injury among young adults treated at an urban emergency department (ED). Methods: This study is a cross-sectional analysis of data collected as part of a longitudinal study. Enrollment took place in an urban ED in a Level 1 trauma center, June through December 2010. All patients aged 18–24 years were eligible. Patients were excluded if they were incarcerated, critically ill, or unable to read English. St...

  4. Validation of educational booklet for HIV/Aids prevention in older adults.

    Science.gov (United States)

    Cordeiro, Luana Ibiapina; Lopes, Thais de Oliveira; Lira, Luciane Elise de Abreu; Feitoza, Sarah Maria de Sousa; Bessa, Maria Eliana Peixoto; Pereira, Maria Lúcia Duarte; Feitoza, Aline Rodrigues; Souza, Adriano Rodrigues de

    2017-01-01

    To describe the process of manufacturing and validation of an educational booklet for HIV/Aids prevention in older adults. Methodological study developed in two phases - manufacturing of the booklet and validation of the educational material by judges. The manufacturing process involved a situational diagnosis with older adults, and its result indicated gaps in the knowledge with respect to HIV/Aids. The validation process was performed by nine judges, selected by convenience. It was considered an agreement index of at least 0.80, analyzed through the content validity index. We opted for a dialogue between two older adults divided into three categories: myths and taboos; ignorance; and prevention and importance of diagnosis. The average of the items was 0.90. The suggestions made by the judges were observed and modified for the final version. The material had relevant content for the judges, in addition to being able to be used by health professionals in the education and clarification of issues on the subject. Descrever o processo de construção e validação de cartilha educativa para prevenção de HIV/Aids em idosos. Estudo metodológico desenvolvido em duas etapas - construção da cartilha e validação do material educativo por juízes. O processo de construção envolveu um diagnóstico situacional com idosos, cujo resultado apontou lacunas no conhecimento com relação ao HIV/Aids. Já o processo de validação foi realizado por nove juízes, selecionados por conveniência. Considerou-se uma concordância de no mínimo 0,80, analisado pelo índice de validade de conteúdo. Optou-se por um diálogo entre dois idosos dividido em três categorias: mitos e tabus; desconhecimento; e prevenção e importância do diagnóstico. A média dos itens foi de 0,90. As sugestões realizadas pelos juízes foram acatadas e modificadas para a versão final. O material apresentou conteúdo relevante para os juízes, além de poder ser utilizado pelos profissionais de sa

  5. Emergency contraception” and prevention of pregnancy after sexual violence

    OpenAIRE

    Bilokapić, Šimun

    2010-01-01

    Tragic incident of sexual violence and its dramatic conse- quences oblige the whole social community, and above all doctors and medical staff, to respecting, sympathy and care for the entire welfare of the injured person. For decades the issue of prevention of pregnancy after rape has been giving rise to medical and moral attention in the treatment of the victim, raising the questions Is such a practice justified and are the modern means, methods and procedures, kno...

  6. Online social communication patterns among emerging adult women with histories of childhood attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Mikami, Amori Yee; Szwedo, David E; Ahmad, Shaikh I; Samuels, Andrea Stier; Hinshaw, Stephen P

    2015-08-01

    Little is known about adult women with attention-deficit/hyperactivity disorder (ADHD); however, available evidence suggests that they experience social impairment. Online social networking websites such as Facebook have become endemic outlets through which emerging adults communicate with peers. No study has examined the peer interactions of emerging adults with childhood histories of ADHD in this developmentally relevant online domain. Participants in the current study were an ethnically diverse sample of 228 women, 140 of whom met diagnostic criteria for ADHD in childhood and 88 who composed a matched comparison sample. These women were assessed at 3 time points spanning 10 years (mean age = 9.6 at Wave 1, 14.1 at Wave 2, 19.6 at Wave 3). After statistical control of demographic covariates and comorbidities, childhood ADHD diagnosis predicted, by emerging adulthood, a greater stated preference for online social communication and a greater tendency to have used online methods to interact with strangers. A childhood diagnosis of ADHD also predicted observations of fewer Facebook friends and less closeness and support from Facebook friends in emerging adulthood. These associations were mediated by a composite of face-to-face peer relationship impairment during childhood and adolescence. Intriguingly, women with persistent diagnoses of ADHD from childhood to emerging adulthood differed from women with consistent comparison status in their online social communication; women with intermittent diagnoses of ADHD had scores intermediate between the other 2 groups. Results are discussed within the context of understanding the social relationships of women with childhood histories of ADHD. (c) 2015 APA, all rights reserved).

