WorldWideScience

Sample records for prevention programme lessons

  1. Key Programme Science lessons from an HIV prevention 'Learning Site' for sex workers in Mombasa, Kenya.

    Science.gov (United States)

    McClarty, Leigh M; Bhattacharjee, Parinita; Isac, Shajy; Emmanuel, Faran; Kioko, Japheth; Njiraini, Margaret; Gichangi, Peter; Okoth, Clifford Duncan; Musimbi-Mbole, Janet; Blanchard, James F; Moses, Stephen; Muysyoki, Helgar; Becker, Marissa L

    2017-12-14

    In 2013, Kenya's National AIDS and STI Control Programme established a Learning Site (LS) in Mombasa County to support and strengthen capacity for HIV prevention programming within organisations working with sex workers. A defining feature of LS was the use of a Programme Science approach throughout its development and implementation. We provide an overview of the key components of LS, present findings from 23 months of programme monitoring data, and highlight key Programme Science lessons from its implementation and monitoring. Routine monitoring data collected from September 2013 through July 2015 are presented. Individual-level service utilisation data were collected monthly and indicators of interest were analysed over time to illustrate trends in enrolment, programme coverage and service utilisation among sex workers in Mombasa County. Over the monitoring period, outreach programme enrolment occurred rapidly; condom distribution targets were met consistently; rates of STI screening remained high and diagnoses declined; and reporting of and response to violent incidents increased. At the same time, enrolment in LS clinics was relatively low among female sex workers, and HIV testing at LS was low among both female and male sex workers. Lessons learnt from operationalising the Programme Science framework through the Mombasa LS can inform the development and implementation of similar LS in different geographical and epidemiological contexts. Importantly, meaningful involvement of sex workers in the design, implementation and monitoring processes ensures that overall programme performance is optimised in the context of local, 'on-the-ground' realities. Additionally, learnings from LS highlight the importance of introducing enhanced monitoring and evaluations systems into complex programmes to better understand and explain programme dynamics over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  2. Lessons from a peer-led obesity prevention programme in English schools.

    Science.gov (United States)

    Bell, Sarah L; Audrey, Suzanne; Cooper, Ashley R; Noble, Sian; Campbell, Rona

    2017-04-01

    Obesity in young people is a major public health concern. Energy balance, the interrelationship between diet and physical activity, is known to be a key determinant. Evidence supports the development of school-based approaches to obesity prevention. ASSIST (A Stop Smoking in Schools Trial) is an effective school-based, peer-led smoking prevention programme for 12-13-year-old students, based on diffusion of innovations theory. The AHEAD (Activity and Healthy Eating in ADolescence) study tested the feasibility of adapting ASSIST to an obesity prevention intervention. The AHEAD intervention was tested and refined during a pilot study in one school, followed by an exploratory trial in six schools. Quantitative (self-report behavioural questionnaires and evaluation forms) and qualitative (structured observations, focus groups and interviews) research methods were used to examine the implementation and acceptability of the intervention. The potential effectiveness of the intervention in increasing healthy eating was measured using self-report behavioural questionnaires. Activity monitors (accelerometers) were used to measure physical activity. Results show it was feasible to implement the AHEAD intervention, which was well received. However, implementation was resource and labour intensive and relatively expensive. Furthermore, there was no evidence of promise that the intervention would increase physical activity or healthy eating in adolescents. Although diet and physical activity are both relevant for obesity prevention, the focus on two behaviours appeared too complex for informal diffusion through peer networks. This identifies a tension, particularly for adolescent peer-led health promotion, between the desire not to isolate or oversimplify health behaviours and the need to present clear, succinct health promotion messages. © The Author (2014). Published by Oxford University Press.

  3. Measles prevention in adolescents: lessons learnt from implementing a high school catch-up vaccination programme in New South Wales, Australia, 2014-2015.

    Science.gov (United States)

    Nicholl, Sonya; Seale, Holly; Sheppeard, Vicky; Campbell-Lloyd, Sue

    2016-01-01

    In response to a significant increase of measles cases and a high percentage of unvaccinated adolescents in New South Wales, Australia, a measles high school catch-up vaccination programme was implemented between August and December 2014. This study aimed to explore the factors affecting school-based supplementary immunization activities (SIAs) and to inform future SIA and routine school-based vaccination programme implementation and service provision. Focus group analysis was conducted among public health unit (PHU) staff responsible for implementing the SIA catch-up programme. Key areas discussed were pre-programme planning, implementation, resources, consent materials, media activity and future directions for school vaccination programme delivery. Sessions were audio recorded, transcribed verbatim and reviewed. Thematic analysis was conducted to identify the major themes. Two independent focus groups with 32 participants were conducted in January 2015. Barriers to the SIA implementation included lead time, consent processes, interagency collaboration, access to the targeted cohort and the impact of introducing a SIA to an already demanding curriculum and school programme immunization schedule. A positive PHU school coordinator rapport and experience of PHU staff facilitated the implementation. Consideration of different approaches for pre-clinic vaccination status checks, student involvement in the vaccination decision, online consent, workforce sharing between health districts and effective programme planning time were identified for improving future SIA implementation. Although many barriers to school programme implementation have been identified in this study, with adequate resourcing and lead time, SIAs implemented via a routine school vaccination programme are an appropriate model to target adolescents.

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

    Science.gov (United States)

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

    2014-09-10

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

  5. Youth, Terrorism and Education: Britain's Prevent Programme

    Science.gov (United States)

    Thomas, Paul

    2016-01-01

    Since the 7/7 bombings of July 2005, Britain has experienced a domestic terror threat posed by a small minority of young Muslims. In response, Britain has initiated "Prevent," a preventative counter-terrorism programme. Building on previous, general critiques of Prevent, this article outlines and critically discusses the ways in which…

  6. Lessons Learned from Environmental Remediation Programmes

    International Nuclear Information System (INIS)

    2014-01-01

    Several remediation projects have been developed to date, and experience with these projects has been accumulated. Lessons learned span from non-technical to technical aspects, and need to be shared with those who are beginning or are facing the challenge to implement environmental remediation works. This publication reviews some of these lessons. The key role of policy and strategies at the national level in framing the conditions in which remediation projects are to be developed and decisions made is emphasized. Following policy matters, this publication pays attention to the importance of social aspects and the requirement for fairness in decisions to be made, something that can only be achieved with the involvement of a broad range of interested parties in the decision making process. The publication also reviews the funding of remediation projects, planning, contracting, cost estimates and procurement, and issues related to long term stewardship. Lessons learned regarding technical aspects of remediation projects are reviewed. Techniques such as the application of cover systems and soil remediation (electrokinetics, phytoremediation, soil flushing, and solidification and stabilization techniques) are analysed with respect to performance and cost. After discussing soil remediation, the publication covers issues associated with water treatment, where techniques such as ‘pump and treat’ and the application of permeable barriers are reviewed. Subsequently, there is a section dedicated to reviewing briefly the lessons learned in the remediation of uranium mining and processing sites. Many of these sites throughout the world have become orphaned, and are waiting for remediation. The publication notes that little progress has been made in the management of some of these sites, particularly in the understanding of associated environmental and health risks, and the ability to apply prediction to future environmental and health standards. The publication concludes

  7. Substance use prevention programmes among adolescents ...

    African Journals Online (AJOL)

    Substance use among adolescents is a major problem facing the world today. However, there are challenges on prevention of substance use among this population. The purpose of this systematic review was to explore and describe current evidence on substance use prevention programmes among adolescents focusing ...

  8. National programme for prevention of burn injuries

    Directory of Open Access Journals (Sweden)

    Gupta J

    2010-10-01

    Full Text Available The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.

  9. Stakeholders' perceptions of programme sustainability: findings from a community-based fall prevention programme.

    Science.gov (United States)

    Hanson, H M; Salmoni, A W

    2011-08-01

    Sustainability of health promotion and injury prevention programmes is a goal of practitioners and an increasingly common requirement of funding bodies. However, less is known about the views held by individual stakeholders involved in such programmes regarding their perceptions of facilitators and barriers to achieving sustainability. This paper aims to share the perceptions of programme sustainability held by key stakeholders involved in a community-based fall prevention programme in three Ontario demonstration communities in Canada. A qualitative case study research design. A holistic multiple case study method was employed. In total, 45 stakeholders involved in various aspects of the project participated from three demonstration sites. Stakeholders' perceptions were gathered on the individual actions they took in an effort to promote sustainability, and the barriers they perceived as preventing or limiting sustainability. Stakeholders reported taking a number of actions to aid programme sustainability, with some actions deemed to be more functional in aiding sustainability than others. Common actions reported by stakeholders included partnership formation, networking and increasing community capacity. Stakeholders also perceived a number of barriers to achieving sustainability, including insufficient human and financial resources, lack of co-ordination and buy-in, heavy reliance on volunteers and an inability to mobilize physicians. Stakeholders' perceptions of sustainability were used to develop recommendations for sustainability for both communities and funding bodies. The views and experiences shared by the stakeholders in this project can serve as lessons learnt to aid in the sustainability of other health promotion and injury prevention programmes in the future. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  10. Determining Factors for Cyberbullying Prevention Programmes

    Science.gov (United States)

    Manzuoli, Cristina Hennig; Medina, Liliana Cuesta

    2017-01-01

    This study reports on the first stages of a larger project to develop an ICT-supported cyberbullying prevention programme that fosters development of children's communication skills for the safe use of social media. To establish baseline data on the incidence and growth of cyberbullying in Bogotá, Colombia, we applied a Revised School Violence…

  11. The effects of a three-year smoking prevention programme in secondary schools in Helsinki.

    Science.gov (United States)

    Vartiainen, Erkki; Pennanen, Marjaana; Haukkala, Ari; Dijk, Froukje; Lehtovuori, Riku; De Vries, Hein

    2007-06-01

    This study evaluates the effects of a 3-year smoking prevention programme in secondary schools in Helsinki. The study is part of the European Smoking prevention Framework Approach (ESFA), in which Denmark, Finland, the Netherlands, Portugal, Spain and the UK participated. A total of 27 secondary schools in Finland participated in the programme (n = 1821). Schools were randomised into experimental (13) and control groups (14). The programme included 14 information lessons about smoking and refusal skills training. The 3-year smoking prevention programme was also integrated into the standard curriculum. The community-element of the programme included parents, parish confirmation camps and dentists. The schools in the experimental group received the prevention programme and the schools in the control group received the standard health education curriculum. Among baseline never smokers (60.8%), the programme had a significant effect on the onset of weekly smoking in the experimental group [OR = 0.63 (0.45-0.90) P = 0.009] when compared with the control group. Being female, doing poorly at school, having parents and best friends who smoke and more pocket money to spend compared with others were associated with an increased likelihood of daily and weekly smoking onset. These predictors did not have an interaction effect with the experimental condition. This study shows that a school- and community-based smoking prevention programme can prevent smoking onset among adolescents.

  12. School-based programmes for preventing smoking.

    Science.gov (United States)

    Thomas, Roger E; McLellan, Julie; Perera, Rafael

    2013-04-30

    Helping young people to avoid starting smoking is a widely endorsed public health goal, and schools provide a route to communicate with nearly all young people. School-based interventions have been delivered for close to 40 years. The primary aim of this review was to determine whether school smoking interventions prevent youth from starting smoking. Our secondary objective was to determine which interventions were most effective. This included evaluating the effects of theoretical approaches; additional booster sessions; programme deliverers; gender effects; and multifocal interventions versus those focused solely on smoking. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Tobacco Addiction Group's Specialised Register, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Health Star, and Dissertation Abstracts for terms relating to school-based smoking cessation programmes. In addition, we screened the bibliographies of articles and ran individual MEDLINE searches for 133 authors who had undertaken randomised controlled trials in this area. The most recent searches were conducted in October 2012. We selected randomised controlled trials (RCTs) where students, classes, schools, or school districts were randomised to intervention arm(s) versus a control group, and followed for at least six months. Participants had to be youth (aged 5 to 18). Interventions could be any curricula used in a school setting to deter tobacco use, and outcome measures could be never smoking, frequency of smoking, number of cigarettes smoked, or smoking indices. Two reviewers independently assessed studies for inclusion, extracted data and assessed risk of bias. Based on the type of outcome, we placed studies into three groups for analysis: Pure Prevention cohorts (Group 1), Change in Smoking Behaviour over time (Group 2) and Point Prevalence of Smoking (Group 3). One hundred and thirty-four studies involving 428,293 participants met the inclusion criteria. Some

  13. tanzania danida dental health programme progress in prevention

    African Journals Online (AJOL)

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

  14. Informing New String Programmes: Lessons Learned from an Australian Experience

    Science.gov (United States)

    Murphy, Fintan; Rickard, Nikki; Gill, Anneliese; Grimmett, Helen

    2011-01-01

    Although there are many examples of notable string programmes there has been relatively little comparative analysis of these programmes. This paper examines three benchmark string programmes (The University of Illinois String Project, The Tower Hamlets String Teaching Project and Colourstrings) alongside Music4All, an innovative string programme…

  15. School-based secondary prevention programmes for preventing violence.

    Science.gov (United States)

    Mytton, J; DiGuiseppi, C; Gough, D; Taylor, R; Logan, S

    2006-07-19

    Early aggressive behaviour is a risk factor for later violence and criminal behaviour. Despite over 20 years of violence prevention interventions being delivered in the school setting, questions remain regarding the effectiveness of different interventions for children exhibiting aggressive behaviour. To examine the effect of school based violence prevention programmes for children identified as aggressive or at risk of being aggressive. We searched CENTRAL, Cochrane Injuries Group specialised register, MEDLINE, EMBASE, other specialised databases and reference lists of articles. We also contacted authors and organisations to identify any further studies. We included trials meeting the following criteria; 1) participants were randomly assigned to intervention and control groups; 2) outcome data were collected concurrently; 3) participants comprised children in mandatory education identified as exhibiting, or at risk of, aggressive behaviour; 4) interventions designed to reduce aggression, violence, bullying, conflict or anger; 5) school based interventions; 6) outcomes included aggressive behaviour, school and agency responses to acts of aggression, or violent injuries. Data were collected on design, participants, interventions, outcomes and indicators of study quality. Results of any intervention to no intervention were compared immediately post-intervention and at 12 months using meta-analysis where appropriate. Of 56 trials identified, none reported data on violent injuries. Aggressive behaviour was significantly reduced in intervention groups compared to no intervention groups immediately post intervention in 34 trials with data, (Standardised Mean Difference (SMD) = -0.41; 95% confidence interval (CI) -0.56 to -0.26). This effect was maintained in the seven studies reporting 12 month follow-up (SMD = -0.40, (95% CI -0.73 to -0.06)). School or agency disciplinary actions in response to aggressive behaviour were reduced in intervention groups for nine trials

  16. Predictors of efficacy in depression prevention programmes. Meta-analysis.

    NARCIS (Netherlands)

    Jané Llopis, E.; Hosman, C.M.H.; Jenkins, R.B.; Anderson, P.D.

    2003-01-01

    BACKGROUND: Worldwide, 340 million people are affected by depression, with high comorbid, social and economic costs. AIMS: To identify potential predictors of effect in prevention programmes. METHOD: A meta-analysis was made of 69 programmes to reduce depression or depressive symptoms. RESULTS: The

  17. The challenges of quantitative evaluation of a multi-setting, multi-strategy community-based childhood obesity prevention programme: lessons learnt from the eat well be active Community Programs in South Australia.

    Science.gov (United States)

    Wilson, Annabelle M; Magarey, Anthea M; Dollman, James; Jones, Michelle; Mastersson, Nadia

    2010-08-01

    To describe the rationale, development and implementation of the quantitative component of evaluation of a multi-setting, multi-strategy, community-based childhood obesity prevention project (the eat well be active (ewba) Community Programs) and the challenges associated with this process and some potential solutions. ewba has a quasi-experimental design with intervention and comparison communities. Baseline data were collected in 2006 and post-intervention measures will be taken from a non-matched cohort in 2009. Schoolchildren aged 10-12 years were chosen as one litmus group for evaluation purposes. Thirty-nine primary schools in two metropolitan and two rural communities in South Australia. A total of 1732 10-12-year-old school students completed a nutrition and/or a physical activity questionnaire and 1637 had anthropometric measures taken; 983 parents, 286 teachers, thirty-six principals, twenty-six canteen and thirteen out-of-school-hours care (OSHC) workers completed Program-specific questionnaires developed for each of these target groups. The overall child response rate for the study was 49 %. Sixty-five per cent, 43 %, 90 %, 90 % and 68 % of parent, teachers, principals, canteen and OSHC workers respectively, completed and returned questionnaires. A number of practical, logistical and methodological challenges were experienced when undertaking this data collection. Learnings from the process of quantitative baseline data collection for the ewba Community Programs can provide insights for other researchers planning similar studies with similar methods, particularly those evaluating multi-strategy programmes across multiple settings.

  18. The Management of innovation: Lessons from a Danish Development Programme

    DEFF Research Database (Denmark)

    Clausen, Lennie

    1997-01-01

    The paper reports from an ongoing Danish development programme entitled "Process and Product Development in the Building Industry". The programme is a joint initiatvie, initiated by the Ministry of Housing and Building and the Ministry of Busines and Industry. In a competition in 1994 four consor...

  19. Lessons learnt from a three-year pilot field epidemiology training programme.

    Science.gov (United States)

    Hoy, Damian; Durand, A Mark; Hancock, Thane; Cash, Haley L; Hardie, Kate; Paterson, Beverley; Paulino, Yvette; White, Paul; Merritt, Tony; Fitzgibbons, Dawn; Gopalani, Sameer Vali; Flint, James; Edwin A Merilles, Onofre; Kashiwabara, Mina; Biaukula, Viema; Lepers, Christelle; Souares, Yvan; Nilles, Eric; Batikawai, Anaseini; Huseynova, Sevil; Patel, Mahomed; Saketa, Salanieta T; Durrheim, David; Henderson, Alden; Roth, Adam

    2017-01-01

    The Pacific region has widely dispersed populations, limited financial and human resources and a high burden of disease. There is an urgent need to improve the availability, reliability and timeliness of useable health data. The purpose of this paper is to share lessons learnt from a three-year pilot field epidemiology training programme that was designed to respond to these Pacific health challenges. The pilot programme built on and further developed an existing field epidemiology training programme for Pacific health staff. The programme was delivered in country by epidemiologists working for Pacific Public Health Surveillance Network partners. The programme consisted of five courses: four one-week classroom-based courses and one field epidemiology project. Sessions were structured so that theoretical understanding was achieved through interaction and reinforced through practical hands-on group activities, case studies and other interactive practical learning methods. As of September 2016, 258 students had commenced the programme. Twenty-six course workshops were delivered and one cohort of students had completed the full five-course programme. The programme proved popular and gained a high level of student engagement. Face-to-face delivery, a low student-to-facilitator ratio, substantial group work and practical exercises were identified as key factors that contributed to the students developing skills and confidence. Close engagement of leaders and the need to quickly evaluate and adapt the curriculum were important lessons, and the collaboration between external partners was considered important for promoting a harmonized approach to health needs in the Pacific.

  20. Unravelling the effect of the Dutch school-based nutrition programme Taste Lessons

    NARCIS (Netherlands)

    Battjes-Fries, Marieke C.E.; Dongen, van Ellen J.I.; Renes, Reint Jan; Meester, Hante J.; Veer, van 't Pieter; Haveman-Nies, Annemien

    2016-01-01

    Background: To unravel the effect of school-based nutrition education, insight into the implementation process is needed. In this study, process indicators of Taste Lessons (a nutrition education programme for Dutch elementary schools) and their association with changes in behavioural

  1. Public health lessons from a pilot programme to reduce mother-to ...

    African Journals Online (AJOL)

    Objective. Short-course antiretroviral therapy (ART) has been shown to be effective in reducing mother-to-child transmission (MTCT) of HIV-1. This article details the public health lessons learnt from a district-based pilot programme where a short-murse zidovudine (ZDV) regimen has been used in a typical South African ...

  2. To what extent do youth-focused prevention programmes reflect ...

    African Journals Online (AJOL)

    Despite considerable effort directed towards youth focused prevention activities in South Africa, little is known about the content of these activities. A major concern is the extent to which substance abuse prevention programmes reflect evidence-based practices (EBPs). This paper reports on the findings from a ...

  3. A comparison of pregnancy prevention programmes in Europe

    NARCIS (Netherlands)

    Crijns, Ineke; Zomerdijk, Inge; Sturkenboom, Miriam; de Jong-van den Berg, Lolkje; Straus, Sabine

    Background: Pregnancy prevention programmes (PPP) can be imposed by regulatory authorities to minimise the risk of exposure to teratogenic drugs during pregnancy, thus preventing congenital anomalies. The objective of this study was to explore the reasons to request PPPs in the EU and the elements

  4. We have the programme, what next? Planning the implementation of an injury prevention programme.

    Science.gov (United States)

    Donaldson, Alex; Lloyd, David G; Gabbe, Belinda J; Cook, Jill; Finch, Caroline F

    2017-08-01

    The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context. 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/.

  5. Developing the @MINDSET Conflict Prevention Programme in Schools.

    OpenAIRE

    FLETCHER, Bobbie; EMADI-COFFIN, Barbara; HETHERINGTON, Janet

    2016-01-01

    This paper examines issues of conflict in schools by using a systems approach based on the Hackman and Morris (1975) Input-Process-Output Model of group performance and Granovetter’s multiple level perspective on macro, meso and micro group levels (1973). This analysis informs the understanding of a school as a community in order to further develop the diversity management programme for the @MINDSET Erasmus+ project. The @MINDSET Conflict Prevention Programme is based on the extensive work of...

  6. Evaluation of a tobacco prevention programme among teenagers in Sweden.

    Science.gov (United States)

    Hedman, Linnéa; Andersson, Martin; Stridsman, Caroline; Rönmark, Eva

    2015-05-14

    To study the prevalence of tobacco use among teenagers, to evaluate a tobacco prevention programme and to study factors related to participation in the prevention programme. Population-based prospective cohort study. Within the Obstructive Lung disease in Northern Sweden (OLIN) studies, a cohort study about asthma in schoolchildren started in 2006. All children aged 7-8 years in three municipalities were invited to a questionnaire survey and 2585 (96%) participated. The cohort was followed up at age 11-12 years (n=2612, 95% of invited) and 14-15 years (n=2345, 88% of invited). In 2010, some of the children in the OLIN cohort (n=447) were invited to a local tobacco prevention programme and 224 (50%) chose to participate. At the age of 14-15 years, the prevalence of daily smoking was 3.5%. Factors related to smoking were female sex, having a smoking mother, participation in sports and lower parental socioeconomic status (SES). The prevalence of using snus was 3.3% and risk factors were male sex, having a smoking mother, having a snus-using father and non-participation in the prevention programme. In the prevention programme, the prevalence of tobacco use was significantly lower among the participants compared with the controls in the cohort. Factors related to non-participation were male sex, having a smoking mother, lower parental SES and participation in sports. The prevalence of tobacco use was lower among the participants in the tobacco prevention programme compared with the non-participants as well as with the controls in the cohort. However, the observed benefit of the intervention may be overestimated as participation was biased by selection. 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.

  7. National infection prevention and control programmes: Endorsing quality of care.

    Science.gov (United States)

    Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

    2014-01-01

    Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

  8. Preventing childhood obesity in Asia: an overview of intervention programmes.

    Science.gov (United States)

    Uijtdewilligen, L; Waters, C N; Müller-Riemenschneider, F; Lim, Y W

    2016-11-01

    The rapid economic growth in Asia in the past few decades has contributed to the global increase in childhood obesity prevalence. Yet, little is known about obesity prevention efforts in this region. This systematic review provides an overview of child obesity prevention programmes in Asia. Searches were performed in six electronic databases. Out of 4,234 studies, 17 were included, among them 11 controlled trials (of which five were randomized). Only one study was published before 2007. Identified studies were predominantly conducted in China and Thailand and targeted primary school children in a school setting. Most studies implemented different programmes, frequently targeting behavioural modification through nutrition/health education lectures and/or physical activity sessions. Programme effects related to obesity outcome measures were mixed. Most substantial effects were found for outcomes such as improved health knowledge and/or favourable lifestyle practices. The relatively small number of relevant publications in Asia highlights the need for scientific evaluations of existing and future programmes. This will help ensure the implementation and dissemination of evidence-based approaches that have been proven to be effective in the Asian context. Targeting preschool settings and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes. © 2016 World Obesity.

  9. A Structured Approach to Academic Technology Transfer: Lessons Learned from imec’s 101 Programme

    Directory of Open Access Journals (Sweden)

    Dimitri Schuurman

    2017-08-01

    Full Text Available In this article, we describe imec’s 101 Programme for academic technology transfer and explain how it supports researchers by following a structured process in a limited amount of time and by carefully involving different stakeholders and people with relevant skills and expertise. The programme combines insights in terms of processes and of team composition from the entrepreneurship literature and puts them into practice in an internal incubation programme that is generated from the bottom-up. Based on hands-on experiences and interviews with key stakeholders in the process, we evaluate the programme and distill lessons learned. The article highlights the importance of a structured technology transfer process in the early stages of opportunity discovery and entrepreneurial action, and it offers insights on team formation for academic spin-offs.

  10. Five typologies of alcohol and drug prevention programmes

    DEFF Research Database (Denmark)

    Demant, Jakob Johan; Laura Marie, Schierff

    2018-01-01

    Adolescents exhibit a high rate of use of alcohol and illicit drugs. Effect studies rarely describe the actual content of the interventions in detail. Less is known about what was actually done in the prevention than about their effects. Aim: This study is a review study grouping the qualitatively...... for analysis. The sample consisted of 33 peer-reviewed articles published between January 2010 and December 2014. Findings: Five categories of intervention and prevention programmes were identified: ‘Information-based or testing-based primary prevention approaches’, ‘Primary prevention approaches incorporating...

  11. Lessons learnt from a three-year pilot field epidemiology training programme

    Directory of Open Access Journals (Sweden)

    Damian Hoy

    2017-09-01

    Full Text Available Problem: The Pacific region has widely dispersed populations, limited financial and human resources and a high burden of disease. There is an urgent need to improve the availability, reliability and timeliness of useable health data. Context: The purpose of this paper is to share lessons learnt from a three-year pilot field epidemiology training programme that was designed to respond to these Pacific health challenges. The pilot programme built on and further developed an existing field epidemiology training programme for Pacific health staff. Action: The programme was delivered in country by epidemiologists working for Pacific Public Health Surveillance Network partners. The programme consisted of five courses: four one-week classroom-based courses and one field epidemiology project. Sessions were structured so that theoretical understanding was achieved through interaction and reinforced through practical hands-on group activities, case studies and other interactive practical learning methods. Outcome: As of September 2016, 258 students had commenced the programme. Twenty-six course workshops were delivered and one cohort of students had completed the full five-course programme. The programme proved popular and gained a high level of student engagement. Discussion: Face-to-face delivery, a low student-to-facilitator ratio, substantial group work and practical exercises were identified as key factors that contributed to the students developing skills and confidence. Close engagement of leaders and the need to quickly evaluate and adapt the curriculum were important lessons, and the collaboration between external partners was considered important for promoting a harmonized approach to health needs in the Pacific.

  12. Preventing Unplanned Pregnancy and Completing College: An Evaluation of Online Lessons. 2nd Edition

    Science.gov (United States)

    Antonishak, Jill; Connolly, Chelsey

    2014-01-01

    The National Campaign to Prevent Teen and Unplanned Pregnancy published free online lessons that help students take action to prevent unplanned pregnancy and complete their education. From the fall of 2012 to the spring of 2014, approximately 2,800 students took the online lessons and participated in pre- and post-lesson evaluation surveys at four…

  13. Development of an HIV Prevention Videogame: Lessons Learned

    OpenAIRE

    Kimberly Hieftje; Lynn E. Fiellin; Tyra Pendergrass; Lindsay R Duncan

    2016-01-01

    The use of videogames interventions is becoming an increasingly popular and effective strategy in disease prevention and health promotion; however, few health videogame interventions have been scientifically rigorously evaluated for their efficacy. Moreover, few examples of the formative process used to develop and evaluate evidence-based health videogame interventions exist in the scientific literature. The following paper provides valuable insight into the lessons learned during the process...

  14. Implementing a community-based diabetes prevention programme in Ireland

    OpenAIRE

    O'Riordan, Bernadette; Haseldine, Clair

    2017-01-01

    Abstract Summary: There is consensus in the literature that early detection, treatment and prevention is imperative for the wellbeing of society and the health care system (1).  There is strong evidence which shows that T2D is preventable (2-5).  Early identification of people at risk of T2D and lifestyle interventions has been shown to reduce progression to T2D. This abstract describes a diabetes prevention programme that has been set up in the community by a clinical nurse specialist and ph...

  15. Development of an HIV Prevention Videogame: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Kimberly Hieftje

    2016-06-01

    Full Text Available The use of videogames interventions is becoming an increasingly popular and effective strategy in disease prevention and health promotion; however, few health videogame interventions have been scientifically rigorously evaluated for their efficacy. Moreover, few examples of the formative process used to develop and evaluate evidence-based health videogame interventions exist in the scientific literature. The following paper provides valuable insight into the lessons learned during the process of developing the risk reduction and HIV prevention videogame intervention for young adolescents, PlayForward: Elm City Stories. 

  16. Design lessons from using programmable controllers in the MFTF-BETA Personnel Safety and Interlocks System

    International Nuclear Information System (INIS)

    Branum, J.D.

    1983-01-01

    Applying programmable controllers in critical applications such as personnel safety and interlocks systems requires special considerations in the design of both hardware and software. All modern programmable controller systems feature extensive internal diagnostic capabilities to protect against problems such as program memory errors; however most, if not all present designs lack an intrinsic capability for detecting and countering failures on the ''field-side'' of their I/O modules. Many of the most common styles of I/O modules can also introduce potentially dangerous sneak circuits, even without component failure. This paper presents the most significant lessons learned to date in the design of the MFTF-BETA Personnel Safety and Interlocks System, which utilizes two non-redundant programmable controllers with over 800 I/O points each. Specific problems recognized during the design process as well as those discovered during initial testing and operation are discussed along with their specific solutions in hardware and software

  17. Design lessons from using programmable controllers in the MFTF-B personnel safety and interlocks system

    International Nuclear Information System (INIS)

    Branum, J.D.

    1983-01-01

    Applying programmable controllers in critical applications such as personnel safety and interlocks systems requires special considerations in the design of both hardware and software. All modern programmable controller systems feature extensive internal diagnostic capabilities to protect against problems such as program memory errors; however most, if not all present designs lack an intrinsic capability for detecting and countering failures on the field-side of their I/O modules. Many of the most common styles of I/O modules can also introduce potentially dangerous sneak circuits, even without component failure. This paper presents the most significant lessons learned to date in the design of the MFTF-B Personnel Safety and Interlocks System, which utilizes two non-redundant programmable controllers with over 800 I/O points each. Specific problems recognized during the design process as well as those discovered during initial testing and operation are discussed along with their specific solutions in hardware and software

  18. The Focus on Youth Prevention and Education Research Programme

    Directory of Open Access Journals (Sweden)

    Lynette Deveaux

    2016-10-01

    Full Text Available Like many developing or transitional countries affected by the HIV epidemic, The Bahamas has been deeply committed to HIV and sexually transmitted infection reduction and continues to make great strides in controlling the epidemic within its boundaries. Encouraged by the impact of the Focus on Youth Caribbean (FOYC, a school-based HIV/AIDS prevention programme and its parenting component on Grade 6 and Grade 10 students and their parents, a team of researchers from The Bahamas and the United States sought to implement a similar programme at a national level, while simultaneously evaluating factors that impact the sustainability of sexual risk-reduction programmes like FOYC. This paper describes five research projects conducted in The Bahamas between 1998 and 2016 and includes a list of over 40 published research articles

  19. Environmental radioprotection: main lessons learnt from the Envirhom programme

    International Nuclear Information System (INIS)

    Garnier-Laplace, J.; Adam, C.; Gilbin, R.; Simon, O.; Tran, D.; Massabuau, J.C.; Fortin, C.; Denison, D.; Pradines, C.; Floriani, M.; Henner, P.

    2004-01-01

    Within the field of chronic low-level exposure of ecosystems to radionuclides where data are critically sparse, the ENVIRHOM research programme launched two years ago at the Institute for Radioprotection and Nuclear Safety, proposes to acquire the needed knowledge for Ecological Risk Assessment specific to bioaccumulation of alpha and beta emitters in living organisms. Gaps of knowledge within this field constitute a strong limitation to our capability to make a reasonable risk estimate. Internal doses cannot be accurately calculated and potentially associated biological effects at any organization level remain fairly unknown. As a result, derivation of ecologically relevant and knowledge-based predicted no-effects concentrations becomes a critical issue in ERA. The scope of this presentation is to illustrate the relevance of the development of a greater depth of understanding of radionuclide fate and biological effects at several hierarchical levels to support quantitative risk assessments with defined and acceptable uncertainty bounds. The following crucial issues are discussed and exemplified for uranium and other alpha or beta emitters. First, radionuclide bioavailability is a key knowledge to an accurate assessment of both exposure and effect and media quality criteria are needed. Second, specificities of chronic exposures have to be taken into account to obtain accurate dose estimates and induced effects, as exposure conditions (concentration and duration) strongly modify the radionuclide internal distribution at various biological scales. Lastly, considering different scales for biological effects (from early to delayed, from subcellular to high organisation level) is crucial to evidence ecologically relevant indicators. A global overview of operational data from ENVIRHOM - media criteria to assess exposure, dose-effects relationships at various biological scales that constitute primary data to introduce radionuclides in ERA methods in a consistent manner

  20. POPS: a school-based prevention programme for eating disorders

    OpenAIRE

    Warschburger, Petra; Helfert, Susanne; Krentz, Eva Maria

    2011-01-01

    Abstract Aim Disordered eating is a significant social and economic issue in Western societies. Weight and shape concerns are highly prevalent during adolescence and an alarming percentage of adolescents already show disturbed eating patterns. Sociocultural factors like the beauty ideal promoted by the media and social agents are among the main reasons for this trend. Prevention programmes which focus on established protective and risk factors are needed ...

  1. Prevention of mother to child transmission of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe.

    Science.gov (United States)

    Perez, Freddy; Orne-Gliemann, Joanna; Mukotekwa, Tarisai; Miller, Anna; Glenshaw, Monica; Mahomva, Agnes; Dabis, François

    2004-11-13

    Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. Pilot implementation of the first programme for prevention of mother to child transmission of HIV in rural Zimbabwe. 120 bed district hospital in Buhera district (285,000 inhabitants), Manicaland, Zimbabwe. Programme uptake indicators monitored for 18 months; impact of policy evaluated by assessing up-scaling of programme. Voluntary counselling and testing services for HIV were provided in the hospital antenatal clinic. Women identified as HIV positive and informed of their serostatus and their newborn were offered a single dose antiretroviral treatment of nevirapine; mother-child pairs were followed up through routine health services. Nursing staff and social workers were trained, and community mobilisation was conducted. No services for prevention of mother to child transmission of HIV were available at baseline. Within 18 months, 2298 pregnant women had received pretest counselling, and the acceptance of HIV testing reached 93.0%. Of all 2137 women who had an HIV test, 1588 (74.3%) returned to collect their result; 326 of the 437 HIV positive women diagnosed had post-test counselling, and 104 (24%) mother-child pairs received nevirapine prophylaxis. Minimum staffing, an enhanced training programme, and involvement of district health authorities are needed for the implementation and successful integration of services for prevention of mother to child transmission of HIV. Voluntary counselling and testing services are important entry points for HIV prevention and care and for referral to community networks and medical HIV care services. A district approach is critical to extend programmes for prevention of mother to child transmission of HIV in rural settings. The lessons learnt from this pilot programme have contributed to the design of the national expansion

  2. Fostering Learning in Large Programmes and Portfolios: Emerging Lessons from Climate Change and Sustainable Development

    Directory of Open Access Journals (Sweden)

    Blane Harvey

    2017-02-01

    Full Text Available In fields like climate and development, where the challenges being addressed can be described as “wicked”, learning is key to successful programming. Useful practical and theoretical work is being undertaken to better understand the role of reflexive learning in bringing together different knowledge to address complex problems like climate change. Through a review of practical cases and learning theories commonly used in the areas of resilience, climate change adaptation and environmental management, this article: (i reviews the theories that have shaped approaches to reflexive learning in large, highly-distributed climate change and resilience-building programmes for development; and (ii conducts a comparative learning review of key challenges and lessons emerging from early efforts to promote and integrate reflexive learning processes in programmes of this nature. Using a case study approach, the authors focus on early efforts made in four large, inter-related (or nested programmes to establish, integrate and sustain learning processes and systems. Eight themes emerged from the review and are considered from the perspective of learning programmes as emergent communities of practice. By investigating how these themes play out in the nested programming, the paper contributes to the limited existing body of evidence on learning in large climate change programmes and identifies areas where future efforts might focus.

  3. Global health diplomacy for obesity prevention: lessons from tobacco control.

    Science.gov (United States)

    Blouin, Chantal; Dubé, Laurette

    2010-07-01

    To date the global health diplomacy agenda has focused primarily on infectious diseases. Policymakers have not dedicated the same level of attention to chronic diseases, despite their rising contribution to the global burden of disease. Negotiation of the Framework convention on tobacco control provides an apt example from global health diplomacy to tackle diet-related chronic diseases. What lessons can be learned from this experience for preventing obesity? This article looks at why a global policy response is necessary, at the actors and interests involved in the negotiations, and at the forum for diplomacy.

  4. Payment for performance in the Family Health Programme: lessons from the UK Quality and Outcomes Framework

    Directory of Open Access Journals (Sweden)

    Matthew Harris

    2012-06-01

    Full Text Available OBJECTIVE: Payment for performance financial incentive schemes reward doctors based on the quality and the outcomes of their treatment. In Brazil, the Ministry of Health is looking to scale up its use in public hospitals and some municipalities are developing payment for performance schemes even for the Family Health Programme. In this article the Quality and Outcomes Framework used in the UK since 2004 is discussed, as well as its experience to elaborate some important lessons that Brazilian municipalities should consider before embarking on payment for performance scheme in primary care settings.

  5. Mediterranean fruit fly preventative release programme in southern California

    International Nuclear Information System (INIS)

    Dowell, Robert V.; Meyer, Fred; Siddiqu, Isi A.; Leon Spaugy, E.

    2000-01-01

    California employs several area-wide pest management programmes that use the release of sterile insects to protect its commercial and dooryard agriculture. The first was developed in response to the discovery of the Mexican fruit fly, Anastrepha ludens, in Tijuana, Mexico and adjacent areas in San Diego County, California. Initially pesticide sprays of malathion and bait were applied to host plants around each fly find site. Additionally, soil sprays of diazion (0.05 kg per 93 m 2 ) were applied under every host plant around each fly find site. It soon became apparent that this approach was expensive and environmentally damaging. This led the interested parties, the California Department of Food and Agriculture (CDFA), the United States Department of Agriculture (USDA) and the government of Mexico to develop a programme that utilises the release of sterile Mexican fruit flies over the city of Tijuana in order to prevent the establishment of a breeding population of this fly in the city. The belief is that preventing the Mexican fruit fly from breeding in Tijuana will help protect both that city and California. To date, no Mexican fruit fly larvae have been found in Tijuana or the adjacent areas of California. The second programme was developed in response to the discovery of the pink bollworm, Pectinophora gossypiella, in cotton in the Imperial Valley area of southern California. As the pink bollworm spread throughout the cotton growing region of southern California, it became a significant pest that threatened the 405,000 hectares of cotton grown in the San Joaquin Valley to the north. To keep this pest out of the San Joaquin Valley, the CDFA/USDA and California cotton growers use the large-scale releases of sterile pink bollworms in areas in which wild pink bollworms are captured each year. Thus far, the pink bollworm has been prevented from establishing a permanent presence in the San Joaquin Valley and the cotton growers in southern California, Arizona and

  6. Effectiveness of a universal school-based programme for preventing depression in Chinese adolescents: a quasi-experimental pilot study.

    Science.gov (United States)

    Wong, Paul W C; Fu, King-Wa; Chan, Kim Y K; Chan, Wincy S C; Liu, Patricia M Y; Law, Yik-Wa; Yip, Paul S F

    2012-12-15

    Evidence of the effectiveness, rather than efficacy, of universal school-based programmes for preventing depression among adolescents is limited. This study examined the effectiveness of a universal depression prevention programme, "The Little Prince is Depressed" (LPD), which adopted the cognitive-behavioural model and aimed to reduce depressive symptoms and enhance protective factors of depression among secondary school students in Hong Kong. A quasi-experimental design was adopted for this pilot study. Thirteen classes were assigned to the intervention or control conditions according to the deliberation of the programme administrator of the four participating schools. Implementation was carried out in two phases, with a professional-led first phase and teacher-led programme second phase. LPD consisted of a 12-week school-based face-to-face programme with psycho-educational lessons and homework assignments. Students completed the programme generally showed positive development in help-seeking attitudes and self-esteem. For students who had more depressive symptoms at pre-assessment, the programme was found to be significant in enhancing cognitive-restructuring skills and support-seeking behaviours. The programme was not, however, found to be statistically significant in reducing depressive symptoms of the participants over the study period. A small sample size, a high attrition rate, and a short follow-up time frame. The LPD programme was successful in building resilience of the students in general and enhancing the cognitive-behavioural skills of students with depressive symptoms. While we did not find sufficient evidence for concluding that the LPD was effective in reducing depressive symptoms, we believe that these results highlight the challenges of implementing evidence-based practices generated from highly controlled environments in real-life settings. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Preventing obesity at weaning: parental views about the EMPOWER programme.

    Science.gov (United States)

    Barlow, J; Whitlock, S; Hanson, S; Davis, H; Hunt, C; Kirkpatrick, S; Rudolf, M

    2010-11-01

    Infant growth and lifestyle are now recognized as being critical determinants of later obesity. EMPOWER (Empowering Parents to Prevent Obesity at Weaning: Exploratory Research) was developed as an intervention for parents whose babies are at high risk. Delivered by specially trained health visitors, it is underpinned by the Family Partnership Model and uses a strengths-based, solution-focused way of working with families. Mothers of babies participating in the pilot of EMPOWER in Leeds were recruited to take part in a study to examine perceptions about the programme's acceptability and usefulness. Interviews were taped and transcribed, and thematic analysis undertaken. Families talked positively about the approach of the EMPOWER health visitor with her emphasis on listening, partnership working and shared problem-solving. Parents particularly valued the use of a non-judgemental approach, which they felt had helped them to discuss openly, sensitive issues such as weight and diet. They identified a number of important benefits ranging from increased knowledge about the most appropriate types and amount of food to feed their toddler, to more far-reaching changes within the family as a whole, including modifications to their own diet and lifestyle. Programmes of this nature were perceived as more valuable than the standard help that is currently available. The EMPOWER programme appears to be both acceptable and valued by targeted parents and a potentially effective means of supporting high-risk families to prevent their children from developing obesity. An exploratory randomized controlled trial is now underway to ascertain the feasibility of conducting a definitive phase 3 trial. © 2010 Blackwell Publishing Ltd.

  8. The North Karelia lessons for prevention of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Tiina Laatikainen

    2007-06-01

    Full Text Available

    Background: As a result of the high cardiovascular disease (CVD rates in Finland in late 1960’s, which became a source of national concern, a major community based programme for CVD prevention called the North Karelia project was established. Aim: The aim of the project was to carry out a programme of comprehensive community based interventions to reduce coronary heart disease (CHD mortality and morbidity.

    Methods: Using lifestyle modification methods and strategies for environmental change the programme aimed to reduce three main risk factors: smoking, elevated blood cholesterol and blood pressure. Several intervention settings and strategies in the community were used.

    Results: Since the 1970’s the CHD mortality in North Karelia has declined by more than 80%. Major reductions have been seen across the main three cardiovascular risk factors. Among both men and women, total serum cholesterol levels within the population declined by almost 20% and systolic blood pressure by about 10%. Smoking among men decreased from 52% to 33%, while among women a slight increase in smoking prevalence was recorded.

    Conclusions: The North Karelia project has shown that a comprehensive, determined, theory-based community program can have a meaningful and positive effect on risk factors and lifestyles. Furthermore, these changes are associated with favorable changes in chronic disease rates and the health of the population.

  9. An evaluation of a public health practitioner registration programme: lessons learned for workforce development.

    Science.gov (United States)

    Rahman, Em; Wills, Jane

    2014-09-01

    This article explores the lessons learned for workforce development from an evaluation of a regional programme to support the assessment and registration of public health practitioners to the UK Public Health Register (UKPHR) in England. A summative and process evaluation of the public health practitioner programme in Wessex was adopted. Data collection was by an online survey of 32 public health practitioners in the Wessex area and semi-structured interviews with 53 practitioners, programme support, employers and system leaders. All survey respondents perceived regulation of the public health workforce as very important or important. Managers and system leaders saw a register of those fit to practise and able to define themselves as a public health practitioner as a necessary assurance of quality for the public. Yet, because registration is voluntary for practitioners, less value was currently placed on this than on completing a master's qualification. The local programme supports practitioners in the compilation of a retrospective portfolio of evidence that demonstrates fitness to practise; practitioners and managers stated that this does not support current and future learning needs or the needs of those working at a senior level. One of the main purposes of statutory regulation of professionals is to protect the public by an assurance of fitness to practise where there is a potential for harm. The widening role for public health practitioners without any regulation means that there is the risk of inappropriate interventions or erroneous advice. Regulators, policy makers and system leaders need to consider how they can support the development of the public health workforce to gain professional recognition at all levels of public health, including practitioners alongside specialists, and support a professional career framework for the public health system. © Royal Society for Public Health 2014.

  10. Accrediting the MD Programme in Sultan Qaboos University: Process, Earned Benefits, and Lessons Learned

    Directory of Open Access Journals (Sweden)

    Sulayma Albarwani

    2015-12-01

    Full Text Available The MD Programme of the College of Medicine and Health Sciences, Sultan Qaboos University, has been accredited recently. The College has been preparing for this event for more than ten years and wishes to share its experience with other regional medical colleges. The process of accreditation per se took less than three years to complete and most of the time was spent to prepare for the process; to build-up capacity in addition to implementing curricular reforms and other requirements that were needed to comply with accreditation standards. In the end of this exercise, the College has earned many benefits as well as learned some lessons. This article describes the most notable activities and events and discusses how the College responded to the challenges posed.

  11. Lessons from the evaluation of the UK's NHS R&D Implementation Methods Programme

    Directory of Open Access Journals (Sweden)

    Hanney Stephen R

    2007-02-01

    Full Text Available Abstract Background Concern about the effective use of research was a major factor behind the creation of the NHS R&D Programme in 1991. In 1994, an advisory group was established to identify research priorities in research implementation. The Implementation Methods Programme (IMP flowed from this, and its commissioning group funded 36 projects. In 2000 responsibility for the programme passed to the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D, which asked the Health Economics Research Group (HERG, Brunel University, to conduct an evaluation in 2002. By then most projects had been completed. This evaluation was intended to cover: the quality of outputs, lessons to be learnt about the communication strategy and the commissioning process, and the benefits from the projects. Methods We adopted a wide range of quantitative and qualitative methods. They included: documentary analysis, interviews with key actors, questionnaires to the funded lead researchers, questionnaires to potential users, and desk analysis. Results Quantitative assessment of outputs and dissemination revealed that the IMP funded useful research projects, some of which had considerable impact against the various categories in the HERG payback model, such as publications, further research, research training, impact on health policy, and clinical practice. Qualitative findings from interviews with advisory and commissioning group members indicated that when the IMP was established, implementation research was a relatively unexplored field. This was reflected in the understanding brought to their roles by members of the advisory and commissioning groups, in the way priorities for research were chosen and developed, and in how the research projects were commissioned. The ideological and methodological debates associated with these decisions have continued among those working in this field. The need for an effective communication strategy for the

  12. Healthwise South Africa: Cultural Adaptation of a School-Based Risk Prevention Programme

    Science.gov (United States)

    Wegner, L.; Flisher, A. J.; Caldwell, L. L.; Vergnani, T.; Smith, E. A.

    2008-01-01

    There is a need for effective prevention programmes aimed at reducing risk behaviour among South African adolescents. HealthWise South Africa is a school-based programme designed to reduce sexual and substance use risk behaviour, and promote positive use of leisure time among high-school learners (students). Based on successful programmes in the…

  13. Control of zoonoses in emergency situations: lessons learned during recent outbreaks (gaps and weaknesses of current zoonoses control programmes

    Directory of Open Access Journals (Sweden)

    Darem Tabbaa

    2008-12-01

    Full Text Available In emergency situations, domestic animals and wildlife are, like people, exposed to infectious diseases and environmental contaminants in the air, soil, water and food. They can suffer from acute and/or chronic diseases from such exposure. Often animals serve as disease reservoirs or early warning systems for the community in regard to the spread of zoonotic diseases. Over 100 years of experience have shown that animal and human health are closely related. During the past few years, emergent disease episodes have increased; nearly all have involved zoonotic agents. As there is no way to predict when or where the next important new zoonotic pathogen will emerge or what its ultimate importance might be, investigation at the first sign of emergence of a new zoonotic disease is particularly important. Today, in many emerging situations, different activities involving zoonotic disease control are at risk because of failed investigative infrastructures or financial constraints. Considering that zoonotic diseases have their own characteristics, their prevention and control require unique strategies, based more on fundamental and applied research than on traditional approaches. Such strategies require cooperation and coordination between animal and public health sectors and the involvement of other disciplines and experts such as epidemiologists, entomologists, environmentalists and climatologists. Lessons learned from the avian influenza pandemic threat, the Crimean-Congo haemorrhagic fever and rabies outbreaks are presented and the gaps and weakness of current control programmes are discussed.

  14. Monitoring and evaluation of strategic change programme implementation-Lessons from a case analysis.

    Science.gov (United States)

    Neumann, Jan; Robson, Andrew; Sloan, Diane

    2018-02-01

    This study considered the monitoring and evaluation of a large-scale and domestic and global strategic change programme implementation. It considers the necessary prerequisites to overcome challenges and barriers that prevent systematic and effective monitoring and evaluation to take place alongside its operationalisation. The work involves a case study based on a major industrial company from the energy sector. The change programme makes particular reference to changes in business models, business processes, organisation structures as well as Enterprise Resource Planning infrastructure. The case study focussed on the summative evaluation of the programme post-implementation. This assessment involved 25 semi-structured interviews with employees across a range of managerial strata capturing more than 65 roles within the change programme at both local and global levels. Data relating to their perception of evaluation effectiveness and shortcomings were analysed by means of template analysis. The study identifies responsibilities for executing an evaluation alongside various methods and tools that are appropriate, thereby focussing on the "Who" (roles, responsibility for particular activities) and "How" (methods and tools) rather than "What" to monitor and evaluate. The findings are presented generically so they offer new insights and transferability for practitioners involved in managing strategic change and its associated evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The cervical cancer prevention programme in Costa Rica

    Science.gov (United States)

    Rojas, Ileana Quirós

    2015-01-01

    Cervical and uterine cancer continues to be an important issue for women around the world, although neoplasia has the greatest demonstrated potential for prevention. Costa Rica has achieved important advances in the reduction of the incidence and mortality of these cancers since the last century. This is the result of a series of policies, programmes, and plans, not only at the level of the health care system, but also in other areas. Increased access for women to care in health centres, fundamentally at the primary level, has been vital, as has ensuring the quality of cytology readings and access to diagnosis and treatment for precursor lesions for in situ and invasive cancers. Despite all of these achievements, there are still challenges to be overcome, which are widespread in many countries in Latin America and the Caribbean. It is important to learn from the experiences of other countries in order to improve women’s health not only as a health objective, but also as an ethical imperative to promote the exercise of women’s rights to life and health. PMID:26557876

  16. The Simalelo Peer Education Programme for HIV prevention: a ...

    African Journals Online (AJOL)

    The aim of the project was to evaluate a peer education programme in Zambia run by local people in relation to changes in behaviours, the effects of the programme on the community and the dynamics of peer health promotion. A qualitative process evaluation using focus groups consisting of both participants in the peer ...

  17. A systematic review of education programmes to prevent concussion in rugby union.

    Science.gov (United States)

    Fraas, Michael R; Burchiel, Jessica

    2016-11-01

    There is a high incidence of concussion sustained by athletes participating in rugby union, many of which go unreported. A lack of sufficient knowledge about concussion injuries may explain athletes' failure to report. Several rugby union-playing countries have developed injury education and prevention programmes to address this issue. The aim of the current review was to systematically assess the content and level of evidence on concussion education/prevention programmes in rugby union and to make recommendations for the quality, strength, and consistency of this evidence. We searched PubMed, PsycInfo, MEDLINE, SPORTDiscuss, Webofscience, and conducted a manual search for articles. Ten articles were included for review. Of these, six focused on the BokSmart injury prevention programme in South Africa, two focused on the RugbySmart injury prevention programme in New Zealand, one was an analysis of prevention programmes, and one was a systematic review of rugby injury prevention strategies. Despite the initiative to develop concussion education and prevention programmes, there is little evidence to support the effectiveness of such programmes. There is evidence to support education of coaches and referees. In addition, there is scant evidence to suggest that education and rule changes may have the benefit of changing athlete behaviours resulting in a reduction in catastrophic injury.