  7. The impact of religious faith and internalized homonegativity on resiliency for black lesbian, gay, and bisexual emerging adults.

    Science.gov (United States)

    Walker, Ja'Nina J; Longmire-Avital, Buffie

    2013-09-01

    Religious faith has been instrumental in fostering positive mental health outcomes for historically disenfranchised populations, such as Black Americans. However, the religious institutional devaluing of same-sex behavior and identity fuels internalized homonegativity (i.e., negative thoughts regarding one's same-sex sexual behavior) for nonheterosexual congregants. This study sought to examine the relations between religious faith, internalized homonegativity, and resiliency for Black lesbian, gay, and bisexual (LGB) emerging adults. One hundred seventy-five Black LGB emerging adults, ranging in age between 18 and 25 years old, completed an online survey designed to examine multiple identities and psychological well-being. Utilizing hierarchical linear regression, we found that internalized homonegativity moderated the relationship between religious faith and resiliency. Religious faith was a significant contributor to resiliency when the participant concurrently reported high internalized homonegativity. This finding highlights the importance of understanding the complex interplay of religious faith, internalized homonegativity, and resiliency for Black LGB emerging adults. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. The role of minority stress in second-generation Black emerging adult college students' high-risk drinking behaviors.

    Science.gov (United States)

    Pittman, Delishia M; Cho Kim, Sara; Hunter, Carla D; Obasi, Ezemenari M

    2017-07-01

    This study used a minority stress framework to investigate the relationships between multiple stressors (e.g., general life stress, race related stress, and acculturative stress) and high-risk drinking behaviors in a sample of second-generation Black emerging adult college students across the United States. Participants (n = 148) were recruited from U.S. colleges and universities as part of a large, multiwave cross-sectional study. Findings from this study mirrored those in the extant literature: the positive relationship between race-related stress and high-risk drinking behaviors found in other marginalized groups. However, when all stressors were entered into the model, acculturative stress accounted for significant variance in high-risk drinking behaviors above and beyond general life and race-related stressors in second generation Black emerging adult college students. Findings underscore the need to better understand the influence of acculturative stress on high-risk drinking behaviors among second-generation Black emerging adult college students: an understudied population in both the acculturation and alcohol use literatures. Implications for future research and clinical practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Race/ethnicity and the use of preventive health care among adults with intellectual and developmental disabilities.

    Science.gov (United States)

    Bershadsky, Julie; Hiersteiner, Dorothy; Fay, Mary L; Bradley, Valerie

    2014-10-01

    Past research has been dedicated to documenting disparities in use of preventive health care faced by racial and ethnic minorities. In addition, studies have looked at the disparities in use of preventive health care experienced by individuals with intellectual and developmental disabilities (ID/DD). There is little known research that examines disparities in preventive health care use by individuals with ID/DD who identify as African American or Hispanic. This study aimed to determine whether National Core Indicators data demonstrate racial and/or ethnic disparities in the use of preventive health care. Further, this study examined whether those racial and/or ethnic disparities in the use of preventive health care persisted when the analysis controlled for other demographic factors. Data were derived from the 2011 to 2012 administration of the Adult Consumer Survey of the National Core Indicators Project. The association of race/ethnicity and preventive health care was assessed using binary logistic regression models. There seem to be differences in receipt of preventive care by race/ethnicity. However, most of these differences were not significant after other person-level factors were accounted for. Race/ethnicity may be less of a factor in accessing preventive care among adults with ID/DD receiving services than among the general population.

  10. Change You Can Believe In: Changes in Goal Setting During Emerging and Young Adulthood Predict Later Adult Well-Being.

    Science.gov (United States)

    Hill, Patrick L; Jackson, Joshua J; Roberts, Brent W; Lapsley, Daniel K; Brandenberger, Jay W

    2011-03-01

    A widely held assumption is that changes in one's goals and motives for life during emerging and young adulthood have lasting influences on well-being into adulthood. However, this claim has yet to receive rigorous empirical testing. The current study examined the effects of prosocial and occupational goal change during college on adult well-being in a 17-year study of goal setting ( N = 416). Using a latent growth model across three time points, both level and growth in goal setting predicted later well-being. Moreover, goal changes both during college and in young adulthood uniquely predicted adult well-being, controlling for goal levels entering college. These findings suggest that what matters for attaining adult well-being is both how you enter adulthood and how you change in response to it.

  11. 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.

  12. Colorectal cancer prevention and intentions to use low-dose aspirin: A survey of 1000 U.S. adults aged 40-65.

    Science.gov (United States)

    Jensen, Jakob D; Holton, Avery E; Krakow, Melinda; Weaver, Jeremy; Donovan, Erin; Tavtigian, Sean

    2016-04-01

    The Translating Research into Action (TRIA) study was initiated to gather dissemination information on emerging cancer control recommendations. Daily, low-dose aspirin has been identified as a promising means of preventing colorectal cancer, and stakeholders are already calling for research to facilitate dissemination. Thus, the current study sought to identify factors related to intention to use aspirin for colorectal cancer prevention. In April 2014, U.S. adults aged 40-65 (N=1000) were recruited to participate in a survey grounded in the health belief model. Older, Black males were more likely to intend to use low-dose aspirin to prevent colorectal cancer. Smokers, and those with a history of polyps, were also more receptive to initiating daily, low-dose aspirin use. Five psychosocial factors were related to intention including self-efficacy, response efficacy, perceived barriers, perceived susceptibility to colorectal cancer, and cancer information overload. Initial campaigns/interventions designed to increase daily, low-dose aspirin for colorectal cancer prevention may be more effective if they target receptive populations (older, Black males) using messages informed by the health belief model. Copyright © 2016. Published by Elsevier Ltd.

  13. The role of plant biosecurity in preventing and controlling emerging plant virus disease epidemics.

    Science.gov (United States)

    Rodoni, B

    2009-05-01

    A number of research strategies have been initiated over the last decade to enhance plant biosecurity capacity at the pre-border, border and post-border frontiers. In preparation for emerging plant virus epidemics, diagnostic manuals for economically important plant viruses that threaten local industries have been developed and validated under local conditions. Contingency plans have also been prepared that provide guidelines to stakeholders on diagnostics, surveillance, survey strategies, epidemiology and pest risk analysis. Reference collections containing validated positive virus controls have been expanded to support a wide range of biosecurity sciences. Research has been conducted to introduce high throughput diagnostic capabilities and the design and development of advanced molecular techniques to detect virus genera. These diagnostic tools can be used by post entry quarantine agencies to detect known and unknown plant viral agents. Pre-emptive breeding strategies have also been initiated to protect plant industries if and when key exotic viruses become established in localized areas. With the emergence of free trade agreements between trading partners there is a requirement for quality assurance measures for pathogens, including viruses, which may occur in both the exporting and importing countries. These measures are required to ensure market access for the exporting country and also to minimize the risk of the establishment of a damaging virus epidemic in the importing country.

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

    Science.gov (United States)

    Edoh, Thierry

    2018-04-10

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

  15. Dietary-induced cancer prevention: An expanding research arena of emerging diet related to healthcare system.

    Science.gov (United States)

    Pal, Dilipkumar; Banerjee, Subham; Ghosh, Ashoke Kumar

    2012-01-01

    Diet plays a vital role in the management of cancer because they are the source of important physiologically functional components. Scientific observations support the idea that dietary supplement can prevent breast cancer recurrences. Strong correlations are established between the high intake of saturated fat and the incidence of different types of cancer. It is found that chronic alcohol consumption is associated with increased risk of cancers of oral cavity, pharynx, esophagus, and larynx. Again, some evidences are also found regarding phosphorous, glutamate level in the body, and incidence of cancer. Different physiologically functional components are found in the dietary materials. Fibers, the major dietary components, have long been recognized for the unique properties in the treatment of cancer, which are related to its antineoplastic functions. Antioxidant rich diet has been added to the list of cancer-preventing dietary components. Also, recently published research has shown that natural carotenoids in the diet leads to a normalization of body epithelial cells and protects against the risk of stomach and esophagus cancer, and improves the immune system's response. Again, fruit juices, processed vegetable juices, orange peel, green tea, vitamins, flavonoids, and trace materials have cancer inhibitory properties. Clearly, there has been increasing recognition of chemoprotective functions. Now, it can be recognized for another kind of functionality for the improvement of the health of mankind.