  18. Evaluation of a Peer-Led Smoking Prevention Programme for Romanian Adolescents

    Science.gov (United States)

    Lotrean, L. M.; Dijk, F.; Mesters, I.; Ionut, C.; De Vries, H.

    2010-01-01

    The goal of this study was to assess the effects of a school-based smoking prevention programme that used both a video and peer-led discussion groups among Romanian junior high school students aged 13-14 years. The programme embraced the social influence approach and concentrated on enhancing self-efficacy and the acquisition of cigarette refusal…

  19. Effect of a prevention programme on the incidence of rugby injuries ...

    African Journals Online (AJOL)

    However, in practice the prevention programme did have a significantly positive effect on the incidence of intrinsic rugby injuries among 15- and 16-year-old schoolboys over a period of 2 years. Timely introduction of this programme during the off-season is advised. South African Journal of Sports Medicine Vol. 19 (2) 2007: ...

  20. Industry sponsored youth smoking prevention programme in Malaysia: a case study in duplicity

    OpenAIRE

    Assunta, M; Chapman, S

    2004-01-01

    Objective: To review tobacco company strategies of using youth smoking prevention programmes to counteract the Malaysian government's tobacco control legislation and efforts in conducting research on youth to market to them.

  1. Outputs and cost of HIV prevention programmes for truck drivers in Andhra Pradesh, India

    Directory of Open Access Journals (Sweden)

    Dandona Rakhi

    2009-05-01

    Full Text Available Abstract Background HIV prevention programmes for truck drivers form part of the HIV control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and use of resources. Methods Detailed cost and output data were collected from written records and interviews for 2005–2006 fiscal year using standardized methods at six sampled HIV prevention programmes for truck drivers in the Indian state of Andhra Pradesh. The total economic cost for these programmes was computed and the relation of unit cost of services per truck driver with programme scale was assessed using regression analysis. Results A total of 120,436 truck drivers were provided services by the six programmes of which 55.9% were long distance truck drivers. The annual economic cost of providing services to a truck driver varied between programmes from US$ 1.52 to 4.56 (mean US$ 2.49. There was an inverse relation between unit economic cost of serving a truck driver and scale of the programme (R2 = 0.63; p = 0.061. The variation between programmes in the average number of contacts made by the programme staff with truck drivers was 1.3 times versus 5.8 times for contacts by peer educators. Only 1.7% of the truck drivers were referred by the programmes for counseling and HIV testing. Conclusion These data provide information for further planning of HIV prevention programmes for truck drivers and estimating the resources needed for such programmes. The findings suggest the need to strengthen the role of peer educators and increase referral of truck drivers for HIV testing.

  2. Abstinence And Faithfulness Programmes For Prevention Of Hiv ...

    African Journals Online (AJOL)

    Questions have been raised on whether abstinence and faithfulness programs work, particularly for young people. Research is needed for evidence-based documentation of the effectiveness or otherwise of abstinence and faithfulness programmes in young people. This review was conducted in three stages: identification ...

  3. Trialling a shaken baby syndrome prevention programme in the Auckland District Health Board.

    Science.gov (United States)

    Kelly, Patrick; Wilson, Kati; Mowjood, Aqeela; Friedman, Joshua; Reed, Peter

    2016-02-19

    To describe and evaluate a shaken baby prevention programme trialled in the Auckland District Health Board from January 2010, to December 2011. Development and implementation of the programme, telephone survey of a sample of caregivers and written survey of a sample of providers. At least 2,592 caregivers received the trial programme. 150 (6%) were surveyed by telephone a median of 6 weeks later. 128 (85%) remembered at least one key message, unprompted; most commonly "It's OK to walk away" (94/150, 63%). When asked, 92% had made a plan for what to do when frustrated and 63% had shared the information with others. Only 98/150 (65%) watched the programme DVD. Many said they already knew about the risks of shaking a baby, but still found the programme highly relevant. Thirty-one nurses were surveyed. There was a high degree of agreement that the programme was relevant. Barriers to programme delivery included time, workload and the documentation required. A shaken baby prevention programme adapted to New Zealand can be introduced in a District Health Board and is acceptable to caregivers and health professionals. Further research is needed to evaluate the content, mode of delivery and effectiveness of this programme.

  4. Evaluation of RugbySmart: a rugby union community injury prevention programme.

    Science.gov (United States)

    Gianotti, Simon M; Quarrie, Ken L; Hume, Patria A

    2009-05-01

    RugbySmart, a rugby union injury prevention programme, was launched in New Zealand in 2001. It was compulsory for all coaches and referees to complete RugbySmart requirements annually in order to continue coaching or refereeing. After 5 years of implementation the programme partners, Accident Compensation Corporation and New Zealand Rugby Union, evaluated RugbySmart to determine its effectiveness in reducing injuries. The purpose was to evaluate the effect of RugbySmart on reducing injury rates per 100,000 players and resulting injury prevention behaviours. The RugbySmart programme was associated with a decrease in injury claims per 100,000 players in most areas the programme targeted; the programme had negligible impact on non-targeted injury sites. The decrease in injury claims numbers was supported by results from the player behaviour surveys pre- and post-RugbySmart. There was an increase in safe behaviour in the contact situations of tackle, scrum and ruck technique.

  5. Using the intervention mapping protocol to develop a maintenance programme for the SLIMMER diabetes prevention intervention.

    Science.gov (United States)

    Elsman, Ellen B M; Leerlooijer, Joanne N; Ter Beek, Josien; Duijzer, Geerke; Jansen, Sophia C; Hiddink, Gerrit J; Feskens, Edith J M; Haveman-Nies, Annemien

    2014-10-27

    Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a maintenance programme for the extensive SLIMMER intervention, an existing diabetes prevention intervention for high-risk individuals, implemented in a real-life setting in the Netherlands. The maintenance programme was developed using the Intervention Mapping protocol. Programme development was informed by a literature study supplemented by various focus group discussions and feedback from implementers of the extensive SLIMMER intervention. The maintenance programme was designed to sustain a healthy diet and physical activity pattern by targeting knowledge, attitudes, subjective norms and perceived behavioural control of the SLIMMER participants. Practical applications were clustered into nine programme components, including sports clinics at local sports clubs, a concluding meeting with the physiotherapist and dietician, and a return session with the physiotherapist, dietician and physical activity group. Manuals were developed for the implementers and included a detailed time table and step-by-step instructions on how to implement the maintenance programme. The Intervention Mapping protocol provided a useful framework to systematically plan a maintenance programme for the extensive SLIMMER intervention. The study showed that planning a maintenance programme can build on existing implementation structures of the extensive programme. Future research is needed to determine to what extent the maintenance programme contributes to sustained effects in participants of lifestyle interventions.

  6. Preventive medical programmes to personnel exposed to ionizing radiation

    International Nuclear Information System (INIS)

    Estrada F, E.

    1996-01-01

    The increasing use of ionizing radiation in the medical field as well as in industry and research grants has special importance to the security aspects related to the individual as well as his surroundings, reason for which the implementation of effective Occupational Radiation Protection Programmes constitutes a priority. Presently, in Guatemala, an Occupational Medicine Programme, directed to the Radiosanitary watch over of occupationally exposed personnel does not exist. It is the goal in this project to organize and establish such programme, based on protective and training actions focused toward the employee as the main entity, his specific activities and his work surroundings. Medical watch over together with Radiation Protection will permit the reduction of the occurrence probability of accidents or incidents, as well as the limitation of stochastic effects to the undermost values. The application scope of the present project is, in the first place, directed to the occupationally exposed personnel of the Direcci[n General de Energ[a Nuclear, as regulatory entity of these activities, and afterwards, its application in the different institutions which work with ionizing radiations. All the previously exposed is based on the Nuclear Legislation prevailing in Guatemala as well as the recommendations of international organizations. (author)

  7. Programmes for the prevention of parent-to-child transmission of HIV in Papua New Guinea: Health system challenges and opportunities.

    Science.gov (United States)

    Tynan, Anna; Vallely, Lisa; Kupul, Martha; Neo, Ruthy; Fiya, Voletta; Worth, Heather; Kariwiga, Grace; Mola, Glen D L; Kaldor, John; Kelly-Hanku, Angela

    2017-09-27

    Prevention of parent-to-child transmission (PPTCT) of HIV is a highly complex package of interventions, which spans services in both maternal and child health programmes. In Papua New Guinea (PNG), a commitment to ensure that all pregnant women and their partners have access to the full range of PPTCT interventions exists; however, efforts to increase access and utilisation of PPTCT remain far from optimal. The aim of this paper is to examine health care worker (HCW) perception of health system factors impacting on the performance of PPTCT programmes. Sixteen interviews were undertaken with HCWs involved in the PPTCT programme. Application of the WHO 6 building blocks of a health system was applied, and further thematic analysis was conducted on the data with assistance from the analysis software NVivo. Broken equipment, problems with access to medication and supplies, and poorly supported workforce were reported as barriers for implementing a successful PPTCT programme. The absence of central coordination of this complex, multistaged programme was also recognised as a key issue. The study findings highlight an important need for investment in appropriately trained and supported HCWs and integration of services at each stage of the PPTCT programme. Lessons from the PPTCT experience in PNG may inform policy discussions and considerations in other similar contexts. Copyright © 2017 John Wiley & Sons, Ltd.

  8. [Questionnaire for the evaluation of drug preventive intervention programmes at the workplace (FEBSI)].

    Science.gov (United States)

    Loeber, S; Mann, K; Croissant, B

    2009-03-01

    At present, only a few studies have assessed the efficacy of intervention programmes that focus on drug prevention at the workplace, and there is only little information available with respect to the development and evaluation of suitable instruments for the evaluation of such prevention programs. Questionnaire procedures, nevertheless, seem to be basically suitable. We developed and evaluated the questionnaire for the evaluation of drug preventive intervention programs at the workplace (FEBSI) to provide a suitable instrument to assess the effectiveness of programmes that focus on drug prevention at the workplace. We assessed and analysed data for the evaluation of this questionnaire in the context of a prevention programme in two large industrial companies. We found a three-factor solution with satisfying reliability scores for each factor. The extracted factors of the questionnaire reflect the following areas: consequences of substance use at work, compliance with employment agreements, and knowledge and behaviour. Programme participants could be reliably distinguished from non-participants by using the FEBSI. So far, the questionnaire seems to be a suitable and reliable instrument for the evaluation of drug prevention programmes.

  9. How effective are exercise-based injury prevention programmes for soccer players?

    NARCIS (Netherlands)

    Beijsterveldt, A.M.C. van; Horst, N. van der; Port, I.G.L. van de; Backx, F.J.G.

    2013-01-01

    The incidence of soccer (football) injuries is among the highest in sports. Despite this high rate, insufficient evidence is available on the efficacy of preventive training programmes on injury incidence. Objective To systematically study the evidence on preventive exercise-based training

  10. The prevention of overweight and obesity in children and adolescents : a review of interventions and programmes

    NARCIS (Netherlands)

    Doak, C M; Visscher, T L S; Renders, C M; Seidell, J C

    Overweight and obesity are serious, large-scale, global, public health concerns requiring population-based childhood overweight and obesity prevention. The overall objective of this review is to identify aspects of successful childhood overweight prevention programmes. This objective will be met by

  11. The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes.

    NARCIS (Netherlands)

    Doak, C.M.; Visscher, T.L.S.; Renders, C.M.; Seidell, J.C.

    2006-01-01

    Overweight and obesity are serious, large-scale, global, public health concerns requiring population-based childhood overweight and obesity prevention. The overall objective of this review is to identify aspects of successful childhood overweight prevention programmes. This objective will be met by

  12. International institutions, global health initiatives and the challenge of sustainability: lessons from the Brazilian AIDS programme.

    Science.gov (United States)

    Le Loup, G; Fleury, S; Camargo, K; Larouzé, B

    2010-01-01

    The sustainability of successful public health programmes remains a challenge in low and middle income settings. These programmes are often subjected to mobilization-demobilization cycle. Indeed, political and organizational factors are of major importance to ensure this sustainability. The cooperation between the World Bank and the Brazilian AIDS programme highlights the role of international institutions and global health initiatives (GHI), not only to scale up programmes but also to guarantee their stability and sustainability, at a time when advocacy is diminishing and vertical programmes are integrated within health systems. This role is critical at the local level, particularly when economic crisis may hamper the future of public health programmes. Political and organizational evolution should be monitored and warnings should trigger interventions of GHI before the decline of these programmes.

  13. Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.

    Science.gov (United States)

    Soban, Lynn M; Kim, Linda; Yuan, Anita H; Miltner, Rebecca S

    2017-09-01

    To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  14. Effects of a suicide prevention programme for hospitalised patients with mental illness in South Korea.

    Science.gov (United States)

    Jun, Won Hee; Lee, Eun Ju; Park, Jeong Soon

    2014-07-01

    To investigate the effects of a suicide prevention programme on the levels of depression, self-esteem, suicidal ideation and spirituality in patients with mental illness. Instances of suicide have significant correlations with depression, low self-esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self-esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness. The study was a quasi-experimental study with a nonequivalent control group, nonsynchronised design. The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively. The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital. The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self-esteem and spirituality between the groups. The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation. Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital. © 2013 John Wiley

  15. A cost-outcome approach to pre and post-implementation of national sports injury prevention programmes.

    Science.gov (United States)

    Gianotti, Simon; Hume, Patria A

    2007-12-01

    In New Zealand (NZ), the Accident Compensation Corporation (ACC) has developed a pre and post-implementation cost-outcome formulae for sport injury prevention to provide information regarding the success of a prevention programme. The ACC provides for the cost of all personal injuries in NZ and invests in prevention programmes to offset 1.6 million annual claims that cost $NZD 1.9 billion. The ACC invests in nine national community sport injury prevention programmes that represent 40% of sport claims and costs. Pre-implementation is used to determine the decision whether to invest in implementation and to determine the level of such investment for the injury prevention programme. Post-implementation is calculated two ways: unadjusted, assuming ceteris paribus; and adjusted assuming no prevention programme was in place. Post-implementation formulae provide a return on investment (ROI) for each dollar invested in the programme and cost-savings. The cost-outcome formulae approach allows ACC to manage expectations of the prevention programme as well as when it will provide a ROI, allowing it to take a long-term view for investment in sport injury prevention. Originally developed for its sport injury prevention programmes, the cost-outcome formulae have now been applied to the other prevention programmes ACC invests in such as home, road and workplace injury prevention.

  16. Embedding operational research into national disease control programme: lessons from 10 years of experience in Indonesia

    Directory of Open Access Journals (Sweden)

    Yodi Mahendradhata

    2014-10-01

    Full Text Available There is growing recognition that operational research (OR should be embedded into national disease control programmes. However, much of the current OR capacity building schemes are still predominantly driven by international agencies with limited integration into national disease control programmes. We demonstrated that it is possible to achieve a more sustainable capacity building effort across the country by establishing an OR group within the national tuberculosis (TB control programme in Indonesia. Key challenges identified include long-term financial support, limited number of scientific publications, and difficulties in documenting impact on programmatic performance. External evaluation has expressed concerns in regard to utilisation of OR in policy making. Efforts to address this concern have been introduced recently and led to indications of increased utilisation of research evidence in policy making by the national TB control programme. Embedding OR in national disease control programmes is key in establishing an evidence-based disease control programme.

  17. Analysis of Efficiency of Isoniazid Preventive Therapy Programme ...

    African Journals Online (AJOL)

    The most highly indicated causes of death were gastroenteritis (18.75%), cryptococcal meningitis (17.5%) and pneumonia (16.25%). ... and the lack of holistic care for people living with Human Immunodeficiency Virus led to opportunistic infections leading to mortality among patients receiving isoniazid preventive therapy.

  18. Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India

    Science.gov (United States)

    Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca

    2013-01-01

    Abstract Problem Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. Approach In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. Local setting In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. Relevant changes By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. Lessons learnt A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines. PMID:23599555

  19. Determinants of willingness to pay taxes for a community-based prevention programme.

    Science.gov (United States)

    Lindholm, L A; Rosén, M E; Stenbeck, M E

    1997-06-01

    Prevention can reduce the risk of disease, but has other consequences as well. Willingness-to-pay (WTP) is one method to analyse these multi-dimensional consequences, if the stated WTP is assumed to be a function of all the expected positive and negative effects perceived. An interview study of a community-based cardiovascular disease prevention programme in northern Sweden shows that expectations regarding reduced mortality in the community and future savings in public health care spending increase the perceived value of the programme. Among personal benefits, decreased disease risk was not positively associated with WTP, while a low level of anxiety was.

  20. Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.

    Science.gov (United States)

    Sranacharoenpong, Kitti; Hanning, Rhona M

    2011-10-01

    The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs. Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable. Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings. Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the

  1. Application of a child abuse prevention programme in an educational context

    Directory of Open Access Journals (Sweden)

    Juan M. Moreno-Manso

    2014-10-01

    Full Text Available This study analyses the effectiveness of a child abuse prevention programme in an educational context. The proposal for action is based on the use of stories as an instrument of primary prevention. The programme aims to improve a child's capacity to face potentially threatening situations and was applied in 10 primary schools of Extremadura (Spain to 317 pupils aged 9 and 10 years old. There were 12 sessions whose aim was for the children to gain an awareness of abuse, identify situations of abuse and learn strategies to face them. This was done through the use of tutorials and by linking the programme to the aims of the pupils' educational stage. The evaluation of the programme shows that the pupils in the experimental group resolved the situations with increasing skill, confidence and determination; and that they could see more clearly where to look for help in terms of protection measures. The tutors evaluated the programme positively, considering the contents useful for prevention.

  2. [Characteristics of elderly leaders volunteering to participate in a fall prevention programme].

    Science.gov (United States)

    Shimanuki, Hideki; Ueki, Shouzoh; Ito, Tunehisa; Honda, Haruhiko; Takato, Jinro; Kasai, Toshiyuki; Sakamoto, Yuzuru; Niino, Naoakira; Haga, Hiroshi

    2005-09-01

    This study was conducted to assess characteristics of elderly leaders volunteering to participate in a fall prevention programme. We surveyed 1,503 individuals (75 elderly leaders volunteering to participate in a fall prevention programme and 1,428 non-leader elderly) among the elderly population living in a rural community, Miyagi Prefecture. Subjects were aged 70-84 years. The questionnaire covered socio-demographic factors, as well as physical, psychology and social variables. To analyze the characteristics of the elderly leaders volunteering to participate in this programme, the relationships of socio-demographic, physical, psychology and social factors to whether the elderly were leaders in the programme were analyzed using logistic regression. As a result of multiple logistic regression analysis, the characteristics of elderly leaders volunteering to participate in the fall prevention programme were as follows; 1) being male (OR = 0.25, 95%CI 0.14-0.44); 2) young age (OR=0.43, 95%CI 0.25-0.73); 3) having a high intellectual activity (OR = 2.72, 95%CI 1.65-4.48); 4) being well satisfied with their health (OR = 1.45, 95%CI 1.02-2.07), and 5) having a high IKIGAI (OR = 1.06, 95%CI 1.01-1.13). Only elderly individuals capable of high-level intellectual activities can fill the roles of elderly volunteer group leaders discussed in this study.

  3. Prevention of violence against women and girls: lessons from practice.

    Science.gov (United States)

    Michau, Lori; Horn, Jessica; Bank, Amy; Dutt, Mallika; Zimmerman, Cathy

    2015-04-25

    This Series paper describes programming to prevent violence against women and girls, and emphasises the importance of systematic, sustained programming across the social ecology (ie, the delicate equilibrium of interacting social, institutional, cultural, and political contexts of people's lives) to transform gender-power inequalities. Effective prevention policy and programming is founded on five core principles: first, analysis and actions to prevent violence across the social ecology (individual, interpersonal, community, and societal); second, intervention designs based on an intersectional gender-power analysis; third, theory-informed models developed on the basis of evidence; fourth, sustained investment in multisector interventions; and finally, aspirational programming that promotes personal and collective thought, and enables activism on women's and girls' rights to violence-free lives. Prevention programming of the future will depend on all of us having a vision of, and a commitment to, gender equality to make violence-free lives for women and girls a reality. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Status of fuel transmutation programmes in Japan and France. Lessons drawn from results

    Energy Technology Data Exchange (ETDEWEB)

    Arai, Y.; Pillon, S

    2004-07-01

    France and Japan are currently developing a comprehensive and complementary programme focusing on the transmutation of minor actinides (MA: Np, Am, Cm) and fission products (FP: Tc, I, Cs) in fast breeder reactors (FBR). A summary of current MA-fuel transmutation programmes in France and Japan is provided in this paper, covering objectives, results and perspectives, with emphasis placed on the complementary effort of the two countries. (authors)

  5. Promoting widening participation and higher education: Lessons from a four year intervention programme

    OpenAIRE

    Pinheiro-Torres, C; Portman-Smith, C

    2008-01-01

    Since the labour government came to power in 1997, a major policy has been to increase the participation rates of those entering higher education, particularly those from lower-socio economic backgrounds. Just over 10 years later, little has changed. The Brunel Urban Scholars programme is a 4 year long intervention programme for students from lower socio-economic backgrounds aged 12-16. It aims, through university style teaching, emersion in a university environment, and regular interaction w...

  6. Lessons from the evolution of a CBR programme for people affected by leprosy in Northern Nigeria.

    Science.gov (United States)

    Ebenso, Bassey; Idah, Michael; Anyor, Terver; Opakunmi, Femi

    2010-12-01

    This paper reviews the 13-year evolution of the social economic activities in Northern Nigeria from a welfare-oriented to a community-centred programme for people affected by leprosy. The review relied on the analysis of policy and strategy documents, programme guidelines and statistical and evaluation reports. Findings revealed that the transformation among other things, demanded formulation of new programme policies and guidelines; and staff training in CBR principles and practice. Findings also showed that adopting CBR principles and community development projects can stimulate improvements in living conditions, self-esteem and acceptance of people affected by leprosy into the community. Regardless of becoming a more inclusive and participatory programme wherein people affected by leprosy contribute to programme implementation and evaluation; groups affected by leprosy remain economically dependent on the programme and partnership mobilisation is weak. This explains why the priorities for sustaining the processes and impacts generated through CBR in northern Nigeria include: i) empowering groups to access mainline services; ii) working through partners to implement CBR and attract extra funding/ownership of interventions, and iii) promoting human rights of people affected by leprosy and working for a barrier free environment. In the absence of an agreeable understanding and method of assessing sustainability in CBR, we recommend the field-testing of a proposal for evaluating sustainability, to determine its utility in different contexts. Such field-tests have the potential of influencing policy and practice in the future.

  7. The Prevent programme: an ethical dilemma for teachers as well as psychiatrists.

    Science.gov (United States)

    Reed, Stephanie

    2016-04-01

    The UK government's Prevent programme affects professionals and the people who rely on their services across the public sector, particularly now that workers are legally bound to report their concerns about individuals they believe to be at risk of radicalisation. This article discusses the risks that the strategy presents to the work of teachers and the bonds of trusts between staff and students.

  8. Romantic Relationships: An Important Context for HIV/STI and Pregnancy Prevention Programmes with Young People

    Science.gov (United States)

    Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia

    2014-01-01

    Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…

  9. Parental Support for Teenage Pregnancy Prevention Programmes in South Carolina Public Middle Schools

    Science.gov (United States)

    Rose, India; Prince, Mary; Flynn, Shannon; Kershner, Sarah; Taylor, Doug

    2014-01-01

    Teenage pregnancy is a major public health issue in the USA; this is especially true in the state of South Carolina (SC). Research shows that well developed, good-quality teenage pregnancy prevention (TPP) programmes can be effective in modifying young people's sexual behaviour. While several quantitative studies have examined parents' perceptions…

  10. HIV prevention policy and programme planning: What can mathematical modelling contribute?

    NARCIS (Netherlands)

    Hankins, C.A.

    2014-01-01

    This thesis explores the potential contribution of mathematical modelling to informed decision-making on policy and programme planning for novel HIV prevention tools. Its hypothesis is that, under certain conditions, modelling results can be a useful addition to the evidence and other factors that

  11. Effect of a mother-to-child HIV prevention programme on infant ...

    African Journals Online (AJOL)

    Seventy randomly selected caregivers with young children in the survey; m-depth structured interviews with 11 nutrition counsellors and 11 mothers enrolled in the programme. Results. Caregivers have good knowledge of the spread and prevention of HIV. A majority knew that breast-feeding can transmit lllV but 90% stated ...

  12. programme

    African Journals Online (AJOL)

    Aid for AIDS (AfA) is a disease management programme (DIVIPI available to beneficiaries and employees of contracted medical funds and ... the challenges alluded to in the first article, including late enrolment and the measurement of survival, especially in patients with ... I the HIV prevalence and incidence (new infections].

  13. Tobacco prevention advertising: lessons from the commercial world.

    Science.gov (United States)

    Rust, L

    1999-01-01

    This paper presents observations on how commercial TV advertising usually works with young people, discusses the special circumstances using advertising as a smoking prevention tool, and suggests research to guide future efforts. It is important for prevention efforts to recognize that in everyday life many young people are not systematic decision-makers; their intentions are extremely volatile and context-dependent, and they are highly spontaneous. So trying to change their smoking risk status with a TV ad that affects their conscious intentions toward smoking may not impact how they react when someone offers to share a cigarette with them behind the garage--even if it affects how they answer a "Do you think you'll ever take up smoking?" question right after seeing the ad. Advertising is good at getting consumers to focus on products--either in creating new brands, or in keeping familiar brands foremost in mind. Advertising is also good at providing models of concrete behaviors for people to imitate. Prevention efforts need to use advertising for what it is good at, and by and large this means being very concrete. Ultimately, for research to contribute to better prevention advertising, it needs to give the people who actually create that advertising a set of vivid, compelling images of who it is they are trying to reach and what it is that moves them. Some research methods which, when done properly, can serve this function are focus groups, anthropological studies, psychographic segmentations, moment-by-moment observational measurement, improved copy-testing methodology, and grounded-theory development.

  14. How effective are exercise-based injury prevention programmes for soccer players? : A systematic review.

    Science.gov (United States)

    van Beijsterveldt, A M C; van der Horst, Nick; van de Port, Ingrid G L; Backx, Frank J G

    2013-04-01

    The incidence of soccer (football) injuries is among the highest in sports. Despite this high rate, insufficient evidence is available on the efficacy of preventive training programmes on injury incidence. To systematically study the evidence on preventive exercise-based training programmes to reduce the incidence of injuries in soccer. The databases EMBASE/MEDLINE, PubMed, CINAHL, Cochrane Central Register of controlled trials, PEDro and SPORTDiscus™ were searched for relevant articles, from inception until 20 December 2011. The methodological quality of the included studies was assessed using the PEDro scale. The inclusion criteria for this review were (1) randomized controlled trials or controlled clinical trials; (2) primary outcome of the study is the number of soccer injuries and/or injury incidence; (3) intervention focusing on a preventive training programme, including a set of exercises aimed at improving strength, coordination, flexibility or agility; and (4) study sample of soccer players (no restrictions as to level of play, age or sex). The exclusion criteria were: (1) the article was not available as full text; (2) the article was not published in English, German or Dutch; and (3) the trial and/or training programme relates only to specific injuries and/or specific joints. To compare the effects of the different interventions, we calculated the incidence risk ratio (IRR) for each study. Six studies involving a total of 6,099 participants met the inclusion criteria. The results of the included studies were contradictory. Two of the six studies (one of high and one of moderate quality) reported a statistical significant reduction in terms of their primary outcome, i.e. injuries overall. Four of the six studies described an overall preventive effect (IRRbased programmes to prevent soccer injuries. Some reasons for the contradictory findings could be different study samples (in terms of sex and soccer type) in the included studies, differences between

  15. FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide—a narrative review

    Science.gov (United States)

    Bizzini, Mario; Dvorak, Jiri

    2015-01-01

    In 2009, FIFA promoted and disseminated the FIFA 11+ injury prevention programme worldwide. Developed and studied by the FIFA Medical Assessment and Research Centre (F-MARC), the programme was based on a randomised controlled study and one countrywide campaign in amateur football that significantly reduced injuries and healthcare costs. Since the FIFA 11+ launch, key publications have confirmed the preventive effects of the programme and have evaluated its performance effects in female as well as male amateur football players. Furthermore, implementation strategies of this prevention programme have also been studied. The goal of this narrative review was to summarise the available scientific evidence about the FIFA 11+ programme. While FIFA continues to disseminate and implement FIFA 11+ among its Member Associations, adaptations of the injury prevention programme for children and referees have been developed and are currently being evaluated. PMID:25878073

  16. Prevention of non-contact anterior cruciate ligament injuries in sports. Part II: systematic review of the effectiveness of prevention programmes in male athletes.

    Science.gov (United States)

    Alentorn-Geli, Eduard; Mendiguchía, Jurdan; Samuelsson, Kristian; Musahl, Volker; Karlsson, Jon; Cugat, Ramon; Myer, Gregory D

    2014-01-01

    To synthesize the results of systematic literature review focused on the effectiveness of anterior cruciate ligament (ACL) injury prevention programmes in male athletes. All abstracts and articles of potential interest identified through the systematic literature search were reviewed in detail to determine on inclusion status. Information regarding prevention programmes to reduce ACL injuries or to modify risk factors for ACL injuries in male athletes was systematically extracted and included intervention and study design, characteristics of participants, sport and level of competition, characteristics of prevention programmes, results, and conclusions. All studies were evaluated for methodological quality to assess the risk of bias. The principal findings of this systematic review are as follows: (1) most of the studies applied prevention programmes that utilized risk factors as outcomes of interest as opposed to ACL injury incidence (5 and 2 studies, respectively); (2) the effectiveness of prevention programmes to reduce ACL injuries in male athletes is equivocal (1 in favour, 1 against) and only refers to soccer players; (3) the effectiveness of prevention programmes to modify risk factors for ACL injuries in male athletes is controversial (2 in favour, 3 against) and outcome data are limited to cutting manoeuvres. Data regarding the effectiveness of prevention programmes to reduce ACL injuries or to modify risk factors for ACL injuries in male athletes are scarce and not conclusive. Future research to better determine the most effective approaches to optimize the effectiveness of prevention programmes targeted to reduce ACL injuries in male athletes is warranted.

  17. A parenting programme to prevent abuse of adolescents in South Africa: study protocol for a randomized controlled trial

    OpenAIRE

    Cluver, L; Meinck, F; Shenderovich, Y; Ward, CL; Herrero Romero, R; Lombard, C; Doubt, JS; Steinert, J; Catanho, R; Wittesaele, C; DeStone, S; Salah, N; Mpimilashe, P; Lachman, J; Loening, H

    2016-01-01

    Background An estimated one billion children experience child abuse each year, with the highest rates in low- and middle-income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence-prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting and reduce adolescent behavioural problems. This trial aim...

  18. Developing a culturally tailored stroke prevention walking programme for Korean immigrant seniors: a focus group study.

    Science.gov (United States)

    Choi, Sarah E; Kwon, Ivy; Chang, Emiley; Araiza, Daniel; Thorpe, Carol Lee; Sarkisian, Catherine A

    2016-12-01

    To gain better understanding of (i) beliefs and knowledge about stroke; (ii) attitudes about walking for stroke prevention; and (iii) barriers and facilitators to walking among Korean seniors for the cultural tailoring of a stroke prevention walking programme. Physical inactivity is a major risk factor for stroke. Korean immigrant seniors are one of the most sedentary ethnic groups in the United States. An explorative study using focus group data. Twenty-nine Korean immigrant seniors (64-90 years of age) who had been told by a doctor at least once that their blood pressure was elevated participated in 3 focus groups. Each focus group consisted of 8-11 participants. Focus group audiotapes were transcribed and analysed using standard content analysis methods. Participants identified physical and psychological imbalances (e.g. too much work and stress) as the primary causes of stroke. Restoring 'balance' was identified as a powerful means of stroke prevention. A subset of participants expressed that prevention may be beyond human control. Overall, participants acknowledged the importance of walking for stroke prevention, but described barriers such as lack of personal motivation and unsafe environment. Many participants believed that providing opportunities for socialisation while walking and combining walking with health information sessions would facilitate participation in and maintenance of a walking programme. Korean immigrant seniors believe strongly that imbalance is a primary cause of stroke. Restoring balance as a way to prevent stroke is culturally special among Koreans and provides a conceptual base in culturally tailoring our stroke prevention walking intervention for Korean immigrant seniors. A stroke prevention walking programme for Korean immigrant seniors may have greater impact by addressing beliefs about stroke causes and prevention such as physical and psychological imbalances and the importance of maintaining emotional well-being. © 2016 John

  19. Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

    Science.gov (United States)

    Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

    2015-01-01

    Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

  20. Preventing anxiety and depression in adolescents: A randomised controlled trial of two school based Internet-delivered cognitive behavioural therapy programmes

    Directory of Open Access Journals (Sweden)

    Nora Wong

    2014-04-01

    Full Text Available The aims of the current study were to 1 establish the efficacy of two Internet-based prevention programmes to reduce anxiety and depressive symptoms in adolescents; and 2 investigate the distribution of psychological symptoms in a large sample of Australian adolescents prior to the implementation of the intervention. A cluster randomised controlled trial was conducted with 976 Year 9–10 students from twelve Australian secondary schools in 2009. Four schools were randomly allocated to the Anxiety Internet-based prevention programme (n = 372, five schools to the Depression Internet-based prevention programme (n = 380 and three to their usual health classes (n = 224. The Thiswayup Schools for Anxiety and Depression prevention courses were presented over the Internet and consist of 6–7 evidence-based, curriculum consistent lessons to improve the ability to manage anxiety and depressive symptoms. Participants were assessed at baseline and post-intervention. Data analysis was constrained by both study attrition and data corruption. Thus post-intervention data were only available for 265/976 students. Compared to the control group, students in the depression intervention group showed a significant improvement in anxiety and depressive symptoms at the end of the course, whilst students in the anxiety intervention demonstrated a reduction in symptoms of anxiety. No significant differences were found in psychological distress. The Thiswayup Schools Depression and Anxiety interventions appear to reduce anxiety and depressive symptoms in adolescents using a curriculum based, blended online and offline cognitive behavioural therapy programme that was implemented by classroom teachers. Given the study limitations, particularly the loss of post-intervention data, these findings can only be considered preliminary and need to be replicated in future research.

  1. Pesticide leaching through sandy and loamy fields – Long-term lessons learnt from the Danish Pesticide Leaching Assessment Programme

    International Nuclear Information System (INIS)

    Rosenbom, Annette E.; Olsen, Preben; Plauborg, Finn; Grant, Ruth; Juhler, René K.; Brüsch, Walter; Kjær, Jeanne

    2015-01-01

    The European Union authorization procedure for pesticides includes an assessment of the leaching risk posed by pesticides and their degradation products (DP) with the aim of avoiding any unacceptable influence on groundwater. Twelve-year's results of the Danish Pesticide Leaching Assessment Programme reveal shortcomings to the procedure by having assessed leaching into groundwater of 43 pesticides applied in accordance with current regulations on agricultural fields, and 47 of their DP. Three types of leaching scenario were not fully captured by the procedure: long-term leaching of DP of pesticides applied on potato crops cultivated in sand, leaching of strongly sorbing pesticides after autumn application on loam, and leaching of various pesticides and their DP following early summer application on loam. Rapid preferential transport that bypasses the retardation of the plow layer primarily in autumn, but also during early summer, seems to dominate leaching in a number of those scenarios. - Highlights: • Field-results reveal shortcomings in the EU authorization procedure for pesticides. • The plough layer can be bypassed via preferential transport in e.g. wormholes. • Pesticides properties are decisive for leaching pattern on the sandy fields. • The hydrogeological settings control the leaching patterns on the loamy fields. • Pesticide detection frequency seems to be independent of the month of the year. - Long-term lessons learnt from the Danish Pesticide Leaching Assessment Programme reveals shortcomings in the European Union authorization procedure for pesticides

  2. Industry sponsored youth smoking prevention programme in Malaysia: a case study in duplicity.

    Science.gov (United States)

    Assunta, M; Chapman, S

    2004-12-01

    To review tobacco company strategies of using youth smoking prevention programmes to counteract the Malaysian government's tobacco control legislation and efforts in conducting research on youth to market to them. Systematic keyword and opportunistic website searches of formerly private internal industry documents. Search terms included Malay, cmtm, jaycees, YAS, and direct marketing; 195 relevant documents were identified for this paper. Industry internal documents reveal that youth anti-smoking programmes were launched to offset the government's tobacco control legislation. The programme was seen as a strategy to lobby key politicians and bureaucrats for support in preventing the passage of legislation. However, the industry continued to conduct research on youth, targeted them in marketing, and considered the teenage market vital for its survival. Promotional activities targeting youth were also carried out such as sports, notably football and motor racing, and entertainment events and cash prizes. Small, affordable packs of cigarettes were crucial to reach new smokers. The tobacco industry in Malaysia engaged in duplicitous conduct in regard to youth. By buying into the youth smoking issue it sought to move higher on the moral playing field and strengthen its relationship with government, while at the same time continuing to market to youth. There is no evidence that industry youth smoking prevention programmes were effective in reducing smoking; however, they were effective in diluting the government's tobacco control legislation.

  3. What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes

    Science.gov (United States)

    Finch, Caroline F; Doyle, Tim LA; Dempsey, Alasdair R; Elliott, Bruce C; Twomey, Dara M; White, Peta E; Diamantopoulou, Kathy; Young, Warren; Lloyd, David G

    2014-01-01

    Background Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future. PMID:24047571

  4. Establishing an Online HIV Peer Helping Programme: A Review of Process Challenges and Lessons Learned

    Science.gov (United States)

    Harris, Gregory E.; Corcoran, Valerie; Myles, Adam; Lundrigan, Philip; White, Robert; Greidanus, Elaine; Savage, Stephanie L.; Pope, Leslie; McDonald, James; Yetman, Gerard

    2015-01-01

    Background: Online peer support can be a valuable approach to helping people living with HIV, especially in regions with large rural populations and relatively centralised HIV services. Design: This paper focuses on a community-university partnership aimed at developing an online peer support programme in the Canadian province of Newfoundland and…

  5. Injury prevention and safety promotion course in a Russian Master of Public Health programme.

    Science.gov (United States)

    Kudryavtsev, Alexander V; Nilssen, Odd; Sumarokov, Yury; Ytterstad, Børge

    2012-01-01

    The Global Burden of Disease Studies describe and emphasise injury as a major and increasing component in the panorama of global ill health. Russia has the one of the highest injury rates in Europe. When a Master in Public Health programme was planned and started in 2007 in Arkhangelsk, Russia, under the auspices of University of Tromsø, Norway, a course on Injury Prevention and Safety Promotion was included. A take-over programme (training-the-trainers) was implemented within the course. The present paper describes the course content, the students and their background, the training-the-trainers programme, the evaluation procedure and its results. So far, 53 students have passed the course, 77% being female. The majority of students were medical doctors (51%), psychologists (11%), pedagogues (9%), dentists (6%) and nurses (6%). The take-over programme has functioned well by gradually using students of excellence as teachers. In 2012, the take-over programme is completed and only Russians teach. Evaluation by students of the course content, organisation and pedagogic approach was useful for improvements.

  6. Deltas for the future: Lessons learned in a water innovation programme

    OpenAIRE

    Van der Duin, P.; Bruggeman, W.; Sule, M.

    2011-01-01

    Delta regions worldwide have to cope with increasing pressure on land use and the consequences of climate change and rising sea-levels. Usual methods and solutions are no longer satisfactory for future challenges of flood protection, sustainable energy, and freshwater supply. Consequently, truly innovative approaches and technologies have to be developed and implemented. Therefore, Rijkswaterstaat (NL) has executed a water innovation programme (WINN) in the period 2002 -2010, in cooperation w...

  7. An overview of international siting programmes for radioactive waste disposal facilities: Possible lessons for Sweden

    International Nuclear Information System (INIS)

    Richardson, P.J.

    1994-01-01

    The purpose of this short report is to examine methodologies used in countries other than Sweden which are following a process of site selection for nuclear waste management and disposal facilities. It is planned here to identify possible countries and methodologies which may offer the authorities in Sweden suggestions for the future, and it is hoped that further work, possibly involving in-country visits and detailed reviews will follow. The end result of this exercise is to learn from the efforts (successes and/or mistakes) of other countries, thereby enabling Sweden to pursue a siting policy which involves as many stakeholders as possible, resulting in a programme which Swedish citizens can feel they truly own. First, the classification of siting methodologies is reviewed, both those of the past and those currently in use. Examples from programmes around the world are given. The distinction between Public Involvement and Public Participation in the siting process is discussed, in light of the programmes reviewed. Methodologies worthy of further study for adaptation to the Swedish situation are then highlighted in the context of a general discussion of the issues raised. Finally, a series of recommendations as to further investigations are given, which could be carried out as a part of this project. Particular methodologies in particular countries and their relevance to the Swedish situation are discussed. 66 refs

  8. Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme

    OpenAIRE

    Sorhaindo, Annik; Bonell, Chris; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Mitchell, Kirstin

    2016-01-01

    Research on the unintended consequences of targeting ‘high-risk’ young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust...

  9. THE ACUTE EFFECTS OF THE PREVENT INJURY ENHANCE PERFORMANCE PROGRAMME (PEP) ON ACL INJURY RISK FACTORS

    OpenAIRE

    Clarke, S; McCann, C

    2015-01-01

    The purpose of this study was to determine the immediate effects the prevent injury enhance performance programme (PEP) had on lower extremity biomechanics in relation to anterior cruciate ligament (ACL) risk factors compared to when it was not performed. 8 healthy males were required to perform a number of drop rebound jumps as a task that mimicked the sudden deceleration seen during ACL injuries. The PEP significantly (p

  10. Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa.

    Science.gov (United States)

    Visser, Maretha; Thurman, Tonya R; Spyrelis, Alexandra; Taylor, Tory M; Nice, Johanna K; Finestone, Michelle

    2018-03-06

    Preventing HIV among young people is critical to achieving and sustaining global epidemic control. Evidence from Western settings suggests that family-centred prevention interventions may be associated with greater reductions in risk behaviour than standard adolescent-only models. Despite this, family-centred models for adolescent HIV prevention are nearly non-existent in South Africa - home to more people living with HIV than any other country. This paper describes the development and formative evaluation of one such intervention: an evidence-informed, locally relevant, adolescent prevention intervention engaging caregivers as co-participants. The programme, originally consisting of 19 sessions for caregivers and 14 for adolescents, was piloted with 12 groups of caregiver-adolescent dyads by community-based organizations (CBOs) in KwaZulu-Natal and Gauteng provinces. Literature and expert reviews were employed in the development process, and evaluation methods included analysis of attendance records, session-level fidelity checklists and facilitator feedback forms collected during the programme pilot. Facilitator focus group discussions and an implementer programme workshop were also held. Results highlighted the need to enhance training content related to cognitive behavioural theory and group management techniques, as well as increase the cultural relevance of activities in the curriculum. Participant attendance challenges were also identified, leading to a shortened and simplified session set. Findings overall were used to finalize materials and guidance for a revised 14-week group programme consisting of individual and joint sessions for adolescents and their caregivers, which may be implemented by community-based facilitators in other settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Evaluation of a school-based programme of universal eating disorders prevention: is it more effective in girls at risk?

    Science.gov (United States)

    Raich, R M; Portell, M; Peláez-Fernández, M A

    2010-01-01

    There is currently controversy surrounding the effectiveness of universal versus selective prevention in eating disorders (ED). The present study aims at evaluating the effectiveness of universal school-based ED prevention administered to female secondary school students (n = 349). Students received either the full prevention programme (learning basic concepts of nutrition, criticism of aesthetic models of beauty emphasising extreme thinness, media literacy (ML)), a partial version of the programme (without nutritional education), or no prevention programme. Students were also classified on the presence or absence of distinct risk factors for ED: Early menarche, overweight, dieting, negative attitudes to food and perceived pressure to be thin. Pre-test data were collected 1 week prior to implementation of the prevention programme, and post-test data were collected on the last day of the programme. Results suggested that both the full and partial prevention programmes reduced perceived pressure to be thin and improved eating attitudes and knowledge of nutrition in all the participants (regardless of risk); however, greater effect sizes were found among particular high-risk groups (early menarche, overweight and highly influenced by aesthetic models of beauty emphasising extreme thinness). School-based programmes of universal intervention may have an important role to play in the prevention of ED.

  12. Integrating Social Marketing Into Fijian HIV/AIDS Prevention Programs: Lessons From Systematic Review.

    Science.gov (United States)

    Sewak, Aarti; Singh, Gurmeet

    2017-01-01

    Social marketing techniques have been tested and proven useful within the health sector worldwide. In Fiji, social marketing was introduced in the early 1990s, and more rapidly during the last decade to improve national response to an increasing incidence of sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Given the limited amount of research in the area of program evaluation in Pacific Island Countries and Territories (PICTs), this study systematically analyzes five Fijian HIV/AIDS prevention programs through Andreasen's benchmark criteria, in order to identify gaps in program design that ultimately impact program effectiveness. Assessment results unveil some interesting trends regarding the focus and applications of past Fijian HIV/AIDS prevention programs in the past decade. This article discusses these findings and other valuable lessons for future HIV/AIDS prevention strategies in Fiji and elsewhere.

  13. The DARE programme, success ans lessons learned from libraries to libratories

    CERN Multimedia

    CERN. Geneva

    2005-01-01

    The DARE Programme is the Dutch national OAI program. It started January 2003 with a budget of MEuro 5.9 and will last until December 2006. Renowned successes are the national sites DAREnet, harvesting the openly available content of the IR's of all universities and some national research organisations, and Keur der Wetenschap/Cream of Science, exhibiting the complete oeuvre of more than 200 Dutch top scientists (see: www.darenet.nl). Recently we started project LOREnet, the equivalent of DAREnet for the educational community. The presentation will tell about the successes, the experiences and the transformation from libraries to 'libratories'.

  14. Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees.

    Science.gov (United States)

    Bell, Jennifer L; Collins, James W; Wolf, Laurie; Gronqvist, Raoul; Chiou, Sharon; Chang, Wen-Ruey; Sorock, Gary S; Courtney, Theodore K; Lombardi, David A; Evanoff, Bradley

    2008-12-01

    In 2007, the Bureau of Labor Statistics reported that the incidence rate of lost workday injuries from slips, trips and falls (STFs) on the same level in hospitals was 35.2 per 10,000 full-time equivalents (FTE), which was 75% greater than the average rate for all other private industries combined (20.2 per 10,000 FTEs). The objectives of this 10-year (1996-2005) longitudinal study were to: 1) describe occupational STF injury events in hospitals; 2) evaluate the effectiveness of a comprehensive programme for reducing STF incidents among hospital employees. The comprehensive prevention programme included analysis of injury records to identify common causes of STFs, on-site hazard assessments, changes to housekeeping procedures and products, introduction of STF preventive products and procedures, general awareness campaigns, programmes for external ice and snow removal, flooring changes and slip-resistant footwear for certain employee subgroups. The hospitals' total STF workers' compensation claims rate declined by 58% from the pre-intervention (1996-1999) rate of 1.66 claims per 100 FTE to the post-intervention (2003-2005) time period rate of 0.76 claims per 100 FTE (adjusted rate ratio = 0.42, 95% CI: 0.33-0.54). STFs due to liquid contamination (water, fluid, slippery, greasy and slick spots) were the most common cause (24%) of STF claims for the entire study period 1996-2005. Food services, transport/emergency medical service and housekeeping staff were at highest risk of a STF claim in the hospital environment. Nursing and office administrative staff generated the largest numbers of STF claims. STF injury events in hospitals have a myriad of causes and the work conditions in hospitals are diverse. This research provides evidence that implementation of a broad-scale prevention programme can significantly reduce STF injury claims.

  15. The Outcome of a Preventive Dental Care Programme on the Prevalence of Localized Aggressive Periodontitis in Down's Syndrome Individuals

    Science.gov (United States)

    Zigmond, Maora; Stabholz, A.; Shapira, J.; Bachrach, G.; Chaushu, G.; Becker, A.; Yefenof, E.; Merrick, J.; Chaushu, S.

    2006-01-01

    Background: Periodontal disease in Down's syndrome (DS) individuals develops earlier and is more rapid and extensive than in age-matched normal individuals. The present study evaluated a group of DS patients, who had been participating in a 10-year preventive dental programme, for the impact of the programme on their periodontal status. Methods:…

  16. Young Women's Lived Experience of Participating in a Positive Youth Development Programme: The "Teens & Toddlers" Pregnancy Prevention Intervention

    Science.gov (United States)

    Sorhaindo, Annik; Mitchell, Kirstin; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Bonell, Chris

    2016-01-01

    Purpose: Evaluation of the Teens & Toddlers (T&T) positive youth development (PYD) and teenage pregnancy prevention programme suggested that the intervention had minimal effectiveness partly due to its unclear theory of change. The purpose of this paper is to examine the lived experiences of young women participating in the programme to…

  17. Preventing childhood obesity in early care and education settings: lessons from two intervention studies.

    Science.gov (United States)

    Benjamin Neelon, S E; Østbye, T; Hales, D; Vaughn, A; Ward, D S

    2016-05-01

    Obesity prevention in young children is a public health priority. In the USA, nearly 10% of children less than 5 years of age are obese, and most attend some form of out-of-home child care. While a number of interventions have been conducted in early care and education settings, few have targeted the youngest children in care or the less formal types of child care like family child care homes. Additionally, only two previous studies provided recommendations to help inform future interventions. This paper presents lessons learned from two distinct intervention studies in early care and education settings to help guide researchers and public health professionals interested in implementing and evaluating similar interventions. We highlight two studies: one targeting children ages 4 to 24 months in child care centres and the other intervening in children 18 months to 4 years in family child care homes. We include lessons from our pilot studies and the ongoing larger trials. To date, our experiences suggest that an intervention should have a firm basis in behaviour change theory; an advisory group should help evaluate intervention materials and plan for delivery; and realistic recruitment goals should recognize economic challenges of the business of child care. A flexible data collection approach and realistic sample size calculations are needed because of high rates of child (and sometimes facility) turnover. An intervention that is relatively easy to implement is more likely to appeal to a wide variety of early care and education providers. Interventions to prevent obesity in early care and education have the potential to reach large numbers of children. It is important to consider the unique features and similarities of centres and family child care homes and take advantage of lessons learned from current studies in order to develop effective, evidence-based interventions. © 2016 John Wiley & Sons Ltd.

  18. Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Krommes, Kasper Kühn; Esteve, Ernest

    2017-01-01

    Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+). Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham...... intervention) among football players. Data sources MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016. Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention...... programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio...

  19. Preventing plane-assisted suicides through the lessons of research on homicide and suicide-homicide.

    Science.gov (United States)

    Rice, Timothy R; Sher, Leo

    2016-08-01

    The Germanwings 9525 incident drew significant attention to the 'plane-assisted suicide' construct, yet little scientific literature exists on this topic. This paper reviews the available literature and applies lessons from the suicide-homicide and men's mental health literature to better understand this construct from a scientific perspective. A systematic review of the relevant clinical literature was undertaken. Multiple lines of evidence suggests the applicability and relevance of suicide-homicide research and men's mental health to the plane-assisted suicide phenomenon. Plane-assisted suicides occur within an overwhelmingly male, middle aged population who, in addition to suicide, commit large scale acts of murder. Issues of divorce, separation, and threats to masculinity appear integral to an effective prevention program. Further research in the understanding of plane-assisted suicide as a product of neuropsychiatric disorder may advance such prevention efforts and have the opportunity to reduce the loss of life in future tragedies.