  16. Dietary-induced cancer prevention: An expanding research arena of emerging diet related to healthcare system

    Directory of Open Access Journals (Sweden)

    Dilipkumar Pal

    2012-01-01

    Full Text Available Diet plays a vital role in the management of cancer because they are the source of important physiologically functional components. Scientific observations support the idea that dietary supplement can prevent breast cancer recurrences. Strong correlations are established between the high intake of saturated fat and the incidence of different types of cancer. It is found that chronic alcohol consumption is associated with increased risk of cancers of oral cavity, pharynx, esophagus, and larynx. Again, some evidences are also found regarding phosphorous, glutamate level in the body, and incidence of cancer. Different physiologically functional components are found in the dietary materials. Fibers, the major dietary components, have long been recognized for the unique properties in the treatment of cancer, which are related to its antineoplastic functions. Antioxidant rich diet has been added to the list of cancer-preventing dietary components. Also, recently published research has shown that natural carotenoids in the diet leads to a normalization of body epithelial cells and protects against the risk of stomach and esophagus cancer, and improves the immune system′s response. Again, fruit juices, processed vegetable juices, orange peel, green tea, vitamins, flavonoids, and trace materials have cancer inhibitory properties. Clearly, there has been increasing recognition of chemoprotective functions. Now, it can be recognized for another kind of functionality for the improvement of the health of mankind.

  17. Cervical cancer in sub-Saharan Africa: an emerging and preventable disease associated with oncogenic human papillomavirus.

    Science.gov (United States)

    Mboumba Bouassa, R S; Prazuck, T; Lethu, T; Meye, J F; Bélec, L

    2017-02-01

    Highly oncogenic human papillomavirus (HPV) infections are responsible for 7.7 % of cancers in developing countries, mainly cervical cancer. The incidence of this emerging cancer is steadily increasing in sub-Saharan Africa, with more than 75,000 new cases and close to 50,000 deaths a year, a toll further increased by HIV infection. According to the World Health Organization, cervical cancer will kill more than 443,000 women per year worldwide by 2030, nearly 90 % of them in sub-Saharan Africa. This increase in cervical cancer incidence in Africa is now counteracting the progress made by African women in reducing maternal mortality and increasing longevity. Nevertheless, cervical cancer is a potentially preventable noncommunicable disease that can be averted or halted by primary (vaccination), secondary (early diagnosis of situations at risk), and tertiary (early diagnosis of proven cases of cervical neoplasia) prevention. The close links between HIV and HPV justify linking cervical cancer prevention, screening, and management programs with AIDS programs as part of the "90-90-90" initiative of the UNAIDS, both nationally and regionally. Innovative strategies based on effective, rapid, inexpensive, and mobile screening tools, including at best molecular biology as well as vaccination and awareness programs, should be rapidly implemented and evaluated in sub-Saharan Africa.

  18. Nighttime assaults: using a national emergency department monitoring system to predict occurrence, target prevention and plan services

    Directory of Open Access Journals (Sweden)

    Bellis Mark A

    2012-09-01

    Full Text Available Abstract Background Emergency department (ED data have the potential to provide critical intelligence on when violence is most likely to occur and the characteristics of those who suffer the greatest health impacts. We use a national experimental ED monitoring system to examine how it could target violence prevention interventions towards at risk communities and optimise acute responses to calendar, holiday and other celebration-related changes in nighttime assaults. Methods A cross-sectional examination of nighttime assault presentations (6.01 pm to 6.00 am; n = 330,172 over a three-year period (31st March 2008 to 30th March 2011 to English EDs analysing changes by weekday, month, holidays, major sporting events, and demographics of those presenting. Results Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P 2 = 0.918; P  Conclusions To date, the role of ED data has focused on helping target nightlife police activity. Its utility is much greater; capable of targeting and evaluating multi-agency life course approaches to violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.

  19. Falls Prevention Education for Older Adults during and after Hospitalization: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Lee, Den-Ching A.; Pritchard, Elizabeth; McDermott, Fiona; Haines, Terry P.

    2014-01-01

    Objectives: To assess the effectiveness of patient education in reducing falls, promoting behavioural change and the uptake of prevention activities in older adults during and after hospitalization. Design: Systematic review and meta-analysis. Methods: A systematic search of five health science databases was performed up to November 2012. Studies…

  20. Evaluation of a nationwide mass media campaign aimed at prevention of weight gain in Dutch young adults

    NARCIS (Netherlands)

    B.M. Wammes (Birgitte)

    2007-01-01

    textabstractThe prevalence of overweight and obesity is increasing rapidly. In the Netherlands, the prevalence of obesity has roughly doubled over the last decade and now more than 40% of the Dutch adult population is overweight and more than 10% obese. To promote weight-gain preventive actions