  20. Development of a national injury prevention/safe community programme in Vietnam.

    Science.gov (United States)

    Luau, H C; Svanström, L; Ekman, R; Duong, H L; Nguyen, O C; Dahlgren, G; Hoang, P

    2001-03-01

    The aim of this study is to describe the initiation of a national programme on injury prevention/safe community (IP/SC). Market economy, Doi Moi, was introduced in Vietnam in 1986, and since then the injury pattern has been reported to have changed. The number of traffic injury deaths has increased three-fold from 1980 to 1996 and traffic injuries more than four-fold. Injuries are now the leading cause of mortality in hospitals. There are difficulties in obtaining a comprehensive picture of the injury pattern from official statistics and, in conjunction with the work initiated by the Ministry of Health, a number of local reporting systems have already been developed. Remarkable results have been achieved within the IP/SC in a very short time, based on 20 years of experience. An organizational construction system has been built from province to local community areas. Management is based on administrative and legislative documents. IP/SC implementation is considered the duty of the whole community, local authorities and people committees, and should be incorporated into local action plans. The programme is a significant contribution towards creating a safe environment in which everybody may live and work, allowing the stability for society to develop. Implementation of the programme in schools is a special characteristic. The programme will be developed in 800 schools with a large number of pupils (25% of the population). This model for safer schools is considerably concerned and is a good experience to disseminate. The recommendations are that more pilot models of IP/SC should be conducted in other localities and that the programme should be expanded to a national scale. Furthermore, co-operation between sectors and mass organizations should be encouraged and professional skills of key SC members at all levels should be raised.

  1. THE EFFECTS OF OTAGO EXERCISE PROGRAMME FOR FALL PREVENTION IN ELDERLY PEOPLE

    Directory of Open Access Journals (Sweden)

    Nancy N. Patel

    2015-08-01

    Full Text Available Background: The ‘Otago exercise programme’ (OEP is a strength and balance retraining programme designed to prevent falls in older people living in the community. The aim of this study was to find the effects of Otago exercise programme for fall prevention in community dwelling elderly people. Method: The sample comprised 30 community dwelling elderly around sinhgad road, pune (out of 30, 4 were dropouts aged over 60 years both male and female falling under moderate fall risk measured by Tinetti Performance Oriented Mobility Assessment. The intervention consisted mainly strength and balance training. Intervention was done for 1 hr every day, 5 days per week for 6weeks. Outcome measure assessment was done pre, 3rd week and post intervention. Pre and post comparison of following three outcome measures was done. Outcome measures: Tinetti Performance Oriented Mobility Assessment, 10RM and Chair stand test. Result: Paired t-test was done. Results of p value for 10RM (p value = 0.00, Tinetti performance oriented mobility assessment (p value = 0.00 and chair stand test (p value = 0.01 was found to be highly significant. Out of 26 subjects with moderate risk of fall pre intervention, 24 subjects showed low risk of fall during post intervention assessment of Tinetti Performance Oriented Mobility Assessment. Conclusion: The Otago exercise programme is significantly effective increasing strength of lower limb and improving in balance, gait and therefore ultimately preventing fall in community dwelling Indian elder people. Hence, Otago exercise protocol can be used in day to day clinical practice and also as a home exercise program.

  2. Predicting the life-time benefit of school-based smoking prevention programmes.

    Science.gov (United States)

    Jit, Mark; Aveyard, Paul; Barton, Pelham; Meads, Catherine A

    2010-06-01

    School-based smoking prevention programmes may delay the age of smoking initiation, but do not appear to achieve lasting reductions in smoking prevalence beyond school-leaving age. We explored whether delaying the age at which someone initiates smoking may have life-time benefits by increasing the likelihood of quitting in later life. Data from the General Household Survey of Great Britain were used in a logistic regression model to examine the association between age at which someone initiates regular smoking and the probability that the person will quit smoking later in life. The effect of confounding variables (sex, ethnicity, socio-economic class, education and geographical location) was taken into account. The predicted relationship was used in a cohort model to estimate the life-time reduction in smoking prevalence and all-cause mortality of a school-based smoking prevention programme. Age of regular smoking initiation was associated strongly with the probability of quitting later in life (coefficient -0.103, P < 0.001). The strength of the association was slightly reduced but still significant when confounding variables were included (coefficient -0.075, P < 0.001). An intervention that delays smoking initiation without decreasing smoking prevalence at age 18 may reduce adult smoking prevalence by 0.13-0.32% (depending on age) and all-cause mortality by 0.09% over the life-time of the sample. School-based smoking prevention programmes have potential for a beneficial effect over the life-time of the participants even if they have no apparent effect at school-leaving age.

  3. Isokinetic strength effects of FIFA'a "The 11+" injury prevention training programme

    DEFF Research Database (Denmark)

    Brito, João; Figueiredo, Pedro; Fernandes, Luís

    2010-01-01

    The purpose of this study was to evaluate whether FIFA's Medical Assessment and Research Centre (F-MARC) injury prevention programme, "The 11+", improves isokinetic strength of the knee extensor and flexor muscles in sub-elite soccer players. Twenty players aged 22.3 ± 4.2 yr performed "The 11+" 3...... significantly improved the conventional H/Q ratio at 60°/s by 14.8{\\%} and the DCR by 13.8% in the non-dominant limb (pknee joint....

  4. Measures needed to strengthen strategic HIV/AIDS prevention programmes in China.

    Science.gov (United States)

    Chen, P

    2007-01-01

    This paper traces the commonly believed three phases of the HIV/AIDs epidemic in China from the early 1980s to the present time and reviews how the Chinese Government and NGOs are dealing with the crisis. Transmission routes for HIV infection in China are thought to be via IDUs, blood plasma donors, sexual contacts and from mother-to-child transmissions. The author examined interventions for HIV/ AIDS prevention tried in other countries that could provide useful lessons learned and discussed how they could be adapted or replicated in China. While recognising the need for the treatment of HIV positive persons and AIDS patients, this paper is limited to suggesting a number of proven strategic interventions to prevent new HIV infections in China among the "general population", adolescents in schools, sex workers and their clients, injecting drug users, and, prevention of mother to child transmission of HIV/AIDS to stem the epidemic. An extensive literature search of articles in published academic journals, published and unpublished documents of international agencies and development NGOs and media reports was conducted for data source to this paper. Internet search engines such as ProQuest, PubMed, Google and Yahoo search engines were used as well as hard copies of reports and internal documents available at the UNFPA Country Technical Services Team's Office in Bangkok tapped for information.

  5. Effects of an Ai Chi fall prevention programme for patients with Parkinson's disease.

    Science.gov (United States)

    Pérez-de la Cruz, S; García Luengo, A V; Lambeck, J

    2016-04-01

    One of the main symptoms of Parkinson's disease is the high incidence of falls occurring due to the decline of both static and dynamic balance. The aim of this study is to determine the effect of an Ai Chi programme designed to prevent falls in patients with Parkinson's disease by improving both functional independence and perception of physical pain. Fifteen patients diagnosed with Parkinson's disease (Hoehn and Yahr stages 1-3) participated in a 10-week Ai Chi programme consisting of 30 to 45-minute aquatic exercise sessions twice a week. The assessment measures used in this study were the pain visual analogue scale (VAS), the Tinetti gait and balance assessment tool, and the Timed Get up and Go test. The results were calculated by applying the Friedman test to 3 related measurements: patients at baseline, at post-treatment (at the end of the 10 week programme) and after one month of follow-up. The data obtained showed a significant improvement (p Parkinson's disease. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Exploring individual adaptations to an anterior cruciate ligament injury prevention programme.

    Science.gov (United States)

    Fox, Aaron S; Bonacci, Jason; McLean, Scott G; Saunders, Natalie

    2018-01-01

    Individual responses to anterior cruciate ligament injury prevention programmes (ACL IPPs) have received little attention. This study examined the effects of an ACL IPP on neuromuscular control and lower limb biomechanics during landing at the group and individual levels. Sixteen female athletes were randomly allocated to training (n=8) or control (n=8) groups. Electromyography, and three-dimensional kinematic and kinetic data were collected during landing at two testing sessions. Repeated measures ANOVA and effect sizes (Cohen's d) examined the effect of the IPP at the group and individual levels. A sub-group analysis comparing the effect of the IPP on 'high-' (i.e. large peak knee abduction moment at baseline) versus 'low-risk' individuals was also conducted. At the group level; the IPP increased activation of the medial hamstrings prior to landing (p0.91), however these results did not reach statistical significance (p>0.05). The IPP induced adaptations during landing, however, individual data revealed dissimilar responses to the programme. Individuals displaying a pre-existing high-risk strategy may incur greater benefits from IPPs, yet only if the programme targets the relevant high-risk strategy. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme.

    Science.gov (United States)

    Sorhaindo, Annik; Bonell, Chris; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Mitchell, Kirstin

    2016-06-01

    Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women. Black and minority ethnic young women perceived that the assessment of their risk was based on stereotyping. Others felt their outgoing character was misinterpreted as signifying risk. To manage these imposed labels, stigma and reputational risks, young women responded to being targeted by adopting strategies, such as distancing, silence and refusal. To limit harmful consequences, programmes could involve prospective participants in determining their need for intervention or introduce programmes for young people at all levels of risk. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  8. School-based education programmes for the prevention of child sexual abuse.

    Science.gov (United States)

    Walsh, Kerryann; Zwi, Karen; Woolfenden, Susan; Shlonsky, Aron

    2015-04-16

    Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school-based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny. To systematically assess evidence of the effectiveness of school-based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students' protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both. In September 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE and 11 other databases. We also searched two trials registers and screened the reference lists of previous reviews for additional trials. We selected randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of school-based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention. Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias. We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse. This is an update of a Cochrane Review that included 15 trials (up to August 2006). We identified 10 additional trials for the period to September 2014. We excluded one trial from the original review. Therefore, this update includes a total of 24 trials (5802 participants). We conducted several meta-analyses. More than half of the trials in each meta-analysis contained unit of analysis errors.1. Meta-analysis of two trials (n = 102) evaluating protective behaviours favoured intervention (odds

  9. The potential and reality of the solar water heater programme in South African townships: Lessons from the City of Tshwane

    International Nuclear Information System (INIS)

    Curry, Claire; Cherni, Judith A.; Mapako, Maxwell

    2017-01-01

    The South African solar water heater (SWH) programme is part of national policy to improve the country's electricity security, an innovative strategy to provide indigent households with free solar water heaters. The study assesses the effects of the government programme for poor townships on reduction of household electricity consumption, decline in energy poverty, and reduction in CO2 emissions; and estimates the impact of SWH on reducing electricity demand nationwide. It reports results from fieldwork carried out in the City of Tshwane to measure both quantitatively and qualitatively the success of the project's deployment in townships. Although households register average savings of 27% on their monthly electricity bills and off-peak electricity demand has reduced significantly in the area, a variety of problems prevented the project from attaining the desired level of impact. Difficulties encountered include technical faults with the heaters combined with nonavailability of maintenance; a rise in water consumption; lack of community engagement leading to apathy; and dearth of owner training leading to underuse. The gap between inflated estimates and real savings is discussed. Expanding the programme could generate jobs but significant challenges remain. - Highlights: • The government's aim of saving electricity and reducing utility bills partly achieved. • Savings of electricity are estimated at about 25% less than the potential saving. • Wrong assumption that peak time is only 1 h produced savings 5 times larger. • ESKOM & government overlooked providing Information on the SWH to the householders. • No maintenance led to abandonment by many or water leaking increasing utility bills.

  10. [Geriatric health promotion and prevention for independently living senior citizens: programmes and target groups].

    Science.gov (United States)

    Dapp, U; Anders, J; Meier-Baumgartner, H P; v Renteln-Kruse, W

    2007-08-01

    Nearly all diseases in old age that are epidemiologically important can be reduced or prevented successfully through consequent changes in individual lifestyle, a systematic provision of measures in primary prevention (i.e. vaccination programmes) and the creation of health promoting settings. However, at the moment the amount of potential for preventative interventions is neither systematically nor sufficiently utilised in Germany. Two different preventative approaches: a) multidimensional advice session in small groups through an interdisciplinary team at a geriatric centre (seniors come to seek advice offered at a centre) or b) multidimensional advice at the seniors home through one member of the interdisciplinary team from the geriatric centre (expert takes advice to seniors home) were tested simultaneously with a well-described study sample of 804 independent community-dwelling senior citizens aged 60 years or over, without need of care and cognitive impairments recruited from general practices. Information about target group specific approaches in health promotion and prevention for senior citizens were retrieved from analyses of sociodemographic, medical, psychological and spacial characteristics of this study sample. The majority of the study sample (580 out of 804 or 72.1%) decided to participate: a) 86.7% (503 out of 580) attended at the geriatric centre and sought advice in group sessions and b) 13.3% (77 out of 580) decided to receive advice in a preventive home visit. A total of 224 seniors (224 out of 804 or 27.9%) refused to participate at all. These three target groups were characterised on the basis of their age, gender, education, social background, health status, health behaviour, use of preventive care, self perceived health, functional disabilities, social net and social participation and distance or accessibility of preventative approaches. The 503 senior citizens who participated in small group sessions at the geriatric centre were

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

    LENUS (Irish Health Repository)

    Phelan, D

    2012-02-01

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

  12. Could targeted exercise programmes prevent lower limb injury in community Australian football?

    Science.gov (United States)

    Andrew, Nadine; Gabbe, Belinda J; Cook, Jill; Lloyd, David G; Donnelly, Cyril J; Nash, Clare; Finch, Caroline F

    2013-08-01

    Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five

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

    Science.gov (United States)

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

    2006-05-01

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

  14. Universal parenting programme to prevent early childhood behavioural problems: cluster randomised trial.

    Science.gov (United States)

    Hiscock, Harriet; Bayer, Jordana K; Price, Anna; Ukoumunne, Obioha C; Rogers, Susan; Wake, Melissa

    2008-02-09

    To determine whether a parenting programme, offered universally in primary care, can prevent behavioural problems in children and improve parenting and maternal mental health. Cluster randomised trial. 40 primary care nursing centres (clusters) in Victoria, Australia. 733 English speaking mothers of 8 month old children sequentially recruited from well child appointments; 656 retained at 24 months. Structured three session programme at age 8-15 months, co-led by well child providers and a parenting expert. The programme covered normal development and behaviour, strategies to increase desired behaviour, and strategies to reduce unwanted behaviour. Maternal report of child externalising behaviour (child behavior checklist 1(1/2)-5 year old), parenting (parent behavior checklist), and maternal mental health (depression anxiety stress scales) at 18 and 24 months. At 18 months, child behaviour and parenting scores were similar in the two groups. At 24 months, externalising scores in the intervention and control groups were similar (mean 11.9 (SD 7.2) v 12.9 (7.4)); however, on the parent behavior checklist subscale scores, intervention group parents were less likely to report harsh/abusive parenting (mean 38.9 (SD 7.7) v 40.5 (8.8); adjusted mean difference -1.83, 95% confidence interval -3.12 to -0.55) and unreasonable expectations of child development (40.9 (9.9) v 42.7 (9.6); -2.18, -3.74 to -0.62). Mean scores for nurturing parenting and maternal mental health were similar in the two groups at both times. A universal parenting programme resulted in modest improvement in parenting factors that predict behavioural problems in children but did not reduce externalising behavioural problems or affect maternal mental health at 2 years. Trial registration ISRCTN 77531789.

  15. Implementing a community-based obesity prevention programme: experiences of stakeholders in the north east of England.

    Science.gov (United States)

    Middleton, G; Henderson, H; Evans, D

    2014-06-01

    Recent literature indicates the potential of community-based obesity prevention programmes in the endeavour to reduce the prevalence of obesity in developed nations. Considerable suggestion and advocacy come from theoretical standpoints and little is known on actual practical application of this type of multi-component health promotion programme. This article explores the experiences of 'implementation' by stakeholders of a large community-based obesity prevention programme, facilitated by a National Health Service Care Trust in the north-east of England, UK. Three stakeholder groups (senior health officials, public health workers and community members) who had administrated and experienced the programme since its conception in 2006 provide perspectives on the aspects of local delivery and receipt. Semi-structured interviews and focus groups were conducted with stakeholders (28 participants in total). The participants felt there were three broad aspects which shaped and constrained the delivery and receipt of the programme, namely partnership working, integration of services and quality issues. Data indicated that it had taken time to establish working partnerships between the multi-agencies involved in the community-based obesity programme. Strategic management would aid the processes of communication and collaboration between agencies and also the local community involved in the administration, delivery and participation of interventions in the programme. Secondly, the way in which the programme is justified and sustained will have to be reviewed, with the intention of using a suitable evaluative framework or tool for monitoring purposes.

  16. Adolescents' perceptions about smoking prevention strategies: a comparison of the programmes of the American Lung Association and the Tobacco Institute.

    Science.gov (United States)

    DeBon, M; Klesges, R C

    1996-01-01

    To evaluate components of the teenage smoking prevention programmes of the American Lung Association (ALA) and the Tobacco Institute (TI). Group administration of written questionnaires in school. The components of the ALA's and TI's programmes were presented to students in seven strategy vignettes, covering the following topics: peer pressure/enhanced communication; parents as role models; health consequences of smoking; cost of smoking; smoking as an illegal act; tips for quitting smoking; and responsible decision making. 172 seventh-grade students (mean age = 12.3 years) from six parochial schools in Memphis, Tennessee, United States. Student ratings of the perceived effectiveness of the ALA and TI approaches (in helping to stop teens from smoking) within each strategy vignette, and students' choice between these two approaches as to which was the better smoking prevention technique. Although there were some moderating effects of gender and race, participants overall strongly favoured the ALA programme over that of the TI. Of the seven programme components, the ALA's approach was rated more effective on six (peer pressure, parents as role models, the health consequences of smoking, the cost of smoking, tips for quitting smoking, responsible decision making) and the TI's was rated more effective on one (not smoking because it is illegal). The ALA's programme was perceived to be much more effective than the TI's programme by those whom these programmes are ultimately intended to influence-young people. Future research in this area should pursue longitudinal designs to determine if programme endorsement is predictive of smoking status.

  17. Lessons in Suicide Prevention from the Golden Gate Bridge: Means Restriction, Public Health, and the School Psychologist

    Science.gov (United States)

    Miller, David N.

    2013-01-01

    Youth suicide is a global public health problem and some lessons for more effectively preventing it can be found in a perhaps unlikely source: the Golden Gate Bridge. Issues discussed include means restriction and method substitution, the stigma associated with suicide and the consequences of it, myths and misconceptions regarding suicide, and…

  18. Design and Implementation of a Pilot Obesity Prevention Program in a Low-Resource School: Lessons Learned and Research Recommendations

    Science.gov (United States)

    Baskin, Monica L.; Zunker, Christie; Worley, Courtney B.; Dial, Brenda; Kimbrough, Linda

    2009-01-01

    Purpose: This paper seeks to describe the design, implementation, and lessons learned from an obesity prevention pilot program delivered in a low resource school in the USA. Design/methodology/approach: A planned program evaluation was conducted to: document explicitly the process of designing and implementing the program; and assess the…

  19. Lessons From a Pilot Community-Driven Approach for Obesity Prevention.

    Science.gov (United States)

    Hilgendorf, Amy; Stedman, John; Inzeo, Paula Tran; McCall, Ann; Burrows, Judy; Krueger, Scott; Christens, Brian; Pollard, Ethen; Meinen, Amy; Korth, Amy; Wolf, Lesley; Adams, Alexandra

    2016-11-01

    The Wisconsin Obesity Prevention Initiative has piloted a novel approach for community action for obesity prevention that incorporates both coalition and community organizing efforts in 2 counties. This article describes lessons learned to date from this experience. A description of the progress made in these communities and the support provided by Initiative staff and other partners are drawn from process evaluation of the pilot from November 2014 through December 2015, as well as the reflections of community partners. In Marathon County, building towards coalition action required thoughtful re-engagement and restructuring of an existing obesity-focused coalition. Community organizing surfaced local concerns related to the root causes of obesity, including poverty and transit. In Menominee County, coalition and community organizing efforts both have drawn attention to cultural assets for health promotion, such as traditional food practices, as well as the links between cultural loss and obesity. Building coalition action and community organizing varies across community contexts and requires addressing various steps and challenges. Both approaches require critical local examination of existing community action and stakeholders, attention to relationship building, and support from outside partners. In coalition action, backbone staff provide important infrastructure, including member recruitment and facilitating group processes towards collaboration. Community organizing involves broad resident engagement to identify shared interests and concerns and build new leadership. A community-driven systems change model offers potential to increase community action for obesity prevention.

  20. Determinants of participation in a fall assessment and prevention programme among elderly fallers in Hong Kong: prospective cohort study.

    Science.gov (United States)

    Wong, Eliza L Y; Woo, Jean; Cheung, Annie W L; Yeung, Pui-Yi

    2011-04-01

    The study was undertaken to estimate the uptake rate of a fall prevention programme among older fallers and explore related factors. Fall injuries are a major cause nationally of the loss of independence in old age, but they are preventable. Acceptance of fall prevention programmes is therefore important to reduce the risk of falling. Patients aged ≥60 attending the Department of Accident & Emergency of a regional hospital in Hong Kong between 2006 and 2007 were recruited. The study included a baseline interview, focus group interview and a cross-sectional 1-year follow-up telephone survey to assess uptake and its related factors. A total 68% of 1194 older people attended the fall programme. Factors associated with programme participation included the perception of fall as being preventable [OR=3.47, 95% CI (1.59-7.56)] or recoverable [OR=1.73, 95% CI (1.06-2.82)], a safe outside environment; absence of chronic illness, and ability to walk without aids. Old-age people, those living in old-age homes and of lower education level were less likely to join the programme. Older people with the selected characteristics were less likely to attend the fall prevention programme, thus were less likely to benefit from them. Support from family/carers may be an important element in participation. In a nursing context, in primary care practice, all of these factors should be taken into account in any future development of a fall prevention programme in Hong Kong of this nature. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  1. The HIV prevention cascade: integrating theories of epidemiological, behavioural, and social science into programme design and monitoring.

    Science.gov (United States)

    Hargreaves, James R; Delany-Moretlwe, Sinead; Hallett, Timothy B; Johnson, Saul; Kapiga, Saidi; Bhattacharjee, Parinita; Dallabetta, Gina; Garnett, Geoff P

    2016-07-01

    Theories of epidemiology, health behaviour, and social science have changed the understanding of HIV prevention in the past three decades. The HIV prevention cascade is emerging as a new approach to guide the design and monitoring of HIV prevention programmes in a way that integrates these multiple perspectives. This approach recognises that translating the efficacy of direct mechanisms that mediate HIV prevention (including prevention products, procedures, and risk-reduction behaviours) into population-level effects requires interventions that increase coverage. An HIV prevention cascade approach suggests that high coverage can be achieved by targeting three key components: demand-side interventions that improve risk perception and awareness and acceptability of prevention approaches; supply-side interventions that make prevention products and procedures more accessible and available; and adherence interventions that support ongoing adoption of prevention behaviours, including those that do and do not involve prevention products. Programmes need to develop delivery platforms that ensure these interventions reach target populations, to shape the policy environment so that it facilitates implementation at scale with high quality and intensity, and to monitor the programme with indicators along the cascade. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. What childhood obesity prevention programmes work? A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Y; Cai, L; Wu, Y; Wilson, R F; Weston, C; Fawole, O; Bleich, S N; Cheskin, L J; Showell, N N; Lau, B D; Chiu, D T; Zhang, A; Segal, J

    2015-07-01

    Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2-18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet-physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions

  3. What childhood obesity prevention programmes work? A systematic review and meta-analysis

    Science.gov (United States)

    Wang, Y.; Cai, L.; Wu, Y.; Wilson, R. F.; Weston, C.; Fawole, O.; Bleich, S. N.; Cheskin, L. J.; Showell, N. N.; Lau, B. D.; Chiu, D. T.; Zhang, A.; Segal, J.

    2015-01-01

    Summary Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2–18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet–physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school

  4. Experience from community based childhood burn prevention programme in Bangladesh: implication for low resource setting.

    Science.gov (United States)

    Mashreky, S R; Rahman, A; Svanström, L; Linnan, M J; Shafinaz, S; Rahman, F

    2011-08-01

    A comprehensive community-based burn prevention framework was developed for rural Bangladesh taking into consideration the magnitude, consequences of burns, risk factors of childhood burn, health seeking behaviour of parents after a burn injury of a child and the perception of community people. This paper explains the comprehensive framework of the childhood burn prevention programme and describes its acceptability, feasibility and sustainability. A number of methodologies were adopted in developing the framework, such as, (i) building up relevant information on childhood burn and prevention methods, (ii) arranging workshops and consultation meetings with experts and related stakeholders and (iii) piloting components of the framework on a small scale. Lack of supervision of the children, hazardous environment at home and the low level awareness about childhood burn and other injuries were identified as the major attributes of childhood burn in Bangladesh. To address these factors "Triple S" strategies were identified for the prevention framework. These strategies are: Safe environment. Supervision. Skill development. According to these strategies, home safety, community crèche, school safety, formation of community groups and general awareness activities were identified as the different components of the childhood burn prevention framework in rural Bangladesh. The framework was piloted in a small scale to explore its feasibility acceptability and sustainability. The framework was found to be acceptable by the community. It is also expected to be feasible and sustainable as very low cost and locally available technology and resources were utilized in the framework. Large scale piloting is necessary to explore its effectiveness and ability to scale up all over the whole country. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  5. Feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders: cluster randomised controlled trial.

    Science.gov (United States)

    Sharpe, Helen; Schober, Ilka; Treasure, Janet; Schmidt, Ulrike

    2013-12-01

    Body image dissatisfaction during adolescence is common but not benign. School-based interventions have the potential for wide reach, but scalability of previous programmes is limited by a reliance on external facilitators. To assess the acceptability, feasibility and efficacy of a teacher-delivered body image intervention. A pilot clustered randomised controlled trial in which 16 classes of adolescent girls were allocated to a 6-session body image programme (n = 261), or usual curriculum control (n = 187) (registration: ISRCTN42594993). Students in the intervention group had significantly improved body esteem and self-esteem and reduced thin-ideal internalisation. Effects for body esteem and thin-ideal internalisation were maintained for 3 months. There were no group differences for eating pathology, peer factors or depression. Acceptability, feasibility and efficacy varied between schools. Teacher-delivered body image lessons have promise but further work is needed to increase efficacy and make interventions suitable across a range of schools.

  6. Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

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    Julie Storr

    2017-01-01

    Full Text Available Abstract Health care-associated infections (HAI are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline.

  7. Recruitment strategies for a hand dermatitis prevention programme in the food industry.

    Science.gov (United States)

    Kaatz, Martin; Ladermann, Regina; Stadeler, Martina; Fluhr, Joachim Wilhelm; Elsner, Peter; Bauer, Andrea

    2008-09-01

    An interdisciplinary 'Skin Disease Prevention Programme (SDPP) in the baking, hotel, and catering industries' was established. However, only 30% of the eligible employees suffering from occupational hand dermatitis (OHD) participated in the programme. The aim of the present study was to increase the participation rate in the SDPP from 30% to 50% by specific recruitment strategies. Two hundred and twenty five baker and catering trade employees suffering from OHD were included in a prospective controlled intervention study. The employees were invited to take part in the SDPP using (i) a standard invitation letter (n = 40), (ii) a newly developed, personalized, and targeted invitation letter (n = 52), (iii) the new invitation letter and a case report (n = 75), and (iv) the new invitation letter, the case report, and the additional information (n = 58). The commitment of the employees to join the SDPP increased significantly from 30% to 54% (P < 0.02) in the group receiving the new personalized targeted invitation letter. Neither the additional case report nor the supplementation with additional information concerning the SDPP did further increase the recruitment. The strategy to personalize and target the new invitation letter was successful to influence the employees' commitment to participate in the SDPP.

  8. Scientific rationale for the Finnish Allergy Programme 2008-2018: emphasis on prevention and endorsing tolerance.

    Science.gov (United States)

    von Hertzen, L C; Savolainen, J; Hannuksela, M; Klaukka, T; Lauerma, A; Mäkelä, M J; Pekkanen, J; Pietinalho, A; Vaarala, O; Valovirta, E; Vartiainen, E; Haahtela, T

    2009-05-01

    In similarity to many other western countries, the burden of allergic diseases in Finland is high. Studies worldwide have shown that an environment rich in microbes in early life reduces the subsequent risk of developing allergic diseases. Along with urbanization, such exposure has dramatically reduced, both in terms of diversity and quantity. Continuous stimulation of the immune system by environmental saprophytes via the skin, respiratory tract and gut appears to be necessary for activation of the regulatory network including regulatory T-cells and dendritic cells. Substantial evidence now shows that the balance between allergy and tolerance is dependent on regulatory T-cells. Tolerance induced by allergen-specific regulatory T-cells appears to be the normal immunological response to allergens in non atopic healthy individuals. Healthy subjects have an intact functional allergen-specific regulatory T-cell response, which in allergic subjects is impaired. Evidence on this exists with respect to atopic dermatitis, contact dermatitis, allergic rhinitis and asthma. Restoration of impaired allergen-specific regulatory T-cell response and tolerance induction has furthermore been demonstrated during allergen-specific subcutaneous and sublingual immunotherapy and is crucial for good therapeutic outcome. However, tolerance can also be strengthened unspecifically by simple means, e.g. by consuming farm milk and spending time in nature. Results so far obtained from animal models indicate that it is possible to restore tolerance by administering the allergen in certain circumstances both locally and systemically. It has become increasingly clear that continuous exposure to microbial antigens as well as allergens in foodstuffs and the environment is decisive, and excessive antigen avoidance can be harmful and weaken or even prevent the development of regulatory mechanisms. Success in the Finnish Asthma Programme was an encouraging example of how it is possible to reduce both

  9. School-based education programmes for the prevention of unintentional injuries in children and young people.

    Science.gov (United States)

    Orton, Elizabeth; Whitehead, Jessica; Mhizha-Murira, Jacqueline; Clarkson, Mandy; Watson, Michael C; Mulvaney, Caroline A; Staniforth, Joy Ul; Bhuchar, Munish; Kendrick, Denise

    2016-12-27

    Unintentional injuries are the leading cause of death in children aged four to 18 years and are a major cause of ill health. The school setting offers the opportunity to deliver preventive interventions to a large number of children and has been used to address a range of public health problems. However, the effectiveness of the school setting for the prevention of different injury mechanisms in school-aged children is not well understood. To assess the effects of school-based educational programmes for the prevention of injuries in children and evaluate their impact on improving children's safety skills, behaviour and practices, and knowledge, and assess their cost-effectiveness. We ran the most recent searches up to 16 September 2016 for the following electronic databases: Cochrane Injuries Group Specialised Register; Cochrane Central Register of Controlled Trials; Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations; Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R); Embase and Embase Classic (Ovid); ISI Web of Science: Science Citation Index Expanded; ISI Web of Science Conference Proceedings Citation Index-Science; ISI Web of Science: Social Sciences Citation Index; ISI Web of Science: Conference Proceedings Citation Index - Social Sciences & Humanities; and the 14 October 2016 for the following electronic databases: Health Economics Evaluations Database (HEED); Health Technology Assessment Database (HTA); CINAHL Plus (EBSCO); ZETOC; LILACS; PsycINFO; ERIC; Dissertation Abstracts Online; IBSS; BEI; ASSIA; CSA Sociological Abstracts; Injury Prevention Web; SafetyLit; EconLit (US); PAIS; UK Clinical Research Network Study Portfolio; Open Grey; Index to Theses in the UK and Ireland; Bibliomap and TRoPHI. We included randomised controlled trials (RCTs), non-randomised controlled trials (non-RCTs), and controlled before-and-after (CBA) studies that evaluated school-based educational programmes aimed at preventing a range of injury mechanisms. The

  10. School-based education programmes for the prevention of child sexual abuse.

    Science.gov (United States)

    Zwi, K J; Woolfenden, S R; Wheeler, D M; O'brien, T A; Tait, P; Williams, K W

    2007-07-18

    Child sexual abuse is a significant problem that requires an effective means of prevention. To assess: if school-based programmes are effective in improving knowledge about sexual abuse and self-protective behaviours; whether participation results in an increase in disclosure of sexual abuse and/or produces any harm; knowledge retention and the effect of programme type or setting. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, CINAHL, Sociological Abstracts, Dissertation Abstracts and other databases using MESH headings and text words specific for child sexual assault and randomised controlled trials (RCTs) were conducted in August 2006. RCTs or quasi-RCTs of school-based interventions to prevent child sexual abuse compared with another intervention or no intervention. Meta-analyses and sensitivity analysis, using two imputed intraclass correlation coefficients (ICC) (0.1, 0.2), were used for four outcomes: protective behaviours, questionnaire-based knowledge, vignette-based knowledge and disclosure of abuse. Meta-analysis was not possible for retention of knowledge, likelihood of harm, or effect of programme type and setting. Fifteen trials measuring knowledge and behaviour change as a result of school-based child sexual abuse intervention programmes were included. Over half the studies in each initial meta-analysis contained unit of analysis errors. For behaviour change, two studies had data suitable for meta-analysis; results favoured intervention (OR 6.76, 95% CI 1.44, 31.84) with moderate heterogeneity (I(2)=56.0%) and did not change significantly when adjustments using intraclass coefficients were made. Nine studies were included in a meta-analysis evaluating questionnaire-based knowledge. An increase in knowledge was found (SMD 0.59; 0.44, 0.74, heterogeneity (I2=66.4%). When adjusted for an ICC of 0.1 and 0.2 the results were SMD 0.6 (0.45, 0.75) and 0.57 (0.44, 0.71) respectively. Heterogeneity decreased

  11. Programme Costing of a Physical Activity Programme in Primary Prevention: Should the Costs of Health Asset Assessment and Participatory Programme Development Count?

    Directory of Open Access Journals (Sweden)

    Silke B. Wolfenstetter

    2012-01-01

    Full Text Available This analysis aims to discuss the implications of the “health asset concept”, introduced by the WHO, and the “investment for health model” requiring a “participatory approach” of cooperative programme development applied on a physical activity programme for socially disadvantaged women and to demonstrate the related costing issues as well as the relevant decision context. The costs of programme implementation amounted to €48,700. Adding the costs for developing the programme design of €48,800 results in total costs of €97,500; adding on top of that the costs of asset assessment running to €35,600 would total €133,100. These four different cost figures match four different types of potentially relevant decisions contexts. Depending on the decision context the total costs, and hence the incremental cost-effectiveness ratio of a health promotion intervention, could differ considerably. Therefore, a detailed cost assessment and the identification of the decision context are of crucial importance.

  12. Findings from a comprehensive diarrhoea prevention and treatment programme in Lusaka, Zambia

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    Samuel Bosomprah

    2016-06-01

    Full Text Available Abstract Background The Programme for the Awareness and Elimination of Diarrhoea (PAED was a pilot comprehensive diarrhoea prevention and control programme aimed to reduce post-neonatal, all-cause under-five mortality by 15 % in Lusaka Province. Interventions included introduction of the rotavirus vaccine, improved clinical case management of diarrhoea, and a comprehensive community prevention and advocacy campaign on hand washing with soap, exclusive breastfeeding up to 6 months of age, and the use of ORS and Zinc. This study aimed to assess the impact of PAED on under-5 mortality. Methods The study was a pre-post evaluation design. The Demographic and Health Survey style population-based two-stage approach was used to collect data at the beginning of the intervention and 3 years following the start of intervention implementation in Lusaka province. The primary outcome of interest was an all-cause, post-neonatal under-five mortality rate defined as the probability of dying after the 28th day and before the fifth birthday among children aged 1–59 months. The Kaplan-Meier time to event analysis was used to estimate the probability of death; multiplying this probability by 1000 to yield the post-neonatal mortality rate. Survival-time inverse probability weighting model was used to estimate Average Treatment Effect (ATE. Results The percentage of children under age 5 who had diarrhoea in the last 2 weeks preceding the survey declined from 15.8 % (95 % CI: 15.2 %, 16.4 % in 2012 to 12.7 % (95 % CI: 12.3 %, 13.2 % in 2015. Over the same period, mortality in post-neonatal children under 5 years of age declined by 34 %, from an estimated rate of 29 deaths per 1000 live births (95 % CI: (26, 32 death per 1000 live births to 19 deaths per 1000 live births (95 % CI: (16, 21 death per 1000 live births. When every child in the population of children aged 1–59 months is exposed to the intervention, the average time-to-death was estimated to

  13. Findings from a comprehensive diarrhoea prevention and treatment programme in Lusaka, Zambia.

    Science.gov (United States)

    Bosomprah, Samuel; Beach, Lauren B; Beres, Laura K; Newman, Jonathan; Kapasa, Kabwe; Rudd, Cheryl; Njobvu, Lungowe; Guffey, Brad; Hubbard, Sydney; Foo, Karen; Bolton-Moore, Carolyn; Stringer, Jeffrey; Chilengi, Roma

    2016-06-06

    The Programme for the Awareness and Elimination of Diarrhoea (PAED) was a pilot comprehensive diarrhoea prevention and control programme aimed to reduce post-neonatal, all-cause under-five mortality by 15 % in Lusaka Province. Interventions included introduction of the rotavirus vaccine, improved clinical case management of diarrhoea, and a comprehensive community prevention and advocacy campaign on hand washing with soap, exclusive breastfeeding up to 6 months of age, and the use of ORS and Zinc. This study aimed to assess the impact of PAED on under-5 mortality. The study was a pre-post evaluation design. The Demographic and Health Survey style population-based two-stage approach was used to collect data at the beginning of the intervention and 3 years following the start of intervention implementation in Lusaka province. The primary outcome of interest was an all-cause, post-neonatal under-five mortality rate defined as the probability of dying after the 28th day and before the fifth birthday among children aged 1-59 months. The Kaplan-Meier time to event analysis was used to estimate the probability of death; multiplying this probability by 1000 to yield the post-neonatal mortality rate. Survival-time inverse probability weighting model was used to estimate Average Treatment Effect (ATE). The percentage of children under age 5 who had diarrhoea in the last 2 weeks preceding the survey declined from 15.8 % (95 % CI: 15.2 %, 16.4 %) in 2012 to 12.7 % (95 % CI: 12.3 %, 13.2 %) in 2015. Over the same period, mortality in post-neonatal children under 5 years of age declined by 34 %, from an estimated rate of 29 deaths per 1000 live births (95 % CI: (26, 32) death per 1000 live births) to 19 deaths per 1000 live births (95 % CI: (16, 21) death per 1000 live births). When every child in the population of children aged 1-59 months is exposed to the intervention, the average time-to-death was estimated to be about 8 months more than when no child is

  14. The “FIFA 11+” warm-up programme for preventing injuries in soccer players: a systematic review

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    Alex de Andrade Fernandes

    Full Text Available Introduction Soccer is among the sports with the highest injury rate. A group of international experts from the Fédération Internationale de Football Association — FIFA’s Medical Assessment and Research Centre — have developed the “FIFA 11+”, a warm-up programme whose main goal is to reduce the risk of common injuries in both male and female soccer players. Objective To conduct a literature review in order to check the efficiency of the “FIFA 11 +” warm-up programme in preventing injuries in soccer players. Methods We conducted a systematic review of studies in the databases MEDLINE/PubMed, SciELO, ScienceDirect and SPORTDiscus, using the following keywords in combination with one another: “injury”, “prevention” and “warm-up”. Results Five studies met the inclusion criteria. In four studies, the authors conclude that the “FIFA 11 +” warm-up programme is effective for preventing injuries in soccer players. In one study, this protective effect was not observed. Conclusion The analyzed studies indicate that the FIFA 11+ warm-up programme for the prevention of sports injuries show positive signs that the use of the programme may help reduce the incidence of injuries in girls aged 13–17 years. In a male children population the results are inconclusive and further research is needed.

  15. Estimating the Cost-Effectiveness of HIV Prevention Programmes in Vietnam, 2006-2010: A Modelling Study.

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    Quang Duy Pham

    Full Text Available Vietnam has been largely reliant on international support in its HIV response. Over 2006-2010, a total of US$480 million was invested in its HIV programmes, more than 70% of which came from international sources. This study investigates the potential epidemiological impacts of these programmes and their cost-effectiveness.We conducted a data synthesis of HIV programming, spending, epidemiological, and clinical outcomes. Counterfactual scenarios were defined based on assumed programme coverage and behaviours had the programmes not been implemented. An epidemiological model, calibrated to reflect the actual epidemiological trends, was used to estimate plausible ranges of programme impacts. The model was then used to estimate the costs per averted infection, death, and disability adjusted life-year (DALY.Based on observed prevalence reductions amongst most population groups, and plausible counterfactuals, modelling suggested that antiretroviral therapy (ART and prevention programmes over 2006-2010 have averted an estimated 50,600 [95% uncertainty bound: 36,300-68,900] new infections and 42,600 [36,100-54,100] deaths, resulting in 401,600 [312,200-496,300] fewer DALYs across all population groups. HIV programmes in Vietnam have cost an estimated US$1,972 [1,447-2,747], US$2,344 [1,843-2,765], and US$248 [201-319] for each averted infection, death, and DALY, respectively.Our evaluation suggests that HIV programmes in Vietnam have most likely had benefits that are cost-effective. ART and direct HIV prevention were the most cost-effective interventions in reducing HIV disease burden.

  16. Estimating the Cost-Effectiveness of HIV Prevention Programmes in Vietnam, 2006-2010: A Modelling Study.

    Science.gov (United States)

    Pham, Quang Duy; Wilson, David P; Kerr, Cliff C; Shattock, Andrew J; Do, Hoa Mai; Duong, Anh Thuy; Nguyen, Long Thanh; Zhang, Lei

    2015-01-01

    Vietnam has been largely reliant on international support in its HIV response. Over 2006-2010, a total of US$480 million was invested in its HIV programmes, more than 70% of which came from international sources. This study investigates the potential epidemiological impacts of these programmes and their cost-effectiveness. We conducted a data synthesis of HIV programming, spending, epidemiological, and clinical outcomes. Counterfactual scenarios were defined based on assumed programme coverage and behaviours had the programmes not been implemented. An epidemiological model, calibrated to reflect the actual epidemiological trends, was used to estimate plausible ranges of programme impacts. The model was then used to estimate the costs per averted infection, death, and disability adjusted life-year (DALY). Based on observed prevalence reductions amongst most population groups, and plausible counterfactuals, modelling suggested that antiretroviral therapy (ART) and prevention programmes over 2006-2010 have averted an estimated 50,600 [95% uncertainty bound: 36,300-68,900] new infections and 42,600 [36,100-54,100] deaths, resulting in 401,600 [312,200-496,300] fewer DALYs across all population groups. HIV programmes in Vietnam have cost an estimated US$1,972 [1,447-2,747], US$2,344 [1,843-2,765], and US$248 [201-319] for each averted infection, death, and DALY, respectively. Our evaluation suggests that HIV programmes in Vietnam have most likely had benefits that are cost-effective. ART and direct HIV prevention were the most cost-effective interventions in reducing HIV disease burden.

  17. Assessment of a training programme for the prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance. A prospective, quasiexperimental, pre- and post-study of the nursing team in a 16-bed medical/surgical ICU. Pre-intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post-intervention phase mirrored the pre-intervention phase. Nurses answered more questions correctly on the post-intervention questionnaire than on the pre-intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post-intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37). The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

  18. Assessment of a training programme for the prevention of ventilator-associated pneumonia

    Science.gov (United States)

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Background Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. Aim To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance. Method A prospective, quasiexperimental, pre- and post-study of the nursing team in a 16-bed medical/surgical ICU. Pre-intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post-intervention phase mirrored the pre-intervention phase. Findings Nurses answered more questions correctly on the post-intervention questionnaire than on the pre-intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post-intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37). Conclusion The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance. PMID:23061618

  19. Engaging Parents in Parentline Plus' Time to Talk Community Programme as Part of England's Teenage Pregnancy Strategy: Lessons for Policy and Practice

    Science.gov (United States)

    Cullen, Mairi Ann; Davis, Liz; Lindsay, Geoff; Davis, Hilton

    2012-01-01

    Based on 65 interviews with professionals and parents conducted during 2007-2008, this 16-month, mainly qualitative evaluation of Parentline Plus' Time to Talk Community Programme (a preventative initiative within England's teenage pregnancy strategy) found that a community development approach and an ethos of partnership with parents and…

  20. 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

  1. 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

  2. Evaluating a Pregnancy and STI Prevention Programme in Rural, At-Risk, Middle School Girls in the USA

    Science.gov (United States)

    Hill, Julie C.; Lynne-Landsman, Sarah D.; Graber, Julia A.; Johnson, Kelly J.

    2016-01-01

    Objective: Young people in urban areas are often the focus of pregnancy and sexually transmitted infection (STI) prevention programmes because of their high risk of unwanted pregnancy and contracting an STI. Young people in rural areas are far less studied but also have a high risk of similar outcomes. This study evaluates Giving Our Girls…

  3. Domestic Violence and Abuse Prevention Programmes in the Early Years Classroom: A Pastoral, Academic and Financial Priority?

    Science.gov (United States)

    McKee, Bronagh E.; Mason, Sarah

    2015-01-01

    Prevention programmes underpin every child's right to "feel" safe and to "be" safe from all forms of harm. Delivered in schools across the globe, they aim to equip children with knowledge about safety and the skills to seek help early. By drawing upon international prevalence and impact research, as well as the legal, policy…

  4. Effects of a School-Based Stress Prevention Programme on Adolescents in Different Phases of Behavioural Change

    Science.gov (United States)

    Vierhaus, Marc; Maass, Asja; Fridrici, Mirko; Lohaus, Arnold

    2010-01-01

    This study examines whether the assumptions of the Transtheoretical Model (TTM) are useful to evaluate the effectiveness of a school-based stress prevention programme in adolescence to promote appropriate coping behaviour. The TTM assumes three consecutive phases in the adoption of behavioural patterns. Progress throughout the phases is promoted…

  5. Impact of a District-Wide Diabetes Prevention Programme Involving Health Education for Children and the Community

    Science.gov (United States)

    Sheeladevi, Sethu; Sagar, Jayanthi; Pujari, Siddharth; Rani, Padmaja Kumari

    2014-01-01

    Objective: To present results from a district-wide diabetes prevention programme involving health education for school children and the local community. Method: The model of health education that was utilized aimed to secure lifestyle changes and the identification of diabetes risk by school children (aged 9-12 years). The children acted as health…

  6. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.

    Science.gov (United States)

    Wasserman, Danuta; Hoven, Christina W; Wasserman, Camilla; Wall, Melanie; Eisenberg, Ruth; Hadlaczky, Gergö; Kelleher, Ian; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Guillemin, Francis; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean-Pierre; Keeley, Helen; Musa, George J; Nemes, Bogdan; Postuvan, Vita; Saiz, Pilar; Reiter-Theil, Stella; Varnik, Airi; Varnik, Peeter; Carli, Vladimir

    2015-04-18

    Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025

  7. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies

    Directory of Open Access Journals (Sweden)

    Child Sue

    2012-09-01

    Full Text Available Abstract Background More than a third of people over the age of 65 years fall each year. Falling can lead to a reduction in quality of life, mortality, and a risk of prolonged hospitalisation. Reducing and preventing falls has become an international health priority. To help understand why research evidence has often not been translated into changes in clinical practice, we undertook a systematic review and synthesis of qualitative research in order to identify what factors serve as barriers and facilitators to the successful implementation of fall-prevention programmes. Methods We conducted a review of literature published between 1980 and January 2012 for qualitative research studies that examined barriers and facilitators to the effective implementation of fall-prevention interventions among community-dwelling older people and healthcare professionals. Two reviewers independently screened studies for inclusion, extracted data, and assessed methodological quality according to predefined criteria. Findings were synthesised using meta-ethnography. Results Of the 5010 articles identified through database searching, 19 were included in the review. Analysis of the 19 studies revealed limited information about the mechanisms by which barriers to implementation of fall-prevention interventions had been overcome. Data synthesis produced three overarching concepts: (1 practical considerations, (2 adapting for community, and (3 psychosocial. A line of argument synthesis describes the barriers and facilitators to the successful implementation of fall-prevention programmes. These concepts show that the implementation of fall-prevention programmes is complex and multifactorial. This is the first systematic review and synthesis of qualitative studies to examine factors influencing the implementation of fall-prevention programmes from the perspectives of both the healthcare professional and the community-dwelling older person. Conclusions The current

  8. The Politics of Prevention: Lessons from the Neglected History of US HIV/AIDS Policy.

    Science.gov (United States)

    Padamsee, Tasleem J

    2017-02-01

    The history of government action on HIV/AIDS has much to teach us about the dynamics and possibilities of US public health policy, but it has been insufficiently studied by social scientists of the epidemic. This article draws on a large set of original interviews with policy makers, thousands of news articles, and extensive documentation to reconstruct the history of three areas of debate and decision making about HIV prevention since 1990: needle exchange, HIV testing, and sex education for at-risk groups. These histories illuminate three key lessons. First, scientific evidence has less power to drive public health policy in the United States than in the United Kingdom, which is used as a comparison case to contextualize US choices within a broader range of options. Second, moral concerns weigh so heavily in the United States that a publicly articulated moral argument can countermand the dictates of solid scientific evidence, the voices of experts, and practical considerations to push public health policy in entirely oppositional directions. Third, having the ear of the presidential administration is usually a necessary-although not always sufficient-condition for the success of advocates trying to move US policy in the public health-indicated direction. Copyright © 2017 by Duke University Press.

  9. Effectiveness of programmes as part of primary prevention demonstrated on the example of cardiovascular diseases and the metabolic syndrome.

    Science.gov (United States)

    Korczak, Dieter; Dietl, Markus; Steinhauser, Gerlinde

    2011-04-01

    The HTA-report (HTA = Health Technology Assessment) deals with the primary prevention of cardiovascular diseases and diabetes mellitus type 2. In 2009 approximately 356,000 people died in Germany due to cardiovascular diseases. According to estimations about 6.3 million people are suffering from diabetes mellitus type 2. The interventions that are subsidized by the public health insurance are mainly focused on sufficient physical activities, healthy nutrition, stress management and the reduction of the consumption of addictive drugs and luxury food. Which lifestyle-related measures and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are effective? To what extent will the health status be improved by these offers? To what extent will existing health resources and skills be strengthened by these offers? Are there any differences regarding the effectiveness among the interventions with respect to different settings or subgroups? Which lifestyle-related interventions and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are sustainable and cost-effective? Which outcome parameters are in the view of the contributors decisive for the evaluation of the effectiveness? In the view of the contributor are there different values between the outcome parameters? In the view of the payers and other actors are there different values between the outcome parameters? Which ethical and juridical factors have to be considered? Which social and/or socio-economic parameters influence the use of the services and effectiveness? A systematic literature research is done in 35 databases. For the period 2005 to 2010, reviews, epidemiological and clinical studies as well as economical evaluations which deal with primary prevention programmes regarding cardiovascular diseases or the metabolic syndrome are included. 44 publications meet the inclusion criteria. These studies confirm the effectiveness of the

  10. Effectiveness of programmes as part of primary prevention demonstrated on the example of cardiovascular diseases and the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2011-01-01

    Full Text Available Background: The HTA-report (HTA = Health Technology Assessment deals with the primary prevention of cardiovascular diseases and diabetes mellitus type 2. In 2009 approximately 356,000 people died in Germany due to cardiovascular diseases. According to estimations about 6.3 million people are suffering from diabetes mellitus type 2. The interventions that are subsidized by the public health insurance are mainly focused on sufficient physical activities, healthy nutrition, stress management and the reduction of the consumption of addictive drugs and luxury food. Objectives: Which lifestyle-related measures and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are effective? To what extent will the health status be improved by these offers? To what extent will existing health resources and skills be strengthened by these offers? Are there any differences regarding the effectiveness among the interventions with respect to different settings or subgroups? Which lifestyle-related interventions and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are sustainable and cost-effective? Which outcome parameters are in the view of the contributors decisive for the evaluation of the effectiveness? In the view of the contributor are there different values between the outcome parameters? In the view of the payers and other actors are there different values between the outcome parameters? Which ethical and juridical factors have to be considered? Which social and/or socio-economic parameters influence the use of the services and effectiveness? Methods: A systematic literature research is done in 35 databases. For the period 2005 to 2010, reviews, epidemiological and clinical studies as well as economical evaluations which deal with primary prevention programmes regarding cardiovascular diseases or the metabolic syndrome are included. Results: 44 publications meet the

  11. Lessons Learned from PISA: A Systematic Review of Peer-Reviewed Articles on the Programme for International Student Assessment

    Science.gov (United States)

    Hopfenbeck, Therese N.; Lenkeit, Jenny; El Masri, Yasmine; Cantrell, Kate; Ryan, Jeanne; Baird, Jo-Anne

    2018-01-01

    International large-scale assessments are on the rise, with the Programme for International Student Assessment (PISA) seen by many as having strategic prominence in education policy debates. The present article reviews PISA-related English-language peer-reviewed articles from the programme's first cycle in 2000 to its most current in 2015. Five…

  12. Collaborative Framework for Designing a Sustainability Science Programme: Lessons Learned at the National Autonomous University of Mexico

    Science.gov (United States)

    Charli-Joseph, Lakshmi; Escalante, Ana E.; Eakin, Hallie; Solares, Ma. José; Mazari-Hiriart, Marisa; Nation, Marcia; Gómez-Priego, Paola; Pérez-Tejada, César A. Domínguez; Bojórquez-Tapia, Luis A.

    2016-01-01

    Purpose: The authors describe the challenges and opportunities associated with developing an interdisciplinary sustainability programme in an emerging economy and illustrate how these are addressed through the approach taken for the development of the first postgraduate programme (MSc and PhD) in sustainability science at the National Autonomous…

  13. Internet-Based Recruitment to a Depression Prevention Intervention: Lessons From the Mood Memos Study

    Science.gov (United States)

    Jorm, Anthony Francis; Mackinnon, Andrew James

    2013-01-01

    Background Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. Objective To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. Methods Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. Results The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. Conclusions Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. Trial Registration ACTRN

  14. Internet-based recruitment to a depression prevention intervention: lessons from the Mood Memos study.

    Science.gov (United States)

    Morgan, Amy Joanna; Jorm, Anthony Francis; Mackinnon, Andrew James

    2013-02-12

    Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. ACTRN12609000925246.

  15. ‘Croque&bouge’: A feasible and acceptable programme for obesity prevention in preschoolers at risk and their parents

    Directory of Open Access Journals (Sweden)

    Sophie Bucher Della Torre

    2015-02-01

    Full Text Available Objectives: To conceptualize and pilot test a programme of three workshops aiming to prevent the development of overweight in susceptible preschool children. Methods: Three workshops were conducted, targeting both parents and children. The curriculum for parents included discussions on feeding responsibilities, healthy eating, taste development, neophobia and physical activity recommendations. Children participated in various play activities with fruits and vegetables and read stories about hunger and satiety feelings. Recruitment was organized through paediatricians and child-care centres. Evaluation of the programme focused on feasibility, adequacy for children’s age, parents’ perception of impact and, for children, change of the ability to recognize and willingness to taste fruits and vegetables. Results: A total of 21 children and one of their parents participated in the programme. The programme was found to be feasible and adequate for the targeted community. Parents reported perceiving a positive impact of the intervention; however, this finding was not statistically significant. The major difficulty was identifying and recruiting families and engaging the parents in a discussion about weight. Conclusions: This short programme aiming to improve parents’ ability to offer healthy environment and promote healthy eating behaviour was feasible and acceptable for families with young children. When developing and implementing such programmes, close collaboration with paediatricians and other health providers should be sought in order to identify and reach children at risk of obesity and their family.

  16. ES[S]PRIT--An Internet-Based Programme for the Prevention and Early Intervention of Eating Disorders in College Students

    Science.gov (United States)

    Bauer, Stephanie; Moessner, Markus; Wolf, Markus; Haug, Severin; Kordy, Hans

    2009-01-01

    New communication technologies offer novel possibilities for the prevention of mental illness, in which geographical and psychosocial distances often hamper help-seeking. This paper introduces ES[S]PRIT, an Internet-based eating disorders (ED) prevention programme for university students. The programme follows a stepped-care approach combining…

  17. Perspectives of rural health and human service practitioners following suicide prevention training programme in Australia: A thematic analysis.

    Science.gov (United States)

    Jones, Martin; Ferguson, Monika; Walsh, Sandra; Martinez, Lee; Marsh, Michael; Cronin, Kathryn; Procter, Nicolas

    2018-01-08

    There are well-established training programmes available to support health and human services professionals working with people vulnerable to suicide. However, little is known about involving people with lived experience in the delivery of suicide prevention training with communities with increased rates of suicide. The aim of this paper was to report on a formative dialogical evaluation that explored the views of health and human services workers with regard to a suicide prevention training programme in regional (including rural and remote areas) South Australia which included meaningful involvement of a person with lived experience in the development and delivery of the training. In 2015, eight suicide prevention training workshops were conducted with health and human services workers. All 248 participants lived and worked in South Australian regional communities. We interviewed a subsample of 24 participants across eight sites. A thematic analysis of the interviews identified five themes: Coproduction is key, It is okay to ask the question, Caring for my community, I can make a difference and Learning for future training. The overall meta-theme was "Involvement of a person with lived experience in suicide prevention training supports regional communities to look out for people at risk of suicide." This paper highlights the need for suicide prevention training and other workforce development programmes to include lived experience participation as a core component in development and delivery. © 2018 John Wiley & Sons Ltd.

  18. GIS in Public Health: applications in the Legionnaires' disease prevention programme

    Directory of Open Access Journals (Sweden)

    Emiliano Aránguez Ruiz

    2006-12-01

    Full Text Available This experience has been developed by the Public Health Institute of the Community of Madrid in order to use the GIS tools in the Legionnaires’ disease prevention programme and specifically in three work areas: epidemiologic surveillance, cooling towers environmental control and plans of intervention in case of an outbreak of Legionnaires’ disease.After having considered different strategies with their advantages the selected model have been the use of map viewers in the intranet with a different configuration format depending on its goals: images map viewers for systematic non-outbreak cases and cooling towers surveillance, viewers that allow an easier and usual consultation and, in the other hand, layers map viewers, better adapted to more complex users’ necessities and so designed to work in emergency situations. Both models are implemented to decentralise the use of these indispensable tools and make them closer of the public health professionals.Some methodological proposals to study spatial association of Legionaires’disease outbreaks are also presented and discussed in this paper.

  19. Most at-risk populations: contextualising HIV prevention programmes targeting marginalised groups in Zanzibar, Tanzania.

    Science.gov (United States)

    Ahmed, Naheed

    2014-09-01

    According to a 2009 UNAIDS report the HIV/AIDS prevalence rate in Zanzibar, Tanzania, is low in the general population (0.6%), but high among vulnerable groups, specifically sex workers (10.8%), injecting drug users (15.1%), and men who have sex with men (12.3%). In response to this concentrated epidemic, the Government of Zanzibar, international and local non-profit organisations have focused their prevention activities on these marginal populations. Although these efforts are beneficial in terms of disseminating information about HIV/AIDS and referring clients to health clinics, they fail to address how the socio-economic status of these groups places them at a greater risk for contracting and dying from the virus. Furthermore, there is an absence of qualitative research on these populations which is needed to understand the challenges these groups face and to improve the effectiveness of interventions. Through interviews with employees of government agencies and non-profit organisations, medical professionals, vulnerable populations and HIV/AIDS patients, this paper used a political economy of health and syndemic framework to examine how local realities inform and challenge HIV/AIDS programmes in Zanzibar.

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Sema K Sgaier

    2014-05-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Twenty-five years of the WHO vaccines prequalification programme (1987-2012): lessons learned and future perspectives.

    Science.gov (United States)

    Dellepiane, Nora; Wood, David

    2015-01-01

    The World Health Organization (WHO) vaccines prequalification programme was established in 1987. It is a service provided to United Nations procurement agencies to ensure that the vaccines supplied through these agencies are consistently safe and effective under conditions of use in national immunization programmes. This review describes the purpose and aims of the programme, its evolution during 25 years of existence, its added value, and its role in the context of the WHO strategy to ensure the global availability of vaccines of assured quality. The rationale for changes introduced during the implementation of the programme is provided. The paper also discusses the resources involved, both human and financial, its performance, strengths and weaknesses and steps taken to maximize its efficiency. This historical perspective is used to inform proposed future changes to the service. Copyright © 2013 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  4. Effects of a workplace prevention programme for problem gambling: study protocol for a cluster randomised controlled trial.

    Science.gov (United States)

    Rafi, Jonas; Ivanova, Ekaterina; Rozental, Alexander; Carlbring, Per

    2017-09-25

    Despite being considered a public health problem, no prevention programme for problem gambling in workplace settings has been scientifically evaluated. This study aims to fill a critical gap in the field of problem gambling by implementing and evaluating a large-scale prevention programme in organisations. Ten organisations, with a total of n=549 managers and n=8572 employees, will be randomised to either receiving a prevention programme or to a waitlist control condition. Measurements will be collected at the baseline and 3, 12 and 24 months after intervention. The primary outcome of interest is the managers' inclination to act when worried or suspicious about an employee's problem gambling or other harmful use. Additional outcomes of interest include the Problem Gambling Severity Index and gambling habits in both managers and employees. Furthermore, qualitative analyses of the responses from semistructured interviews with managers will be performed. This study has been approved by the regional ethics board of Stockholm, Sweden, and it will contribute to the body of knowledge concerning prevention of problem gambling. The findings will be published in peer-reviewed, open-access journals. NCT02925286; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Proposal of procedures to prevent errors in radiotherapy based in learned lessons of accidental expositions

    International Nuclear Information System (INIS)

    Bueno, Giselle Oliveira Vieira

    2007-01-01

    In order to consider some procedures to prevent errors in radiotherapy based in learned lessons of accidental expositions and in accordance with information contained in international reports elaborated by International Atomic Energy Agency (IAEA) and of the data base availability by the European group Radiation Oncology Safety Information System (ROSIS) on the events, a research of the occurred errors was performed. For the evaluation of the incidents a data base based in the ROSIS and added plus a parameter was created 'type of error'. All the stored data make possible the evaluation of the 839 incidents in terms of frequency of the type of error, the process of detention, the number of reached patients and the degree of severity. Of the 50 types of found errors, the type of error more frequently was 'incorrect treatment coordinate', confirmed with the data of literature and representing 28,96 por cent of the total of the incidents. The results showed 44,44 por cent are discovered at the moment of the treatment and that the process of verification of the fiche or clinical revision of the patient is a verification more occurred insurance and in 43,33 por cent of the searched events. The results indicated that more than 50 por cent of the incidents the severity degree are void and approximately 62 por cent a patient are affected during the accomplishment of the radiotherapy. This work showed that to analyze the data base according to methodology proposal for Klein et al.; for Reason, and Dunscombe et al. is interesting to insert more characteristic detailed in the data base such as: the number of fractions for affected patient, number of fields of treatment for fraction that was affected, shunting line of the prescribed dose and shunting line of the volume prescribed in all the registered in cadastral map events. Some causes exist that can lead the errors when patient they are submitted to the radiotherapy. Some measures can be taken so that these errors do not

  6. Overdose prevention for injection drug users: Lessons learned from naloxone training and distribution programs in New York City

    Directory of Open Access Journals (Sweden)

    Nandi Vijay

    2007-01-01

    Full Text Available Abstract Background Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs. Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. Methods During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. Results There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a political climate surrounding naloxone distribution; b extant prescription drug laws; c initial low levels of recruitment into the program; d development of participant appropriate training methodology; e challenges in the design of a suitable formal evaluation; and f evolution of program response to naloxone. Conclusion Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in

  7. Overdose prevention for injection drug users: lessons learned from naloxone training and distribution programs in New York City.

    Science.gov (United States)

    Piper, Tinka Markham; Rudenstine, Sasha; Stancliff, Sharon; Sherman, Susan; Nandi, Vijay; Clear, Allan; Galea, Sandro

    2007-01-25

    Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention) and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP) in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a) political climate surrounding naloxone distribution; b) extant prescription drug laws; c) initial low levels of recruitment into the program; d) development of participant appropriate training methodology; e) challenges in the design of a suitable formal evaluation; and f) evolution of program response to naloxone. Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in program planning and implementation, developing evaluation

  8. Study of compliance with a new, targeted antenatal D immunization prevention programme in Denmark

    DEFF Research Database (Denmark)

    Damkjaer, M B; Perslev, A; Clausen, F B

    2012-01-01

    A targeted routine antenatal anti-D prophylaxis programme was implemented in Denmark where anti-D immunoglobulin is given based on the result from noninvasive antenatal screening for fetal RHD. Our objective was to evaluate compliance with this new programme right after its initiation. Materials and...

  9. Older people's perception of and coping with falling, and their motivation for fall-prevention programmes

    DEFF Research Database (Denmark)

    Høst, Dorte; Hendriksen, Carsten; Borup, Ina

    2011-01-01

    This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes.......This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes....

  10. Evaluation of programmes for the prevention of behavioural problems and for development of social competences

    DEFF Research Database (Denmark)

    Knudsmoen, Hege; Holth, Per; Nissen, Poul

    2006-01-01

    Rapport om forskningsbaseret vurdering af programmer med henblik på reduktion af problemadfærd og udvikling af social kompetence i Norge......Rapport om forskningsbaseret vurdering af programmer med henblik på reduktion af problemadfærd og udvikling af social kompetence i Norge...

  11. Replicating Impact of a Primary School HIV Prevention Programme: Primary School Action for Better Health, Kenya

    Science.gov (United States)

    Maticka-Tyndale, E.; Mungwete, R.; Jayeoba, O.

    2014-01-01

    School-based programmes to combat the spread of HIV have been demonstrated to be effective over the short-term when delivered on a small scale. The question addressed here is whether results obtained with small-scale delivery are replicable in large-scale roll-out. Primary School Action for Better Health (PSABH), a programme to train teachers to…

  12. Family-based programmes for preventing smoking by children and adolescents.

    Science.gov (United States)

    Thomas, Roger E; Baker, Philip R A; Thomas, Bennett C; Lorenzetti, Diane L

    2015-02-27

    groups of studies were considered separately.Most studies had a judgement of 'unclear' for at least one risk of bias criteria, so the quality of evidence was downgraded to moderate. Although there was heterogeneity between studies there was little evidence of statistical heterogeneity in the results. We were unable to extract data from all studies in a format that allowed inclusion in a meta-analysis.There was moderate quality evidence family-based interventions had a positive impact on preventing smoking when compared to a no intervention control. Nine studies (4810 participants) reporting smoking uptake amongst baseline non-smokers could be pooled, but eight studies with about 5000 participants could not be pooled because of insufficient data. The pooled estimate detected a significant reduction in smoking behaviour in the intervention arms (risk ratio [RR] 0.76, 95% confidence interval [CI] 0.68 to 0.84). Most of these studies used intensive interventions. Estimates for the medium and low intensity subgroups were similar but confidence intervals were wide. Two studies in which some of the 4487 participants already had smoking experience at baseline did not detect evidence of effect (RR 1.04, 95% CI 0.93 to 1.17).Eight RCTs compared a combined family plus school intervention to a school intervention only. Of the three studies with data, two RCTS with outcomes for 2301 baseline never smokers detected evidence of an effect (RR 0.85, 95% CI 0.75 to 0.96) and one study with data for 1096 participants not restricted to never users at baseline also detected a benefit (RR 0.60, 95% CI 0.38 to 0.94). The other five studies with about 18,500 participants did not report data in a format allowing meta-analysis. One RCT also compared a family intervention to a school 'good behaviour' intervention and did not detect a difference between the two types of programme (RR 1.05, 95% CI 0.80 to 1.38, n = 388).No studies identified any adverse effects of intervention. There is moderate

  13. Lessons from reproductive health to inform multipurpose prevention technologies: don't reinvent the wheel.

    Science.gov (United States)

    Brady, Martha; Manning, Judy

    2013-12-01

    This paper presents the public health rationale for multipurpose prevention technologies (MPTs) for sexual and reproductive health (SRH) based on regional trends in demographic and SRH indicators. It then distils important lessons gleaned from the introduction of contraceptive and reproductive health products over the past several decades in order to inform the development and future introduction of MPTs for SRH. A comparison of current demographic and public health regional data clearly revealed that the greatest confluence of women's SRH concerns occurs in sub-Saharan Africa and South/West Asia. These regional overlaps of SRH risks and outcomes present a strong rationale for developing MPTs designed to simultaneously protect against unintended pregnancy, HIV and other STIs. Information from acceptability, marketing, and operations research on the female condom, emergency contraception, pills and intravaginal rings identified key product characteristics and socio-behavioral issues to be considered in the development and introduction of MPTs. Product characteristics such as formulation, duration of action, presence and magnitude of side effects, prescription status (over-the-counter vs. prescribed), provider type and training and user perspectives, all contributed in varying degrees to both provider and user bias, and subsequent uptake of these family planning methods. Underlying socio-behavioral issues, including risk perception, ambivalence, and social costs also contributed to demand and use. Early identification of target populations will be critical to market shaping, demand creation and defining appropriate service delivery channels for MPTs. Ultimately, knowledge, attitudes, perceptions and practices of users (and their partners) will drive the success- or failure- of product introduction. MPTs provide a compelling response to the multiple and reinforcing SRH risks faced by women in key regions of the world, but specific product characteristics and their

  14. Prevention programme for eating disturbances in adolescents. Is their effect on body image maintained at 30 months later?

    Science.gov (United States)

    Espinoza, Paola; Penelo, Eva; Raich, Rosa M

    2013-03-01

    We assessed changes in the body image of Spanish adolescents who participated in a programme aimed at preventing disordered eating, with a 30-month follow-up. 254 girls and 189 boys aged 12-14 were assigned to a control group (n=201) or one of two possible experimental conditions: media literacy programme (ML, n=143) and media literacy plus nutrition awareness programme (ML+NUT, n=99). Body image was assessed with the Body Image Questionnaire (Qüestionari d'Imatge Corporal; QÜIC). Pre-test, post-test, 7- and 30-month follow-up measurements were taken. Linear model analyses were carried out with a 2×3×3 ANOVA (sex×group×phase), adjusted by the baseline level. At 30-month follow-up, ML and ML+NUT participants showed fewer body problems and more body satisfaction than the control group. There is a need for prevention programmes addressing eating and body image disturbances that involve both boys and girls. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Planning the diffusion of a neck-injury prevention programme among community rugby union coaches.

    Science.gov (United States)

    Donaldson, Alex; Poulos, Roslyn G

    2014-01-01

    This paper describes the development of a theory-informed and evidence-informed, context-specific diffusion plan for the Mayday Safety Procedure (MSP) among community rugby coaches in regional New South Wales, Australia. Step 5 of Intervention Mapping was used to plan strategies to enhance MSP adoption and implementation. Coaches were identified as the primary MSP adopters and implementers within a system including administrators, players and referees. A local advisory group was established to ensure context relevance. Performance objectives (eg, attend MSP training for coaches) and determinants of adoption and implementation behaviour (eg, knowledge, beliefs, skills and environment) were identified, informed by Social Cognitive Theory. Adoption and implementation matrices were developed and change-objectives for coaches were identified (eg, skills to deliver MSP training to players). Finally, intervention methods and specific strategies (eg, coach education, social marketing and policy and by-law development) were identified based on advisory group member experience, evidence of effective coach safety behaviour-change interventions and Diffusion of Innovations theory. This is the first published example of a systematic approach to plan injury prevention programme diffusion in community sports. The key strengths of this approach were an effective researcher-practitioner partnership; actively engaging local sports administrators; targeting specific behaviour determinants, informed by theory and evidence; and taking context-related practical strengths and constraints into consideration. The major challenges were the time involved in using a systematic diffusion planning approach for the first time; and finding a planning language that was acceptable and meaningful to researchers and practitioners.

  16. Multidrug resistant Salmonella enterica isolated from conventional pig farms using antimicrobial agents in preventative medicine programmes.

    Science.gov (United States)

    Cameron-Veas, Karla; Fraile, Lorenzo; Napp, Sebastian; Garrido, Victoria; Grilló, María Jesús; Migura-Garcia, Lourdes

    2018-04-01

    A longitudinal study was conducted to investigate the presence of multidrug antimicrobial resistance (multi-AR) in Salmonella enterica in pigs reared under conventional preventative medicine programmes in Spain and the possible association of multi-AR with ceftiofur or tulathromycin treatment during the pre-weaning period. Groups of 7-day-old piglets were treated by intramuscular injection with ceftiofur on four farms (n=40 piglets per farm) and with tulathromycin on another four farms (n=40 piglets per farm). A control group of untreated piglets (n=30 per farm) was present on each farm. Faecal swabs were collected for S. enterica culture prior to treatment, at 2, 7 and 180days post-treatment, and at slaughter. Minimal inhibitory concentrations of 14 antimicrobial agents, pulsed-field gel electrophoresis and detection of resistance genes representing five families of antimicrobial agents were performed. Plasmids carrying cephalosporin resistant (CR) genes were characterised. Sixty-six S. enterica isolates were recovered from five of eight farms. Forty-seven isolates were multi-AR and four contained bla CTX-M genes harboured in conjugative plasmids of the IncI1 family; three of these isolates were recovered before treatment with ceftiofur. The most frequent AR genes detected were tet(A) (51/66, 77%), sul1 (17/66, 26%); tet(B) (15/66, 23%) and qnrB (10/66, 15%). A direct relation between the use of ceftiofur in these conditions and the occurrence of CR S. enterica was not established. However, multi-AR was common, especially for ampicillin, streptomycin, sulphonamides and tetracycline. These antibiotics are used frequently in veterinary medicine in Spain and, therefore, should be used sparingly to minimise the spread of multi-AR. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Evaluating an in-school injury prevention programme's effect on children's helmet wearing habits.

    Science.gov (United States)

    Blake, Gary; Velikonja, Diana; Pepper, Veronica; Jilderda, Irene; Georgiou, Georgia

    2008-06-01

    To evaluate the effectiveness of the Bikes, Blades and Boards (BB&B) programme. It was hypothesized that children who participated in the BB&B programme would demonstrate greater knowledge of how to wear their helmets safely than a control group who did not participate in the programme and retain their skills when assessed 1 year later. Single blind cluster randomized design. Twelve classes of grade 2 students (n = 162) participated; six classes were assigned to an experimental or control group. A blinded research assistant, taking 3-5 minutes per child, completed the Helmet Checklist with each group on two occasions and scores of the experimental group (post-BB&B programme) were compared to the control group. The experimental group was reassessed using the Helmet Checklist, 1 year later. The BB&B programme consisted of a presentation, bicycle helmet checklist, demonstration and individual practice and feedback. Children in the experimental group showed a better knowledge of how to wear their helmets safely compared to the control group (F = 51.84, CI = 9.11-9.71) and retained this knowledge 1 year after participating in the BB&B programme. The BB&B programme is effective in teaching grade 2 children how to wear their helmets correctly, which is knowledge they retain for at least 1 year.

  18. Outcome Evaluation of "Cool and Clean", a Sports-Based Substance Use Prevention Programme for Young People in Switzerland

    Science.gov (United States)

    Wicki, Matthias; Kuntsche, Sandra; Stucki, Stephanie; Marmet, Simon; Annaheim, Beatrice

    2018-01-01

    Aims: The aim of this study was to evaluate the outcomes of Cool and Clean, Switzerland's largest substance use prevention programme, targeted specifically at 10- to 20-year-olds who belong to a sports club and train as part of a team. Method: Based on a representative sample of young people who belong to a sports club and train as part of a team…

  19. A parenting programme to prevent abuse of adolescents in South Africa: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Cluver, Lucie; Meinck, Franziska; Shenderovich, Yulia; Ward, Catherine L; Romero, Rocio Herrero; Redfern, Alice; Lombard, Carl; Doubt, Jenny; Steinert, Janina; Catanho, Ricardo; Wittesaele, Camille; De Stone, Sachin; Salah, Nasteha; Mpimpilashe, Phelisa; Lachman, Jamie; Loening, Heidi; Gardner, Frances; Blanc, Daphnee; Nocuza, Mzuvekile; Lechowicz, Meryn

    2016-07-19

    An estimated one billion children experience child abuse each year, with the highest rates in low- and middle-income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence-prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting and reduce adolescent behavioural problems. This trial aims to evaluate the effectiveness of Sinovuyo Teen compared to an attention-control group of a water hygiene programme. This is a pragmatic cluster randomised controlled trial, with stratified randomisation of 37 settlements (rural and peri-urban) with 40 study clusters in the Eastern Cape of South Africa. Settlements receive either a 14-session parenting support programme or a 1-day water hygiene programme. The primary outcomes are child abuse and parenting practices, and secondary outcomes include adolescent behavioural problems, mental health and social support. Concurrent process evaluation and qualitative research are conducted. Outcomes are reported by both primary caregivers and adolescents. Brief follow-up measures are collected immediately after the intervention, and full follow-up measures collected at 3-8 months post-intervention. A 15-24-month follow-up is planned, but this will depend on the financial and practical feasibility given delays related to high levels of ongoing civil and political violence in the research sites. This is the first known trial of a parenting programme to prevent abuse of adolescents in a low- or middle-income country. The study will also examine potential mediating pathways and moderating factors. Pan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. It can be found by searching for the key word 'Sinovuyo' on their website or via the following link: http://www.pactr.org/ATMWeb/appmanager/atm

  20. Intermittent preventive treatment for malaria among children in a refugee camp in Northern Uganda: lessons learned.

    Science.gov (United States)

    Coldiron, Matthew E; Lasry, Estrella; Bouhenia, Malika; Das, Debashish; Okui, Peter; Nyehangane, Dan; Mwanga, Juliet; Langendorf, Celine; Elder, Greg; Salumu, Léon; Grais, Rebecca F

    2017-05-23

    Northern Uganda hosts a large population of refugees from South Sudan, and malaria is one of the major health problems in the area. In 2015, intermittent preventive treatment for malaria (IPTc) was implemented in two refugee camps among children aged 6 months to 14 years. Three distributions of dihydroartemisinin-piperaquine (DP) were conducted at 8-week intervals. The first dose was directly administered at IPTc distribution sites and the second and third doses were given to caregivers to administer at home. A multi-faceted evaluation was implemented, including coverage surveys, malaria prevalence surveys, reinforced surveillance, and pharmacovigilance. Programme coverage exceeded 90% during all three distributions with a total of 40,611 participants. Compared to same period during the previous year (only available data), the incidence of malaria in the target populations was reduced (IRR 0.73, 95% CI 0.69-0.77 among children under 5 years old; IRR 0.70, 95% CI 0.67-0.72 among children aged 5-14 years). Among those not targeted for intervention, the incidence between the 2 years increased (IRR 1.49, 95% CI 1.42-1.56). Cross-sectional surveys showed a prevalence of parasitaemia (microscopy or PCR) of 12.9-16.4% (95% CI 12.6-19.3) during the intervention, with the highest prevalence among children aged 5-14 years, but with a large increase 8 weeks after the final distribution. A total of 57 adverse events were reported during the intervention period, including one severe adverse event (death from varicella). Adverse events were of mild to moderate severity, and were mainly dermatologic and gastrointestinal. This is the first documentation of an IPTc programme in a refugee camp. The positive impact of DP on the incidence of malaria, together with its favourable safety profile, should lead to further use of IPTc in similar settings. Expanding coverage groups and decreasing intervals between distributions might provide more benefit, but would need to be balanced

  1. Letting go of an old habit: group leaders' experiences of a client-centred multidisciplinary falls-prevention programme.

    Science.gov (United States)

    Johansson, Erika; Borell, Lena; Jonsson, Hans

    2014-03-01

    It has been suggested that the prevention of disability and falls should be conducted from a client-centred approach, especially when it includes how individuals learn new strategies in everyday life. In addition, programmes for the prevention of falls need to be multi-professional and multidisciplinary in order to be effective. In preventive work with clients, using the approach of client-centredness, the therapists work together with the clients to enable them to achieve occupational goals. There are few studies in fall prevention that have explored group leaders' experiences, i.e., studies that focus on the experiences of group leaders when working from a client-centred approach. This study aims to explore, by the use of focus-group interviews, the therapists' experiences of being group leaders in a fall-prevention programme that applied the ideas and approaches described above. The analysis revealed that a change in the role of being a group leader had taken place during the intervention process. Three primary categories pertaining to this process were identified: (i) the group leaders moved between the role of expert and the role of facilitator; the group climate (ii) facilitated the translation of expert knowledge to applied knowledge; and (iii) increased awareness as a prerequisite for change.

  2. Replacing Concrete with Natural and Social Engineering: Learning the Lessons of Stakeholder Engagement from South West Water's Upland Catchment Management Programme

    Science.gov (United States)

    Smith, David; Grand-Clement, Emile; Brazier, Richard

    2014-05-01

    Replacing Concrete with Natural and Social Engineering: Learning the Lessons of Stakeholder Engagement from South West Water's Upland Catchment Management Programme Smith, D., Grand-Clement, E., Anderson, K., Luscombe, D., G, N., Bratis, Brazier, R.E Peatlands in the South West of the British Isles have been extensively drained for agricultural reclamation and peat cutting. The improvement in food production resulting from this management practice has never clearly been observed. Instead, we are now faced with several detrimental consequences on a whole suite of ecosystem services, such as the delivery of water, water quality, biodiversity and carbon storage. Alongside the direct environmental implications, poor water quality is increasing water treatment costs and will drive significant future investment. As a result, water companies now need to find appropriate solutions to varying water levels and decreasing water quality through catchment management. The Mires Project, the catchment management programme used by South West Water (SWW) is working with a wide range of stakeholders to restore the hydrological functioning of peatlands, and the ecosystem services they provide. This programme is driven by overarching legal requirements (i.e. the water framework directive, Natura 2000), future climate change predictions, corporate responsibility and commercial needs. Post-restoration scientific monitoring is at the heart of the project improving of our understanding of the eco-hydrological and chemical process driving changes in management practice. The challenges faced from the involvement of a wide range of stakeholders will be explored, focusing on the benefits from stakeholder involvement in catchment management and hydrological research, but also considering the difficulties to be overcome. SWW is working with private land-owners, government agencies, local and national park Authorities, community and single interest groups and research institutions to achieve its

  3. Towards an Online Bachelor of Information Science Degree Programme in a Nigerian University: Part 2--Lessons from a Market Survey

    Science.gov (United States)

    Tiamiyu, Mutawakilu; Ajiferuke, Isola; Longe, Folake; Nwagwu, Williams; Ogunsola, Kemi; Opesade, Adeola; Olatokun, Wole

    2012-01-01

    This is the second of two articles that reports aspects of a study that was undertaken to assess the information industry and job market needs that the curriculum of the proposed programme must target. The first article specified the research problem and objectives, reviewed some key definitions and methodologies that were used, and the findings,…

  4. Improving homeless persons’ utilization of primary care : Lessons to be learned from an outreach programme in The Netherlands

    NARCIS (Netherlands)

    Elissen, A.M.J.; van Raak, A.J.A.; Derck, E.W.C.C.; Vrijhoef, H.J.M.

    2013-01-01

    Faced with rising homelessness, countries around the world are in need of innovative approaches to caring for those without shelter, who, more often than not, suffer from severe health problems. We conducted a case study of an innovative Dutch Primary Care for the Homeless (PCH) programme to gain

  5. Evaluating the effect of policies and interventions to address inequalities in health: lessons from a Dutch programme

    NARCIS (Netherlands)

    Stronks, Karien; Mackenbach, Johan P.

    2006-01-01

    OBJECTIVES: Many initiatives have been taken in European countries that are designed to reduce inequalities in health. However, the effects of only a very few of these initiatives have been assessed. The main aim of a Dutch research and development programme was to systematically investigate and

  6. Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India.

    Science.gov (United States)

    Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca; Sgaier, Sema K

    2013-04-01

    Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines.

  7. Professional Attitudes of the Teachers in Implementation of a School-Based Programme about Prevention of the Use Psychoactive Substances in 5-7 Grade

    Directory of Open Access Journals (Sweden)

    Kozhuharova Penka Petkova

    2015-08-01

    Full Text Available The subject of the research is the planning, implementation and evaluation of the program about prevention of the use of psychoactive substances among students 5-7 grade. The study was conducted by survey method with 314 teachers who teach in twenty-six schools. The qualification of the teachers to work with the program about prevention was studied in the lesson of the class. We studied the forms, through which the preventive activity, topicality, the methods used and course curricula for hours in individual classes were implemented. It was found that there was an interaction between the various recipients of the preventive activity. The preparation and qualification of the teachers to work on a program for the prevention of the use of alcohol and tobacco products was studied in the lesson of the class. We pointed out some problematic aspects and guidelines for development of the preventive activity.

  8. Obesity Prevention in a City State: Lessons from New York City during the Bloomberg Administration.

    Science.gov (United States)

    Kelly, Paul M; Davies, Anna; Greig, Alexandra J M; Lee, Karen K

    2016-01-01

    To illuminate the key components of multi-sector reform to address the obesogenic environment in New York City during the administration of Mayor Michael Bloomberg from 2002 to 2013, we conducted a case study consisting of interviews with and a critical analysis of the experiences of leading decision makers and implementers. Key informant interviews (N = 41) conducted in 2014 were recorded, transcribed, coded, and thematically analyzed. Participants included officials from the Health Department and other New York City Government agencies, academics, civil society members, and private sector executives. Participants described Mayor Bloomberg as a data-driven politician who wanted to improve the lives of New Yorkers. He appointed talented Commissioners and encouraged them and their staff to be bold, innovative, and collaborative. Multiple programs spanning multiple sectors, with varied approaches and targets, were supported. This study found that much of the work relied on loose coalitions across City Government, with single agencies responsible for their own agendas, some with health co-benefits. Many policies were implemented through non-legislative mechanisms such as executive orders and the Health Code. Despite support from academic and some civil society groups, strong lobbying from industry and an unfavorable media led to some reforms being modified, legally challenged or blocked completely, particularly food environment modifiers. In contrast, reforms of the physical environment were described as highly consultative across and outside government and resulted in slower but more sustained reform. The Bloomberg administration was a "window of opportunity" with the imprimatur of the executive to progress a long-term, multi-faceted obesity prevention strategy, which has successfully reversed childhood trends. Through the involvement of external researchers and the extensive use of empirical data from a wide range of participants, this study offers a unique

  9. Costs and longer-term savings of parenting programmes for the prevention of persistent conduct disorder: a modelling study

    Directory of Open Access Journals (Sweden)

    Beecham Jennifer

    2011-10-01

    Full Text Available Abstract Background Conduct disorders are the most common psychiatric disorders in children and may persist into adulthood in about 50% of cases. The costs to society are high and impact many public sector agencies. Parenting programmes have been shown to positively affect child behaviour, but little is known about their potential long-term cost-effectiveness. We therefore estimate the costs of and longer-term savings from evidence-based parenting programmes for the prevention of persistent conduct disorder. Methods A decision-analytic Markov model compares two scenarios: 1 a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2 the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted. Results Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices. Conclusions Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.

  10. Lessons from EU conflict prevention efforts in the Western Balkans and the Horn of Africa

    DEFF Research Database (Denmark)

    Rodt, Annemarie Peen; Tvilling, Johannes

    2017-01-01

    ’s ambitions and the realities on the ground. Key lessons identified in comparative case studies of CSDP missions The EU supports its strategic approach towards both the Western Balkans and the Horn of Africa through a series of CSDP deployments focused on strengthening security structures through police...... in these or other regions. Key lessons identified through comparative case studies of EULEX Kosovo and EUCAP Nestor/Somalia relate to the importance of (i) clear mission mandates with concrete benchmarks and verifiable indicators of success, (ii) consistency and predictability of political support from Member...

  11. The preventive effect of the bounding exercise programme on hamstring injuries in amateur soccer players: the design of a randomized controlled trial.

    Science.gov (United States)

    Van de Hoef, S; Huisstede, B M A; Brink, M S; de Vries, N; Goedhart, E A; Backx, F J G

    2017-08-22

    Hamstring injuries are the most common muscle injury in amateur and professional soccer. Most hamstring injuries occur in the late swing phase, when the hamstring undergoes a stretch-shortening cycle and the hamstring does a significant amount of eccentric work. The incidence of these injuries has not decreased despite there being effective injury prevention programmes focusing on improving eccentric hamstring strength. As this might be because of poor compliance, a more functional injury prevention exercise programme that focuses on the stretch-shortening cycle might facilitate compliance. In this study, a bounding exercise programme consisting of functional plyometric exercises is being evaluated. A cluster-randomized controlled trial (RCT). Male amateur soccer teams (players aged 18-45 years) have been randomly allocated to intervention and control groups. Both groups are continuing regular soccer training and the intervention group is additionally performing a 12-week bounding exercise programme (BEP), consisting of a gradual build up and maintenance programme for the entire soccer season. The primary outcome is hamstring injury incidence. Secondary outcome is compliance with the BEP during the soccer season and 3 months thereafter. Despite effective hamstring injury prevention programmes, the incidence of these injuries remains high in soccer. As poor compliance with these programmes may be an issue, a new plyometric exercise programme may encourage long-term compliance and is expected to enhance sprinting and jumping performance besides preventing hamstring injuries. NTR6129 . Retrospectively registered on 1 November 2016.

  12. Programmes for advance distribution of misoprostol to prevent post-partum haemorrhage: a rapid literature review of factors affecting implementation.

    Science.gov (United States)

    Smith, Helen J; Colvin, Christopher J; Richards, Esther; Roberson, Jeffrey; Sharma, Geeta; Thapa, Kusum; Gülmezoglu, A Metin

    2016-02-01

    Recent efforts to prevent post-partum haemorrhage (PPH) in low-income countries have focused on providing women with access to oral misoprostol during home birth. The WHO recommends using lay health workers (LHWs) to administer misoprostol in settings where skilled birth attendants are not available. This review synthesizes current knowledge about the barriers and facilitators affecting implementation of advance community distribution of misoprostol to prevent PPH, where misoprostol may be self-administered or administered by an LHW.We searched for and summarized available empirical evidence, and collected primary data from programme stakeholders about their experiences of programme implementation.We present key outcomes and features of advanced distribution programmes that are in operation or have been piloted globally. We categorized factors influencing implementation into those that operate at the health system level, factors related to the community and policy context and those factors more closely connected to the end user.Debates around advance distribution have centred on the potential risks and benefits of making misoprostol available to pregnant women and community members during pregnancy for administration in the home. However, the risks of advance distribution appear manageable and the benefits of self-administration, especially for women who have little chance of expert care for PPH, are considerable. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  13. Strengthening capacity to research the social determinants of health in low- and middle-income countries: lessons from the INTREC programme.

    Science.gov (United States)

    Henschke, Nicholas; Mirny, Anna; Haafkens, Joke A; Ramroth, Heribert; Padmawati, Siwi; Bangha, Martin; Berkman, Lisa; Trisnantoro, Laksono; Blomstedt, Yulia; Becher, Heiko; Sankoh, Osman; Byass, Peter; Kinsman, John

    2017-05-25

    The INDEPTH Training & Research Centres of Excellence (INTREC) collaboration developed a training programme to strengthen social determinants of health (SDH) research in low- and middle-income countries (LMICs). It was piloted among health- and demographic researchers from 9 countries in Africa and Asia. The programme followed a blended learning approach and was split into three consecutive teaching blocks over a 12-month period: 1) an online course of 7 video lectures and assignments on the theory of SDH research; 2) a 2-week qualitative and quantitative methods workshop; and 3) a 1-week data analysis workshop. This report aims to summarise the student evaluations of the pilot and to suggest key lessons for future approaches to strengthen SDH research capacity in LMICs. Semi-structured interviews and questionnaires with 24 students from 9 countries in Africa and Asia were used to evaluate each teaching block. Information was collected about the students' motivation and interest in studying SDH, any challenges they faced during the consecutive teaching blocks, and suggestions they had for future courses on SDH. Of the 24 students who began the programme, 13 (54%) completed all training activities. The students recognised the need for such a course and its potential to improve their skills as health researchers. The main challenges with the online course were time management, prior knowledge and skills required to participate in the course, and the need to get feedback from teaching staff throughout the learning process. All students found the face-to-face workshops to be of high quality and value for their work, because they offered an opportunity to clarify SDH concepts taught during the online course and to gain practical research skills. After the final teaching block, students felt they had improved their data analysis skills and were better able to develop research proposals, scientific manuscripts, and policy briefs. The INTREC programme has trained a

  14. Does a fall prevention educational programme improve knowledge and change exercise prescribing behaviour in health and exercise professionals? A study protocol for a randomised controlled trial

    OpenAIRE

    Tiedemann, A; Sturnieks, D L; Hill, A-M; Lovitt, L; Clemson, L; Lord, S R; Harvey, L; Sherrington, C

    2014-01-01

    Introduction Falling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on heal...

  15. Rational Emotive Behavior Based on Academic Procrastination Prevention: Training Programme of Effectiveness

    Science.gov (United States)

    Düsmez, Ihsan; Barut, Yasar

    2016-01-01

    The research is an experimental study which has experimental and control groups, and based on pre-test, post-test, monitoring test model. Research group consists of second and third grade students of Primary School Education and Psychological Counseling undergraduate programmes in Giresun University Faculty of Educational Sciences. The research…

  16. Advancing the strategic use of HIV operations research to strengthen local policies and programmes: the Research to Prevention Project.

    Science.gov (United States)

    Kerrigan, Deanna; Kennedy, Caitlin E; Cheng, Alison Surdo; Sandison, Sarah J; Fonner, Virginia A; Holtgrave, David R; Brahmbhatt, Heena

    2015-01-01

    In the field of HIV prevention, there is renewed interest in operations research (OR) within an implementation science framework. The ultimate goal of such studies is to generate new knowledge that can inform local programmes and policies, thus improving access, quality, efficiency and effectiveness. Using four case studies from the USAID-funded Research to Prevention (R2P) project, we highlight the strategic use of OR and the impact it can have on shaping the focus and content of HIV prevention programming across geographic and epidemic settings and populations. These case studies, which include experiences from several sub-Saharan African countries and the Caribbean, emphasize four unique ways that R2P projects utilized OR to stimulate change in a given context, including: (1) translating findings from clinical trials to real-world settings; (2) adapting promising structural interventions to a new context; (3) tailoring effective interventions to underserved populations; and (4) prioritizing key populations within a national response to HIV. Carefully crafted OR can bridge the common gap that exists between research-generated knowledge and field-based practice, lead to substantial, real-world changes in national policies and programmes, and strengthen local organizations and the use of data to be more responsive to a given topic or population, ultimately supporting a locally tailored HIV response.

  17. Harm Reduction for the Prevention of Youth Gambling Problems: Lessons Learned From Adolescent High-Risk Behavior Prevention Programs

    Science.gov (United States)

    Dickson, Laurie M.; Derevensky, Jeffrey L.; Gupta, Rina

    2004-01-01

    Despite the growing popularity of the harm reduction approach in the field of adolescent alcohol and substance abuse, a harm reduction approach to prevention and treatment of youth problem gambling remains largely unexplored. This article poses the question of whether the harm reduction paradigm is a promising approach to the prevention of…

  18. Pesticide leaching through sandy and loamy fields - long-term lessons learnt from the Danish Pesticide Leaching Assessment Programme.

    Science.gov (United States)

    Rosenbom, Annette E; Olsen, Preben; Plauborg, Finn; Grant, Ruth; Juhler, René K; Brüsch, Walter; Kjær, Jeanne

    2015-06-01

    The European Union authorization procedure for pesticides includes an assessment of the leaching risk posed by pesticides and their degradation products (DP) with the aim of avoiding any unacceptable influence on groundwater. Twelve-year's results of the Danish Pesticide Leaching Assessment Programme reveal shortcomings to the procedure by having assessed leaching into groundwater of 43 pesticides applied in accordance with current regulations on agricultural fields, and 47 of their DP. Three types of leaching scenario were not fully captured by the procedure: long-term leaching of DP of pesticides applied on potato crops cultivated in sand, leaching of strongly sorbing pesticides after autumn application on loam, and leaching of various pesticides and their DP following early summer application on loam. Rapid preferential transport that bypasses the retardation of the plow layer primarily in autumn, but also during early summer, seems to dominate leaching in a number of those scenarios. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Challenges faced by health workers in implementing the prevention of mother-to-child HIV transmission (PMTCT) programme in Uganda.

    Science.gov (United States)

    Nuwagaba-Biribonwoha, H; Mayon-White, R T; Okong, P; Carpenter, L M

    2007-09-01

    To report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda. Interviews were conducted with 15 key informants including counsellors, obstetricians and PMTCT coordinators at the five PMTCT test sites in Uganda to investigate the benefits, challenges and sustainability of the PMTCT programme. Audio-taped interviews were held with each informant between January and June 2003. These were transcribed verbatim and manually analysed using the framework approach. The perceived benefits reported by informants were improvement of general obstetric care, provision of antiretroviral prophylaxis for HIV-positive mothers, staff training and community awareness. The main challenges lay in the reluctance of women to be tested for HIV, incomplete follow-up of participants, non-disclosure of HIV status and difficulties with infant feeding for HIV-positive mothers. Key informants thought that the programme's sustainability depended on maintaining staff morale and numbers, on improving services and providing more resources, particularly antiretroviral therapy for the HIV-positive women and their families. Uganda's experience in piloting the PMTCT programme reflected the many challenges faced by health workers. Potentially resource-sparing strategies such as the 'opt-out' approach to HIV testing required further evaluation.

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

    Science.gov (United States)

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

    2017-05-01

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

  1. Programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean.

    Science.gov (United States)

    Kelly, J A; Somlai, A M; Benotsch, E G; Amirkhanian, Y A; Fernandez, M I; Stevenson, L Y; Sitzler, C A; McAuliffe, T L; Brown, K D; Opgenorth, K M

    2006-01-01

    This study assessed the programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in 75 countries in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. Multiple databases and expert recommendations were used to identify one major HIV-prevention NGO in the capital or a large city in each country, and in-depth interviews were conducted with each NGO Director. Most NGOs are carrying out their programmes with minimal funding and few regularly employed personnel. Most are highly dependent on international donors, but reliance on small grants with short funding periods limits programme development capacity. HIV-prevention activities varied by region, with African NGOs most likely to use peer education and community awareness events; Eastern European NGOs most likely to offer needle exchange; Latin American NGOs to have resource centres and offer risk reduction programmes; and Caribbean organizations to use mass education approaches. Across regions, NGOs most often targeted the general public and youth, although specialized at-risk groups were the additional focus of attention in some regions. Limited funding, governmental indifference or opposition, AIDS stigma, and social discomfort discussing sex were often cited as barriers to new HIV-prevention programmes. NGOs are critical service providers. However, their funding, programmes, and resource capacities must be strengthened if NGOs are to realize their full potential in HIV prevention.

  2. A cluster randomised school-based lifestyle intervention programme for the prevention of childhood obesity and related early cardiovascular disease (JuvenTUM 3

    Directory of Open Access Journals (Sweden)

    Haller Bernhard

    2011-04-01

    Full Text Available Abstract Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease. The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear, as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function. In this study a comprehensive school-based randomized intervention programme will be investigated in 10-14-year old children addressing the influence of lifestyle intervention on inactivity, cardiometabolic risk factors and early signs of vascular disease. Methods/Design 15 secondary schools in Southern Germany are randomly assigned to intervention or control schools. Children in the fifth grade (10-11 years will be observed over four years. The study combines a school-based with a home-based approach, aiming at children, teachers and parents. The main components are weekly lifestyle-lessons for children, taught by regular classroom teachers to increase physical activity in- and outside of school, to improve eating patterns at school and at home, to reduce media consumption and to amplify well-being. In 4-6 annual meetings, teachers receive information about health-related topics with worksheets for children and supporting equipment, accounting for school-specific needs and strategies. Parents' trainings are provided on a regular basis. All examinations are performed at the beginning and at the end of every school year. Anthropometry includes measurements of BMI, waist and upper arm circumferences, skinfold thickness as well as peripheral blood pressure. Blood sampling includes lipid parameters, insulin, glucose, hsCRP, adiponectin, and IL-6 as well as testosteron and estrogen to determine maturation status. Vascular function is non-invasively assessed by measuring arterial stiffness in large

  3. Efficacy of a movement control injury prevention programme in adult men's community rugby union: a cluster randomised controlled trial.

    Science.gov (United States)

    Attwood, Matthew J; Roberts, Simon P; Trewartha, Grant; England, Mike E; Stokes, Keith A

    2018-03-01

    Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking. To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players. 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

  4. The effectiveness and promising strategies of obesity prevention and treatment programmes among adolescents from disadvantaged backgrounds: a systematic review.

    Science.gov (United States)

    Kornet-van der Aa, D A; Altenburg, T M; van Randeraad-van der Zee, C H; Chinapaw, M J M

    2017-05-01

    This review aimed to summarize the evidence on the effectiveness of obesity prevention and treatment programmes for adolescents from socioeconomically disadvantaged backgrounds. A secondary aim was to identify potential successful intervention strategies for this target group. PubMed, EMBASE, PsycINFO and Cochrane Library were searched from January 2000 up to February 2016. Intervention studies targeting adolescents from disadvantaged backgrounds were included, with body mass index as outcome. Secondary outcomes were other adiposity measures, physical activity, diet, sedentary behaviour and screen time. Two independent reviewers extracted data, coded intervention strategies and conducted quality assessments. Fourteen studies were included: nine obesity prevention and five obesity treatment studies. Two preventive and four treatment studies showed significant beneficial effects on body mass index. Five of six studies (four preventive, one treatment studies) measuring dietary behaviour reported significant intervention effects. Evidence on other secondary outcomes was inconclusive. We found no conclusive evidence for which specific intervention strategies were particularly successful in preventing or treating obesity among disadvantaged adolescents. However, the current evidence suggests that involving adolescents in the development and delivering of interventions, the use of experiential activities and involvement of parents seem to be promising strategies. More high quality studies are needed. PROSPERO registration number: CRD42016041612. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  5. Implementation of prevention of mother-to-child transmission of HIV programme through private hospitals of Delhi--policy implications.

    Science.gov (United States)

    Gupta, A K; Garg, C R; Joshi, B C; Rawat, N; Dabla, V; Gupta, A

    2015-01-01

    In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines. Out of total 575 private hospitals registered with Government of Delhi, 336 (58.4%) catering to pregnant women were identified. About 100 private hospitals with facility of antenatal care, vaginal/caesarean delivery and postnatal care and minimum 10 indoor beds were selected for study. Study sample comprised of large corporate hospitals (≥100 beds; n = 29), medium-sized hospitals (25 to Policy, HIV testing was done without pre/post-test counselling/or consent of women, no PMTCT protocol existed, delivery of HIV-positive women was not undertaken and no efforts were made to link HIV-positive women to antiretroviral treatment. Major intervention observed was medical termination of pregnancy, which indicates lack of awareness in private hospitals about available interventions under national programme. The role of private hospitals in management of HIV in pregnant women must be recognized and mainstreamed in HIV control efforts. There is an urgent need for capacity building of private health care providers to improve standards of practice. National AIDS Control Organization may consider establishing linkages or adopting model developed by some countries with generalized epidemic for delivering PMTCT services in private health sector.

  6. The PreCardio-study protocol – a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme

    Directory of Open Access Journals (Sweden)

    Jacobs Nele

    2007-09-01

    Full Text Available Abstract Background Cardiovascular diseases (CVD are the leading cause of death and the third cause of disability in Europe. Prevention programmes should include interventions aimed at a reduction of medical risk factors (hypertension, hypercholesterol, hyperglycemia, overweight and obesity as well as behavioural risk factors (sedentary lifestyle, high fat intake and low fruit and vegetable intake, smoking. The aim of this study is to investigate the effects of a multifaceted, multidisciplinary electronic prevention programme on cardiovascular risk factors. Methods/Design In a randomized controlled trial, one group will receive a maximal intervention (= intervention group. The intervention group will be compared to the control group receiving a minimal intervention. An inclusion of 350 patients in total, with a follow-up of 3 years is foreseen. The inclusion criteria are age between 25–65 and insured by the Onderlinge Ziekenkas, insuring for guaranteed income in case of illness for self-employed. The maximal intervention group receives several prevention consultations by their general practitioner (GP using a new type of cardiovascular risk calculator with personalised feedback on behavioural risk factors. These patients receive a follow-up with intensive support of health behaviour change via different methods, i.e. a tailored website and personal advice of a multidisciplinary team (psychologist, physiotherapist and dietician. The aim of this strategy is to reduce cardiovascular risk factors according to the guidelines. The primary outcome measures will be cardiovascular risk factors. The secondary outcome measures are cardiovascular events, quality of life, costs and incremental cost effectiveness ratios. The control group receives prevention consultations using a new type of cardiovascular risk calculator and general feedback. Discussion This trial incorporates interventions by GPs and other health professionals aiming at a reduction of

  7. A concept mapping approach to identifying the barriers to implementing an evidence-based sports injury prevention programme.

    Science.gov (United States)

    Donaldson, Alex; Callaghan, Aisling; Bizzini, Mario; Jowett, Andrew; Keyzer, Patrick; Nicholson, Matthew

    2018-01-20

    Understanding the barriers to programme use is important to facilitate implementation of injury prevention programmes in real-word settings. This study investigated the barriers to coaches of adolescent female soccer teams, in Victoria, Australia, implementing the evidence-based FIFA 11+ injury prevention programme. Concept mapping with data collected from 19 soccer coaches and administrators. Brainstorming generated 65 statements as barriers to 11+ implementation. After the statements were synthesised and edited, participants sorted 59 statements into groups (mean, 6.2 groups; range, 3-10 groups). Multidimensional scaling and hierarchical cluster analysis identified a six-cluster solution: Lack of 11+ knowledge among coaches (15 statements), Lack of player enjoyment and engagement (14), Lack of link to football-related goals (11), Lack of facilities and resources (8), Lack of leadership (6) and Lack of time at training (5). Statements in the 'Lack of 11+ knowledge among coaches' cluster received the highest mean importance (3.67 out of 5) and feasibility for the Football Federation to address (3.20) rating. Statements in the 'Lack of facilities and resources' cluster received the lowest mean importance rating (2.23), while statements in the 'Lack of time at training' cluster received the lowest mean feasibility rating (2.19). A multistrategy, ecological approach to implementing the 11+-with specific attention paid to improving coach knowledge about the 11+ and how to implement it, linking the 11+ to the primary goal of soccer training, and organisational leadership-is required to improve the uptake of the 11+ among the targeted coaches. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Implementation of an App-based neuromuscular training programme to prevent ankle sprains: a process evaluation using the RE-AIM Framework

    NARCIS (Netherlands)

    Vriend, I.; Coehoorn, I.; Verhagen, E.A.L.M.

    2015-01-01

    Background/aim: The contemporary electronic media is regarded as a practical tool in the dissemination of preventive measures and interventions. For this purpose an App (free of charge) was developed including an efficacious programme for the prevention of ankle sprain recurrences. This study

  9. A survey of energy drinks consumption practices among student -athletes in Ghana: lessons for developing health education intervention programmes

    Science.gov (United States)

    2012-01-01

    Background Globally, young adults and college athletes are primary targets of the marketing campaigns of energy drink companies. Consequently, it is reported that young adults and college athletes consume energy drinks frequently. The purpose of this study was to determine the prevalence of energy drink consumption among student-athletes selected from seven public universities in Ghana. The study assessed the energy drink consumption patterns, types usually consumed, frequency of consumption and reasons why athletes consumed energy drinks. Methods A total number of 180 student-athletes gave their consent to participate in the study and completed a questionnaire which was administered during an inter-university sports competition. Results Most of the participants (62.2%) reported consuming at least one can of energy drink in a week. A high proportion (53.6%) of the respondents who drink energy drinks indicated that they did so to replenish lost energy after training or a competition. Other reasons given as to why energy drinks were consumed by the study participants included to provide energy and fluids to the body (25.9%), to improve performance (9.8%) and to reduce fatigue (5.4%). Conclusion These results suggest the need to plan health education programmes to particularly correct some wrong perceptions that athletes have regarding the benefits of energy drinks and also create awareness among student-athletes about the side effects of excessive intake of energy drinks. PMID:22444601

  10. A survey of energy drinks consumption practices among student -athletes in Ghana: lessons for developing health education intervention programmes

    Directory of Open Access Journals (Sweden)

    Buxton Christiana

    2012-03-01

    Full Text Available Abstract Background Globally, young adults and college athletes are primary targets of the marketing campaigns of energy drink companies. Consequently, it is reported that young adults and college athletes consume energy drinks frequently. The purpose of this study was to determine the prevalence of energy drink consumption among student-athletes selected from seven public universities in Ghana. The study assessed the energy drink consumption patterns, types usually consumed, frequency of consumption and reasons why athletes consumed energy drinks. Methods A total number of 180 student-athletes gave their consent to participate in the study and completed a questionnaire which was administered during an inter-university sports competition. Results Most of the participants (62.2% reported consuming at least one can of energy drink in a week. A high proportion (53.6% of the respondents who drink energy drinks indicated that they did so to replenish lost energy after training or a competition. Other reasons given as to why energy drinks were consumed by the study participants included to provide energy and fluids to the body (25.9%, to improve performance (9.8% and to reduce fatigue (5.4%. Conclusion These results suggest the need to plan health education programmes to particularly correct some wrong perceptions that athletes have regarding the benefits of energy drinks and also create awareness among student-athletes about the side effects of excessive intake of energy drinks.

  11. A survey of energy drinks consumption practices among student -athletes in Ghana: lessons for developing health education intervention programmes.

    Science.gov (United States)

    Buxton, Christiana; Hagan, John E

    2012-03-24

    Globally, young adults and college athletes are primary targets of the marketing campaigns of energy drink companies. Consequently, it is reported that young adults and college athletes consume energy drinks frequently. The purpose of this study was to determine the prevalence of energy drink consumption among student-athletes selected from seven public universities in Ghana. The study assessed the energy drink consumption patterns, types usually consumed, frequency of consumption and reasons why athletes consumed energy drinks. A total number of 180 student-athletes gave their consent to participate in the study and completed a questionnaire which was administered during an inter-university sports competition. Most of the participants (62.2%) reported consuming at least one can of energy drink in a week. A high proportion (53.6%) of the respondents who drink energy drinks indicated that they did so to replenish lost energy after training or a competition. Other reasons given as to why energy drinks were consumed by the study participants included to provide energy and fluids to the body (25.9%), to improve performance (9.8%) and to reduce fatigue (5.4%). These results suggest the need to plan health education programmes to particularly correct some wrong perceptions that athletes have regarding the benefits of energy drinks and also create awareness among student-athletes about the side effects of excessive intake of energy drinks.

  12. LESSONS FROM THE EVALUATION OF A PUBLIC OUT-PATIENT SUBSTANCE ABUSE TREATMENT PROGRAMME IN THE WESTERN CAPE

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    Strebel, Anna

    2013-05-01

    Full Text Available Substance abuse is widely regarded as a major health and social problem in South Africa, and particularly in the Western Cape (Corrigall, Ward, Stinson, Struthers, Frantz, Lund, Flisher & Joska, 2007; Myers, Fakier & Louw, 2009. The complex nature of patterns of substance abuse, as well as the particular problems associated with this abuse, has implications for the development and implementation of treatment interventions. The most common primary drug of abuse in the Western Cape amongst patients admitted to treatment programmes is methamphetamine (known locally as “tik” (Dada, Plüddemann, Parry, Vawda & Fourie, 2012. The previous decade saw a dramatic rise in methamphetamine (hereafter indicated as MA use, particularly among youths, with over half the patients in treatment for MA abuse being younger than 25 years (Plüddemann, Parry, Dada, Bhana, Bachoo & Fourie, 2010. MA is also often used in combination with other drugs, and this prevalence of poly-substance abuse needs to be taken into account in the planning of services (Harker, Kader, Myers, Falkier, Parry, Flisher, Peltzer, Ramlagan & Davids, 2008.

  13. Diagnostic concordance of breast pathologists: lessons from the National Health Service Breast Screening Programme Pathology External Quality Assurance Scheme.

    Science.gov (United States)

    Rakha, Emad A; Ahmed, Mohamed A; Aleskandarany, Mohammed A; Hodi, Zsolt; Lee, Andrew H S; Pinder, Sarah E; Ellis, Ian O

    2017-03-01

    Previous concordance studies examining accuracy of breast diagnosis by pathologists, typically targeting difficult, histologically challenging breast lesions using artificial and restrictive environments, have reported aberrantly high levels of diagnostic discordance. The results of these studies may be misinterpreted by non-pathologists and raise concerns relating to routine practice. This study aims to assess the diagnostic agreement among UK breast pathologists. Two hundred and forty consecutive breast lesions, submitted by participants from their routine practice, included in the UK National Health Service Breast Screening Programme (NHSBSP) breast pathology EQA scheme during the last 10 years were reviewed. An average of approximately 600 participants viewed each case. Data on diagnostic categories (benign, atypical, in-situ malignant and invasive malignant) were collected. In this study, benign and atypical diagnoses were grouped together. The overall diagnostic agreement level was in the almost perfect range. Thirty-five cases (14.6%) showed diagnostic concordance of ≤95%. Reasons for discordance included one or more of: (1) scheme methodology limitations such as: (i) miscoding of certain lesions (e.g. phyllodes tumours and lobular neoplasia) (n = 7) and (ii) variable representation of the index lesion on glass slides (n = 18); and (2) diagnostically challenging cases that may be interpreted more easily using immunohistochemistry (n = 28). These latter included benign and malignant papillary lesions (n = 12), complex sclerosing lesions (n = 7), intraductal epithelial proliferative lesions (n = 6) and an unusual special tumour type (n = 1). Further review identified pathologists' misinterpretation in 13 cases (5.4%), with an average discordance rate of only 4.2%. The performance of breast pathologists is high. Exclusion of the effect of the scheme methodology limitations highlights further the high performance rate and identifies true diagnostically

  14. Estimating the cost-effectiveness of lifestyle intervention programmes to prevent diabetes based on an example from Germany: Markov modelling

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    Neumann Anne

    2011-11-01

    Full Text Available Abstract Background Type 2 diabetes mellitus (T2D poses a large worldwide burden for health care systems. One possible tool to decrease this burden is primary prevention. As it is unethical to wait until perfect data are available to conclude whether T2D primary prevention intervention programmes are cost-effective, we need a model that simulates the effect of prevention initiatives. Thus, the aim of this study is to investigate the long-term cost-effectiveness of lifestyle intervention programmes for the prevention of T2D using a Markov model. As decision makers often face difficulties in applying health economic results, we visualise our results with health economic tools. Methods We use four-state Markov modelling with a probabilistic cohort analysis to calculate the cost per quality-adjusted life year (QALY gained. A one-year cycle length and a lifetime time horizon are applied. Best available evidence supplies the model with data on transition probabilities between glycaemic states, mortality risks, utility weights, and disease costs. The costs are calculated from a societal perspective. A 3% discount rate is used for costs and QALYs. Cost-effectiveness acceptability curves are presented to assist decision makers. Results The model indicates that diabetes prevention interventions have the potential to be cost-effective, but the outcome reveals a high level of uncertainty. Incremental cost-effectiveness ratios (ICERs were negative for the intervention, ie, the intervention leads to a cost reduction for men and women aged 30 or 50 years at initiation of the intervention. For men and women aged 70 at initiation of the intervention, the ICER was EUR27,546/QALY gained and EUR19,433/QALY gained, respectively. In all cases, the QALYs gained were low. Cost-effectiveness acceptability curves show that the higher the willingness-to-pay threshold value, the higher the probability that the intervention is cost-effective. Nonetheless, all curves are

  15. Effect of nationwide injury prevention programme on serious spinal injuries in New Zealand rugby union: ecological study.

    Science.gov (United States)

    Quarrie, Kenneth L; Gianotti, Simon M; Hopkins, Will G; Hume, Patria A

    2007-06-02

    To investigate the effect of RugbySmart, a nationwide educational injury prevention programme, on the frequency of spinal cord injuries. Ecological study. New Zealand rugby union. Population at risk of injury comprised all New Zealand rugby union players. From 2001, all New Zealand rugby coaches and referees have been required to complete RugbySmart, which focuses on educating rugby participants about physical conditioning, injury management, and safe techniques in the contact phases of rugby. Numbers of all spinal injuries due to participation in rugby union resulting in permanent disablement in 1976-2005, grouped into five year periods; observed compared with predicted number of spinal injuries in 2001-5. Eight spinal injuries occurred in 2001-5, whereas the predicted number was 18.9 (relative rate=0.46, 95% confidence interval 0.19 to 1.14). Only one spinal injury resulted from scrums over the period; the predicted number was 9.0 (relative rate=0.11, 0.02 to 0.74). Corresponding observed and predicted rates for spinal injuries resulting from other phases of play (tackle, ruck, and maul) were 7 and 9.0 (relative rate=0.83, 0.29 to 2.36). The introduction of the RugbySmart programme coincided with a reduction in the rate of disabling spinal injuries arising from scrums in rugby union. This study exemplifies the benefit of educational initiatives in injury prevention and the need for comprehensive injury surveillance systems for evaluating injury prevention initiatives in sport.

  16. Lessons learnt from implementing an empirically informed recruitment approach for FEM-PrEP, a large HIV prevention clinical trial

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    Parker C

    2014-12-01

    Full Text Available Caleb Parker,1 Amy Corneli,1 Kawango Agot,2 Jacob Odhiambo,2 Jesse Asewe,2 Khatija Ahmed,3 Joseph Skhosana,3 Malebo Ratlhagana,3 Michele Lanham,1 Christina Wong,1 Jennifer Deese,1 Rachel Manongi,4 Lut Van Damme,1On behalf of the FEM-PrEP recruitment group 1FHI 360, Global Health, Population and Nutrition, Durham, NC, USA; 2Impact Research and Development Organization, Kisumu, Kenya; 3Setshaba Research Centre, Soshanguve, Pretoria, South Africa; 4Kilimanjaro Christian Medical Centre, Moshi, Tanzania Abstract: We implemented an empirically informed, geographically based recruitment approach for FEM-PrEP, a human immunodeficiency virus (HIV prevention clinical trial of daily oral emtricitabine (FTC and tenofovir disoproxil fumarate (TDF for HIV prevention. During the formative research phase, we conducted a modification of the Priorities for Local AIDS Control Efforts (PLACE method and used those data and staff experiences to identify and prioritize for recruitment geographic areas where HIV incidence might be high. During the clinical trial, we implemented a routinely monitored and flexible recruitment plan in the geographical areas identified in the formative research. We describe three lessons learnt from implementing this approach: 1 the PLACE data were critical in identifying places presumed to be high risk; 2 staff experiences, in combination with PLACE data, were needed to inform a practical recruitment strategy; and 3 recruiting in establishments in priority areas identified by the PLACE data led to screening many HIV-positive women at the Bondo site (Kenya, placing additional burden on clinic staff. These lessons learnt highlight the critical importance of having a flexible and monitored recruitment strategy. Although we successfully recruited a study population at higher risk for HIV, FEM-PrEP was unable to determine the effectiveness of FTC/TDF for HIV prevention, due to low adherence to the study product among participants. We must

  17. The Polish National Investment Fund Programme: Mass Privatisation With a Difference?

    OpenAIRE

    Iraj Hashi

    2000-01-01

    The Polish mass privatisation programme (MPP), though debated at length in the early phase of transition, was implemented with a long delay which led to the deterioration of the financial position of many of the companies in the scheme and the loss of, at least, some of the potential benefits of such schemes. The most important lesson of the programme for other countries is that mass privatisation should be implemented quickly in order to avoid uncertainty and to prevent opportunistic behavio...

  18. The Capacity Building programmes of GITEWS - visions, goals, lessons learned, and re-iterated needs and demands

    Science.gov (United States)

    Schlurmann, T.; Siebert, M.

    2011-02-01

    It was envisioned that the framework of the German-Indonesian Tsunami Early Warning System (GITEWS) should achieve an integral architecture and overarching technical design of an end-to-end tsunami early warning system (TEWS). In order to achieve this ambitious goal on a national and local level, a tailored set of capacity building measures has been started and implemented. The programme was meant and designed to meet requirements and urgent needs considering awareness raising campaigns, technical trainings and higher level education programs. These components have been integrated as complementary modules in order to ensure facilitating the early warning system to be operated, maintained and improved, and that institutions and people in coastal areas will respond adequately and timely in case of future tsunamis. Remarkable progress has been accomplished as well as programs and campaigns are being implemented in regard to a sustainable capacity development conducted by national institutions in Indonesia. Yet, local administrative and preparedness efforts on the Indonesian coastlines are still underdeveloped. This stems from the fact of missing links towards sustainable coastal zone management schemes on a broad local level. Yet, the demand and urgent need for an adequate and integrated disaster risk reduction and management addressing also other hazards in the region of interest is (still) substantial. Given the tragic loss of life and severe damages resulting from the December 2004 tsunami and recent series of severe earthquakes, the need for urgent mitigating action in the imperilled coastal regions of Sumatra and Java remains extremely high. The conceptual Capacity Building framework, its anticipated goals in the beginning of the project and, lately, the finally achieved objectives are promising. A significant contribution for mainstreaming scientific approaches and transfer methodological disaster risk reduction attempts towards other regions exposed to coastal

  19. The Capacity Building programmes of GITEWS – visions, goals, lessons learned, and re-iterated needs and demands

    Directory of Open Access Journals (Sweden)

    T. Schlurmann

    2011-02-01

    Full Text Available It was envisioned that the framework of the German-Indonesian Tsunami Early Warning System (GITEWS should achieve an integral architecture and overarching technical design of an end-to-end tsunami early warning system (TEWS. In order to achieve this ambitious goal on a national and local level, a tailored set of capacity building measures has been started and implemented. The programme was meant and designed to meet requirements and urgent needs considering awareness raising campaigns, technical trainings and higher level education programs. These components have been integrated as complementary modules in order to ensure facilitating the early warning system to be operated, maintained and improved, and that institutions and people in coastal areas will respond adequately and timely in case of future tsunamis. Remarkable progress has been accomplished as well as programs and campaigns are being implemented in regard to a sustainable capacity development conducted by national institutions in Indonesia. Yet, local administrative and preparedness efforts on the Indonesian coastlines are still underdeveloped. This stems from the fact of missing links towards sustainable coastal zone management schemes on a broad local level. Yet, the demand and urgent need for an adequate and integrated disaster risk reduction and management addressing also other hazards in the region of interest is (still substantial. Given the tragic loss of life and severe damages resulting from the December 2004 tsunami and recent series of severe earthquakes, the need for urgent mitigating action in the imperilled coastal regions of Sumatra and Java remains extremely high. The conceptual Capacity Building framework, its anticipated goals in the beginning of the project and, lately, the finally achieved objectives are promising. A significant contribution for mainstreaming scientific approaches and transfer methodological disaster risk reduction attempts towards other regions

  20. Sickness absence in student nursing assistants following a preventive intervention programme

    DEFF Research Database (Denmark)

    Svensson, A L; Marott, J L; Suadicani, P

    2011-01-01

    BACKGROUND: We have previously shown that a multidimensional programme combining physical training, patient transfer techniques and stress management significantly reduced sickness absence rates in student nurse assistants (NAs) after 14 months of follow-up. At follow-up, the control group had...... reduced SF-36 scores for general health perception [general health (GH)], psychological well-being [mental health (MH)] and energy/fatigue [vitality (VT)] compared with the intervention group, which remained at the baseline level for all three measures. AIMS: To ascertain whether this effect remained...... subjects from the original intervention study, 306 (54%) completed a postal questionnaire at 36 months. RESULTS: Sickness absence increased in both groups between the first and second follow-up. At the second follow-up, the intervention group had a mean of 18 days of sickness absence compared with 25...

  1. FAMILY–TEACHER PARTNERSHIP IN FOSTERING THE DEVELOPMENT OF CHILDREN`S SOCIAL SKILLS USING THE BULLYING PREVENTION PROGRAMME “FREE FROM BULLYING” IN ESTONIAN SCHOOLS

    OpenAIRE

    Leida Talts; Sirje Piht; Maia Muldma

    2017-01-01

    This research focused on the most important topics areas in parents` communication with the teachers and their assessments of the values prevailing in the classroom of second grade children using the programme “Free of Bullying”. The Free of Bullying methodology is fostering the development of children`s social skills, where family-teacher partnership plays essential role. The bullying prevention programme, initiated in the Kingdom of Denmark in 2007 and implemented in kindergartens in Estoni...

  2. Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial.

    Science.gov (United States)

    Fisher, Jane; Rowe, Heather; Wynter, Karen; Tran, Thach; Lorgelly, Paula; Amir, Lisa H; Proimos, Jenny; Ranasinha, Sanjeeva; Hiscock, Harriet; Bayer, Jordana; Cann, Warren

    2016-03-07

    Interventions to prevent postpartum common mental disorders (PCMD) among unselected populations of women have had limited success. The aim was to determine whether What Were We Thinking (WWWT) a gender-informed, psychoeducational programme for couples and babies can prevent PCMD among primiparous women 6 months postpartum. Cluster-randomised controlled trial. 48 Maternal and Child Health Centres (MCHCs) from 6 Local Government Areas in Melbourne, Australia were allocated randomly to usual care (24) or usual care plus WWWT (24). English-speaking primiparous women receiving primary care at trial MCHCs were recruited to the intervention (204) and control (196) conditions. Of these, 187 (91.7%) and 177 (90.3%) provided complete data. WWWT is a manualised programme comprising primary care from a trained nurse, print materials and a face-to-face seminar. Data sources were standardised and study-specific measures collected in blinded computer-assisted telephone interviews at 6 and 26 weeks postpartum. The primary outcome was PCMD assessed by Composite International Diagnostic Interviews and Patient Health Questionnaire (PHQ) Depression and Generalised Anxiety Disorder modules. In intention-to-treat analyses the adjusted OR (AOR) of PCMD in the intervention compared to the usual care group was 0.78 (95% CI 0.38 to 1.63, ns), but mild to moderate anxiety symptoms (AOR 0.58, 95% CI 0.35 to 0.97) and poor self-rated health (AOR 0.46, 95% CI 0.22 to 0.97) were significantly lower. In a per protocol analysis, comparing the full (three component) intervention and usual care groups, the AOR of PCMD was 0.36, (95% CI 0.14 to 0.95). The WWWT seminar was appraised as salient, comprehensible and useful by >85% participants. No harms were detected. WWWT is readily integrated into primary care, enables inclusion of fathers and addresses modifiable risks for PCMD directly. The full intervention appears a promising programme for preventing PCMD, optimising family functioning, and as the

  3. The effective of preventive training programme on the incidence of anterior cruciate ligament injuries in female soccer players

    Directory of Open Access Journals (Sweden)

    Atakan Çağlayan

    2015-12-01

    Full Text Available Aim: The aim of this study was to prevent non-contact Anterior Cruciate Ligament (ACL injuries that occur more frequently because of anatomic, hormonal and muscular differences in female athletes, with a training programme including neuromuscular, proprioceptive and flexilibity training drills and seeing the changes on physical and physiological parameters on female athletes. Material and Methods: Our study consists of 76 female soccer players (Experimental Group (EG: 20, age:17.2±3.38years and Control Group (CG: 56, age:17.5±3.14years whom participated in Turkish Female Soccer 1. League. EG were given a training programme for six weeks, three days a week, nearly 30 minutes. Retrospective questionnaire that enclosed six months was applied to both EG and CG. For the assesment of physical and physological affects of training programme; leg strength, speed, vertical jump, aerobic and anaerobic capacity, balance, flexibility, height, weight and skinfold thickness were measured. Results: As a result of statistical analysises there wasn’t seen any significant difference on the incidence of ACL injury between EG and CG (p>0.05. A significant difference was detected on vertical jump, aerobic-anaerobic power, balance, leg strength and body fat percentage at the level of (p<0.01, speed and flexibility at the level of p<0.05. Conclusion: After six-week recovery training program there was’t not seen any ACL injury until the end of the season. Furthermore, we observed significant differences after evaulation of biomotor properties of female athletes. We suggest that this kind of researchs must be made perennial with the participation of more athletes with multidisipliner workship.

  4. Burden of NCDs, Policies and Programme for Prevention and Control of NCDs in India

    Directory of Open Access Journals (Sweden)

    R K Srivastava

    2011-01-01

    Full Text Available Noncommunicable diseases and injuries account for 52% of deaths in India. Burden of noncommunicable diseases and resultant mortality is expected to increase unless massive efforts are made to prevent and control NCDs and their risk factors. Based on available evidence, cancer, diabetes, hypertension, cardiovascular diseases, stroke, chronic obstructive pulmonary disease, chronic kidney disease, mental disorders and trauma are the leading causes of morbidity, disability and mortality in India. Government of India had supported the States in prevention and control of NCDs through several vertical programs since 1980s. However, during the 11 th plan, there was considerable upsurge to prevent and control NCDs. New programs were started on a low scale in limited number of districts. However, there has not been any considerable change in the burden of NCDs. Based on experiences in the past, there is need to emphasize on health promotion and preventive measures to reduce exposure to risk factors. Facilities and capacity for screening, early diagnosis and effective management are required within the public health care system. Public awareness program, integrated management and strong monitoring system would be required for successful implementation of the program and making services universally accessible in the country.

  5. Alcohol Prevention: What Can Be Expected of a Harm Reduction Focused School Drug Education Programme?

    Science.gov (United States)

    Midford, Richard; Cahill, Helen; Ramsden, Robyn; Davenport, Gillian; Venning, Lynne; Lester, Leanne; Murphy, Bernadette; Pose, Michelle

    2012-01-01

    Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit. Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school…

  6. Programme potential for the prevention of and response to sexual violence among female refugees: a literature review.

    Science.gov (United States)

    Robbers, Gianna Maxi Leila; Morgan, Alison

    2017-11-01

    Continuing international conflict has resulted in several million people seeking asylum in other countries each year, over half of whom are women. Their reception and security in overburdened camps, combined with limited information and protection, increases their risk and exposure to sexual violence (SV). This literature review explores the opportunities to address SV against female refugees, with a particular focus on low-resource settings. A systematic literature review of articles published between 2000 and 2016 was conducted following PRISMA guidelines. Databases including Medline (Ovid), PubMed, Scopus, PsychINFO, CINAHL and the Cochrane Library. Grey literature from key refugee websites were searched. Studies were reviewed for quality and analysed according to the framework outlined in the UNHCR Guidelines on Prevention and Response of Sexual Violence against Refugees. Twenty-nine studies met the inclusion criteria, of which 7 studies addressed prevention, 14 studies response and 8 addressed both. There are limited numbers of rigorously evaluated SV prevention and response interventions available, especially in the context of displacement. However, emerging evidence shows that placing a stronger emphasis on programmes in the category of engagement/participation and training/education has the potential to target underlying causes of SV. SV against female refugees is caused by factors including lack of information and gender inequality. This review suggests that SV interventions that engage community members in their design and delivery, address harmful gender norms through education and advocacy, and facilitate strong cooperation between stakeholders, could maximise the efficient use of limited resources.

  7. Roles, responsibilities and characteristics of lay community health workers involved in diabetes prevention programmes: A systematic review

    Science.gov (United States)

    Oldenburg, Brian

    2017-01-01

    Aim To examine the characteristics of community health workers (CHWs) involved in diabetes prevention programmes (DPPs) and their contributions to expected outcomes. Methods Electronic databases including PubMed-MEDLINE, EBSCOHost, and SCOPUS/EMBASE were searched for studies published between January 2000 and March 2016. All studies that used CHWs to implement DPP in ≥18-year-old participants without diabetes but at high risk for developing the condition, irrespective of the study design, setting or outcomes measured, were included. Results were synthesized narratively. Results Forty papers of 30 studies were identified. Studies were mainly community-based and conducted in minority populations in USA. Sample sizes ranged from 20 participants in a single community to 2369 participants in 46 communities. Although CHWs were generally from the local community, their qualifications, work experience and training received differed across studies. Overall the training was culturally sensitive and/or appropriate, covering topics such as the importance of good nutrition and the benefits of increased physical activity, communication and leadership. CHWs delivered a variety of interventions and also screened or recruited participants. The shared culture and language between CHWs and participants likely contributed to better programme implementation and successful outcomes. Conclusions The complexity of DPPs and the diverse CHW roles preclude attributing specific outcomes to CHW involvement. Nevertheless, documenting potential CHW roles and the relevant training required may optimise CHW contributions and facilitate their involvement in DPPs in the future. PMID:29216263

  8. Roles, responsibilities and characteristics of lay community health workers involved in diabetes prevention programmes: A systematic review.

    Directory of Open Access Journals (Sweden)

    Jillian Hill

    Full Text Available To examine the characteristics of community health workers (CHWs involved in diabetes prevention programmes (DPPs and their contributions to expected outcomes.Electronic databases including PubMed-MEDLINE, EBSCOHost, and SCOPUS/EMBASE were searched for studies published between January 2000 and March 2016. All studies that used CHWs to implement DPP in ≥18-year-old participants without diabetes but at high risk for developing the condition, irrespective of the study design, setting or outcomes measured, were included. Results were synthesized narratively.Forty papers of 30 studies were identified. Studies were mainly community-based and conducted in minority populations in USA. Sample sizes ranged from 20 participants in a single community to 2369 participants in 46 communities. Although CHWs were generally from the local community, their qualifications, work experience and training received differed across studies. Overall the training was culturally sensitive and/or appropriate, covering topics such as the importance of good nutrition and the benefits of increased physical activity, communication and leadership. CHWs delivered a variety of interventions and also screened or recruited participants. The shared culture and language between CHWs and participants likely contributed to better programme implementation and successful outcomes.The complexity of DPPs and the diverse CHW roles preclude attributing specific outcomes to CHW involvement. Nevertheless, documenting potential CHW roles and the relevant training required may optimise CHW contributions and facilitate their involvement in DPPs in the future.

  9. Strategies for successful recruitment of young adults to healthy lifestyle programmes for the prevention of weight gain: a systematic review.

    Science.gov (United States)

    Lam, E; Partridge, S R; Allman-Farinelli, M

    2016-02-01

    Recruiting healthy young adults, aged 18-35, to lifestyle programmes for prevention of weight gain is challenging but important given their increasing rates of obesity. This review aimed to examine the success of different recruitment strategies. A systematic literature search identified 26 separate studies using 10 electronic databases. Participant characteristics and efficacy of interventions were well reported in all studies, but reporting of recruitment procedures, costs, times and effectiveness was minimal. Of those reporting recruitment, both active (e.g. face-to-face) and passive (e.g. print-media and mass-mailings) approaches were identified with the latter most frequently employed. Novel strategies such as social media and marketing approaches were identified. Television and radio have potentially high reach but low efficiency with high cost compared with mass-mailings which yield high numbers of participants. Marketing campaigns appeared to be a promising approach. Incentives demonstrated enhanced recruitment. The use of formative research to guide recruitment strategies for interventions is recommended. Reporting of success, cost and timelines for recruitment should be included in reporting of future trials. This first synthesis of recruitment information can be used to inform recruitment frameworks for lifestyle programmes seeking to attract young adults. © 2015 World Obesity.

  10. Balancing the need to rapidly scale-up and improve clinical outcomes in antiretroviral programmes in developing countries: lessons from an Indian programmatic cohort study.

    Science.gov (United States)

    Bock, Peter; Beyers, Nulda; Fidler, Sarah

    2014-10-01

    Antiretroviral treatment (ART) is highly effective reducing mortality and AIDS-related morbidity in HIV-infected people and at preventing transmission of HIV between individuals. The article reviewed for this commentary reported on data from an Indian ART cohort that showed low median baseline CD4 counts and high rates of mortality and loss to follow-up. Programme implementers in developing regions need to balance the need for rapid scale-up and simultaneous improvement in clinical outcomes. Challenges outlined support HIV treatment strategies that combine improved HIV diagnosis, linkage to care and provision of ART with a strong community-based component. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Reducing Cancer and Cancer Disparities: Lessons From a Youth-Generated Diabetes Prevention Campaign.

    Science.gov (United States)

    Schillinger, Dean; Ling, Pamela M; Fine, Sarah; Boyer, Cherrie B; Rogers, Elizabeth; Vargas, Roberto Ariel; Bibbins-Domingo, Kirsten; Chou, Wen-Ying Sylvia

    2017-09-01

    Adolescence and young adulthood, a period essential for determining exposures over the life-course, is an ideal time to intervene to lower cancer risk. This demographic group can be viewed as both the target audience and generator of messages for cancer prevention, such as skin cancer, obesity-, tobacco-, and human papillomavirus-related cancers. The purpose of this paper is to encourage innovative health communications that target youth; youth behavior; and the structural, environmental, and social determinants of youth behavior as critical areas of focus for cancer prevention and disparities reduction. The authors describe the rationale, processes, products, and early impacts of an award-winning youth diabetes prevention communication campaign model (The Bigger Picture) that harnesses spoken-word messages in school-based and social media presentations. The campaign supports minority adolescent and young adult artists to create content that aligns with values held closely by youth-values likely to resonate and affect change, such as defiance against authority, inclusion, and social justice. This campaign can be leveraged to prevent obesity, which is a cancer risk factor. Then, the authors propose concrete ways that The Bigger Picture's pedagogical model could be adapted for broader cancer prevention messaging for youth of color and youth stakeholders regarding tobacco-related cancers, skin cancers, and human papillomavirus-related cancers. The goal is to demonstrate how a youth-generated and youth-targeted prevention campaign can: (1) reframe conversations about cancer prevention, (2) increase awareness that cancer prevention is about social justice and health equity, and (3) catalyze action to change social norms and confront the social and environmental drivers of cancer disparities. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

  12. Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

    Science.gov (United States)

    Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

    2014-03-01

    In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  13. Population Based Cancer Screening Programmes as a Teachable Moment for Primary Prevention Interventions. A Review of the Literature

    International Nuclear Information System (INIS)

    Senore, Carlo; Giordano, Livia; Bellisario, Cristina; Di Stefano, Francesca; Segnan, Nereo

    2012-01-01

    Background and aim: Unhealthy diet, physical inactivity, and smoking are key risk factors for the major non-communicable diseases such as cancer, cardiovascular diseases, and diabetes. The screening procedure may represent an ideal setting for promoting healthy lifestyles as it represents a time when subjects are probably more inclined to consider a relationship between their own habits and their effects on health. The aim of this study is to review available evidence concerning interventions combining screening and primary prevention interventions, aimed at promoting the adoption of healthy lifestyles. Methods: We searched the MEDLINE and Cochrane library electronic databases for intervention studies of primary prevention interventions implemented in the context of established screening programmes, or of pilot screening projects, where the study design included a comparison group. Results: Comprehensive interventions are acceptable for asymptomatic subjects targeted for cancer screening, can result in improvements and may be cost–effective. A positive impact of these interventions in favoring the adoption of cancer protective dietary behaviors was observed in all studies. Conflicting results were instead reported with respect to physical activity, while no impact could be observed for interventions aimed to favor smoking cessation. Conclusions: The retrieved studies suggest that the screening setting may offer valuable opportunities to provide credible, potentially persuasive life style advice, reaching a wide audience. A multiple risk factor approach may maximize the benefit of behavioral change, as the same health related habits are associated not only with cancers targeted by screening interventions, but also with other cancers, coronary artery disease, and other chronic conditions, while unhealthy behaviors may be mutually reinforcing. In order to cover a maximum number of possibilities, health education programmes should include multiple strategies

  14. What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

    Science.gov (United States)

    Guinness, Lorna

    2011-01-01

    This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X’s contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these

  15. What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

    Science.gov (United States)

    Guinness, Lorna

    2011-06-01

    This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X's contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these

  16. Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand.

    Directory of Open Access Journals (Sweden)

    Dan Allman

    Full Text Available BACKGROUND: This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired. METHODS: In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP guided this work. RESULTS: Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs. Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will. DISCUSSION: Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical

  17. Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand.

    Science.gov (United States)

    Allman, Dan; Ditmore, Melissa Hope; Kaplan, Karyn

    2014-01-01

    This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired. In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP) guided this work. Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs). Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will. Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical and participatory practice in other parts of the world where

  18. Assessment of a training programme for the prevention of ventilator-associated pneumonia

    OpenAIRE

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Background Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. Aim To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects complia...

  19. Process evaluation of a participatory ergonomics programme to prevent low back pain and neck pain among workers

    Directory of Open Access Journals (Sweden)

    Driessen Maurice T

    2010-08-01

    Full Text Available Abstract Background Both low back pain (LBP and neck pain (NP are major occupational health problems. In the workplace, participatory ergonomics (PE is frequently used on musculoskeletal disorders. However, evidence on the effectiveness of PE to prevent LBP and NP obtained from randomised controlled trials (RCTs is scarce. This study evaluates the process of the Stay@Work participatory ergonomics programme, including the perceived implementation of the prioritised ergonomic measures. Methods This cluster-RCT was conducted at the departments of four Dutch companies (a railway transportation company, an airline company, a steel company, and a university including its university medical hospital. Directly after the randomisation outcome, intervention departments formed a working group that followed the steps of PE during a six-hour working group meeting. Guided by an ergonomist, working groups identified and prioritised risk factors for LBP and NP, and composed and prioritised ergonomic measures. Within three months after the meeting, working groups had to implement the prioritised ergonomic measures at their department. Data on various process components (recruitment, reach, fidelity, satisfaction, and implementation components, i.e., dose delivered and dose received were collected and analysed on two levels: department (i.e., working group members from intervention departments and participant (i.e., workers from intervention departments. Results A total of 19 intervention departments (n = 10 with mental workloads, n = 1 with a light physical workload, n = 4 departments with physical and mental workloads, and n = 4 with heavy physical workloads were recruited for participation, and the reach among working group members who participated was high (87%. Fidelity and satisfaction towards the PE programme rated by the working group members was good (7.3 or higher. The same was found for the Stay@Work ergocoach training (7.5 or higher. In total, 66

  20. Public involvement in the siting of contentious facilities; Lessons from the radioactive waste repository siting programmes in Canada and the United States, with special reference to the Swedish repository siting process

    Energy Technology Data Exchange (ETDEWEB)

    Richardson, P.J. [Geosciences for Development and the Environment (United Kingdom)

    1997-08-01

    This report describes the conclusion of a two-part programme, begun in 1994 with the overall aim of assisting in the development of an acceptable public participation strategy for use in Sweden for the siting of contentious facilities, with particular reference to the ongoing siting programme for a deep repository for spent nuclear fuel. The first part of the work programme, a global review of siting practice, was reported as SSI Rapport 94-15, in November 1994. This recommended further detailed studies of at least two individual programmes, which have now been carried out in Canada and the United States, and are reported on here. They involved face to face meetings with many of the main stake holders in the two programmes and enabled valuable insight to be gained into the potential problems associated with increased public participation, as well as identifying good practice where it exists. The lessons learned have then been applied to the evolving repository siting process in Sweden. 35 refs.

  1. Public involvement in the siting of contentious facilities; Lessons from the radioactive waste repository siting programmes in Canada and the United States, with special reference to the Swedish repository siting process

    International Nuclear Information System (INIS)

    Richardson, P.J.

    1997-08-01

    This report describes the conclusion of a two-part programme, begun in 1994 with the overall aim of assisting in the development of an acceptable public participation strategy for use in Sweden for the siting of contentious facilities, with particular reference to the ongoing siting programme for a deep repository for spent nuclear fuel. The first part of the work programme, a global review of siting practice, was reported as SSI Rapport 94-15, in November 1994. This recommended further detailed studies of at least two individual programmes, which have now been carried out in Canada and the United States, and are reported on here. They involved face to face meetings with many of the main stake holders in the two programmes and enabled valuable insight to be gained into the potential problems associated with increased public participation, as well as identifying good practice where it exists. The lessons learned have then been applied to the evolving repository siting process in Sweden. 35 refs

  2. Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

    Science.gov (United States)

    Brinkman, Sally A; Johnson, Sarah E; Codde, James P; Hart, Michael B; Straton, Judith A; Mittinty, Murthy N; Silburn, Sven R

    2016-11-05

    Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one

  3. CMAM integration: Lessons learned from a case study on community-based child survival programmes in Bangladesh

    International Nuclear Information System (INIS)

    Sadler, Kate; Puett, Chloe; Myatt, Mark

    2014-01-01

    Bangladesh ranks among the five countries with the highest burden of acute malnutrition in the world. Barisal Division is one of the poorest areas of southern Bangladesh, with low access to health care and high prevalence of malnutrition. This prospective cohort study examined the effectiveness and feasibility of adding the diagnosis and treatment of severe acute malnutrition (SAM) to the community case management (CCM) package delivered by community health workers (CHWs) outside health facilities in Bhola District, Barisal Division. CHWs were paid a monthly stipend of 800 Taka (US$11.80). A mid-upper arm circumference measurement and an oedema check for all children under three years old were introduced into routine CHW activities, including monthly growth monitoring and promotion sessions and household visits. CHWs provided ongoing sensitization to households and community members on the causes and consequences of SAM, encouraging early treatment seeking. Integration into the CCM package of services supported high quality of care for cases of SAM, and promoted program effectiveness. The recovery rate (92%), length of stay (37.4 days) and rate of weight gain (6.7 g/kg/day) were all significantly better than international Sphere standards. Further, the coverage achieved by CHWs in this program was 89% (CI 78%–96%), one of the highest levels achieved by SAM treatment services. CHWs achieved high quality of care, with 89% of workers attaining 90% error-free case management or higher in managing cases of SAM. In receiving SAM treatment within a package of integrated services, children treated by CHWs in this study had low levels of complications and co-morbidities. Doorstep delivery promoted early treatment in this remote area. Therefore cases were easier to treat and average caseloads appeared to be manageable for CHWs. While SAM treatment increased CHW workloads, this did not negatively affect the quality of other preventive and curative services delivered

  4. [Efficacy of an intensive prevention programme of coronary heart disease: 5 year follow-up outcomes].

    Science.gov (United States)

    Muñoz, Miguel A; Subirana, Isaac; Ramos, Rafael; Franzi, Alicia; Vila, Joan; Marrugat, Jaume

    2008-04-19

    Most evidence on the efficacy of intensive preventive programs of secondary prevention of coronary diseases comes from Anglo-Saxon countries and effectiveness remains controversial. We have scarce information about the efficacy of these types of programs in Spain. In the present analysis we show the results of the ICAR (Intervención en la Comunidad de Alto Riesgo coronario) study, aimed to analyze the efficacy of an intensive preventive program primary care based in reducing the cardiovascular recurrences and mortality in patients with coronary heart disease. We designed a randomized clinical trial, multicenter and community based, which included 23 health care areas in Catalonia, Spain. We followed for 5 years 2 cohorts of patients with coronary heart disease, aged 30-80 years. The intervention group was quarterly examined by their general practitioner, who adjusted treatments to control their cardiovascular risk factors thoroughly and reinforced life style behaviours. In order to do that, patient's weight and blood pressure were determined in each visit and laboratory test carried out twice a year. Patients in the control group received the usual care. In order to analyze the effect of the intervention cardiovascular recurrences and mortality were registered. We included 983 patients. Mean (standard deviation) age was 64 (10) and 74.5% were men. During the follow-up 235 patients suffered some non-fatal cardiovascular recurrence (109 vs 126 in the control and intervention group, respectively; p = 0.84), and 45 died from cardiovascular recurrences (23 vs 22, respectively; p = 0.57). Adjusted hazard ratio of cardiovascular event and total mortality, for the intervention group were 1.01 (95% confidence interval, 0.74-1.39), and 0.92 (95% confidence interval, 0.54-1.56), respectively. The implementation of an intensive secondary prevention program based on periodical reminds to patients with stable coronary heart disease to attend their general practitioners did not

  5. Local media monitoring in process evaluation. Experiences from the Stockholm Diabetes Prevention Programme.

    Science.gov (United States)

    Andersson, Camilla Maria; Bjärås, Gunilla; Tillgren, Per; Ostenson, Claes-Göran

    2007-01-01

    We present a rationale and approach for longitudinal analyses of media coverage and content, and illustrate how media monitoring can be used in process evaluations. Within a community-based diabetes prevention project, the Stockholm Diabetes Prevention Program, we analyzed the frequency, prominence, and framing of physical activity in local newspapers of three intervention and two control municipalities. In total, 2,128 stories and advertisements related to physical activity were identified between the years 1997 and 2002. Although stories about physical activity were relatively few (n = 224), they were prominently located in all five local newspapers. Physical activity was framed rather similarly in the municipalities. Health aspects, however, were expressed to a greater extent in stories in two of the intervention municipalities. A limited portion (14%) of the articles could be linked directly to the program. It is not possible to assess to what extent the program has had a disseminating effect on the newspapers' health-related content in general, due to weaknesses of the process tracking system and limitations of the study design. Implications for the design is that an evaluative framework should be preplanned and include data collection about media relationships, media's interest in public health, media coverage prior to the program and coverage in other media for comparisons of general trends in the reporting. The material and the current database, however, provide a good basis for quantitative content analysis and qualitative discourse analysis to yield information on the type, frequency, and content of health reporting in local newspapers.

  6. Lowbury Lecture 2007: infection prevention and control strategies for tuberculosis in developing countries - lessons learnt from Africa.

    Science.gov (United States)

    Mehtar, S

    2008-08-01

    The World Health Organization ranks South Africa among the top ten of high-burden countries for tuberculosis (TB). The Western Cape Province has the highest prevalence of TB in the country. Studies performed in healthcare facilities both at Tygerberg Hospital and from Kwa-Zulu Natal province indicate a significant risk for nosocomial transmission of tuberculosis. An audit of provision for infection prevention and control (IPC) programmes revealed that although there were adequate supplies of protective clothing, the greatest need was for training and understanding of IPC principles among healthcare workers. In establishing national IPC guidelines for TB in South Africa, it has become evident that most of these were derived from existing guidelines in developed countries. Though the principles were sound, the practices were not realistic for developing economies and generally not implemented in healthcare facilities. Factors that influence a robust TB management programme are poverty, concurrent human immunodeficiency virus infection, overcrowding, ignorance of the disease and a varied level of health service delivery. It is recommended that a foundation of sound knowledge should be established upon which best practices should be built within the framework of good IPC principles.

  7. Evaluation of an education and activation programme to prevent chronic shoulder complaints: design of an RCT [ISRCTN71777817

    Directory of Open Access Journals (Sweden)

    Goossens Marielle

    2005-02-01

    Full Text Available Abstract Background About half of all newly presented episodes of shoulder complaints (SC in general practice are reported to last for at least six months. Early interventions aimed at the psychological and social determinants of SC are not common in general practice, although such interventions might prevent the development of chronic SC. The Education and Activation Programme (EAP consists of an educational part and a time-contingent activation part. The aim of the EAP is to provide patients with the proper cognitions by means of education, and to stimulate adequate behaviour through advice on activities of daily living. Design The article describes the design of a randomised clinical trial (RCT to evaluate the effectiveness and cost-effectiveness of an EAP in addition to usual care, compared to usual care only, in the prevention of chronic SC after six months. It also describes the analysis of the cost and effect balance. Patients suffering from SC for less than three months are recruited in general practice and through open recruitment. A trained general practitioner or a trained therapist administers the EAP. Primary outcome measures are patient-perceived recovery, measured by self-assessment on a seven-point scale, and functional limitations in activities of daily living. Questionnaires are used to study baseline measures, prognostic measures, process measures and outcome measures. Discussion The inclusion of patients in the study lasted until December 31st 2003. Data collection is to end in June 2004.

  8. Assessing the representativeness of Canadian Hospitals Injury Reporting and Prevention Programme (CHIRPP) sport and recreational injury data in Calgary, Canada.

    Science.gov (United States)

    Kang, Jian; Hagel, Brent; Emery, Carolyn A; Senger, Trudi; Meeuwisse, Willem

    2013-01-01

    The objective of this study was to assess the representativeness of sport and recreational injury data from Canadian Hospital Injury Reporting and Prevention Programme (CHIRPP) in Calgary. Internal representativeness was assessed by comparing CHIRPP and regional health administrative data (ambulatory care classification system-ACCS) at Alberta Children's Hospital (ACH). External representativeness was assessed by comparing CHIRPP with ACCS at all hospitals. Comparisons were performed using descriptive statistics for top injury-producing sports and sports that produced severe injuries. Stratified distributions of injury-producing sports by gender, age group and severity of injury in CHIRPP and ACCS were compared. The proportion of all injuries in Calgary captured by CHIRPP was 64.8% (99%CI: 64.02-65.54%) (16,977/26,206). CHIRPP captured more cases of top injury-producing sports than ACCS at ACH. Rankings of top injury-producing sports in CHIRPP and ACCS at ACH were remarkably consistent (ρ  = 0.92, p sports in CHIRPP and ACCS at all hospitals were almost identical (ρ  = 0.98, p sports by gender, age group and the severity of injury showed strong consistency between CHIRPP and ACCS. It is concluded that CHIRPP in Calgary provides a representative profile of injuries compared to regional health administrative data. This project supports the use of CHIRPP for establishing injury prevention priorities.

  9. Lessons learned from the development of technological support for PTSD prevention : A review

    NARCIS (Netherlands)

    Vakili, V.; Brinkman, W.P.; Neerincx, M.A.

    2012-01-01

    This review2 describes the state-of-the-arttechnologiesthat support mental resilience training for PTSD prevention. It characterizes four current systems across training approaches; seeks insights via interviews with the systemdevelopers; and extracts from thesea set of essential guidelines for

  10. Reorienting a paediatric oral health service towards prevention: lessons from a qualitative study of dental professionals.

    Science.gov (United States)

    Cashmore, Aaron W; Noller, Jennifer; Ritchie, Jan; Johnson, Bronwyn; Blinkhorn, Anthony S

    2011-04-01

    Reorienting primary care dental services towards prevention is a priority for improving the oral health of Australian children with extensive dental caries. We explored the attitudes and beliefs of dental staff about the factors that helped or hindered the establishment and implementation of a hospital-based parent counselling program to manage existing, and prevent new, carious lesions in children. A further aim was to explore the influence of the program on the hospital's reorientation to prevention. Eight of nine program staff participated in two focus group interviews, and two co-ordinating staff participated in semi-structured interviews. Interviews were audio-recorded and transcribed. Interview recordings and transcripts were analysed by qualitative thematic analysis. The participants identified a number of factors that they felt influenced the establishment and implementation of the program, including the dental team's support of the initiative, the advantages of building on existing clinic infrastructure and procedures, the utility of harnessing dental assistants as a resource for oral health promotion, and the confidence of dental professionals to provide parent counselling. Efforts to establish a preventive program in a public paediatric dental service should ensure that all members of the dental team are engaged during all phases of the program, that dental assistants are trained and supported to deliver parent counselling, and that interprofessional partnerships with services such as dietetics are fostered.

  11. Effectiveness and micro-costing of the KiVa school-based bullying prevention programme in Wales: study protocol for a pragmatic definitive parallel group cluster randomised controlled trial.

    Science.gov (United States)

    Clarkson, Suzy; Axford, Nick; Berry, Vashti; Edwards, Rhiannon Tudor; Bjornstad, Gretchen; Wrigley, Zoe; Charles, Joanna; Hoare, Zoe; Ukoumunne, Obioha C; Matthews, Justin; Hutchings, Judy

    2016-02-01

    Bullying refers to verbal, physical or psychological aggression repeated over time that is intended to cause harm or distress to the victims who are unable to defend themselves. It is a key public health priority owing to its widespread prevalence in schools and harmful short- and long-term effects on victims' well-being. There is a need to strengthen the evidence base by testing innovative approaches to preventing bullying. KiVa is a school-based bullying prevention programme with universal and indicated elements and an emphasis on changing bystander behaviour. It achieved promising results in a large trial in Finland, and now requires testing in other countries. This paper describes the protocol for a cluster randomised controlled trial (RCT) of KiVa in Wales. The study uses a two-arm waitlist control pragmatic definitive parallel group cluster RCT design with an embedded process evaluation and calculation of unit cost. Participating schools will be randomised a using a 1:1 ratio to KiVa plus usual provision (intervention group) or usual provision only (control group). The trial has one primary outcome, child self-reported victimisation from bullying, dichotomised as 'victimised' (bullied at least twice a month in the last couple of months) versus 'not victimised'. Secondary outcomes are: bullying perpetration; aspects of child social and emotional well-being (including emotional problems, conduct, peer relations, prosocial behaviour); and school attendance. Follow-up is at 12 months post-baseline. Implementation fidelity is measured through teacher-completed lesson records and independent school-wide observation. A micro-costing analysis will determine the costs of implementing KiVa, including recurrent and non-recurrent unit costs. Factors related to the scalability of the programme will be examined in interviews with head teachers and focus groups with key stakeholders in the implementation of school-based bullying interventions. The results from this trial

  12. Effectiveness of an injury prevention programme for adult male amateur soccer players: a cluster-randomised controlled trial.

    Science.gov (United States)

    van Beijsterveldt, Anna M C; van de Port, Ingrid G L; Krist, Mark R; Schmikli, Sandor L; Stubbe, Janine H; Frederiks, Janet E; Backx, Frank J G

    2012-12-01

    The incidence rate of soccer injuries is among the highest in sports, particularly for adult male soccer players. To investigate the effect of the 'The11' injury prevention programme on injury incidence and injury severity in adult male amateur soccer players. Cluster-randomised controlled trial. Teams from two high-level amateur soccer competitions were randomly assigned to an intervention (n=11 teams, 223 players) or control group (n=12 teams, 233 players). The intervention group was instructed to perform The11 in each practice session during one soccer season. The11 focuses on core stability, eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation and plyometrics with straight leg alignment. All participants of the control group continued their practice sessions as usual. In total, 427 injuries were recorded, affecting 274 of 456 players (60.1%). Compliance with the intervention programme was good (team compliance=73%, player compliance=71%). Contrary to the hypothesis, injury incidences were almost equal between the two study groups: 9.6 per 1000 sports hours (8.4-11.0) for the intervention group and 9.7 (8.5-11.1) for the control group. No significant differences were found in injury severity, but a significant difference was observed in the location of the injuries: players in the intervention group sustained significantly less knee injuries. This study did not find significant differences in the overall injury incidence or injury severity between the intervention and control group of adult male soccer players. More research is recommended, focusing on injury aetiology and risk factors in adult male amateur soccer players.

  13. Effectiveness of an injury prevention programme for adult male amateur soccer players: a cluster-randomised controlled trial

    Science.gov (United States)

    van Beijsterveldt, Anna M C; van de Port, Ingrid G L; Krist, Mark R; Schmikli, Sandor L; Stubbe, Janine H; Frederiks, Janet E; Backx, Frank 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 Cluster-randomised controlled trial. Methods Teams from two high-level amateur soccer competitions were randomly assigned to an intervention (n=11 teams, 223 players) or control group (n=12 teams, 233 players). The intervention group was instructed to perform The11 in each practice session during one soccer season. The11 focuses on core stability, eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation and plyometrics with straight leg alignment. All participants of the control group continued their practice sessions as usual. Results In total, 427 injuries were recorded, affecting 274 of 456 players (60.1%). Compliance with the intervention programme was good (team compliance=73%, player compliance=71%). Contrary to the hypothesis, injury incidences were almost equal between the two study groups: 9.6 per 1000 sports hours (8.4–11.0) for the intervention group and 9.7 (8.5–11.1) for the control group. No significant differences were found in injury severity, but a significant difference was observed in the location of the injuries: players in the intervention group sustained significantly less knee injuries. Conclusions This study did not find significant differences in the overall injury incidence or injury severity between the intervention and control group of adult male soccer players. More research is recommended, focusing on injury aetiology and risk factors in adult male amateur soccer players. PMID:22878257

  14. Rheumatic fever recurrence prevention: a nurse-led programme of 28-day penicillin in an area of high endemnicity.

    Science.gov (United States)

    Spinetto, Heather; Lennon, Diana; Horsburgh, Margaret

    2011-04-01

    To evaluate safety and effectiveness of 28-day long-acting penicillin to prevent recurrences of acute rheumatic fever (ARF).   Historical cohort study using the regional RF register for Auckland, New Zealand, in a 5-14-year-old population with ARF rates of ~40-80/100,000. Consented patients were referred to a population-based delivery programme of free benzathine penicillin every 28 days by community nurses with discharge after the longer of 10 years of treatment or aged 21 years. First-episode and recurrent ARF cases classified as definite (Jones criteria 1992) or probable (Jones criteria 1956) were the main outcome measures. Of the 360 cases meeting the case definitions, 20 recurrences occurred in 19 people (median age 21 years). The age at first episode was 2-52 years (mode 11 years), median age 21.3 (8-40). ARF recurred 0-21 years after penicillin was discontinued. Seventy-two per cent of recurrent cases occurred within 5 years, and 12% between 5 years and 10 years. The 4-weekly long-acting penicillin failure rate (n= 1) was 0.07/100 patient years. The programme failure rate (Auckland residents) was 1.4/100 patient years (n= 20). Patient non-adherence accounted for 55% of recurrences. Two recurrences after discharge from prophylaxis as per the New Zealand guidelines occurred 3 years and 13 years later. In this environment, 28-day long-acting penicillin prophylaxis for at least 10 years delivered by community nurses is safe and effective for patients with no or mild cardiac disease by auscultation at discharge off penicillin. Penicillin delivery every 21 days (as suggested by a recent Cochrane review) would add to costs and complexity. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. Methodologic and Logistic Issues in Conducting Longitudinal Birth Cohort Studies: Lessons Learned from the Centers for Children?s Environmental Health and Disease Prevention Research

    OpenAIRE

    Eskenazi, Brenda; Gladstone, Eleanor A.; Berkowitz, Gertrud S.; Drew, Christina H.; Faustman, Elaine M.; Holland, Nina T.; Lanphear, Bruce; Meisel, Stefanie J.; Perera, Frederica P.; Rauh, Virginia A.; Sweeney, Anne; Whyatt, Robin M.; Yolton, Kimberly

    2005-01-01

    In anticipation of the National Children's Study, lessons can be learned from the smaller birth cohort studies conducted by five Centers for Children's Environmental Health and Disease Prevention Research funded by the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. The populations studied are diverse in ethnicity and social class and reside in urban and rural environments. Although almost all of the centers chose to enroll participants throug...

  16. 'Why are we not doing more for them?': genocide prevention lessons from the Kindertransport.

    Science.gov (United States)

    Angel, J; Evans, D P

    2017-12-01

    Genocide remains one of the most widespread forms of preventable mortality and morbidity for children today. Despite the creation of multiple human rights treaties, genocide has not been eliminated and its effects disproportionally impact children. The Kindertransport was a series of rescue efforts that brought thousands of refugee children to the United Kingdom from Nazi Germany between 1938 and 1940. This qualitative study asks what public health professionals can learn from the prevention efforts of the Kindertransport by examining the experiences and reflections of individuals rescued as children. The specific aims of the study were (1) to analyze qualitatively the impact of the rescue on rescued children; (2) to evaluate the strengths and limitations of the Kindertransport as a prevention effort; and (3) to draw implications for contemporary public health responses to global genocide. Qualitative research study. In-depth interviews, using a semi-structured interview guide, were conducted with 27 survivors of the rescue. The data were thematically coded, and excerpts exported and interpreted in reflection of patterns and themes using Dedoose. Five inductive themes emerged from the data related to the broad spectrum of antisemitic persecution: the breakup of families; integration in the UK via the Kindertransport; the challenges of adapting to a new environment; and the implications for global rescue efforts. The results suggest that the public health community should act to prevent genocide through rapid intervention and rescue; at the same time, the effects of persecution must be addressed and sustained social, emotional, and psychological support must be provided to those rescued. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Cardiovascular disease prevention in low resource settings: lessons from the Heartfile experience in Pakistan.

    Science.gov (United States)

    Nishtar, Sania

    2003-01-01

    This paper outlines activities of the Heartfile Program in Pakistan (http://heartfile.org). The program focuses on cardiovascular disease prevention and health promotion, and includes several initiatives that encompass building policy, reorienting health services, and developing community interventions that utilize the print and electronic media and outreach at the grass-root level to incorporate social marketing approaches. Initiated by the nonprofit private sector, the program now links with major public sector primary healthcare programs, and is currently spearheading formulation of the National Action Plan on Noncommunicable Disease Prevention and Control in Pakistan. In addition, the program is being refined, validated, and packaged as a replicable model for other developing countries and in low resource settings, utilizing appropriate principles of franchising with inbuilt components sensitive to cultural and social adaptations. A review of the planning process, implementation strategy, and fund-raising experience is presented. Strategies unique to low resource settings, such as the development of cost- and time-efficient strategic alliances and partnerships, have also been highlighted. In addition, specific caveats are identified as being helpful to private sector development of chronic disease prevention programs in resource-constrained settings, and a road map to a sustainable public-private sector partnership is provided.

  18. The critical role of communications in a multilevel obesity-prevention intervention: Lessons learned for alcohol educators.

    Science.gov (United States)

    Hatfield, Daniel P; Sliwa, Sarah A; Folta, Sara C; Economos, Christina D; Goldberg, Jeanne P

    2017-01-01

    Multilevel interventions to prevent underage drinking are more effective than individual-level strategies, and messaging campaigns are key to such approaches. Recognizing the benefits of translating best practices across public health domains, this paper details the communications campaign from Shape Up Somerville (SUS), an exemplar for multilevel community-based approaches to address pediatric obesity, highlighting lessons learned for alcohol educators. All elements of SUS, including the communications strategy, were developed collaboratively with local partners. Communication initiatives included community-engaged brand development to unify diverse intervention components; school-based communications to promote new opportunities for healthy eating and physical activity; and media partnerships to promote healthy behaviors community-wide. The overall SUS intervention was effective in reducing prevalence of overweight/obesity among first- to third-graders in Somerville relative to control communities. Process evaluation showed that communications successfully reached diverse community segments and raised awareness of and receptivity to changes. Communications campaigns are essential components of multilevel interventions addressing public health challenges including obesity and underage drinking. Such communications should be developed collaboratively with the target audience and stakeholders, designed to engage community members at multiple levels through multiple channels within a systems framework, and sustained through local partnerships. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Stepwise Reconstruction PROGRAMME of Bohunice V 1 NPP with Regard to SEVERE ACCIDENT Prevention and Mitigation

    International Nuclear Information System (INIS)

    Kuehne, M.; Kerak, M.; Severa, M.

    1997-01-01

    Accident Management means - generally speaking - all measures taken to 'rectum the plant to a safe state and mitigate the consequences of accidents' in the design basis as well as the beyond design basis realm. Sometimes accident management is interpreted as reforming in particular to those actions which are taken to cope with beyond design basis accidents, i.e. in very unlikely situations. The objectives of the measures depend on the category of the accident: design basis accident: * to keep systems and the plant within the licensed limits beyond design basis accident: * to prevent severe core damage, especially at high pressure in the reactor pressurize vessel and or * to mitigate the consequences of severe accidents for the environment The system use is different: design basis accident: * operation of systems within design limits beyond design basis accident: * best use of all available systems even beyond their design limits assuming best estimate conditions for components and systems. With respect to the different system uses it is expedient to distinguish between measures to control accidents under design basis accident conditions or to manage beyond design basis accidents. The evaluation of a safety concept should give precedence to the systems fundamental roles in the design basis realm. beyond design basis -accident management should be seen as an additional, last-resort tool to cope with scenarios in the beyond design basis realm and should therefore be treated separately as a supplement to the 'normal' design basis measures

  20. The First-aid Advice and Safety Training (FAST) parents programme for the prevention of unintentional injuries in preschool children: a protocol.

    Science.gov (United States)

    Mytton, Julie A; Towner, Elizabeth Ml; Kendrick, Denise; Stewart-Brown, Sarah; Emond, Alan; Ingram, Jenny; Blair, Peter S; Powell, Jane; Mulvaney, Caroline; Thomas, James; Deave, Toity; Potter, Barbara

    2014-02-01

    Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.

  1. The BokSmart intervention programme is associated with improvements in injury prevention behaviours of rugby union players: an ecological cross-sectional study

    NARCIS (Netherlands)

    Brown, J.C.; Gardner-Lubbe, S.; Lambert, M.I.; van Mechelen, W.; Verhagen, E.A.L.M.

    2015-01-01

    Background/aim Participants of rugby union (‘rugby’) have an above-average risk of injury compared with other popular sports. Thus, BokSmart, a nationwide injury prevention programme for rugby, was introduced in South Africa in 2009. Improvements in injurypreventing behaviour of players are critical

  2. Effectiveness and cost-effectiveness of an injury prevention programme for adult male amateur soccer players: Design of a cluster-randomised controlled trial

    NARCIS (Netherlands)

    Beijsterveldt, A.M.C. van; Krist, M.R.; Schmikli, S.L.; Stubbe, J.H.; Wit, G.A. de; Inklaar, H.; Port, I.G.L. van de; Backx, F.J.G.

    2011-01-01

    Background and aims Approximately 16% of all sports injuries in the Netherlands are caused by outdoor soccer. A cluster-randomised controlled trial has been designed to investigate the effectiveness and cost-effectiveness of an injury prevention programme ('The11') for male amateur soccer players.

  3. A systematic review on the effectiveness of school and community-based injury prevention programmes on risk behaviour and injury risk in 8-12 year old children

    NARCIS (Netherlands)

    Nauta, J.; van Mechelen, W.; Otten, R.H.J.; Verhagen, E.A.L.M.

    2014-01-01

    Objectives: To review existing literature on the effectiveness of community-based and school-based physical activity related injury prevention programmes implemented to increase safety behaviour and decrease injury risk in 8-12 year old children, considering the methodological quality of the

  4. "Now That I'm Pregnant, I'm No Longer an Example": Peer Educator Experiences of an HIV Prevention Programme in Cape Town, South Africa

    Science.gov (United States)

    Wolf, Kimberly; Africa, Adelene

    2017-01-01

    Despite the popularity of peer education as an HIV prevention strategy across a range of contexts, understanding of the experiences of those intimately placed within these programmes is limited. Instead, the majority of research in this field relies on hegemonic notions of rational human behaviour that operate under the assumption that knowledge…

  5. Isotretinoin use and compliance with the Dutch Pregnancy Prevention Programme: a retrospective cohort study in females of reproductive age using pharmacy dispensing data.

    NARCIS (Netherlands)

    Teichert, M.; Visser, L.E.; Dufour, M.; Rodenburg, E.; Straus, S.M.; Smet, P.A.G.M. de; Stricker, B.H.C.

    2010-01-01

    BACKGROUND: Isotretinoin is very effective in the treatment of severe acne. However, because of the teratogenic properties of this agent an isotretinoin Pregnancy Prevention Programme (PPP) was implemented in the Netherlands to guarantee that treatment is contraindicated in women of reproductive age

  6. Preventing substance misuse: study protocol for a randomised controlled trial of the Strengthening Families Programme 10-14 UK (SFP 10-14 UK).

    Science.gov (United States)

    Segrott, Jeremy; Gillespie, David; Holliday, Jo; Humphreys, Ioan; Murphy, Simon; Phillips, Ceri; Reed, Hayley; Rothwell, Heather; Foxcroft, David; Hood, Kerenza; Roberts, Zoe; Scourfield, Jonathan; Thomas, Claire; Moore, Laurence

    2014-01-17

    Prevention of alcohol, drug and tobacco misuse by young people is a key public health priority. There is a need to develop the evidence base through rigorous evaluations of innovative approaches to substance misuse prevention. The Strengthening Families Programme 10-14 is a universal family-based alcohol, drugs and tobacco prevention programme, which has achieved promising results in US trials, and which now requires cross-cultural assessment. This paper therefore describes the protocol for a randomised controlled trial of the UK version of the Strengthening Families Programme 10-14 (SFP 10-14 UK). The trial comprises a pragmatic cluster randomised controlled effectiveness trial with families as the unit of randomisation, with embedded process and economic evaluations. Participating families will be randomised to one of two treatment groups - usual care with full access to existing services (control group), or usual care plus SFP 10-14 UK (intervention group). The trial has two primary outcomes - the number of occasions that young people report having drunk alcohol in the last 30 days, and drunkenness during the last 30 days, both dichotomised as 'never' and '1-2 times or more'. The main follow-up is at 2 years past baseline, and short-term and intermediate outcomes are also measured at 9 and 15 months. The results from this trial will provide evidence on the effectiveness and cost-effectiveness of an innovative universal family-based substance misuse prevention programme in a UK context. Current Controlled Trials ISRCTN63550893.

  7. Capacity-building of the allied health workforce to prevent and control diabetes: Lessons learnt from the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project.

    Science.gov (United States)

    Wijeyaratne, Chandrika; Arambepola, Carukshi; Karunapema, Palitha; Periyasamy, Kayathri; Hemachandra, Nilmini; Ponnamperuma, Gominda; Beneragama, Hemantha; de Alwis, Sunil

    2016-04-01

    In 2008, to tackle the exponential rise in the clinical burden of diabetes that was challenging the health systems in Sri Lanka, a shift in focus towards patient-centred care linked with community health promotion was initiated by the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project of the Sri Lanka Medical Association. Specific training of "diabetes educator nursing officers" (DENOs), field staff in maternal and child health, footwear technicians, and health promoters from the community, was instituted to improve knowledge, skills and attitudes in the area of control and prevention of diabetes. This article highlights some of the activities carried out to date with the allied health workforce and volunteer community. Specifically, it describes experiences with the DENO programme: the educational and administrative processes adopted, challenges faced and lessons learnt. It also highlights an approach to prevention and management of complications of chronic diabetic foot through training a cohort of prosthetics and orthotics technicians, in the absence of podiatrists, and an initiative to provide low-cost protective footwear. Harnessing the enthusiasm of volunteers - adults and schoolchildren - to address behavioural risk factors in a culturally appropriate fashion has also been a key part of the NIROGI Lanka strategy.

  8. A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi.

    Science.gov (United States)

    Burdon Bailey, Jordana L; Gamble, Luke; Gibson, Andrew D; Bronsvoort, Barend M deC; Handel, Ian G; Mellanby, Richard J; Mazeri, Stella

    2018-03-09

    Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children's knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both pdogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both p<0.001) indicating that the lesson itself was critical in improving knowledge. In summary, we have shown that a short, focused classroom-based lesson on rabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren.

  9. Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

    Science.gov (United States)

    Kelsey, Meredith; Layzer, Jean

    2014-03-01

    This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  10. The president speaks: prevention is best: lessons from protecting the ozone layer.

    Science.gov (United States)

    Woodcock, Ashley

    2012-12-01

    The Montreal Protocol was signed 25 years ago. As a result, the irreversible destruction of the ozone layer was prevented. However, stratospheric ozone will not recover completely until 2060 and the consequent epidemic in skin cancer cases will persist until 2100. Many millions of patients with asthma and chronic obstructive pulmonary disease have safely switched from chlorofluorocarbon (CFC)-powered metered-dose inhalers (MDIs) to either hydrofluorocarbon (HFC) or DPIs. China will be the last country to phase out CFCs by 2016. HFCs are global warming gases which will be controlled in the near future. HFCs in MDIs may be phased out over the next 10-20 years.

  11. Animal Models, Learning Lessons to Prevent and Treat Neonatal Chronic Lung Disease

    Science.gov (United States)

    Jobe, Alan H.

    2015-01-01

    Bronchopulmonary dysplasia (BPD) is a unique injury syndrome caused by prolonged injury and repair imposed on an immature and developing lung. The decreased septation and decreased microvascular development phenotype of BPD can be reproduced in newborn rodents with increased chronic oxygen exposure and in premature primates and sheep with oxygen and/or mechanical ventilation. The inflammation caused by oxidants, inflammatory agonists, and/or stretch injury from mechanical ventilation seems to promote the anatomic abnormalities. Multiple interventions targeted to specific inflammatory cells or pathways or targeted to decreasing ventilation-mediated injury can substantially prevent the anatomic changes associated with BPD in term rodents and in preterm sheep or primate models. Most of the anti-inflammatory therapies with benefit in animal models have not been tested clinically. None of the interventions that have been tested clinically are as effective as anticipated from the animal models. These inconsistencies in responses likely are explained by the antenatal differences in lung exposures of the developing animals relative to very preterm humans. The animals generally have normal lungs while the lungs of preterm infants are exposed variably to intrauterine inflammation, growth abnormalities, antenatal corticosteroids, and poorly understood effects from the causes of preterm delivery. The animal models have been essential for the definition of the mediators that can cause a BPD phenotype. These models will be necessary to develop and test future-targeted interventions to prevent and treat BPD. PMID:26301222

  12. Prevention of Tetanus Outbreak Following Natural Disaster in Indonesia: Lessons Learned from Previous Disasters.

    Science.gov (United States)

    Pascapurnama, Dyshelly Nurkartika; Murakami, Aya; Chagan-Yasutan, Haorile; Hattori, Toshio; Sasaki, Hiroyuki; Egawa, Shinichi

    2016-03-01

    In Indonesia, the Aceh earthquake and tsunami in 2004 killed 127,000 people and caused half a million injuries, while the Yogyakarta earthquake in 2006 caused 5,700 deaths and 37,000 injuries. Because disaster-affected areas are vulnerable to epidemic-prone diseases and tetanus is one such disease that is preventable, we systematically reviewed the literature related to tetanus outbreaks following previous two natural disasters in Indonesia. Based on our findings, recommendations for proper vaccination and education can be made for future countermeasures. Using specified keywords related to tetanus and disasters, relevant documents were screened from PubMed, the WHO website, and books. Reports offering limited data and those released before 2004 were excluded. In all, 16 publications were reviewed systematically. Results show that 106 cases of tetanus occurred in Aceh, with a case fatality ratio (CFR) of 18.9%; 71 cases occurred in Yogyakarta, with CFR of 36.6%. For both outbreaks, most patients had been wounded during scavenging or evacuation after the disaster occurred. Poor access to health care because of limited transportation or hospital facilities, and low vaccination coverage and lack of awareness of tetanus risk contributed to delayed treatment and case severity. Tetanus outbreaks after disasters are preventable by increasing vaccination coverage, improving wound care treatment, and establishing a regular surveillance system, in addition to good practices of disaster management and supportive care following national guidelines. Furthermore, health education for communities should be provided to raise awareness of tetanus risk reduction.

  13. Epidemiology of burns in the United Arab Emirates: lessons for prevention.

    Science.gov (United States)

    Grivna, Michal; Eid, Hani O; Abu-Zidan, Fikri M

    2014-05-01

    To study mechanism, risk factors and outcome of hospitalized burns so as to give recommendations for prevention. Burn patients admitted to Al Ain hospital for more than 24h or who died after arrival were studied over 4 years. Demographics, burn type, location and time of injury, total body burned surface area (TBSA), body region, hospital and ICU stay and outcome were analyzed. 203 patients were studied, 69% were males and 25% were children under 5 years old. The most common location for burn was home. Women were burned more at home (pburns at work were from gas and flame. Burns caused by gas and flame had larger TBSA and longer ICU stay. Six (3%) patients died and nine (4%) were transferred to the specialized burn center. Safety education for caregivers and close supervision of young children is important to reduce pediatric burns. Occupational safety education of young men could prevent burns caused by gas and flame. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Adjuvant bone-targeted therapy to prevent metastasis: lessons from the AZURE study.

    Science.gov (United States)

    Coleman, Robert E

    2012-09-01

    Bone-targeted treatments with bisphosphonates (e.g., zoledronic acid) and denosumab are known to reduce the risk of skeletal complications and prevent treatment-induced bone loss in patients with malignant bone disease. Additionally, these drugs may modify the course of bone destruction via inhibitory effects on the 'vicious cycle' of growth factor and cytokine signalling between tumour and bone cells within the bone marrow microenvironment. In early stage breast cancer, treatment with zoledronic acid has shown improvements in disease-free and overall survival, notably in women with established menopause at diagnosis and in premenopausal women with endocrine-responsive disease, treated with goserelin to suppress ovarian function. Other bisphosphonates such as clodronate may produce similar benefits. Additionally, in castrate-resistant prostate cancer, treatment with denosumab delays the development of bone metastases. These results strongly support the adjuvant use of bone-targeted treatments, but suggest that reproductive hormones are an important treatment modifier to take into account.

  15. Countermarketing Alcohol and Unhealthy Food: An Effective Strategy for Preventing Noncommunicable Diseases? Lessons from Tobacco.

    Science.gov (United States)

    Palmedo, P Christopher; Dorfman, Lori; Garza, Sarah; Murphy, Eleni; Freudenberg, Nicholas

    2017-03-20

    Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review describes common elements of tobacco countermarketing such as describing adverse health consequences, appealing to negative emotions, highlighting industry manipulation of consumers, and engaging users in the design or implementation of campaigns. It then assesses the potential for using these elements to reduce consumption of alcohol and unhealthy foods.

  16. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services.

    Science.gov (United States)

    Wolfenden, Luke; Jones, Jannah; Williams, Christopher M; Finch, Meghan; Wyse, Rebecca J; Kingsland, Melanie; Tzelepis, Flora; Wiggers, John; Williams, Amanda J; Seward, Kirsty; Small, Tameka; Welch, Vivian; Booth, Debbie; Yoong, Sze Lin

    2016-10-04

    Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to:1. describe the impact of such strategies on childcare service staff knowledge, skills or attitudes;2. describe the cost or cost-effectiveness of such strategies;3. describe any adverse effects of such strategies on childcare services, service staff or children;4. examine the effect of such strategies on child diet, physical activity or weight status. We searched the following electronic databases on 3 August 2015: the Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, ERIC, CINAHL and SCOPUS. We also searched reference lists of included trials, handsearched two international implementation science journals and searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). We included any study (randomised or non-randomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. The review authors independently screened abstracts and titles, extracted trial data and assessed risk of bias in pairs; we resolved discrepancies via consensus. Heterogeneity across studies precluded pooling of data and undertaking quantitative

  17. Partners or donors: The perceived roles of Global Fund Principal Recipient NGOs in HIV prevention programmes in Ukraine

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    Svetlana McGill

    2017-01-01

    Full Text Available Ukraine has one of Europe's fastest growing HIV rates and in 2003–2012 was one of the largest recipients of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF. Doctoral research recently completed by the author investigates the conduct and practice of international and national nongovernmental organisations (NGOs as Principal Recipients (PRs of GF grants in Ukraine from 2003 to 2012. An ethnographic enquiry including 50 participant interviews was conducted in three oblasts in Ukraine, and in its capital, Kyiv. The paper presents some of the findings that emerged from the analysis. Discussing the PR NGOs roles and practices in delivering HIV prevention programmes funded by GF, the author argues that the anticipated benefits of NGO partnerships between PR NGOs and their Sub-Recipients (SRs have not been achieved. Rather, PRs acted as donors and ran highly discretionary policies in channelling GF funding to SRs that installed competition and vertical relations between NGO-grantors and NGO-grantees. The outcome was a servile civil society that is dependent on external funding and is unable to genuinely represent their communities. With an anticipated GF phasing out from Ukraine, there is a critical lack of advocacy potential of the civil society to articulate and defend the needs of PLHIV when transferring HIV services into state funding.

  18. Implementation of the Preventive Radiation Protection Act; here: Regulation governing ambient radioactivity monitoring subject to the Preventive Radiation Protection Act. Pt. 1. Measuring programme for specified normal operation monitoring (routine measuring programme). BMU circular letter dated 28.07.94 -RS II 6 - 15 603/3

    International Nuclear Information System (INIS)

    1994-01-01

    The regulation addresses the competent Federal and Land authorities responsible for implementation of the Preventive Radiation Protection Act, and the competent highest Land authorities. The regulation defines the scope of obligatory measurement of ambient radioactivity during normal operation of installations and determines the measuring techniques to be applied for this purpose. The programme determines compulsory instructions to be observed in the performance of the routine measuring programme by the competent Federal and Land authorities and thus ensures nationwide application of standard procedures

  19. Developing a systems approach to prevent meconium aspiration syndrome: lessons learned from multinational studies.

    Science.gov (United States)

    Bhutani, V K

    2008-12-01

    Passage of fetal bowel movement (meconium) is common (in about one out of six births), and in some the staining of the amniotic fluid is a sign of fetal distress. Inhalation of meconium (aspiration syndrome, in upto one out of five to eight such births) just before or at birth may be preventable by a coordinated approach by well-trained and informed birth attendants. Respiratory failure secondary to meconium aspiration syndrome (MAS) remains a major cause of morbidity and mortality in the neonatal population. Infants with hypoxemic respiratory failure because of MAS, persistent pulmonary hypertension of the newborn and pneumonia/sepsis have an increased survival with extracorporeal membrane oxygenation (ECMO). Other treatment options earlier limited to inotropic support, continuous airway pressure (CPAP), conventional ventilatory management, respiratory alkalosis, paralysis and intravenous vasodilators have been replaced by synchronized intermittent mandatory ventilation (SIMV), high-frequency oscillatory ventilation (HFOV), surfactant and inhaled nitric oxide (iNO). HFOV has been advocated for use to improve lung inflation while potentially decreasing lung injury through volutrauma. Other reports describe the enhanced efficacy of HFOV when combined with iNO. Subsequent to studies reporting that surfactant deficiency or inactivation may contribute to neonatal respiratory failure, exogenous surfactant therapy has been implemented with apparent success. Recent studies have shown that iNO therapy in the neonate with hypoxemic respiratory failure can result in improved oxygenation and decreased need for ECMO. However, these innovative interventions are costly, require a sophisticated infrastructure and are not universally accessible. In this paper, a context of systems-approach for prenatal, natal and postnatal management of babies delivered through meconium stained amniotic fluid (MSAF) so that adverse outcomes are minimized and the least number of babies require

  20. Female perspectives of male partners’ inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal

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    Mondli Miya

    2016-02-01

    Full Text Available Background: The South African government intervened by implementing the prevention of mother–to-child transmission programme (PMTCT to curb the HIV transmission from mother to child during and after pregnancy. The PMTCT programme has been at the forefront of global prevention efforts since 1998. Without treatment, the risk of transmission ranges from one in five to one in two newborns; however, the risk of mother-to-child transmission can be reduced to as low as 2%–5% with evidenced interventions. Sub-Saharan Africa, and most particularly South Africa, is the most affected by the pandemic despite having the largest financial investment in PMTCT services across the continent.Objectives: The objectives of the study were to describe and explore the female perspectives of male inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal.Methodology: A qualitative, descriptive, explorative study was conducted through in-depth individual interview of pregnant women until data saturation.Results: The findings of the study revealed that the existing design of public hospitals was not wholly conducive to facilitating male inclusion in maternal and child health services. Resources were largely insufficient to support the participation of pregnant mothers and any attempts to support the inclusion of males needed to be based on a clear increase in service provision.Conclusion: The study recommended male partners’ inclusion in the prevention of mother- to-child HIV transmission to support effective management of HIV in pregnancy and PMTCT programmes. The inclusion of men will provide the holistic support needed by pregnant women on PMTCT programmes.

  1. Preventive Political Morality and the Ontology of Evil: Some Lessons from Literature and Film

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    Krešimir Petković

    2012-01-01

    Full Text Available The article uses different discourses on evil from literature and film to probe Derek Edyvane's political theory that builds a preventive political ethics arguing for "sovereignty of evil". The discussion is limited to a specific evil – violence and violent crime – while its essential causes and consequences in nature and society, and the indicated politics to address it, are subsumed under the term ontology. The underlying idea is that Edyvane must first answer more precisely what evil is and how it works in order to make it sovereign. Avoiding the consequences of evil and building a political consensus around great evils presupposes the understanding of their causes. The method of inquiry that analyses fictional material is legitimated by Edyvane's own employing of art and literature in his study, but more importantly, by special quality and insight of classical films and novels that make them useful in the exploratory phase of research that procreates hypotheses to be tested. After different discourses are explored – ones that see nature, society, politics, or all of them, as roots of violent evil and imply different ideas for its control or eradication – and Edyvane's theory is tested against them, a tentative conclusion is reached that political liberalism is perhaps the best thing that we have to date.

  2. Expected long-term impact of the German screening colonoscopy programme on colorectal cancer prevention: analyses based on 4,407,971 screening colonoscopies.

    Science.gov (United States)

    Brenner, Hermann; Altenhofen, Lutz; Stock, Christian; Hoffmeister, Michael

    2015-07-01

    Endoscopy based screening programmes for colorectal cancer (CRC) are being implemented in an increasing number of countries. In Germany, screening colonoscopy at age 55 or older has been offered since the end of 2002. We aimed to estimate the long-term impact of this offer on CRC prevention. We estimated numbers of prevented CRC cases by expected age and year of their (prevented) occurrence over four decades (2005-2045) by four state Markov models (non-advanced adenoma, advanced adenoma, preclinical CRC, clinically manifest CRC). Estimates are based on screening colonoscopies reported to the German screening colonoscopy registry in 2003-2012 (N=4,407,971), transition rates between the four states and general population mortality rates. Numbers of prevented clinically manifest CRC cases are projected to increase from prevented cases is expected to be higher among men than among women and to strongly vary by age. The vast majority of prevented cases would have occurred at age 75 or older. Despite modest participation rates, the German screening colonoscopy programme will lead to substantial reductions in the CRC burden. The reductions will be fully disclosed in the long run only and predominantly affect numbers of incident cases above 75years of age. Screening offers would need to start at younger ages in order to achieve more effective CRC prevention at younger ages. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

    Science.gov (United States)

    2012-01-01

    Background Male circumcision (MC) has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG) has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH) to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV) program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and community is necessary to assist

  4. Recruiting South Asians to a lifestyle intervention trial: experiences and lessons from PODOSA (Prevention of Diabetes & Obesity in South Asians

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    Tuomilehto Jaakko

    2011-10-01

    Full Text Available Abstract Background Despite the growing emphasis on the inclusion of ethnic minority patients in research, there is little published on the recruitment of these populations especially to randomised, community based, lifestyle intervention trials in the UK. Methods We share our experience of recruitment to screening in the PODOSA (Prevention of Diabetes and Obesity in South Asians trial, which screened 1319 recruits (target 1800 for trial eligibility. A multi-pronged recruitment approach was used. Enrolment via the National Health Service included direct referrals from health care professionals and written invitations via general practices. Recruitment within the community was carried out by both the research team and through our partnerships with local South Asian groups and organisations. Participants were encouraged to refer friends and family throughout the recruitment period. Results Health care professionals referred only 55 potential participants. The response to written invitations via general practitioners was 5.2%, lower than reported in other general populations. Community orientated, personal approaches for recruitment were comparatively effective yielding 1728 referrals (82% to the screening stage. Conclusions The PODOSA experience shows that a community orientated, personal approach for recruiting South Asian ethnic minority populations can be successful in a trial setting. We recommend that consideration is given to cover recruitment costs associated with community engagement and other personalised approaches. Researchers should consider prioritising approaches that minimise interference with professionals' work and, particularly in the current economic climate, keep costs to a minimum. The lessons learned in PODOSA should contribute to future community based trials in South Asians. Trial Registration Current Controlled Trials ISRCTN25729565

  5. Study protocol of a cluster randomized controlled trial evaluating the efficacy of a comprehensive pressure ulcer prevention programme for private for-profit nursing homes.

    Science.gov (United States)

    Kwong, Enid Wai-yung; Lee, Paul Hong; Yeung, Kwan-mo

    2016-01-18

    Because the demand for government-subsidized nursing homes in Hong Kong outstrips the supply, the number of for-profit private nursing homes has been increasing rapidly. However, the standard of care in such homes is always criticized. Pressure ulcers are a major long-term care issue that is closely associated with the quality of care delivered in nursing home settings. The aim of this study is to evaluate the effectiveness of a pressure ulcer prevention programme for residents in private for-profit nursing homes. This is a two-arm cluster randomized controlled trial with an estimated sample size of 1088 residents and 74 care staff from eight for-profit private nursing homes. Eligible nursing homes will be those classified as category A2 homes in the Enhanced Bought Place Scheme (EBPS), having a capacity of around 130-150 beds, and no structured PU prevention protocol and/or programmes in place. Care staff will be health workers, personal care workers, and nurses who are front-line staff providing direct care to residents. Eight nursing homes will be randomly assigned to either an experimental or control group. The experimental group will be provided with an intensive training programme and will be involved in the implementation of a 16-week pressure ulcer prevention protocol, while the control group will deliver the usual pressure ulcer prevention care. The study outcomes are the pressure ulcer prevention knowledge and skills of the care staff and the prevalence and incidence of pressure ulcers. Data on the knowledge and skills of care staff, and prevalence of pressure ulcer will be collected at the base line, and then at the 8(th) week and at completion of the implementation of the protocol. The assessment of the incidence of pressures will start from before the commencement of the intensive training course to the end of the implementation of the protocol. In view of the negative impact of pressure ulcers, it is important to have an effective and evidence

  6. Nature Study, Aborigines and the Australian Kindergarten: Lessons from Martha Simpson's "Australian Programme Based on the Life and Customs of the Australian Black"

    Science.gov (United States)

    Jones, Jennifer

    2014-01-01

    This article examines an experimental kindergarten programme "Work in the Kindergarten: An Australian Programme based on the Life and Customs of the Australian Black" developed by Martha Simpson in early twentieth-century Australia. Here Simpson adapted international Revisionist Froebelian approaches to cultural epoch theory and nature…

  7. The Effectiveness and Sustainability of a Universal School-Based Programme for Preventing Depression in Chinese Adolescents: A Follow-Up Study Using Quasi-Experimental Design.

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    Eliza S Y Lai

    Full Text Available A pilot study about the effectiveness of a universal school-based programme, "The Little Prince is Depressed", for preventing depression in Chinese adolescents in Hong Kong was conducted and reported previously. This study used a larger sample to examine the effectiveness and sustainability of the programme.This study used quasi-experimental design. Twelve schools enrolled in "The Little Prince is Depressed" programme either as an intervention or a control condition. The intervention schools carried out the 12-session programme in two phases: the professional-led first phase and the teacher-led second phase. All participants were required to complete a questionnaire at three time points measuring their (1 depressive, anxiety, and stress levels; (2 knowledge of mental health; (3 attitudes towards mental illness; (4 perceived social support; and (5 help-seeking behaviours.A total of 3,391 students participated in the study. The level of depressive symptoms did not reduce significantly at post-intervention; however, a delayed effect was observed at follow-up assessment for the participants of the teacher-led group in reducing anxiety and stress levels. Also, the knowledge of mental health and attitudes towards mental illness of the intervention-group participants significantly improved at post-test, and the outcomes were maintained at 4 to 5 months after the intervention in both the professional-led and the teacher-led conditions (p<.05. A preference among schoolchildren for whom to seek help from was identified.The universal depression prevention programme was effective in enhancing knowledge of mental health and promoting a more positive attitude towards mental illness among adolescents in Hong Kong. In particular, the teacher-led group showed better outcomes than the professional-led group in reducing students' anxiety and stress at follow-up period. The programme can achieve sustainability in schools if teachers are provided with adequate

  8. The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population.

    Science.gov (United States)

    Lung, F-W; Liao, S-C; Wu, C-Y; Lee, M-B

    2017-06-01

    The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Observational study. A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. A systematic review of the effectiveness of school-based obesity prevention programmes for First Nations, Inuit and Métis youth in Canada.

    Science.gov (United States)

    Godin, K; Leatherdale, S T; Elton-Marshall, T

    2015-06-01

    First Nations, Inuit and Métis (FNIM) youth are disproportionately affected by obesity and represent known a high-risk group in Canada. School-based prevention programmes may have the potential to effectively influence obesity-related health behaviours (i.e. healthy eating and physical activity) among this population. We conducted a systematic review of nine electronic databases (2003-2014) to identify studies that describe school-based programmes that have been developed to improve obesity-related health behaviours and outcomes among FNIM youth in Canada. The objectives of this review were to identify and evaluate the effectiveness of these programmes and assess the strength of the methodologies used to evaluate them. Fifteen studies, representing seven distinct interventions, met our inclusion criteria. The majority of these programmes did not result in significant improvements in outcomes related to obesity, healthy eating, or physical activity among FNIM youth. The studies varied in design rigour and use of evaluation activities. The lack of literature on effective school-based programmes for FNIM youth in Canada that target obesity-related outcomes highlights a priority area for future intervention development, evaluation and dissemination within the peer-reviewed literature. Further research is needed on interventions involving Métis and Inuit youth, secondary school-aged FNIM youth and FNIM youth living in urban settings. © 2015 World Obesity.

  10. The Effectiveness and Sustainability of a Universal School-Based Programme for Preventing Depression in Chinese Adolescents: A Follow-Up Study Using Quasi-Experimental Design.

    Science.gov (United States)

    Lai, Eliza S Y; Kwok, Chi-Leung; Wong, Paul W C; Fu, King-Wa; Law, Yik-Wa; Yip, Paul S F

    2016-01-01

    A pilot study about the effectiveness of a universal school-based programme, "The Little Prince is Depressed", for preventing depression in Chinese adolescents in Hong Kong was conducted and reported previously. This study used a larger sample to examine the effectiveness and sustainability of the programme. This study used quasi-experimental design. Twelve schools enrolled in "The Little Prince is Depressed" programme either as an intervention or a control condition. The intervention schools carried out the 12-session programme in two phases: the professional-led first phase and the teacher-led second phase. All participants were required to complete a questionnaire at three time points measuring their (1) depressive, anxiety, and stress levels; (2) knowledge of mental health; (3) attitudes towards mental illness; (4) perceived social support; and (5) help-seeking behaviours. A total of 3,391 students participated in the study. The level of depressive symptoms did not reduce significantly at post-intervention; however, a delayed effect was observed at follow-up assessment for the participants of the teacher-led group in reducing anxiety and stress levels. Also, the knowledge of mental health and attitudes towards mental illness of the intervention-group participants significantly improved at post-test, and the outcomes were maintained at 4 to 5 months after the intervention in both the professional-led and the teacher-led conditions (pstress at follow-up period. The programme can achieve sustainability in schools if teachers are provided with adequate support.

  11. Adult Literacy: Policies, Programs and Practices. Lessons Learned. Final Report = Alphabetisation des adultes: politiques, programmes et pratiques. Etude bilan. Rapport final.

    Science.gov (United States)

    2001

    Studies and reports examining the problems associated with adult literacy and efforts to address those problems were reviewed to identify lessons for adult literacy programs in Canada and elsewhere. Low literacy levels were linked to above-average rates of personal and/or learning difficulties, low self-esteem, associated social problems, and…

  12. Newsprint media representations of the introduction of the HPV vaccination programme for cervical cancer prevention in the UK (2005?2008)

    OpenAIRE

    Hilton, Shona; Hunt, Kate; Langan, Mairi; Bedford, Helen; Petticrew, Mark

    2010-01-01

    In September 2008, the human papillomavirus (HPV) immunisation programme was introduced in the UK for schoolgirls aged between 12 and 18 years of age. The vaccine shows high efficacy in preventing infection against HPV types 16 and 18 responsible for 70% of cervical cancer. However, to be most effective, the vaccine needs to be administered before exposure to the viruses and therefore, ideally, before young people become sexually active. The introduction of any new vaccine, and perhaps partic...

  13. Preventing substance misuse: study protocol for a randomised controlled trial of the Strengthening Families Programme 10–14 UK (SFP 10–14 UK)

    Science.gov (United States)

    2014-01-01

    Background Prevention of alcohol, drug and tobacco misuse by young people is a key public health priority. There is a need to develop the evidence base through rigorous evaluations of innovative approaches to substance misuse prevention. The Strengthening Families Programme 10–14 is a universal family-based alcohol, drugs and tobacco prevention programme, which has achieved promising results in US trials, and which now requires cross-cultural assessment. This paper therefore describes the protocol for a randomised controlled trial of the UK version of the Strengthening Families Programme 10–14 (SFP 10–14 UK). Methods/Design The trial comprises a pragmatic cluster randomised controlled effectiveness trial with families as the unit of randomisation, with embedded process and economic evaluations. Participating families will be randomised to one of two treatment groups - usual care with full access to existing services (control group), or usual care plus SFP 10–14 UK (intervention group). The trial has two primary outcomes - the number of occasions that young people report having drunk alcohol in the last 30 days, and drunkenness during the last 30 days, both dichotomised as ‘never’ and ‘1-2 times or more’. The main follow-up is at 2 years past baseline, and short-term and intermediate outcomes are also measured at 9 and 15 months. Discussion The results from this trial will provide evidence on the effectiveness and cost-effectiveness of an innovative universal family-based substance misuse prevention programme in a UK context. Trial registration Current Controlled Trials ISRCTN63550893. PMID:24438460

  14. Development, Implementation, and Evaluation of an Interdisciplinary Theory- and Evidence-Based Intervention to Prevent Childhood Obesity: Theoretical and Methodological Lessons Learned

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    Gill A. ten Hoor

    2017-12-01

    Full Text Available Overweight and obesity in children and adolescents is seen as a global health challenge and a priority for prevention (1. To solve such a health issue, we need full understanding of the related health behaviors (and underlying beliefs, and understanding of the biological mechanisms that cause or can prevent the issue. However, for overweight and obesity, drawing a full picture of the exact problem (and the subsequent solution is difficult. In this paper, we describe how we used Intervention Mapping to develop a theory and evidence-based prevention program targeting overweight and obesity and how we investigated the 1-year efficacy of this program on body composition and physical activity of adolescents. A helpful tool, theoretical, and methodological lessons learned are given from our attempt to contribute to solving the obesity problem.

  15. Does a fall prevention educational programme improve knowledge and change exercise prescribing behaviour in health and exercise professionals? A study protocol for a randomised controlled trial.

    Science.gov (United States)

    Tiedemann, A; Sturnieks, D L; Hill, A-M; Lovitt, L; Clemson, L; Lord, S R; Harvey, L; Sherrington, C

    2014-11-19

    Falling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on health and exercise professionals' knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people. A randomised controlled trial involving 220 consenting health and exercise professionals will be conducted. Participants will be individually randomised to an intervention group (n=110) to receive an educational workshop plus access to internet-based support resources, or a wait-list control group (n=110). The two primary outcomes, measured 3 months after randomisation, are: (1) knowledge about fall prevention and (2) self-perceived change in fall prevention exercise prescription behaviour. Secondary outcomes include: (1) participants' confidence to prescribe fall prevention exercises; (2) the proportion of people aged 60+ years seen by trial participants in the past month who were prescribed fall prevention exercise; and (3) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines. Outcomes will be measured with a self-report questionnaire designed specifically for the trial. The trial protocol was approved by the Human Research Ethics Committee, The University of Sydney, Australia. Trial results will be disseminated via peer reviewed journals, presentations at international conferences and participants' newsletters. Trial protocol was registered with the Australian and New Zealand Clinical Trials Registry (Number

  16. Influence of a preschool preventive dental programme on caries prevalence, oral care and secretory immunity to Streptococcus mutans in young adults.

    Science.gov (United States)

    Aida, K L; de Paula Ramos, S; Seixas, G F; Bozza, A; Couto de Almeida, R S; Dezan Garbelini, C C

    2018-05-01

    To evaluate oral hygiene habits, decayed, missing and filled teeth (DMFT) and surfaces (DMFS), dental care, dietetic habits and anti-Streptococcus mutans salivary secretory Immunoglobulin A (SIgA) in young adults who attended a preventive programme during preschool age. The study group (Baby Clinic) comprised 72 patients, aged 18-25 years, who had participated in the Baby Clinic preventive programme. The control group was age- and gender-matched. The patients were examined and unstimulated whole saliva was sampled for detection of anti-S. mutansSIgA antibodies. Control patients presented increased DMFS scores (P  .05). Baby Clinic patients presented better periodontal status (P < .005), less calculus (P < .005) and bleeding on probing (P < .005), and reported visiting dental services more regularly (P < .05). Adjusted multivariate linear regression analysis demonstrated that DMFT was associated with study group (P < .05), gender (P < .05), parents' education (P < .05), carbohydrate intake (P < .001) and levels of anti-S. mutansSIgA (P < .007). DMFS was associated with time elapsed since the last visit to the dentist (P < .005) and weekly carbohydrate intake (P < .005). Preventive programmes for preschool children positively impact on DMFS and periodontal status in young adults, but have no long-term effects on dietary or hygiene habits. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Effectiveness of Structured Teaching Programme on Knowledge regarding Risk factors and Prevention of Suicidal Behaviour among Adolescents in a selected College, Salem, Tamil Nadu

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    N Loganathan

    2015-12-01

    Full Text Available Background & Objectives: The aim of this study is to assess the knowledge regarding risk factors and prevention of suicidal behavior, to evaluate the effectiveness of structured teaching programme on knowledge regarding risk factors and prevention of suicidal behaviour among Adolescents, and to associate the pre-test knowledge regarding risk factors and prevention of suicidal behaviour among adolescents with their selected demographic variables.Materials & Methods: A quantitative evaluative approach with a pre-experimental (one group pre test- post test design was adopted; the setting of the study was Sri Vidya Mandir College, Salem, Tamilnadu. A Structured Self-administered questionnaire was used to assess the knowledge of the adolescents. The systematic random sampling technique was used and 60 adolescents involved on Structured Teaching Programme regarding Risk factors and prevention of Suicidal Behaviour by using a Power-point slide presentation followed with pre-test. On 7th day, the post test was conducted. The data collection period of the study was 09.12.2014 to 15.12.2014.Results: The study findings revealed that during Pre-test, the knowledge regarding risk factors and prevention of suicidal behaviour among adolescents, 45(75% had inadequate knowledge, 15(25% had moderately adequate knowledge and none of them had adequate knowledge. During post test, 23 adolescents (38.33% had adequate knowledge, 37(61.67% had moderately adequate knowledge and none of them had inadequate knowledge. The mean score during pre-test was 9.9±3.88 and the mean score during post test was 17.03±4.12. The paired ‘t’ value was 16.84 which were significant at p<0.05 level. Thus it shows that the structured teaching programme was effective in improving knowledge regarding risk factors and prevention of suicidal behaviour among adolescents. There was no significant association found between the pre-test scores on knowledge regarding risk factors and

  18. Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-09-22

    Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

  19. Implementation process and acceptance of a setting based prevention programme to promote healthy lifestyle in preschool children

    OpenAIRE

    Herbert, Birgit; Strauß, Angelika; Mayer, Andrea; Duvinage, Kristin; Mitschek, Christine; Koletzko, Berthold

    2013-01-01

    Objective: Evaluation of the implementation process of a kindergarten-based intervention ('TigerKids') to promote a healthy lifestyle. Design: Questionnaire survey among kindergarten teachers about programme implementation and acceptance. Setting: Kindergartens in Bavaria, Germany. Methods: Two hundred and fifteen kindergartens were included; 96.3 % returned informative questionnaires. `TigerKids' is a multi-approach behavioural intervention programme to increase physical activity level and t...

  20. Newsprint media representations of the introduction of the HPV vaccination programme for cervical cancer prevention in the UK (2005-2008).

    Science.gov (United States)

    Hilton, Shona; Hunt, Kate; Langan, Mairi; Bedford, Helen; Petticrew, Mark

    2010-03-01

    In September 2008, the human papillomavirus (HPV) immunisation programme was introduced in the UK for schoolgirls aged between 12 and 18 years of age. The vaccine shows high efficacy in preventing infection against HPV types 16 and 18 responsible for 70% of cervical cancer. However, to be most effective, the vaccine needs to be administered before exposure to the viruses and therefore, ideally, before young people become sexually active. The introduction of any new vaccine, and perhaps particularly one given to young teenage girls to prevent a sexually transmitted cancer-causing virus, has the potential to attract a great deal of media attention. This paper reports on content analysis of 344 articles published between January 2005 and December 2008 in 15 UK newspapers. It includes both manifest and latent analysis to examine newsprint media coverage of the introduction of the HPV vaccination programme and its role in HPV advocacy. We concluded that the newspapers were generally positive towards the new HPV vaccination and that over the 4 years period the newsworthiness of the HPV vaccination programme increased. In 2008 two events dominated coverage, firstly, the introduction of the HPV programme in September 2008 and secondly, in August 2008 the diagnosis on camera of cervical cancer given to Jade Goody, a 27 year old mother of two, who gained fame and notoriety in the UK through her participation in several reality television shows. There are two conclusions from this study. Firstly, the positive media coverage surrounding the introduction of the HPV vaccination programme is to be welcomed as it is likely to contribute towards influencing public perceptions about the acceptability and need for HPV vaccination. Secondly, the focus on prevalence rates of HPV infection among women and on women's sexual behaviours, in relation to HPV vaccination 'encouraging' promiscuity, is an unhelpful aspect of media coverage. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

    Science.gov (United States)

    Attwood, Matthew J; Roberts, Simon P; Trewartha, Grant; England, Mike E; Stokes, Keith A

    2018-01-01

    Background Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men’s collision sports such as rugby union is lacking. Objective To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men’s community rugby union players. Methods 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises. Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Results Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). Conclusions The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden. PMID:29055883

  2. Effectiveness and implementation of a community-based prevention programme targeting anabolic androgenic steroid use in gyms: study protocol of a quasi-experimental control group study.

    Science.gov (United States)

    Molero, Yasmina; Gripenberg, Johanna; Bakshi, Ann-Sofie

    2016-01-01

    During the past decades, concerns about increased anabolic androgenic steroid (AAS) use among recreational sportspeople have been raised, yet there is a paucity of AAS prevention efforts targeting this group. Accordingly, doping prevention efforts aimed at gyms have been recommended. The overall objective of the present project is to examine a prevention programme named 100% Pure Hard Training (100% PHT), which targets AAS use among recreational sportspeople training in gyms. Specifically, the project aims to: 1) assess the prevalence of AAS, and its associations with alcohol, illicit drugs, and nutritional supplements use; 2) examine whether 100% PHT can decrease AAS use in gyms, and 3) provide insights into which factors facilitate and/or impede implementation of the programme. The intervention group consists of 27 gyms, and 27 gyms serve as controls. Intervention gyms take part in 100% PHT, a community-based programme involving several components: (a) training of key stakeholders (i.e., gym staff, gym owners, local police, and municipal prevention coordinators) regarding AAS use; (b) developing an action plan for AAS prevention for each gym; (c) certification of gyms that follow 100% PHT; (d) cooperative relationship between stakeholders; (e) annual follow-up of gyms. The project consists of two studies: Study A will examine the prevalence of AAS use and the effectiveness of 100% PHT (aims 1 and 2), and data for Study A will be collected using questionnaires distributed to gym attendees at two assessment points: baseline (pre-intervention) and follow-up (post-intervention). Study B will evaluate the implementation of 100% PHT (aim 3), and semi-structured interviews with participating stakeholders will be carried out post-intervention. Knowledge gained from the present project can be used to develop community-based doping prevention efforts aimed at recreational sportspeople training in gyms. Furthermore, it can provide insights into which factors are important

  3. Effectiveness of a parenting programme in a public health setting: a randomised controlled trial of the positive parenting programme (Triple P level 3 versus care as usual provided by the preventive child healthcare (PCH

    Directory of Open Access Journals (Sweden)

    Jansen Daniëlle EMC

    2010-03-01

    Full Text Available Abstract Background Considering the high burden of disease of psychosocial problems in children and adolescents, early intervention regarding problem behaviour of young children is very important. The Preventive Child Healthcare (PCH offers a good setting to detect such problem behaviour and to provide parenting support to the parents concerned. This paper aims to describe the design of an effectiveness study of a parenting programme for parents of children with mild psychosocial problems after an initial, evidence based screening in routine PCH. Methods/Design The effects of the intervention will be studied in a randomised controlled trial. Prior to a routine PCH health examination, parents complete a screening questionnaire on psychosocial problems. Parents of children with increased but still subclinical levels of psychosocial problems will be assigned at random to the experimental group (Triple P, level 3 or to the control group (care as usual. Outcome measures, such as problem behaviour in the child and parenting behaviour, will be assessed before, directly after and 6 and 12 months after the intervention. Discussion Parenting support may be an effective intervention to reduce psychosocial problems in children but evidence-based parenting programmes that fit the needs of the PCH are not available as yet. Although the Triple P programme seems promising and suitable for a universal population approach, evidence on its effectiveness in routine PCH still lacks. Trial registration NTR1338

  4. Preliminary evaluation of the impact of a Web-based HIV testing programme in Abruzzo Region on the prevention of late HIV presentation and associated mortality.

    Science.gov (United States)

    Polilli, Ennio; Sozio, Federica; Di Stefano, Paola; Clerico, Luigi; Di Iorio, Giancarlo; Parruti, Giustino

    2018-04-01

    This study aimed to analyze the efficacy of a Web-based testing programme in terms of the prevention of late HIV presentation. The clinical characteristics of patients diagnosed with HIV via the Web-based testing programme were compared to those of patients diagnosed in parallel via standard diagnostic care procedures. This study included the clinical and demographic data of newly diagnosed HIV patients enrolled at the study clinic between February 2014 and June 2017. These patients were diagnosed either via standard diagnostic procedures or as a result of the Web-based testing programme. Eighty-eight new cases of HIV were consecutively enrolled; their mean age was 39.1±13.0 years. Fifty-nine patients (67%) were diagnosed through standard diagnostic procedures and 29 (33%) patients came from the Web-based testing programme. Late presentation (62% vs. 34%, p=0.01) and AIDS-defining conditions at presentation (13 vs. 1, p=0.02) were significantly more frequent in the standard care group than in the Web-based group; four of 13 patients with AIDS diagnosed under standard diagnostic procedures died, versus none in the Web-based testing group (pWeb-based recruitment for voluntary and free HIV testing helped to diagnose patients with less advanced HIV disease and no risk of death, from all at-risk groups, in comparison with standard care testing. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Demand generation and social mobilisation for integrated community case management (iCCM and child health: Lessons learned from successful programmes in Niger and Mozambique

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    Alyssa B Sharkey

    2014-11-01

    Full Text Available We present the approaches used in and outcomes resulting from integrated community case management (iCCM programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM.

  6. The current and potential health benefits of the National Health Service Health Check cardiovascular disease prevention programme in England: A microsimulation study.

    Science.gov (United States)

    Mytton, Oliver T; Jackson, Christopher; Steinacher, Arno; Goodman, Anna; Langenberg, Claudia; Griffin, Simon; Wareham, Nick; Woodcock, James

    2018-03-01

    The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation. We developed a microsimulation model to estimate the health benefits (incident ischaemic heart disease, stroke, dementia, and lung cancer) of the NHS Health Check programme in England. We simulated a population of adults in England aged 40-45 years and followed until age 100 years, using data from the Health Survey of England (2009-2012) and the English Longitudinal Study of Aging (1998-2012), to simulate changes in risk factors for simulated individuals over time. We used recent programme data to describe uptake of NHS Health Checks and of 4 associated interventions (statin medication, antihypertensive medication, smoking cessation, and weight management). Estimates of treatment efficacy and adherence were based on trial data. We estimated the benefits of the current NHS Health Check programme compared to a healthcare system without systematic health checks. This counterfactual scenario models the detection and treatment of risk factors that occur within 'routine' primary care. We also explored the impact of making feasible changes to implementation of the programme concerning eligibility, uptake of NHS Health Checks, and uptake of treatments offered through the programme. We estimate that the NHS Health Check programme prevents 390 (95% credible interval 290 to 500) premature deaths before 80 years of age and results in an additional 1,370 (95% credible interval 1,100 to 1,690) people

  7. Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa

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    Mirkuzie Alemnesh H

    2012-12-01

    Full Text Available Abstract Background In the absence of reliable data, antenatal HIV surveillance has been used to monitor the HIV epidemic since the late 1980s. Currently, routine data from Prevention of Mother-to-child HIV transmission (PMTCT programmes are increasingly available. Evaluating whether the PMTCT programme reports provide comparable HIV prevalence estimates with the antenatal surveillance reports is important. In this study, we compared HIV prevalence estimates from routine PMTCT programme and antenatal surveillance in Addis Ababa with the aim to come up with evidence based recommendation. Methods Summary data were collected from PMTCT programmes and antenatal surveillance reports within the catchment of Addis Ababa. The PMTCT programme data were obtained from routine monthly reports from 2004 to 2009 and from published antenatal HIV surveillance reports from 2003 to 2009. Data were analysed using descriptive statistics. Results In Addis Ababa, PMTCT sites had increased from six in 2004 to 54 in 2009. The site expansion was accompanied by an increased number of women testing. There were marked increases in the rate of HIV testing following the introduction of routine opt-out HIV testing approach. Paralleling these increases, the HIV prevalence showed a steady decline from 10.0% in 2004 to 4.5% in 2009. There were five antenatal surveillance sites from 2003 to 2007 in Addis Ababa and they increased to seven by 2009. Four rounds of surveillance data from five sites showed a declining trend in HIV prevalence over the years. The overall antenatal surveillance data also showed that the HIV prevalence among antenatal attendees had declined from 12.4% in 2003 to 5.5% in 2009. The HIV prevalence estimates from PMTCT programme were 6.2% and 4.5% and from antenatal surveillance 6.1 and 5.5% in 2008 and 2009 respectively. Conclusions There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources

  8. A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi

    Science.gov (United States)

    Burdon Bailey, Jordana L.; Gamble, Luke; Gibson, Andrew D.; Bronsvoort, Barend M. deC.; Handel, Ian G.; Mellanby, Richard J.; Mazeri, Stella

    2018-01-01

    Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children’s knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both prabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both prabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren. PMID:29522517

  9. Favourable outcomes of a preventive screening and counselling programme for older people in underprivileged areas in the Netherlands: The PRIMUS project

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    D.J. Annemarie van Dijk

    2017-06-01

    Full Text Available An aging population is associated with an increased prevalence of diabetes, cardiovascular diseases and depression. Important aspects of programmes targeted at older people are: to reach those at risk, effective screening, optimising advice, and referral to local interventions. We examined the effect of a preventive health consultation (PRIMUS, a multi-behavioural screening programme for persons aged 55–74 years in primary care. In a multi-centre randomised controlled trial, the effects of participating in the PRIMUS intervention were compared to a comparison group receiving personalised summaries and advice by postal mail, both preceded by a health risk assessment via a questionnaire. The intervention consisted of a baseline health risk assessment, followed by a preventive health consultation (after 4 weeks, and a follow-up visit (2 weeks later in the primary care centre. A newly developed web-based computer-tailored programme supported the nurse practitioner during the consultation. Main outcomes measures were awareness of, and compliance with referral advice for changing unhealthy lifestyles. The PRIMUS preventive health consultation was successful in older people at risk for cardio metabolic diseases compared to the comparison group (compliance: RR 1.43; 95% CI 1.12–1.79; p < 0.05. The intervention was less successful in older people at risk for mental health problems. This preventive health consultation for older people resulted in positive changes in unhealthy behaviours by optimising reach, raising awareness, motivating and assisting individuals to change, and referring to local interventions.

  10. Trial baseline characteristics of a cluster randomised controlled trial of a school-located obesity prevention programme; the Healthy Lifestyles Programme (HeLP trial

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    Jenny Lloyd

    2017-04-01

    Full Text Available Abstract Background We have developed a healthy lifestyles programme (HeLP for primary school aged children (9–10 years, currently being evaluated in a definitive cluster randomised controlled trial. This paper descriptively presents the baseline characteristics of trial children (BMI, waist circumference, % body fat, diet and physical activity by gender, cluster level socio-economic status, school size and time of recruitment into the trial. Methods Schools were recruited from across the South West of England and allocated 1:1 to either intervention (HeLP or control (usual practice stratified by the proportion of children eligible for free school meals (FSM, 1 Year 5 class. The primary outcome is change in body mass index standard deviation score (BMI sds at 24 months post-randomisation. Secondary outcomes are BMI sds at 18 months, waist circumference and percentage body fat sds at 18 and 24 months, proportion of children classified as underweight, overweight and obese at 18 and 24 months, physical activity (for a sub-sample and food intake at 18 months. Results At baseline 11.4% and 13.6% of children were categorised as overweight or obese respectively. A higher percentage of girls than boys (25.3% vs 24.8% and children from schools in FSM category 2 (28.2% vs 23.2% were overweight or obese. Children were consuming a mean (range of 4.15 (0–13 energy dense snacks (EDS and 3.23 (0–9 healthy snacks (HS per day with children from schools in FSM category 2 consuming more EDS and negative food markers and less HS and positive food markers. Children spent an average 53.6 min per day (11.9 to 124.8 in MVPA and thirteen hours (779.3 min per day (11 h to 15 h doing less than ‘light’ intensity activity. Less than 5% of children achieved the Departments of Health’s recommendation of 60 min of MVPA every day. Conclusion We have excellent completeness of baseline data for all measures and have achieved compliance to accelerometry not

  11. Free formula milk in the prevention of mother-to-child transmission programme: voices of a peri-urban community in South Africa on policy change.

    Science.gov (United States)

    Ijumba, Petrida; Doherty, Tanya; Jackson, Debra; Tomlinson, Mark; Sanders, David; Persson, Lars-Åke

    2013-10-01

    In 2001, South Africa began implementing the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme. This programme included distribution of free formula milk for infants up to 6 months of age at all public health facilities. Effective from 1 January 2011, KwaZulu-Natal became the first province to phase out free formula milk from its PMTCT programme. On 23 August 2011, the South African National Department of Health adopted promotion of exclusive breastfeeding as the national infant feeding strategy and made a decision to withdraw free formula milk from the PMTCT programme. To explore the perceptions and understanding of households at community level on the policy decision to phase out free formula milk from the PMTCT programme in South Africa. An exploratory qualitative study was conducted amongst women enrolled in a community randomized trial known as Good Start III. Focus group discussions were held with grandmothers, fathers and teenage mothers; and in-depth interviews were performed with HIV-positive and HIV-negative mothers. Data were analysed using thematic analysis. Identified themes included: (1) variations in awareness and lack of understanding of the basis for the policy change, (2) abuse of and dysfunctional policy as perceived reasons for policy change and (3) proposed strategies for communicating the policy change. There is an urgent need to develop a multifaceted communication strategy clearly articulating the reasons for the infant feeding policy change and promoting the new breastfeeding strategy. The communication strategy should take into account inputs from the community. With a supportive environment and one national infant feeding strategy, South Africa has an opportunity to reverse years of poor infant feeding practices and to improve the health of all children in the country.

  12. Towards an Online Bachelor of Information Science Degree Programme in a Nigerian University: Part 1--Lessons from the Literature and Existing Curricula

    Science.gov (United States)

    Ajiferuke, Isola; Tiamiyu, Mutawakilu; Longe, Folake; Nwagwu, Williams; Ogunsola, Kemi; Opesade, Adeola; Olatokun, Wole

    2012-01-01

    Training programmes for the information professions worldwide have been shifting and diversifying the scope of their claimed domains and curricula in order to empower their graduates with diverse knowledge and versatile technical skills required to compete successfully in the highly competitive job markets in the information industries. In line…

  13. Implementation Process and Acceptance of a Setting Based Prevention Programme to Promote Healthy Lifestyle in Preschool Children

    Science.gov (United States)

    Herbert, Birgit; Strauss, Angelika; Mayer, Andrea; Duvinage, Kristin; Mitschek, Christine; Koletzko, Berthold

    2013-01-01

    Objective: Evaluation of the implementation process of a kindergarten-based intervention ("TigerKids") to promote a healthy lifestyle. Design: Questionnaire survey among kindergarten teachers about programme implementation and acceptance. Setting: Kindergartens in Bavaria, Germany. Methods: Two hundred and fifteen kindergartens were…

  14. Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use : A randomized clustered trial

    NARCIS (Netherlands)

    Malmberg, Monique; Kleinjan, Marloes; Overbeek, Geertjan|info:eu-repo/dai/nl/25233602X; Vermulst, Ad; Monshouwer, Karin|info:eu-repo/dai/nl/202651967; Lammers, Jeroen; Vollebergh, Wilma A M|info:eu-repo/dai/nl/090632893; Engels, Rutger C M E

    2014-01-01

    Aim: To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design: Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). Setting: General population of 11-15-year-old

  15. Supervised Agricultural Experience Programmes (SAEP) and Work Linked Education (WLE): Panacea for Empowering Youths and Preventing Joblessness

    Science.gov (United States)

    Famiwole, Remigius O.

    2015-01-01

    Youths from Nigerian schools and tertiary institutions are usually unemployable after schooling because they are not empowered with the required saleable skills to earn them a job or with which to establish as entrepreneurs. This paper examines the relevance of Supervised Agricultural Experience Programme (SAEP) and Work Linked Education (WLE) as…

  16. Effectiveness and cost-effectiveness of an injury prevention programme for adult male amateur soccer players: design of a cluster-randomised controlled trial

    Science.gov (United States)

    Krist, Mark R; Schmikli, Sandor L; Stubbe, Janine H; de Wit, G Ardine; Inklaar, Han; van de Port, Ingrid G L; Backx, Frank J G

    2010-01-01

    Background and aims Approximately 16% of all sports injuries in the Netherlands are caused by outdoor soccer. A cluster-randomised controlled trial has been designed to investigate the effectiveness and cost-effectiveness of an injury prevention programme (‘The11’) for male amateur soccer players. The injury prevention programme The11, developed with the support of the World Football Association FIFA, aims to reduce the impact of intrinsic injury risk factors in soccer. Methods Teams playing at first-class amateur level in two districts in the Netherlands are participating in the study. Teams in the intervention group were instructed to apply The11 during each practice session throughout the 2009–10 season. All participants of the control group continued their practice sessions as usual. All soccer-related injuries and related costs for each team were systematically reported online by a member of the medical staff. Player exposure to practice sessions and matches was reported weekly by the coaches. Also the use of The11 during the season after the intervention season will be monitored. Discussion Our hypothesis is that integrating the The11 exercises in the warm-up for each practice session is effective in terms of injury incidence, injury severity, healthcare use, and its associated costs and/or absenteeism. Prevention of soccer injuries is expected to be beneficial to adult soccer players, soccer clubs, the Royal Dutch Football Association (KNVB), health insurance companies and society. PMID:21177664

  17. FAMILY–TEACHER PARTNERSHIP IN FOSTERING THE DEVELOPMENT OF CHILDREN`S SOCIAL SKILLS USING THE BULLYING PREVENTION PROGRAMME “FREE FROM BULLYING” IN ESTONIAN SCHOOLS

    Directory of Open Access Journals (Sweden)

    Leida Talts

    2017-02-01

    Full Text Available This research focused on the most important topics areas in parents` communication with the teachers and their assessments of the values prevailing in the classroom of second grade children using the programme “Free of Bullying”. The Free of Bullying methodology is fostering the development of children`s social skills, where family-teacher partnership plays essential role. The bullying prevention programme, initiated in the Kingdom of Denmark in 2007 and implemented in kindergartens in Estonia since 2010 and in schools since 2013. The main goal of the Free of Bullying methodology is to develop a behavioural culture that fosters respect toward oneself, fellow-pupils and adults, and works through mutual consideration. Creating a trusting relationship with parents and attaching importance to their role in creating a safe classroom atmosphere is essential for preventing the situation where parents are integrated in this process only when painful and negative problem situations occur. The current research sample consists of the parents of second grade children attending the “Free from bullying” pilot schools. The research revealed that from the bullying prevention point of view parents highly appreciate care, tolerance and respect. The most frequent topics of parent-teacher discussion are joint activities of the class and bullying between children. Thus it appears that parents who have been more actively involved through the measures of “Bullying-free school” project more frequently discuss aspects of the social structure of classroom climate with the teacher.

  18. Safe communities in China as a strategy for injury prevention and safety promotion programmes in the era of rapid economic growth.

    Science.gov (United States)

    Wang, Shu-Mei; Dalal, Koustuv

    2013-02-01

    Due to its rapid economic development, China is facing a huge health, social, and economic burden resulting from injuries. The study's objective was to examine Safe Communities in China as a strategy for injury prevention and safety promotion programmes in the era of rapid economic growth. Literature searches in English and Chinese, which included grey literature, were performed on the Chinese Journal Full-text Search System and Medline, using the words "Safe Community", "injury", "economics", and "prevention". The results showed that the existing 35 recognized members of the International Safe Community Network have not placed due emphasis on suicide prevention, which is one of the leading problems in both rural and urban China. A few groups, such as children, the elderly, cyclists, and pedestrians, have received due emphasis, while other vulnerable groups, such as migrant workers, motorcyclists, students, players, and farmers have not received the necessary attention from the Safe Community perspective. As the evidence describes, Safe Communities in China can be a very effective strategy for injury prevention, but four aspects need to be strengthened in the future: (1) establish and strengthen the policy and regulations in terms of injury prevention at the national level; (2) create a system to involve professional organizations and personnel in projects; (3) consider the economic development status of different parts of China; and (4) intentional injury prevention should receive greater attention.

  19. Health belief model based evaluation of school health education programme for injury prevention among high school students in the community context.

    Science.gov (United States)

    Cao, Zhi-Juan; Chen, Yue; Wang, Shu-Mei

    2014-01-10

    Although multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context. This study was to provide information for the evaluation of community-based health education programmes of injury prevention among high school students. The pre-intervention survey was conducted in November 2009. Health belief model (HBM) based health education for injury prevention started in January 2010 and stopped in the end of 2011 among high school students in the community context in Shanghai, China. A post-intervention survey was conducted six weeks after the completion of intervention. Injury-related health belief indicators were captured by a short questionnaire before and after the intervention. Health belief scores were calculated and compared using the simple sum score (SSS) method and the confirmatory factor analysis weighted score (CFAWS) method, respectively. The average reliability coefficient for the questionnaire was 0.89. The factor structure of HBM was given and the data fit HBM in the confirmatory factor analysis (CFA) very well. The result of CFA showed that Perceived Benefits of Taking Action (BEN) and Perceived Seriousness (SER) had the greatest impact on the health belief, Perceived Susceptibility (SUS) and Cues to Action (CTA) were the second and third most important components of HBM respectively. Barriers to Taking Action (BAR) had no notable impact on HBM. The standardized path coefficient was only 0.35, with only a small impact on CTA. The health belief score was significantly higher after intervention (p health belief scores and evaluate the injury related intervention. The community-based school health education might improve injury-related health belief among high school students; however, this preliminary observation needs to be confirmed in further research.

  20. Cost-effectiveness of a cardiovascular disease primary prevention programme in a primary health care setting. Results of the Polish part of the EUROACTION project.

    Science.gov (United States)

    Sović, Nevena; Pająk, Andrzej; Jankowski, Piotr; Duenas, Alejandra; Kawecka-Jaszcz, Kalina; Wolfshaut-Wolak, Renata; Stepaniak, Urszula; Kawalec, Paweł

    2013-01-01

    Well designed cardiovascular disease (CVD) prevention programmes appear to be generally applicable and effective in reducing exposure to risk factors and the incidence of disease. However, introducing them broadly into clinical practice would have a significant impact on the healthcare budget, and requires careful consideration. The purpose of this health economic analysis was to assess the potential cost-effectiveness of the model nurse-led, comprehensive CVD primary prevention programme which was prepared and introduced in the EUROACTION project, in high-risk patients in Poland. A Markov model was developed to assess the long-term costs of preventive intervention. The health states modelled were: event-free (all patients at the beginning of observation), stable angina first year, acute myocardial infarction, stable angina subsequent year, myocardial infarction subsequent year, CVD death, and other causes of death. Health benefits from the reduction in risk factors were estimated based on Framingham risk function assuming the probability of defined health states according to British registers. The time horizon of the analysis was ten years, and one Markov cycle length was one year. The analysis was prepared from the healthcare payer's perspective. A willingness to pay threshold of three gross domestic product (GDP) per capita / quality-adjusted life years (QALY) was used. Univariate sensitivity analysis was conducted. Results were presented as an incremental cost-effectiveness ratio (ICER) expressed as an incremental cost per QALY. In Poland, EUROACTION intervention resulted mainly in reductions in the prevalence of smoking (by 14%) and high blood pressure (by 7%). Intervention on other risk factors, including blood lipids, was found to be less effective. Estimated ICERs were 19,524 PLN for men and 82,262 PLN for women. The programme was even more cost-effective in smokers i.e. estimated ICERs were 12,377 PLN in men and 53,471 PLN in women. The results were most

  1. Methodologic and logistic issues in conducting longitudinal birth cohort studies: lessons learned from the Centers for Children's Environmental Health and Disease Prevention Research.

    Science.gov (United States)

    Eskenazi, Brenda; Gladstone, Eleanor A; Berkowitz, Gertrud S; Drew, Christina H; Faustman, Elaine M; Holland, Nina T; Lanphear, Bruce; Meisel, Stefanie J; Perera, Frederica P; Rauh, Virginia A; Sweeney, Anne; Whyatt, Robin M; Yolton, Kimberly

    2005-10-01

    In anticipation of the National Children's Study, lessons can be learned from the smaller birth cohort studies conducted by five Centers for Children's Environmental Health and Disease Prevention Research funded by the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. The populations studied are diverse in ethnicity and social class and reside in urban and rural environments. Although almost all of the centers chose to enroll participants through medical care facilities, they had to develop independent staffs and structures because of the overburdened medical care system. Some of the lessons learned by the centers include the importance of continuous funding, building community partnerships to conduct culturally appropriate research, hiring bilingual and bicultural staff from the community, prioritizing research goals, developing biorepositories to ensure future utility of samples, instituting quality control procedures for all aspects of specimen and data collection, maintaining frequent contact with study participants, ensuring ethical conduct of the research in a changing medical-legal climate, and communicating results in a timely and appropriate manner to participants and the wider community. All centers underestimated the necessary start-up time, staff, and costs in conducting these birth cohort studies. Despite the logistical complexity and added expenses, all centers emphasize the importance of studying the impact of environmental exposures on those children most at risk, those living in minority and low-income communities. These centers present barriers encountered, solutions found, and considerations for future research, with the hope that the lessons learned can help inform the planning and conduct of the National Children's Study.

  2. Process and impact evaluation of the Romp & Chomp obesity prevention intervention in early childhood settings: lessons learned from implementation in preschools and long day care settings.

    Science.gov (United States)

    de Silva-Sanigorski, Andrea M; Bell, Andrew C; Kremer, Peter; Park, Janet; Demajo, Lisa; Smith, Michael; Sharp, Sharon; Nichols, Melanie; Carpenter, Lauren; Boak, Rachel; Swinburn, Boyd

    2012-06-01

    The Romp & Chomp controlled trial, which aimed to prevent obesity in preschool Australian children, was recently found to reduce the prevalence of childhood overweight and obesity and improve children's dietary patterns. The intervention focused on capacity building and policy implementation within various early childhood settings. This paper reports on the process and impact evaluation of this trial and the lessons learned from this complex community intervention. Process data was collected throughout and audits capturing nutrition and physical activity-related environments and practices were completed postintervention by directors of Long Day Care (LDC) centers (n = 10) and preschools (n = 41) in intervention and comparison (n = 161 LDC and n = 347 preschool) groups. The environmental audits demonstrated positive impacts in both settings on policy, nutrition, physical activity opportunities, and staff capacity and practices, although results varied across settings and were more substantial in the preschool settings. Important lessons were learned in relation to implementation of such community-based interventions, including the significant barriers to implementing health-promotion interventions in early childhood settings, lack of engagement of for-profit LDC centers in the evaluation, and an inability to attribute direct intervention impacts when the intervention components were delivered as part of a health-promotion package integrated with other programs. These results provide confidence that obesity prevention interventions in children's settings can be effective; however, significant efforts must be directed toward developing context-specific strategies that invest in policies, capacity building, staff support, and parent engagement. Recognition by funders and reviewers of the difficulties involved in implementing and evaluating such complex interventions is also critical to strengthening the evidence base on the effectiveness of such public health

  3. Cost-effectiveness of HIV prevention for high-risk groups at scale: an economic evaluation of the Avahan programme in south India.

    Science.gov (United States)

    Vassall, Anna; Pickles, Michael; Chandrashekar, Sudhashree; Boily, Marie-Claude; Shetty, Govindraj; Guinness, Lorna; Lowndes, Catherine M; Bradley, Janet; Moses, Stephen; Alary, Michel; Vickerman, Peter

    2014-09-01

    Avahan is a large-scale, HIV preventive intervention, targeting high-risk populations in south India. We assessed the cost-effectiveness of Avahan to inform global and national funding institutions who are considering investing in worldwide HIV prevention in concentrated epidemics. We estimated cost effectiveness from a programme perspective in 22 districts in four high-prevalence states. We used the UNAIDS Costing Guidelines for HIV Prevention Strategies as the basis for our costing method, and calculated effect estimates using a dynamic transmission model of HIV and sexually transmitted disease transmission that was parameterised and fitted to locally observed behavioural and prevalence trends. We calculated incremental cost-effective ratios (ICERs), comparing the incremental cost of Avahan per disability-adjusted life-year (DALY) averted versus a no-Avahan counterfactual scenario. We also estimated incremental cost per HIV infection averted and incremental cost per person reached. Avahan reached roughly 150 000 high-risk individuals between 2004 and 2008 in the 22 districts studied, at a mean cost per person reached of US$327 during the 4 years. This reach resulted in an estimated 61 000 HIV infections averted, with roughly 11 000 HIV infections averted in the general population, at a mean incremental cost per HIV infection averted of $785 (SD 166). We estimate that roughly 1 million DALYs were averted across the 22 districts, at a mean incremental cost per DALY averted of $46 (SD 10). Future antiretroviral treatment (ART) cost savings during the lifetime of the cohort exposed to HIV prevention were estimated to be more than $77 million (compared with the slightly more than $50 million spent on Avahan in the 22 districts during the 4 years of the study). This study provides evidence that the investment in targeted HIV prevention programmes in south India has been cost effective, and is likely to be cost saving if a commitment is made to provide ART to all

  4. How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa

    Directory of Open Access Journals (Sweden)

    Dubourg Dominique

    2010-11-01

    Full Text Available Abstract Background This paper presents the development of a study design built on the principles of theory-driven evaluation. The theory-driven evaluation approach was used to evaluate an adolescent sexual and reproductive health intervention in Mali, Burkina Faso and Cameroon to improve continuity of care through the creation of networks of social and health care providers. Methods/design Based on our experience and the existing literature, we developed a six-step framework for the design of theory-driven evaluations, which we applied in the ex-post evaluation of the networking component of the intervention. The protocol was drafted with the input of the intervention designer. The programme theory, the central element of theory-driven evaluation, was constructed on the basis of semi-structured interviews with designers, implementers and beneficiaries and an analysis of the intervention's logical framework. Discussion The six-step framework proved useful as it allowed for a systematic development of the protocol. We describe the challenges at each step. We found that there is little practical guidance in the existing literature, and also a mix up of terminology of theory-driven evaluation approaches. There is a need for empirical methodological development in order to refine the tools to be used in theory driven evaluation. We conclude that ex-post evaluations of programmes can be based on such an approach if the required information on context and mechanisms is collected during the programme.

  5. ["Fit4You"--A Programme for Prevention and Reduction of Overweight in Apprentices in the Workplace Setting].

    Science.gov (United States)

    Angerer, P; Niedermeier, H; Graf, T; Manthey, A; Marten-Mittag, B; Schmidt, H-L; Gündel, H

    2015-09-01

    The effect of health promotion at the worksite for overweight adolescents is not known. This 2-year intervention study examined the effect of a multimodal programme including nutrition counselling, sport, and life-skill training on medical and psychological outcomes. The body mass index increased slightly less in the intervention group. Semistructured interviews at the end showed that participants are highly interested in health promotion at the worksite. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

    Science.gov (United States)

    Spoth, Richard; Greenberg, Mark

    2011-09-01

    At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

  7. Understanding the theoretical underpinning of the exercise component in a fall prevention programme for older adults with mild dementia: a realist review protocol.

    Science.gov (United States)

    Booth, Vicky; Harwood, Rowan; Hood, Victoria; Masud, Tahir; Logan, Philippa

    2016-07-19

    Older adults with mild dementia are at an increased risk of falls. Preventing those at risk from falling requires complex interventions involving patient-tailored strength- and balance-challenging exercises, home hazard assessment, visual impairment correction, medical assessment and multifactorial combinations. Evidence for these interventions in older adults with mild cognitive problems is sparse and not as conclusive as the evidence for the general community-dwelling older population. The objectives of this realist review are (i) to identify the underlying programme theory of strength and balance exercise interventions targeted at those individuals that have been identified as falling and who have a mild dementia and (ii) to explore how and why that intervention reduces falls in that population, particularly in the context of a community setting. This protocol will explain the rationale for using a realist review approach and outline the method. A realist review is a methodology that extends the scope of a traditional narrative or systematic evidence review. Increasingly used in the evaluation of complex interventions, a realist enquiry can look at the wider context of the intervention, seeking more to explain than judge if the intervention is effective by investigating why, what the underlying mechanism is and the necessary conditions for success. In this review, key rough programme theories were articulated and defined through discussion with a stakeholder group. The six rough programme theories outlined within this protocol will be tested against the literature found using the described comprehensive search strategy. The process of data extraction, appraisal and synthesis is outlined and will lead to the production of an explanatory programme theory. As far as the authors are aware, this is the first realist literature review within fall prevention research and adds to the growing use of this methodology within healthcare. This synthesis of evidence will

  8. Clinical benefit of the FIFA 11 programme for the prevention of hamstring and lateral ankle ligament injuries among amateur soccer players.

    Science.gov (United States)

    Nouni-Garcia, Rauf; Carratala-Munuera, Concepcion; Orozco-Beltran, Domingo; Lopez-Pineda, Adriana; Asensio-Garcia, María Rosario; Gil-Guillen, Vicente F

    2017-06-22

    To analyse the relationship between the implementation of 'the 11' protocol during the regular season in a men's amateur soccer team and the rate of hamstring and lateral ankle ligament (LAL) injuries, and to estimate the clinical benefit of the programme according to the type of injury and the position field. This cohort study was conducted in two different men's amateur soccer teams. During two seasons, the exposed group (43 players) performed 'the 11' protocol twice a week, and the unexposed group (43 players) performed the regular training programme. All players trained three times per week for 1.5 hours per day. Data collection was performed for every 1000 hours of play. 18 hamstring injuries (injury rate (IR) of 2.26 injuries/1000 training+competition hours) and 15 LAL injuries (IR of 1.88 injuries/1000) were registered in the exposed group. In the unexposed group, there were 25 LAL injuries (IR of 3.14 injuries/1000) and 35 hamstring injuries (IR of 4.39 injuries/1000). The number needed to treat to prevent one new case was 3.9 in LAL injuries, 3.31 in biceps femoris injuries and 10.7 in recurrent hamstring injuries. 'The 11' programme reduced the incidence of hamstring and LAL injuries in amateur players. According to the field position, the programme was effective for defenders and midfielders. In accordance with the type of injury, the exposed group had a lower risk of LAL, biceps femoris and hamstring injuries compared with those in the unexposed group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Effect of a community intervention programme promoting social interactions on functional disability prevention for older adults: propensity score matching and instrumental variable analyses, JAGES Taketoyo study.

    Science.gov (United States)

    Hikichi, Hiroyuki; Kondo, Naoki; Kondo, Katsunori; Aida, Jun; Takeda, Tokunori; Kawachi, Ichiro

    2015-09-01

    The efficacy of promoting social interactions to improve the health of older adults is not fully established due to residual confounding and selection bias. The government of Taketoyo town, Aichi Prefecture, Japan, developed a resident-centred community intervention programme called 'community salons', providing opportunities for social interactions among local older residents. To evaluate the impact of the programme, we conducted questionnaire surveys for all older residents of Taketoyo. We carried out a baseline survey in July 2006 (prior to the introduction of the programme) and assessed the onset of functional disability during March 2012. We analysed the data of 2421 older people. In addition to the standard Cox proportional hazard regression, we conducted Cox regression with propensity score matching (PSM) and an instrumental variable (IV) analysis, using the number of community salons within a radius of 350 m from the participant's home as an instrument. In the 5 years after the first salon was launched, the salon participants showed a 6.3% lower incidence of functional disability compared with non-participants. Even adjusting for sex, age, equivalent income, educational attainment, higher level activities of daily living and depression, the Cox adjusted HR for becoming disabled was 0.49 (95% CI 0.33 to 0.72). Similar results were observed using PSM (HR 0.52, 95% CI 0.33 to 0.83) and IV-Cox analysis (HR 0.50, 95% CI 0.34 to 0.74). A community health promotion programme focused on increasing social interactions among older adults may be effective in preventing the onset of disability. 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.

  10. Economic evaluation of URMEL-ICE, a school-based overweight prevention programme comprising metabolism, exercise and lifestyle intervention in children.

    Science.gov (United States)

    Kesztyüs, Dorothea; Schreiber, Anja; Wirt, Tamara; Wiedom, Martina; Dreyhaupt, Jens; Brandstetter, Susanne; Koch, Benjamin; Wartha, Olivia; Muche, Rainer; Wabitsch, Martin; Kilian, Reinhold; Steinacker, Jürgen M

    2013-04-01

    Measuring the impact of the URMEL-ICE school-based overweight prevention programme on anthropometric measures in primary-school children, computing incremental cost-effectiveness relation (ICER) and net monetary benefit (NMB). This is an intervention study with historical control. Propensity score method is applied to account for group differences. One-year teacher-driven classroom implementation is used, which is based on especially developed teaching material including health education, physical activity breaks and parent involvement. 354 children in the control and 365 children in the intervention group at baseline and follow-up were analysed. Effectiveness is measured as cm waist circumference (WC) and unit (0.01) waist-to-height ratio (WHtR) increase prevented in intervention vs. control group using an adjusted two-level model. Standard cost-effectiveness analysis methods, net benefit regression and a societal perspective for a 1-year time horizon are applied. WC gain was 1.61 cm and WHtR gain was 0.014 significantly less in intervention vs. control group. Intervention costs were euro24.09 per child. ICER was euro11.11 (95% confidence interval (CI) [8.78; 15.02]) per cm WC and euro18.55 (95% CI [14.04; 26.86]) per unit WHtR gain prevented. At a maximum willingness to pay (MWTP) of euro35, both values of the CIs for NMB regarding WC and WHtR are located in the positive range. The study gives new information about the cost-effectiveness of structured health promotion embedded in daily routine at primary schools. Assuming a MWTP of euro35 the intervention is cost-effective with a positive NMB. This result may help decision makers in implementing programmes to prevent childhood overweight in school settings.

  11. Industrial Pollution Prevention Programme (IPPP) Progress report Visit to Environmental Council of Zambia (ECZ) 20.09.-01.10.98

    OpenAIRE

    Aanes, K.

    1998-01-01

    A visit to ECZ was paid by Mr. Karl Jan Aanes, NIVA, with the intention to assess to capacity of the chosen laboratories in Zambia to analyse water samples in the Water Quality Survey Programme. Along with the visting of laboratories a field trip was carried out to collect water samples from the upper part of Kafue and the main tributaries from mine sites. Parallel samples were taken and analysed both at laboratories in Zambia and at NIVA to conduct a preliminary intercalibration between the ...

  12. [An injuries prevention programme in the transport and cargo handling sector, implemented by the ASL 10 Local Health Unit, Florence].

    Science.gov (United States)

    Ariani, F; Tomassini, A

    2009-01-01

    There are doubts about the ability of public health services to significantly reduce occupational injuries through non-targeted investigations and surveillance programmes. For this reason an intervention was designed specifically for the transport and cargo handling sector, in which inspections are concentrated on the minority of higher risk companies, followed by ex-post assessment of the outcomes. The goal of identifying the most hazardous companies through injury data appears to be successful in companies with more than 3 employees. Some problems remain for smaller companies and for the large porterage cooperatives, where the official data on the number of employees is unreliable.

  13. Assessment of the population-level effectiveness of the Avahan HIV-prevention programme in South India: a preplanned, causal-pathway-based modelling analysis.

    Science.gov (United States)

    Pickles, Michael; Boily, Marie-Claude; Vickerman, Peter; Lowndes, Catherine M; Moses, Stephen; Blanchard, James F; Deering, Kathleen N; Bradley, Janet; Ramesh, Banadakoppa M; Washington, Reynold; Adhikary, Rajatashuvra; Mainkar, Mandar; Paranjape, Ramesh S; Alary, Michel

    2013-11-01

    Avahan, the India AIDS initiative of the Bill & Melinda Gates Foundation, was a large-scale, targeted HIV prevention intervention. We aimed to assess its overall effectiveness by estimating the number and proportion of HIV infections averted across Avahan districts, following the causal pathway of the intervention. We created a mathematical model of HIV transmission in high-risk groups and the general population using data from serial cross-sectional surveys (integrated behavioural and biological assessments, IBBAs) within a Bayesian framework, which we used to reproduce HIV prevalence trends in female sex workers and their clients, men who have sex with men, and the general population in 24 South Indian districts over the first 4 years (2004-07 or 2005-08 dependent on the district) and the full 10 years (2004-13) of the Avahan programme. We tested whether these prevalence trends were more consistent with self-reported increases in consistent condom use after the implementation of Avahan or with a counterfactual (assuming consistent condom use increased at slower, pre-Avahan rates) using a Bayes factor, which gave a measure of the strength of evidence for the effectiveness estimates. Using regression analysis, we extrapolated the prevention effect in the districts covered by IBBAs to all 69 Avahan districts. In 13 of 24 IBBA districts, modelling suggested medium to strong evidence for the large self-reported increase in consistent condom use since Avahan implementation. In the remaining 11 IBBA districts, the evidence was weaker, with consistent condom use generally already high before Avahan began. Roughly 32700 HIV infections (95% credibility interval 17900-61600) were averted over the first 4 years of the programme in the IBBA districts with moderate to strong evidence. Addition of the districts with weaker evidence increased this total to 62800 (32000-118000) averted infections, and extrapolation suggested that 202000 (98300-407000) infections were averted

  14. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey

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    Semiyaga Nulu

    2010-06-01

    Full Text Available Abstract Background Mother-to-child transmission of HIV (MTCT accounts for over 95% of all paediatric HIV infections worldwide. Several studies have shown that male participation in the antenatal care of their spouses together with couple counselling and testing for HIV, increases use of the interventions for HIV prevention. The prevention programme of MTCT (PMTCT was launched in Uganda in 2000 and Mbale in 2002. Less than 10% of the pregnant women accepted antenatal HIV testing at Mbale Regional Referral Hospital in 2003; couple counselling and testing for HIV was low. Therefore, we conducted the study to determine the level of male involvement and identify its determinants in the PMTCT programme. Methods A cross-sectional survey of 388 men aged 18 years or more, whose spouses were attending antenatal care at Mbale Regional Referral Hospital, was conducted in Mbale district, Eastern Uganda. A male involvement index was constructed based on 6 questions. The survey was complemented by eight focus group discussions and five in-depth interviews. Results The respondents had a median age of 32 years (inter-quartile range, IQR: 28-37. The majority (74% had a low male involvement index and only 5% of men accompanied their spouses to the antenatal clinic. Men who had attained secondary education were more likely to have a high male involvement index (OR: 1.9, 95% CI: 1.1-3.3 than those who had primary or no formal education. The respondents, whose occupation was driver (OR: 0.3, 95% CI: 0.1-0.7 or those who had fear of disclosure of their HIV sero-status results to their spouses (OR: 0.4, 95% CI: 0.2-0.8, were less likely to have a high male involvement index. Barriers to male involvement in the PMTCT programme were related to both the poor health system, to socio-economic factors and to cultural beliefs. Conclusions Structural and cultural barriers to men's involvement in the PMTCT programme in Mbale district were complex and interrelated. Community

  15. Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players

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    M Lehnert

    2017-04-01

    Full Text Available The purpose of the study was to analyse the changes in muscle strength, power, and somatic parameters in elite volleyball players after a specific pre-season training programme aimed at improving jumping and strength performance and injury prevention. Twelve junior female volleyball players participated in an 8-week training programme. Anthropometric characteristics, isokinetic peak torque (PT single-joint knee flexion (H and extension (Q at 60º/s and 180º/s, counter movement jump (CMJ, squat jump (SJ, and reactive strength index (RSI were measured before and after intervention. Significant moderate effects were found in flexor concentric PT at 60º/s and at 180 º/s in the dominant leg (DL (18.3±15.1%, likely; 17.8±11.2%, very likely and in extensor concentric PT at 180º/s (7.4%±7.8%, very likely in the DL. In the non-dominant leg (NL significant moderate effects were found in flexor concentric PT at 60º/s and at 180º/s (13.7±11.3%, likely; 13.4±8.0%, very likely and in extensor concentric PT at 180º/s (10.7±11.5%, very likely. Small to moderate changes were observed for H/QCONV in the DL at 60º/s and 180º/s (15.9±14.1%; 9.6±10.4%, both likely and in the NL at 60º/s (moderate change, 9.6±11.8%, likely, and small to moderate decreases were detected for H/QFUNC at 180º/s, in both the DL and NL (-7.0±8.3%, likely; -9.5±10.0%, likely. Training-induced changes in jumping performance were trivial (for RSI to small (for CMJ and SJ. The applied pre-season training programme induced a number of positive changes in physical performance and risk of injury, despite a lack of changes in body mass and composition. CITATION: Lehnert M, Sigmund M, Lipinska P et al. Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players. Biol Sport. 2017;34(2:205-213.

  16. A randomized controlled trial of a senior centre group programme for increasing social support and preventing depression in elderly people living at home in Norway

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    Bøen Hege

    2012-05-01

    Full Text Available Abstract Background Late-life depression is a common condition and a challenging public health problem. A lack of social support is strongly associated with psychological distress. Senior centres seem to be suitable arenas for community-based health promotion interventions, although few studies have addressed this subject. The objectives were to examine the effect of a preventive senior centre group programme consisting of weekly meetings, on social support, depression and quality of life. Methods A questionnaire was sent to a random sample of 4,000 persons over 65 in Oslo, and a total of 2,387 completed questionnaires were obtained. These subjects served as a basis for recruitment of participants for a trial, with scores on HSCL-10 being used as a main inclusion criterion. A total of 138 persons were randomized into an intervention group (N = 77 and control group (N = 61. Final analyses included 92 persons. Social support (OSS-3, depression (BDI, life satisfaction and health were measured in interviews at baseline and after 12 months (at the end of the intervention programme. Perceptions of benefits from the intervention were also measured. Mean scores, SD, SE and CI were used to describe the changes in outcomes. Effect sizes were calculated based on the original scales and as Cohen’s d. Paired sample tests and ANOVA were used to test group differences. Results There was an increase in social support in both groups, but greatest in the intervention group. The level of depression increased for both groups, but more so in the control than the intervention group. There was a decrease in life satisfaction, although the decrease was largest among controls. There were almost no differences in reported health between groups. However, effect sizes were small and differences were not statistically significant. In contrast, most of the participants said the intervention meant much to them and led to increased use of the centre. Conclusions In

  17. Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

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    Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

    2016-04-01

    Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  18. Impact of infectious disease epidemics on tuberculosis diagnostic, management, and prevention services: experiences and lessons from the 2014–2015 Ebola virus disease outbreak in West Africa

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    Rashid Ansumana

    2017-03-01

    Full Text Available The World Health Organization (WHO Global Tuberculosis Report 2015 states that 28% of the world's 9.6 million new tuberculosis (TB cases are in the WHO Africa Region. The Mano River Union (MRU countries of West Africa–Guinea, Sierra Leone, and Liberia–have made incremental sustained investments into TB control programmes over the past two decades. The devastating Ebola virus disease (EVD outbreak of 2014–2015 in West Africa impacted significantly on all sectors of the healthcare systems in the MRU countries, including the TB prevention and control programmes. The EVD outbreak also had an adverse impact on the healthcare workforce and healthcare service delivery. At the height of the EVD outbreak, numerous staff members in all MRU countries contracted EBV at the Ebola treatment units and died. Many healthcare workers were also infected in healthcare facilities that were not Ebola treatment units but were national hospitals and peripheral health units that were unprepared for receiving patients with EVD. In all three MRU countries, the disruption to TB services due to the EVD epidemic will no doubt have increased Mycobacterium tuberculosis transmission, TB morbidity and mortality, and decreased patient adherence to TB treatment, and the likely impact will not be known for several years to come. In this viewpoint, the impact that the EVD outbreak had on TB diagnostic, management, and prevention services is described. Vaccination against TB with BCG in children under 5 years of age was affected adversely by the EVD epidemic. The EVD outbreak was a result of global failure and represents yet another ‘wake-up call’ to the international community, and particularly to African governments, to reach a consensus on new ways of thinking at the national, regional, and global levels for building healthcare systems that can sustain their function during outbreaks. This is necessary so that other disease control programmes (like those for TB, malaria

  19. Improving malaria treatment and prevention in India by aiding district managers to manage their programmes with local information: a trial assessing the impact of Lot Quality Assurance Sampling on programme outcomes.

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    Valadez, Joseph J; Devkota, Baburam; Pradhan, Madan Mohan; Meherda, Pramod; Sonal, G S; Dhariwal, Akshay; Davis, Rosemary

    2014-10-01

    This paper reports the first trial of Lot Quality Assurance Sampling (LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) (N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  20. Predictors of medical student remediation and their underlying causes: early lessons from a curriculum change in the University of Auckland Medical Programme.

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    Grainger, Brian; Yielder, Jill; Reid, Papaarangi; Bagg, Warwick

    2017-08-11

    The purpose of this study was to identify predictors of remediation in a medical programme and assess the underlying causes and the quality of remediation provided within the context of a recent curriculum change. A mixed methods study incorporating a retrospective cohort analysis of demographic predictors of remediation during 2013 and 2014, combined with thematic qualitative analysis of educator perspectives derived by interview on factors underlying remediation and the quality of that currently provided by the faculty. 17.7% of all students required some form of remedial assistance and 93% of all students offered remediation passed their year of study. Multivariate analysis showed international students (OR 4.59 95% CI 2.62-7.98) and students admitted via the Māori and Pacific Admission Scheme (OR 3.43 2.29-5.15) were significantly more likely to require remediation. Male students were also slightly more likely than their female classmates to require assistance. No effect was observed for rural origin students, completion of a prior degree or completion of clinical placement in a peripheral hospital. Knowledge application and information synthesis were the most frequently identified underlying problems. Most faculty believed remediation was successful, however, flexibility in the programme structure, improved diagnostics and improved access to dedicated teaching staff were cited as areas for improvement. Remediation is required by nearly a fifth of University of Auckland medical students, with MAPAS and international students being particularly vulnerable groups. Remediation is largely successful, however, interventions addressing reasoning and knowledge application may improve its effectiveness.

  1. Implementing an Alcohol and Other Drug Use Prevention Program Using University-High School Partnerships: Challenges and Lessons Learned

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    Milroy, Jeffrey J.; Orsini, Muhsin Michael; Wyrick, David L.; Fearnow-Kenney, Melodie; Wagoner, Kimberly G.; Caldwell, Rebecca

    2015-01-01

    Background: School-based alcohol and other drug use prevention remains an important national strategy. Collaborative partnerships between universities and high schools have the potential to enhance prevention programming; however, there are challenges to sustaining such partnerships. Purpose: The purpose of this commentary is to underscore…

  2. The outcome of prevention of mother to child transmission (PMTCT) of HIV infection programme in Nnewi, southeast Nigeria.

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    Ikechebelu, J I; Ugboaja, J O; Kalu, S O; Ugochukwu, E F

    2011-01-01

    A lot of challenges face the current efforts at reducing Mother to Child transmission of HIV infection (MTCT) in Sub Saharan Africa due to limited access to Highly active antiretroviral therapy (HAART) and breast feeding practices. A regular review of progress is necessary in order to identify areas of need. This is a one year prospective descriptive study of seven hundred and twenty six mother-infant pairs managed in the PMTCT programme in Nnamdi Azikiwe University Teaching Hospital, Nnewi Southeast Nigeria. The babies HIV status was tested with PCR for HIV DNA while the mothers provided information on infant feeding pattern and the use of antiretroviral (ARV) drugs including prophylaxis for the baby. Information was augmented from the antenatal records. The transmission rate was 2.8% for mothers, who were on HAART, did not breastfeed and whose babies received ARV prophylactic therapy. But for mothers who did not receive HAART, did breastfeed and whose babies did not received ARV prophylactic therapy, the transmission rate was 37.5%. When both the mother and child received ARV drugs, the transmission rate was significantly lower in those who did not breastfeed (2.8%) than in those who breastfed (12.5%)(P < 0.001). When both the mother and child did not receive ARV drugs, the transmission rate significantly lower in those who did not breastfeed (21.1%)than in those who breastfed (37.5%) (P < 0.02). The use of HAART in PMTCT programme in the under resourced areas can achieve similar success rates to that in the industrialized countries. Breastfeeding reduces the efficacy achieved by the use of ARV drugs. Provision of wider access to HAART as well as adequate counselling and support for safer infant feeding practices is recommended.

  3. Evaluation of a programme for prevention of vertical transmission of hepatitis B in a rural block in southern India

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    Anu Mary Alexander

    2013-01-01

    Full Text Available Background & objectives: This study was undertaken to evaluate a community based programme of antenatal screening for hepatitis B surface antigen (HBsAg and selective immunization of children commencing at birth, at a secondary care hospital in south India. The primary objective was to assess immunization coverage among children born to HBsAg positive women; secondary objectives were to study the prevalence of HBsAg among antenatal women, prevalence of HBsAg among immunized children (to estimate vaccine efficacy, seroconversion rate and relationship of maternal hepatitis B e antigen (HBeAg to hepatitis infection. Methods: The prevalence of hepatitis B antigen among antenatal women and immunization coverage achieved with hepatitis B vaccine in a rural block in Vellore, Tamil Nadu were assessed through examination of records. Children born between May 2002 and December 2007 to hepatitis B positive women were followed up for a serological evaluation, based on which vaccine efficacy and the effect of maternal hepatitis B e antigen (HBeAg on breakthrough infection was estimated. Results: The prevalence of hepatitis B surface antigen among antenatal women was 1.58 % (95% CI: 1.35-1.81%. Vaccine coverage for three doses as per a recommended schedule (including a birth dose was 70 per cent, while 82.4 per cent eventually received three doses (including a birth dose. Estimated vaccine efficacy was 68 per cent and seroconversion 92.4 per cent in children aged 6-24 months. Maternal HBeAg was significantly associated with either anti-HBc or HBsAg in immunized children, RR=5.89 (95% CI: 1.21-28.52%. Interpretation & conclusions: The prevalence of hepatitis B among antenatal women in this region was low and a programme of selective immunization was found to be feasible, achieving a high coverage for three doses of the vaccine including a birth dose.

  4. Heading towards the Safer Highways: an assessment of the Avahan prevention programme among long distance truck drivers in India

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    Pandey Arvind

    2011-12-01

    Full Text Available Abstract Background Using data from two rounds of a cross-sectional, national-level survey of long-distance truck drivers, this paper examines the extent and trend of sexual risk behavior, prevalence of STI/HIV, and the linkage between exposure to HIV prevention programs and safe sex behavior. Methods Following the time location cluster sampling approach, major transshipment locations covering the bulk of India’s transport volume along four routes, North-East (NE, North-South (NS, North-West (NW and South-East (SE were surveyed. First round of the survey was conducted in 2007 (sample size 2066 whereas the second round was undertaken in 2009-2010 (sample size 2085. Long distance truck drivers were interviewed about their sexual behaviors, condom use practices, exposure to different HIV prevention interventions, and tested for HIV, reactive syphilis serology, Neiserria gonorrhoeae and Chlamydia trachomatis. The key variable of this evaluation study - exposure to HIV prevention interventions was divided into three categories - no exposure, less intensive exposure and intensive exposure. Data were analyzed using multiple logistic regression methods to understand the relationship between risk behavior and exposure to intervention and between program exposure and condom use. Results The proportion of truckers exposed to HIV prevention interventions has increased over time with much significant increase in the intensive exposure across all the four routes (NE: from 14.9% to 28%, P Conclusions These evaluation study results highlight the ability of intensive program to reach truckers who have sex outside marriage with HIV prevention interventions and promote safe sex behaviors among them. Truckers who practice safe sex behaviors with an exposure to intensive program are less likely to suffer from STIs and HIV, which has implications for HIV prevention program with truckers’ population in India and elsewhere. The simultaneous targeted interventions

  5. The Family Festival Prevention Model: Findings from a Pilot of a Teenage Pregnancy Prevention Programme Conceptualised by and for Mexican American Communities

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    Murphy-Erby, Yvette; Stauss, Kim; Koh, Eun

    2015-01-01

    Despite an overall reduction in teenage pregnancy rates in the USA, the decrease for young women of Mexican heritage in the USA has been less significant than the decrease for their White and African-American peers. Furthermore, the availability of teenage pregnancy prevention models that are conceptualised specifically for people of Mexican…

  6. Global action to prevent war: a programme for government and grassroots efforts to stop war, genocide and other forms of deadly conflict.

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    Dean, J; Forsberg, R C; Mendlovitz, S

    2000-01-01

    At the end of history's bloodiest century and the outset of a new millennium, we have an opportunity to fulfil one of humanity's oldest dreams: making the world largely free of war. Global changes make this goal achievable. Nuclear weapons have shown the folly of war. For the first time, there is no war and no immediate prospect of war among the main military powers. For the first time, many proven measures to prevent armed conflict, distilled in the crucible of this century's wars, are available. If systematically applied, these measures can sharply decrease the frequency and violence of war, genocide, and other forms of deadly conflict. To seize the opportunity, nations should adopt a comprehensive programme to reduce conventional armaments and armed conflict. This programme will complement and strengthen efforts to eliminate nuclear arms. To assure its ongoing worldwide implementation, the conventional reduction programme should be placed in a treaty framework. We propose a four-phased process, with three treaties, each lasting five to ten years, to lay the groundwork for the fourth treaty, which will establish a permanent international security system. The main objectives of the treaties are to achieve: 1. A verified commitment to provide full transparency on conventional armed forces and military spending, not to increase forces during negotiations on arms reductions, and to increase the resources allocated to multilateral conflict prevention and peacekeeping. 2. Substantial worldwide cuts in national armed forces and military spending and further strengthening of United Nations and regional peacekeeping and peace-enforcement capabilities. 3. A trial of a watershed commitment by participating nations, including the major powers, not to deploy their armed forces beyond national borders except in a multilateral action under UN or regional auspices. 4. A permanent transfer to the UN and regional security organizations of the authority and capability for armed

  7. Heading towards the Safer Highways: an assessment of the Avahan prevention programme among long distance truck drivers in India.

    Science.gov (United States)

    Pandey, Arvind; Mishra, Ram Manohar; Sahu, Damodar; Benara, Sudhir Kumar; Sengupta, Uttpal; Paranjape, Ramesh S; Gautam, Abhishek; Lenka, Satya Ranjan; Adhikary, Rajatshurva

    2011-12-29

    Using data from two rounds of a cross-sectional, national-level survey of long-distance truck drivers, this paper examines the extent and trend of sexual risk behavior, prevalence of STI/HIV, and the linkage between exposure to HIV prevention programs and safe sex behavior. Following the time location cluster sampling approach, major transshipment locations covering the bulk of India's transport volume along four routes, North-East (NE), North-South (NS), North-West (NW) and South-East (SE) were surveyed. First round of the survey was conducted in 2007 (sample size 2066) whereas the second round was undertaken in 2009-2010 (sample size 2085). Long distance truck drivers were interviewed about their sexual behaviors, condom use practices, exposure to different HIV prevention interventions, and tested for HIV, reactive syphilis serology, Neiserria gonorrhoeae and Chlamydia trachomatis. The key variable of this evaluation study - exposure to HIV prevention interventions was divided into three categories - no exposure, less intensive exposure and intensive exposure. Data were analyzed using multiple logistic regression methods to understand the relationship between risk behavior and exposure to intervention and between program exposure and condom use. The proportion of truckers exposed to HIV prevention interventions has increased over time with much significant increase in the intensive exposure across all the four routes (NE: from 14.9% to 28%, P India and elsewhere. The simultaneous targeted interventions among female sex workers appeared to have contributed to safe sexual practices among truckers.

  8. How Best to Obtain Valid, Verifiable Data Online From Male Couples? Lessons Learned From an eHealth HIV Prevention Intervention for HIV-Negative Male Couples.

    Science.gov (United States)

    Mitchell, Jason; Lee, Ji-Young; Stephenson, Rob

    2016-09-20

    As interest increases in the development of eHealth human immunodeficiency virus (HIV)-preventive interventions for gay male couples, Web-based methods must also be developed to help increase the likelihood that couples enrolled and data collected from them represent true unique dyads. Methods to recruit and collect reliable and valid data from both members of a couple are lacking, yet are crucial for uptake of novel sexual health and HIV-prevention eHealth interventions. Methods to describe best practices to recruit male couples using targeted advertisements on Facebook are also lacking in the literature, yet could also help in this uptake. The objective of our study was to describe challenges and lessons learned from experiences from two phases (developmental phase and online randomized controlled trial [RCT]) of an eHealth HIV-prevention intervention for concordant HIV-negative male couples in terms of (1) recruiting male couples using targeted advertisements on Facebook, (2) validating that data came from two partners of the couple, and (3) verifying that the two partners of the couple are in a relationship with each other. The developmental phase refined the intervention via in-person focus groups, whereas the pilot-testing phase included an online RCT. For both phases, couples were recruited via targeted Facebook advertisements. Advertisements directed men to a study webpage and screener; once eligible, participants provided consent electronically. A partner referral system was embedded in the consenting process to recruit the relationship partner of the participant. Both men of the couple had to meet all eligibility criteria-individually and as a couple-before they could enroll in the study. Verification of couples' relationships was assessed via the concurrence of predetermined screener items from both partners, done manually in the developmental phase and electronically in the pilot-testing phase. A system of decision rules was developed to assess the

  9. Pathways to policy: Lessons learned in multisectoral collaboration for physical activity and built environment policy development from the Coalitions Linking Action and Science for Prevention (CLASP) initiative.

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    Politis, Christopher E; Mowat, David L; Keen, Deb

    2017-06-16

    The Canadian Partnership Against Cancer funded 12 large-scale knowledge to action cancer and chronic disease prevention projects between 2009 and 2016 through the Coalitions Linking Action and Science for Prevention (CLASP) initiative. Two projects, Healthy Canada by Design (HCBD) and Children's Mobility, Health and Happiness (CMHH), developed policies to address physical activity and the built environment through a multisectoral approach. A qualitative analysis involving a review of 183 knowledge products and 8 key informant interviews was conducted to understand what policy changes occurred, and the underlying critical success factors, through these projects. Both projects worked at the local level to change physical activity and built environment policy in 203 sites, including municipalities and schools. Both projects brought multisectoral expertise (e.g., public health, land use planning, transportation engineering, education, etc.) together to inform the development of local healthy public policy in the areas of land use, transportation and school travel planning. Through the qualitative analysis of the knowledge products and key informant interviews, 163 policies were attributed to HCBD and CMHH work. Fourteen "pathways to policy" were identified as critical success factors facilitating and accelerating the development and implementation of physical activity and built environment policy. Of the 14 pathways to policy, 8 had a focus on multisectoral collaboration. The lessons learned from the CLASP experience could support enhanced multisectoral collaborations to accelerate the development and implementation of physical activity and built environment policy in new jurisdictions across Canada and internationally.

  10. Seven Steps for Developing and Implementing a Preventive Training Program: Lessons Learned from JUMP ACL and Beyond

    Science.gov (United States)

    Frank, Barnett; Donaldson, Alex; de la Motte, Sarah; Cameron, Kenneth L.; Beutler, Anthony I.; DiStefano, Lindsay J.; Marshall, Stephen W.

    2014-01-01

    Musculoskeletal injuries during military and sport-related training are common, costly and potentially debilitating. Thus, there is a great need to develop and implement evidence-based injury prevention strategies to reduce the burden of musculoskeletal injury. The lack of attention to implementation issues is a major factor limiting the ability to successfully reduce musculoskeletal injury rates using evidence-based injury prevention programs. We propose 7 steps that can be used to facilitate successful design and implementation of evidence-based injury prevention programs within the logical constraints of a real-world setting by identifying implementation barriers and associated solutions. Incorporating these 7 steps along with other models for behavioral health interventions may improve the overall efficacy of military and sport-related injury prevention programs. PMID:25280612

  11. The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes.

    Science.gov (United States)

    Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B

    2016-01-01

    External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events

  12. Foot and mouth disease in the Lao People's Democratic Republic: I. A review of recent outbreaks and lessons from control programmes.

    Science.gov (United States)

    Khounsy, S; Conlan, J V; Gleeson, L J; Westbury, H A; Colling, A; Paton, D J; Knowles, N J; Ferris, N P; Blacksell, S D

    2008-12-01

    Foot and mouth disease (FMD) causes sporadic disease outbreaks in the Lao People's Democratic Republic (Lao PDR). As the Lao PDR is a major thoroughfare for transboundary animal movements, regular FMD outbreaks occur, causing economic hardship for farmers and their families. In this review of the recent history of FMD in the Lao PDR between 1997 and 2006, the authors examine the virological and epidemiological aspects of the disease and appropriate control measures, including the distribution of outbreaks, causative serotypes and the molecular epidemiology of the viruses, as well as large-scale vaccination programmes. The dominant serotype, type O, was reported every year from 1998 to 2005. The majority of outbreaks occurred in Vientiane Capital (n = 42; 28%) and the highest number of outbreaks were reported in cattle (n = 94; 61%); followed by buffalo (n = 41; 27%) and pigs (n = 18; 12%). All type A outbreaks occurred in cattle. Type Asia 1 outbreaks were reported in the central provinces around Vientiane Capital between 1996 and 1998.

  13. Scale-up of a programme for malaria vector control using long-lasting insecticide-treated nets: lessons from South Sudan.

    Science.gov (United States)

    Chanda, Emmanuel; Remijo, Constantino D; Pasquale, Harriet; Baba, Samson P; Lako, Richard L

    2014-04-01

    Long-lasting insecticidal nets (LLINs) are important tools in malaria control. South Sudan, like many other endemic countries, has struggled to improve LLIN coverage and utilization. In 2006, Southern Sudan - known as South Sudan after independence in 2011 - initiated a strategic plan to increase LLIN coverage so that at least 60% of households had at least one LLIN each. By 2008, the target coverage was 80% of households and the Global Fund had financed a phased scale-up of LLIN distribution in the region. South Sudan's entire population is considered to be at risk of malaria. Poor control of the vectors and the large-scale movements of returnees, internally displaced people and refugees have exacerbated the problem. By 2012, approximately 8.0 million LLINs had been distributed in South Sudan. Between 2006 and 2009, the percentage of households possessing at least one LLIN increased from about 12% to 53% and LLIN utilization rates increased from 5 to 25% among children younger than 5 years and from 5 to 36% among pregnant women. The number of recorded malaria cases increased from 71 948 in 2008 to 1 198 357 in 2012. In post-conflict settings, a phased programme for the national scale-up of LLIN coverage may not have a substantial impact. A nationwide campaign that is centrally coordinated and based on sound guidelines may offer greater benefits. A strong partnership base and effective channels for the timely and supplementary deployment of LLINs may be essential for universal coverage.

  14. Guide: Monitoring Programme for unannounced inspections undertaken against the National Standards for the Prevention and Control of Healthcare Associated Infections

    LENUS (Irish Health Repository)

    Kabir, Zubair

    2007-01-01

    BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking.

  15. Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Leme, Ana Carolina Barco; Thompson, Debbe; Lenz Dunker, Karin Louise; Nicklas, Theresa; Tucunduva Philippi, Sonia; Lopez, Tabbetha; Vézina-Im, Lydi-Anne; Baranowski, Tom

    2018-04-19

    Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusing on weight may contribute to excessive concern with diet and weight. Therefore, the proposed research will assess whether integrating obesity and eating disorder prevention procedures ('integrated approach') do better than single approach interventions in preventing obesity among adolescents, and if integrated approaches influence weight-related outcomes. Integrated obesity and eating disorder prevention interventions will be identified. Randomised controlled trials and quasi-experimental trials reporting data on adolescents ranging from 10 to 19 years of age from both sexes will be included. Outcomes of interest include body composition, unhealthy weight control behaviours and body satisfaction measurements. MEDLINE/PubMed, PsycINFO, Web of Science and SciELO will be searched. Data will be extracted independently by two reviewers using a standardised data extraction form. Trial quality will be assessed using the Cochrane Collaboration criteria. The effects of integrated versus single approach intervention studies will be compared using systematic review procedures. If an adequate number of studies report data on integrated interventions among similar populations (k>5), a meta-analysis with random effects will be conducted. Sensitivity analyses and meta-regression will be performed only if between-study heterogeneity is high (I 2 ≥75%). Ethics approval will not be required as this is a systematic review of published studies. The findings will be disseminated through conference presentations and peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted

  16. Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a programme for preventing smoking in secondary schools delivered by medical students: a study protocol.

    Science.gov (United States)

    Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Groneberg, David A

    2014-07-24

    A survey conducted by the German Federal Centre for Health Education in 2012 showed that 35.2% of all young adults (18-25 years) and 12.0% of all adolescents (12-17 years) in Germany are regular cigarette smokers. Most smoked their first cigarette in early adolescence. We recently reported a significantly positive short-term effect of a physician-delivered school-based smoking prevention programme on the smoking behaviour of schoolchildren in Germany. However, physician-based programmes are usually very expensive. Therefore, we will evaluate and optimise Education against Tobacco (EAT), a widespread, low-cost programme delivered by about 400 medical students from 16 universities in Germany. A prospective quasi-experimental study design with two measurements at baseline (t1) and 6 months post-intervention (t2) to investigate an intervention in 10-15-year-olds in grades 6-8 at German secondary schools. The intervention programme consists of two 60-min school-based medical-student-delivered modules with (module 1) and without the involvement of patients with tobacco-related diseases and control groups (no intervention). The study questionnaire measuring smoking status (water pipe and cigarette smoking), smoking-related cognitions, and gender, social and cultural aspects was designed and pre-tested in advance. The primary end point is the prevalence of smokers and non-smokers in the two study arms at 6 months after the intervention. The percentage of former smokers and new smokers in the two groups and the measures of smoking behaviour will be studied as secondary outcome measures. In accordance with Good Epidemiologic Practice (GEP) guidelines, the study protocol was submitted for approval by the responsible ethics committee, which decided that the study does not need ethical approval (Goethe University, Frankfurt-Main, Germany). Findings will be disseminated in peer-reviewed journals, at conferences, within our scientific advisory board and through medical

  17. Technological innovation, human capital and social change for sustainability. Lessons learnt from the industrial technologies theme of the EU's Research Framework Programme.

    Science.gov (United States)

    Sabadie, Jesús Alquézar

    2014-05-15

    Europe is facing a twofold challenge. It must maintain or even increase its competitiveness, a basic requirement in a globalised economy and under the current demographic threat. It needs also to tackle the so-called "grand challenges", especially environmental issues, through a sustainable model of production and consumption. Such challenges should lead to new business and industrial models, based on more sustainable production and consumption chains, from design to end of life. This implies a need for new industrial materials and processes, new skills and, indeed, new values and life-styles. Sustainability and innovation are key elements of EU's Research and Innovation Framework Programmes, particularly in the field of industrial technologies (nanotechnologies, materials and industrial technologies), which objective is to "improve the competitiveness of the European industry and generate knowledge to ensure its transformation from a resource intensive to a knowledge intensive industry". Sustainability and innovation are interrelated challenges for R&D. Research can develop technical solutions to tackle environmental or societal challenges, but such technologies need to be successfully commercialised to have a real environmental impact. Several socio-economic studies carried-out by the European Commission show not only the emerging technological and industrial trends, but they also emphasise the need for linking sustainable technologies with social change. Human capital and new social behaviours are critical factors to combine economic competitiveness and sustainability: technology alone is no longer able to solve global challenges. But what kind of human capital (skills, behaviours, and values) are we referring to? How to encourage the shift towards a greener society through human capital? Which reforms are needed in education systems to move towards a sustainable economy? Are there examples of social innovation to be extrapolated and/or generalised? © 2013

  18. [Second wave of the French drug harmonisation programme to prevent medication errors: overall appreciation of healthcare professionals].

    Science.gov (United States)

    Benhamou, D; Nacry, R; Journois, D; Auroy, Y; Durand, D; Arnoux, A; Olier, L; Castot, A

    2012-01-01

    Medication errors are a significant cause of severe healthcare-associated complications. In December 2006, the French Health Products Agency (Afssaps) has issued a protocol to harmonise labeling of injectable drugs vials. In 2007, a first change was launched for four drugs and was followed in 2008-2009 by a second wave concerning 42 active drugs. The present study describes how healthcare professionals have perceived this change and their overall appreciation of the drug harmonisation programme. A survey using an electronic questionnaire was distributed to medical and non-medical professionals in anaesthesia and intensive care and pharmacists in a representative sample of 200 French hospitals. The harmonisation procedure was felt as being overall satisfactory by 53% of professionals who had responded but it was recognised that the new procedure is associated with improved readability and understanding of drug dosage. The use of colour coding was also well accepted by the personnel of clinical units. Respondents expressed significant criticisms regarding both the communication plan and the way the plan was implemented locally in hospitals. Old and new labeling coexisted in 66% of responding hospitals and many respondents described being aware of errors or near-misses that were considered related to the transition. For many important topics, pharmacists had views that were significantly different from clinicians. This national survey describing the perception of healthcare professionals regarding the new harmonisation procedure for injectable drugs highlighted some progress but also a number of deficiencies, notably regarding communication and implementation of the change in clinical units. This survey will be used by the French Health Products Agency to improve future steps of the long-lasting campaign against medication errors. Copyright © 2011 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  19. Feasibility, Acceptability, and Programme Effectiveness of Misoprostol for Prevention of Postpartum Haemorrhage in Rural Bangladesh: A Quasiexperimental Study

    Directory of Open Access Journals (Sweden)

    Abdul Quaiyum

    2014-01-01

    Full Text Available We explored the feasibility of distributing misoprostol tablets using two strategies in prevention of postpartum haemorrhage (PPH among women residing in the Abhoynagar subdistrict of Bangladesh. We conducted a quasiexperimental study with a posttest design and nonequivalent comparison and intervention groups. Paramedics distributed three misoprostol tablets, one delivery mat (Quaiyum’s delivery mat, a packet of five standardized sanitary pads, and one lidded plastic container with detailed counseling on their use. All materials except misoprostol were also provided with counseling sessions to the control group participants. Postpartum blood loss was measured by paramedics using standardized method. This study has demonstrated community acceptability to misoprostol tablets for the prevention of PPH that reduced overall volume of blood loss after childbirth. Likewise, the delivery mat and pad were found to be useful to mothers as tools for assessing the amount of blood loss after delivery and informing care-seeking decisions. Further studies should be undertaken to explore whether government outreach health workers can be trained to effectively distribute misoprostol tablets among rural women of Bangladesh. Such a study should explore and identify the programmatic requirements to integrate this within the existing reproductive health program of the Government of Bangladesh.

  20. Outcome results for the Ma'alahi Youth Project, a Tongan community-based obesity prevention programme for adolescents.

    Science.gov (United States)

    Fotu, K F; Millar, L; Mavoa, H; Kremer, P; Moodie, M; Snowdon, W; Utter, J; Vivili, P; Schultz, J T; Malakellis, M; McCabe, M P; Roberts, G; Swinburn, B A

    2011-11-01

    Tonga has a very high prevalence of obesity with steep increases during youth, making adolescence a critical time for obesity prevention. The Ma'alahi Youth Project, the Tongan arm of the Pacific Obesity Prevention in Communities project, was a 3-year, quasi-experimental study of community-based interventions among adolescents in three districts on Tonga's main island (Tongatapu) compared to the island of Vava'u. Interventions focused mainly on capacity building, social marketing, education and activities promoting physical activity and local fruit and vegetables. The evaluation used a longitudinal design (mean follow-up duration 2.4 years). Both intervention and comparison groups showed similar large increases in overweight and obesity prevalence (10.1% points, n = 815; 12.6% points, n = 897 respectively). Apart from a small relative decrease in percentage body fat in the intervention group (-1.5%, P Youth Project had no impact on the large increase in prevalence of overweight and obesity among Tongan adolescents. Community-based interventions in such populations with high obesity prevalence may require more intensive or longer interventions, as well as specific strategies targeting the substantial socio-cultural barriers to achieving a healthy weight. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

  1. Prevention of vitamin K deficiency bleeding in breastfed infants : Lessons from the Dutch and Danish biliary atresia registries

    NARCIS (Netherlands)

    van Hasselt, Peter M.; de Koning, Tom J.; Kvist, Nina; de Vries, Elsemieke; Lundin, Christina Rydahl; Berger, Ruud; Kimpen, Jan L. L.; Houwen, Roderick H. J.; Jorgensen, Marianne Horby; Verkade, Henkjan J.

    OBJECTIVE. Newborns routinely receive vitamin K to prevent vitamin K deficiency bleeding. The efficacy of oral vitamin K administration may be compromised in infants with unrecognized cholestasis. We aimed to compare the risk of vitamin K deficiency bleeding under different propylactic regimens in

  2. Effects of an Internet-based prevention programme for eating disorders in the USA and Germany--a meta-analytic review.

    Science.gov (United States)

    Beintner, Ina; Jacobi, Corinna; Taylor, Craig Barr

    2012-01-01

    A cross-cultural comparison of a cognitive-behavioural, Internet-based, 8-week prevention programme for eating disorders (StudentBodies™) evaluated in the USA and in Germany was performed. Six US and four German randomized controlled trials with a total (N) of 990 female high school and college students were included in the review. Two of the US and two of the German trials explicitly addressed high risk samples in a selective prevention approach. Effect sizes for main outcomes (disordered eating, weight and shape concerns) were calculated at postintervention and at follow-up. The intervention was associated with moderate improvements in eating disorder-related attitudes, especially reductions of negative body image and the desire to be thin. The reported effects remained significant at follow-up. No clear differences between US and German samples could be found on any of the outcome measures at postintervention. In conclusion, StudentBodies™ seems equally suitable and effective for American and German students. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

  3. Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity.

    Science.gov (United States)

    Hägglund, Gunnar; Andersson, Sofia; Düppe, Henrik; Lauge-Pedersen, Henrik; Pedertsen, Henrik Lauge; Nordmark, Eva; Westbom, Lena

    2005-07-01

    During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CP register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P = 0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated.

  4. To Prevent Misbehavior

    OpenAIRE

    Telep, Valya Goodwin, 1955-

    2009-01-01

    This series of lessons was prepared for parents like you - parents who want to do a better job of disciplining their children. The lessons were especially written for parents of preschool children, ages two to six, but some of the discipline methods are appropriate for older children, too. This lesson focuses on preventing misbehavior.

  5. Effects of a community-oriented obesity prevention programme on indicators of body fatness in preschool and primary school children. Main results from the IDEFICS study.

    Science.gov (United States)

    De Henauw, S; Huybrechts, I; De Bourdeaudhuij, I; Bammann, K; Barba, G; Lissner, L; Mårild, S; Molnár, D; Moreno, L A; Pigeot, I; Tornaritis, M; Veidebaum, T; Verbestel, V; Ahrens, W

    2015-12-01

    Childhood obesity is a major public health concern but evidence-based approaches to tackle this epidemic sustainably are still lacking. The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. Here, we report on the effects of the IDEFICS intervention on indicators of body fatness. The intervention modules addressed the community, school and parental level, focusing on diet, physical activity and stress-related lifestyle factors. A cohort of 16,228 children aged 2-9.9 years - about 2000 per country - was equally divided over intervention and control regions. (Participating countries were Sweden, Germany, Estonia, Hungary, Cyprus, Italy, Spain and Belgium.) We compared the prevalence of overweight/obesity and mean values of body mass index z-score, per cent body fat and waist-to-height ratio over 2 years of follow-up. Mixed models adjusting for age and socioeconomic status of the parents and with an additional random effect for country accounted for the clustered study design. The prevalence of overweight and obesity increased in both the intervention and control group from 18.0% at baseline to 22.9% at follow-up in the control group and from 19.0% to 23.6% in the intervention group. The difference in changes between control and intervention was not statistically significant. For the cohort as a whole, the changes in indicators of body fatness did not show any clinically relevant differences between the intervention and control groups. Changes in favour of intervention treatment in some indicators were counterbalanced by changes in favour of the control group in some other indicators. Over the 2-year-observation period, the IDEFICS primary prevention programme for childhood obesity has not been successful in reducing the prevalence of overweight and obesity nor in improving indicators of body fatness in

  6. Rethinking lessons learned processes

    NARCIS (Netherlands)

    Buttler, T.; Lukosch, S.G.; Kolfschoten, G.L.; Verbraeck, A.

    2012-01-01

    Lessons learned are one way to retain experience and knowledge in project-based organizations, helping them to prevent reinventin,g the wheel or to repeat past mistakes. However, there are several challenges that make these lessonts learned processes a challenging endeavor. These include capturing

  7. Breast cancer prevention: lessons to be learned from mechanisms of early pregnancy-mediated breast cancer protection.

    Science.gov (United States)

    Meier-Abt, Fabienne; Bentires-Alj, Mohamed; Rochlitz, Christoph

    2015-03-01

    Pregnancy at early, but not late age, has a strong and life-long protective effect against breast cancer. The expected overall increase in breast cancer incidence demands the development of a pharmaceutical mimicry of early-age pregnancy-mediated protection. Recently, converging results from rodent models and women on molecular and cellular mechanisms underlying the protective effect of early-age pregnancy have opened the door for translational studies on pharmacologic prevention against breast cancer. In particular, alterations in Wnt and TGFβ signaling in mammary stem/progenitor cells reveal new potential targets for preventive interventions, and thus might help to significantly reduce the incidence of breast cancer in the future. ©2015 American Association for Cancer Research.

  8. How to offer culturally relevant type 2 diabetes screening: lessons learned from the South asian diabetes prevention program.

    Science.gov (United States)

    van Draanen, Jenna; Shafique, Ammara; Farissi, Aziz; Wickramanayake, Dilani; Kuttaiya, Sheela; Oza, Shobha; Stephens, Neil

    2014-10-01

    The literature on diabetes mellitus in the South Asian population clearly states the high-risk status of this group, yet there is a lack of effective models of culturally relevant, community-based screening and education programs for such a group. The South Asian Diabetes Prevention Program (SADPP) was developed to enhance equitable access to diabetes prevention resources for the South Asian communities in Toronto by offering language-specific and culturally relevant services. The SADPP model works through 3 participant education sessions plus an additional attachment and enrolment component. The screening tool that SADPP uses to provide participants with their individual risk score at the first education session is derived from the multiculturally validated Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which has been modified to reflect the distinctive characteristics of the South Asian population. After analyzing the risk scores, 32% of participants were at increased risk, 40% were at high risk, 21% were at very high risk and only 7% were found to be at low risk of diabetes development. Evaluations of the program conducted in 2010 and 2013 revealed that the program is achieving its objectives and that participants increase their knowledge and self-efficacy related to diabetes prevention after program participation. Participants reported that the presentation from the nurse and dietitian, the question-and-answer time, the healthy eating demonstration, the multiple languages of delivery and the convenient location were especially beneficial. Those working in the field are encouraged to adapt this model and to contribute to the development of culturally relevant, community-driven diabetes prevention programs. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  9. Mental health promotion and socio-economic disadvantage: lessons from substance abuse, violence and crime prevention and child health.

    Science.gov (United States)

    Toumbourou, J W; Hemphill, S A; Tresidder, J; Humphreys, C; Edwards, J; Murray, D

    2007-12-01

    Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems. Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES. Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use. Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.

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

    OpenAIRE

    Jacobs, Sally; Johnson, Sheena; Hassell, Karen

    2017-01-01

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

  11. 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 ...

  12. A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to Prevent Injuries in Children's Football.

    Science.gov (United States)

    Rössler, Roland; Junge, Astrid; Bizzini, Mario; Verhagen, Evert; Chomiak, Jiri; Aus der Fünten, Karen; Meyer, Tim; Dvorak, Jiri; Lichtenstein, Eric; Beaudouin, Florian; Faude, Oliver

    2017-12-22

    The objective of this study was to assess the efficacy of a newly developed warm-up programme ('11+ Kids') regarding its potential to reduce injuries in children's football. Children's football teams (under 9 years, under 11 years, and under 13 years age groups) from Switzerland, Germany, the Czech Republic and the Netherlands were invited. Clubs were randomised to an intervention group and a control group, and followed for one season. The intervention group replaced their usual warm-up by '11+ Kids', while the control group warmed up as usual. The primary outcome was the overall risk of football-related injuries. Secondary outcomes were the risks of severe and lower extremity injuries. We calculated hazard ratios using extended Cox models, and performed a compliance analysis. In total, 292,749 h of football exposure of 3895 players were recorded. The mean age of players was 10.8 (standard deviation 1.4) years. During the study period, 374 (intervention group = 139; control group = 235) injuries occurred. The overall injury rate in the intervention group was reduced by 48% compared with the control group (hazard ratio 0.52; 95% confidence interval 0.32-0.86). Severe (74% reduction, hazard ratio 0.26; 95% confidence interval 0.10-0.64) and lower extremity injuries (55% reduction, hazard ratio 0.45; 95% confidence interval 0.24-0.84) were also reduced. Injury incidence decreased with increasing compliance. '11+ Kids' is efficacious in reducing injuries in children's football. We observed considerable effects for overall, severe and lower extremity injuries. The programme should be performed at least once per week to profit from an injury preventive effect. However, two sessions per week can be recommended to further increase the protective benefit. ClinicalTrials.gov identifier: NCT02222025.

  13. Does promoting parents' negative attitudes to underage drinking reduce adolescents' drinking? The mediating process and moderators of the effects of the Örebro Prevention Programme.

    Science.gov (United States)

    Özdemir, Metin; Koutakis, Nikolaus

    2016-02-01

    The Örebro Prevention Programme (ÖPP) was found previously to be effective in reducing drunkenness among adolescents [Cohen's d = 0.35, number needed to treat (NNT) = 7.7]. The current study tested the mediating role of parents' restrictive attitudes to underage drinking in explaining the effectiveness of the ÖPP, and the potential moderating role of gender, immigration status, peers' and parents' drinking and parent-adolescent relationship quality. A quasi-experimental matched-control group study with assessments at baseline, and at 18- and 30-month follow-ups. Of the 895 target youths at ages 12-13 years, 811 youths and 651 parents at baseline, 653 youths and 524 parents at 18-month and 705 youths and 506 parents at 30-month follow-up participated in the study. Youths reported on their past month drunkenness, their parents' and peers' alcohol use and the quality of their relationship with parents. Parents reported on their attitudes to underage drinking. The mediation analyses, using latent growth curve modeling, showed that changes in parents' restrictive attitudes to underage drinking explained the impact of the ÖPP on changes in youth drunkenness, which was reduced, and onset of monthly drunkenness, which was delayed, relative to controls. Mediation effect explained 57 and 45% of the effects on drunkenness and onset of monthly drunkenness, respectively. The programme effects on both parents' attitudes and youth drunkenness were similar across gender, immigrant status, parents' and peers' alcohol use and parent-youth relationship quality. Increasing parents' restrictive attitudes to youth drinking appears to be an effective and robust strategy for reducing heavy underage drinking regardless of the adolescents' gender, cultural origin, peers' and parents' drinking and relationship quality with parents. © 2015 Society for the Study of Addiction.

  14. Summary of lessons learned in Japan from severe accidents: R&D programme for SA-Keisou in Japan. Annex I

    International Nuclear Information System (INIS)

    2015-01-01

    Instrumentation systems in a nuclear power plant are very important for monitoring plant conditions for safe operation and shutdown. The severe accident at the Fukushima Daiichi nuclear power plant in March 2011 caused several severe situations such as failure of the plant power supply for many monitoring instruments, core damage and hydrogen explosion, among other things. Many of the functions of the instrumentation systems were lost. Monitoring the plant’s conditions then became harder to perform. In the event that an accident similar to the one at the Fukushima Daiichi nuclear power plant were to occur in the future, measurements of the important variables, such as reactor water level or reactor pressure, are to be ensured. The development of SA-Keisou1 is needed to monitor these important variables, which contribute to preventing the escalation of an event into a severe accident, mitigating the consequences of a severe accident, achieving a safe state for the plant and confirming that the plant continues to be in a safe state over the long term

  15. Transitioning from antenatal surveillance surveys to routine HIV testing: a turning point in the mother-to-child transmission prevention programme for HIV surveillance in Brazil.

    Science.gov (United States)

    Pereira, Gerson Fernando Mendes; Sabidó, Meritxell; Caruso, Alessandro; Benzaken, Adele Schwartz

    2017-07-05

    In Brazil, due to the rapid increase in programmes for the prevention of mother-to-child transmission (PMTCT), routine programme data are widely available. The objective of this study was to assess the utility of programmatic data to replace HIV surveillance based on the antenatal care (ANC) surveillance survey (SS). We analysed ANC SS data from 219 maternity service clinics. PMTCT variables were extracted from the ANC SS data collection form, which allowed us to capture and compare the ANC SS data and PMTCT HIV test results for each pregnant woman who completed the ANC SS. Both the PMTCT programme and the ANC SS tested for HIV using sequential ELISA and western blot for confirmation. We assessed the completeness (% missing) of the PMTC data included in the ANC SS. Of the 36,713 pregnant women who had ANC SS HIV tests performed, 30,588 also underwent PMTCT HIV testing. The HIV prevalence rate from routine PMTCT testing was 0.36%, compared to 0.38% from the ANC SS testing (relative difference -0.05%; absolute difference -0.02%). The relative difference in prevalence rates between pregnant women in northern Brazil and pregnant women central-west Brazil was -0.98 and 0.66, respectively. Of the 29,856 women who had HIV test results from both the PMTCT and ANC SS, the positive percent agreement of the PMTCT versus the surveillance test was 84.1% (95% confidence interval [CI]: 74.8-91.0), and the negative percent agreement was 99.9% (95% CI: 99.9-100.0). The PMTCT HIV testing uptake was 86.4%. The ANC SS HIV prevalence was 0.33% among PMTCT non-refusers and 0.59% among refusers, with a percent bias of -10.80% and a differential prevalence ratio of 0.56. Syphilis and HIV testing results were complete in 98% and 97.6% of PMTCT reports, respectively. The reported HIV status for the women at clinic entry was missing. Although there were consistent HIV prevalence estimates from the PMTCT data and the ANC SS, the overall positive percent agreement of 84.1% falls below the

  16. Prevention of sexual transmission of Ebola in Liberia through a national semen testing and counselling programme for survivors: an analysis of Ebola virus RNA results and behavioural data.

    Science.gov (United States)

    Soka, Moses J; Choi, Mary J; Baller, April; White, Stephen; Rogers, Emerson; Purpura, Lawrence J; Mahmoud, Nuha; Wasunna, Christine; Massaquoi, Moses; Abad, Neetu; Kollie, Jomah; Dweh, Straker; Bemah, Philip K; Christie, Athalia; Ladele, Victor; Subah, Oneychachi C; Pillai, Satish; Mugisha, Margaret; Kpaka, Jonathan; Kowalewski, Stephen; German, Emilio; Stenger, Mark; Nichol, Stuart; Ströher, Ute; Vanderende, Kristin E; Zarecki, Shauna Mettee; Green, Hugh Henry W; Bailey, Jeffrey A; Rollin, Pierre; Marston, Barbara; Nyenswah, Tolbert G; Gasasira, Alex; Knust, Barbara; Williams, Desmond

    2016-10-01

    Ebola virus has been detected in semen of Ebola virus disease survivors after recovery. Liberia's Men's Health Screening Program (MHSP) offers Ebola virus disease survivors semen testing for Ebola virus. We present preliminary results and behavioural outcomes from the first national semen testing programme for Ebola virus. The MHSP operates out of three locations in Liberia: Redemption Hospital in Montserrado County, Phebe Hospital in Bong County, and Tellewoyan Hospital in Lofa County. Men aged 15 years and older who had an Ebola treatment unit discharge certificate are eligible for inclusion. Participants' semen samples were tested for Ebola virus RNA by real-time RT-PCR and participants received counselling on safe sexual practices. Participants graduated after receiving two consecutive negative semen tests. Counsellors collected information on sociodemographics and sexual behaviours using questionnaires administered at enrolment, follow up, and graduation visits. Because the programme is ongoing, data analysis was restricted to data obtained from July 7, 2015, to May 6, 2016. As of May 6, 2016, 466 Ebola virus disease survivors had enrolled in the programme; real-time RT-PCR results were available from 429 participants. 38 participants (9%) produced at least one semen specimen that tested positive for Ebola virus RNA. Of these, 24 (63%) provided semen specimens that tested positive 12 months or longer after Ebola virus disease recovery. The longest interval between discharge from an Ebola treatment unit and collection of a positive semen sample was 565 days. Among participants who enrolled and provided specimens more than 90 days since their Ebola treatment unit discharge, men older than 40 years were more likely to have a semen sample test positive than were men aged 40 years or younger (p=0·0004). 84 (74%) of 113 participants who reported not using a condom at enrolment reported using condoms at their first follow-up visit (pEbola virus RNA by real-time RT

  17. Needle and syringe programmes and opioid substitution therapy for preventing HCV transmission among people who inject drugs: findings from a Cochrane Review and meta-analysis.

    Science.gov (United States)

    Platt, Lucy; Minozzi, Silvia; Reed, Jennifer; Vickerman, Peter; Hagan, Holly; French, Clare; Jordan, Ashly; Degenhardt, Louisa; Hope, Vivian; Hutchinson, Sharon; Maher, Lisa; Palmateer, Norah; Taylor, Avril; Bruneau, Julie; Hickman, Matthew

    2018-03-01

    To estimate the effects of needle and syringe programmes (NSP) and opioid substitution therapy (OST), alone or in combination, for preventing acquisition of hepatitis C virus (HCV) in people who inject drugs (PWID). Systematic review and meta-analysis. Bibliographic databases were searched for studies measuring concurrent exposure to current OST (within the last 6 months) and/or NSP and HCV incidence among PWID. High NSP coverage was defined as regular NSP attendance or ≥ 100% coverage (receiving sufficient or greater number of needles and syringes per reported injecting frequency). Studies were assessed using the Cochrane risk of bias in non-randomized studies tool. Random-effects models were used in meta-analysis. We identified 28 studies (n = 6279) in North America (13), United Kingdom (five), Europe (four), Australia (five) and China (one). Studies were at moderate (two), serious (17) critical (seven) and non-assessable risk of bias (two). Current OST is associated with 50% [risk ratio (RR) =0.50, 95% confidence interval (CI) = 0.40-0.63] reduction in HCV acquisition risk, consistent across region and with low heterogeneity (I 2  = 0, P = 0.889). Weaker evidence was found for high NSP coverage (RR = 0.79, 95% CI = 0.39-1.61) with high heterogeneity (I 2  = 77%, P = 0.002). After stratifying by region, high NSP coverage in Europe was associated with a 56% reduction in HCV acquisition risk (RR = 0.44, 95% CI = 0.24-0.80) with low heterogeneity (I 2  = 12.3%, P = 0.337), but not in North America (RR = 1.58, I 2  = 89.5%, P = Grades of Recommendation Assessment, Development and Evaluation (GRADE) criteria, the evidence on OST and combined OST/NSP is low quality, while NSP is very low. Opioid substitution therapy reduces risk of hepatitis C acquisition and is strengthened in combination with needle and syringe programmes (NSP). There is weaker evidence for the impact of needle syringe programmes alone, although stronger evidence

  18. Prevention and control of non-communicable diseases in Singapore: a review of national health promotion programmes.

    Science.gov (United States)

    Toh, C M; Chew, S K; Tan, C C

    2002-07-01

    The epidemiological transition in Singapore from infectious to chronic, non-communicable diseases created different challenges for our public health system. The population-based strategy is adopted in primary prevention, through the promotion of a healthy lifestyle--smoking cessation, physical activity, eating right and managing stress. Complementing this are measures to detect chronic conditions early through screening and optimal treatment of the disease. While improvements were seen in the common risk factors of smoking and physical inactivity, prevalence of measurable risk factors like hypertension increased between 1992 and 1998. In 2000, the Ministry of Health initiated a series of national disease management plans for major disease conditions affecting Singaporeans. This approach uses a comprehensive and systematic approach to integrate the various components, with identification of responsible parties to ensure successful implementation of initiatives. Chronic diseases will remain prevalent as our society rapidly ages. Close monitoring of our initiatives in disease management will provide information on the long-term efficacy of such strategies.

  19. Providers' perspectives on the best practices for HIV prevention for men who have sex with men in Berlin, Germany: lessons for policy and prevention.

    Science.gov (United States)

    Grov, Christian; Restar, Arjee; Gussmann, Philip; Schlemmer, Kurt; Rodríguez-Díaz, Carlos E

    2014-12-01

    Using qualitative data via providers' perspectives, the goal of this study was to identify strengths and weaknesses in the current approaches being used to prevent onward transmission of HIV among men who have sex with men (MSM) in Berlin, Germany. In 2013, 18 participants from 10 organizations who provide direct outreach or services to MSM were interviewed (30-75 minutes). With regard to strategies and services that individuals believed contributed to the organization's success, we identified five themes: (1) Having staff and volunteers to "match" the target population, (2) Embracing homosexuality and gay identity, (3) Being invested in the cause, (4) Coordination of services to avoid overlap and duplication, and (5) Seeing eye-to-eye with the target population. Finally, with regard to areas in which organizations felt they could use improvement (i.e., continuing challenges), we identified three themes: (1) Insufficient funding and resources, (2) Insufficient services, and (3) HIV stigma, homophobia, and shifting attitudes about HIV. This study informs HIV prevention approaches in Berlin, Germany as well as other urban centers where MSM are disproportionally affected by the HIV epidemic.

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

    Science.gov (United States)

    Jacobs, Sally; Johnson, Sheena; Hassell, Karen

    2018-02-01

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

  1. Integrating Behavioral HIV Interventions into Biomedical Prevention Trials with Youth: Lessons from Chicago’s Project PrEPare

    Science.gov (United States)

    Hosek, Sybil G.; Green, Keith R.; Siberry, George; Lally, Michelle; Balthazar, Christopher; Serrano, Pedro A.; Kapogiannis, Bill

    2013-01-01

    On the heels of several trials demonstrating the efficacy of pre-exposure prophylaxis (PrEP) and the recent approval by the FDA of the supplemental indication for Truvada as PrEP, researchers, advocates, and community providers are calling for the investigation of implementation strategies that combine behavioral interventions with biomedical prevention. This paper describes the modification and integration of an evidence-based group-level intervention into a small PrEP pilot trial with young men who have sex with men (YMSM). The behavioral intervention as well as ongoing risk reduction counseling sessions were found to be highly acceptable among a sample of racially diverse YMSM. PMID:24223514

  2. Prevention of vitamin K deficiency bleeding in breastfed infants: lessons from the Dutch and Danish biliary atresia registries

    DEFF Research Database (Denmark)

    Hasselt, P.M. van; Koning, T.J. de; Vries, E. de

    2008-01-01

    in infants with biliary atresia. PATIENTS AND METHODS: From Dutch and Danish national biliary atresia registries, we retrieved infants who were either breastfed and received 1 mg of oral vitamin K at birth followed by 25 microg of daily oral vitamin K prophylaxis (Netherlands, 1991-2003), 2 mg of oral......: A daily dose of 25 microg of vitamin K fails to prevent bleedings in apparently healthy infants with unrecognized cholestasis because of biliary atresia. One milligram of weekly oral prophylaxis offers significantly higher protection to these infants and is of similar efficacy as 2 mg of intramuscular...

  3. CaPSCA: Evaluation of a Brief Cancer Prevention Education Programme to Promote Balanced Diet in French School Children.

    Science.gov (United States)

    Rennie, Laura J; Bazillier-Bruneau, Cécile; Rouëssé, Jacques

    2015-12-01

    This study examined the effectiveness of two cancer prevention interventions in improving balanced diet among French children aged 12-14 years. The educational techniques used were taken from the taxonomy of behaviour change techniques (BCTs; Abraham & Michie, 2008). Allocation to intervention group (intervention versus control) was randomised at the school-level, the intervention group received two interventions, each of 1-h duration, containing BCTs including advocated attitude, anticipated success/regret, behaviour modelling and barrier identification. Self-reported diet was assessed pre- and post-interventions. The resulting data were coded by a nutritionist and transformed into a novel measure representing the extent to which the participant achieved a balanced diet. Multilevel modelling indicated that, having taken into account the clustered nature of the data, gender and the differing socio-economic status of the participants, balanced diet decreased over time, b=-1.23, t(1830)=-2.79, p=0.005, but this was qualified by a significant interaction effect with intervention, b=1.42, t(1830)=1.98, p=0.047. Separate models for each intervention group revealed that balanced diet decreased over time in the control group, b=-1.25, t(1195)=-2.47, p=0.014, but did not in the intervention group, b=0.19, t(635)=0.44, p=0.66, suggesting a buffering effect of the interventions on balanced diet over time. These findings demonstrate the effectiveness of educational interventions using established behaviour change techniques, to change behaviour.

  4. Improving ART programme retention and viral suppression are key to maximising impact of treatment as prevention - a modelling study.

    Science.gov (United States)

    McCreesh, Nicky; Andrianakis, Ioannis; Nsubuga, Rebecca N; Strong, Mark; Vernon, Ian; McKinley, Trevelyan J; Oakley, Jeremy E; Goldstein, Michael; Hayes, Richard; White, Richard G

    2017-08-09

    UNAIDS calls for fewer than 500,000 new HIV infections/year by 2020, with treatment-as-prevention being a key part of their strategy for achieving the target. A better understanding of the contribution to transmission of people at different stages of the care pathway can help focus intervention services at populations where they may have the greatest effect. We investigate this using Uganda as a case study. An individual-based HIV/ART model was fitted using history matching. 100 model fits were generated to account for uncertainties in sexual behaviour, HIV epidemiology, and ART coverage up to 2015 in Uganda. A number of different ART scale-up intervention scenarios were simulated between 2016 and 2030. The incidence and proportion of transmission over time from people with primary infection, post-primary ART-naïve infection, and people currently or previously on ART was calculated. In all scenarios, the proportion of transmission by ART-naïve people decreases, from 70% (61%-79%) in 2015 to between 23% (15%-40%) and 47% (35%-61%) in 2030. The proportion of transmission by people on ART increases from 7.8% (3.5%-13%) to between 14% (7.0%-24%) and 38% (21%-55%). The proportion of transmission by ART dropouts increases from 22% (15%-33%) to between 31% (23%-43%) and 56% (43%-70%). People who are currently or previously on ART are likely to play an increasingly large role in transmission as ART coverage increases in Uganda. Improving retention on ART, and ensuring that people on ART remain virally suppressed, will be key in reducing HIV incidence in Uganda.

  5. National Programme for Radiological Protection in Medical Exposures

    International Nuclear Information System (INIS)

    2013-07-01

    A national programme on radiation protection of patients can only be effective and sustainable if there is a joint effort between the regulatory body and the health authorities, and a cooperation with educational institutions, professional bodies and representatives of the industry. The regulatory body needs to promote a strategy of cooperation, and to identify obstacles that may prevent compliance with regulatory requirements and to address them. Not of least is the need for a continuous self-evaluation on the efficacy of the programme. Radiation safety of the patients is a responsibility of the users of the radiation sources involved in diagnostic and treatment. In particular, they are responsible for compliance with regulatory requirements. But safety depends also on aspects that are beyond the capabilities of those authorized to conduct practices. These aspects include educational programmes and institutions to implement them, calibration facilities, national protocols, professional bodies for the establishment of reference levels and contributions from the industry. Neither the users nor the regulatory body alone can achieve that these elements are in place. It needs a network of institutions and cooperation arrangements that involve educational and health authorities, laboratory facilities, professional bodies and the industry. A national programme has to include a strategy of cooperation, identification of obstacles that may prevent compliance with regulatory requirements and address them. Not of least is the need for a continuous self-evaluation on the efficacy of the programme. A group of regulatory agencies belonging to the Ibero American Forum of Nuclear and Radiation Regulatory Agency have exchanged experiences, lessons learned and good practices over three years. This exchange included extensive collaboration with the health authorities. The result of this work is this document containing a self-evaluation approach for the regulatory programme on

  6. Lessons from the 'Humanitarian Golden Rice' project: regulation prevents development of public good genetically engineered crop products.

    Science.gov (United States)

    Potrykus, Ingo

    2010-11-30

    Compared to a non-Genetically Engineered (GE) variety, the deployment of Golden Rice has suffered from a delay of at least ten years. The cause of this delay is exclusively GE-regulation. Considering the potential impact of Golden Rice on the reduction in vitamin A-malnutrition, this delay is responsible for an unjustifiable loss of millions of lives, mostly children and women. GE-regulation is also responsible for the fact that no public institution can deliver a public good GE-product and that thus we have a de facto monopoly in favour of a few potent industries. Considering the forgone benefits from prevented public good GE-products, GE-regulation is responsible for hundreds of millions of lives, all of them, of course, in developing countries. As there is no scientific justification for present GE-regulation, and as it has, so far, not prevented any harm, our society has the urgent responsibility to reconsider present regulation, which is based on an extreme interpretation of the precautionary principle, and change it to science-based regulation on the basis of traits instead of technology. GE-technology has an unprecedented safety record and is far more precise and predictable than any other 'traditional' and unregulated breeding technology. Not to change GE-regulation to a scientific basis is considered by the author 'a crime against humanity'. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative.

    Science.gov (United States)

    Cheadle, Allen; Cromp, DeAnn; Krieger, James W; Chan, Nadine; McNees, Molly; Ross-Viles, Sarah; Kellogg, Ryan; Rahimian, Afsaneh; MacDougall, Erin

    2016-01-01

    Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes. The impact evaluation used a logic model design, linking PSEI changes to longer-term behavioral impacts in healthy eating active living and tobacco use and exposure. Qualitative methods, including stakeholder interviews and surveys, were used to identify initiative success factors. Communities Putting Prevention to Work activities occurred throughout King County, with a focus on 7 low-income communities in South Seattle/King County. The focus communities had a combined population of 652 000, or 35% of the county total, with lower incomes and higher rates of physical inactivity, tobacco use, poor diet, and chronic disease. Twenty-four PSEI strategies were pursued by organizations in sectors including schools, local governments, and community organizations, supported by the public health department. There were 17 healthy eating active living strategies (eg, enhancements to school menus, city planning policies) and 7 tobacco strategies (eg, smoke-free policies in schools, housing, and hospitals). PSEI changes made and numbers of residents reached. Twenty-two of the 24 strategies achieved significant progress toward implementing PSEI changes. The most common success factor was a "dyad" consisting of a dedicated technical assistance provider-either an outside consultant or public health department staff-working closely with a champion from the participating organizations to bring about PSEI changes. An initiative structure that creates and supports external consultant/internal organizational champion dyads in key community sectors offers a promising approach that may be adopted by

  8. Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bryant, Maria; Burton, Wendy; Cundill, Bonnie; Farrin, Amanda J; Nixon, Jane; Stevens, June; Roberts, Kim; Foy, Robbie; Rutter, Harry; Hartley, Suzanne; Tubeuf, Sandy; Collinson, Michelle; Brown, Julia

    2017-01-24

    Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot

  9. [Screening for colorectal cancer: a cost benefit analysis on a health prevention programme at the Boehringer Ingelheim Company].

    Science.gov (United States)

    Schneider, M; Häck, H-J

    2011-05-01

    In Germany, approximately 70.000 people are diagnosed with colorectal cancer every year. With early diagnosis the recovery rates are over 90 % and early intervention can significantly reduce the costs of medical treatment as well as the economic losses from worker productivity. We here present the organisational procedure for bowel cancer screening and have weighed the costs against benefits to employees, the company and the healthcare system. The screening costs are compared with economic benefits. The target group for the study consisted of all 11.536 employees at the company's site in Germany. Volunteers were given a standardized questionnaire about the risk factors for colorectal cancers and an immunological fecal occult blood test (IFOBT). If risk factors for development of colorectal cancer were present or if the test result was positive, a colonoscopy was recommended in accordance with DGVS guidelines (German Society of Digestive and Metabolic diseases). A total of 4.287 employees (37.2 %) indicated an interest in undergoing screening; at the end of the period 3.958 complete datasets (2.296 men and 1.662 women, mean age 51.2 years) were available for evaluation. A colonoscopy was performed on 114 persons. Six cases of overt cancer were detected with three in the 36 - 50 age group and three in the 51 - 65 age group. Five of the six cases were stage T1 or T2. Adenomatous polyps were found and removed in 29 persons. The calculated cost benefit ratio was 1:2 for the company and 1:35 for the public health system. Using the example of colorectal screening, this study represents a cost benefit analysis of this preventative health measure in a company environment. The results show that even while taking into account the financial and personal commitment required, the cost benefit ratio is positive both for the company and for the healthcare system. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control.

    Science.gov (United States)

    Liwanag, Harvy Joy; Uy, Jhanna; Bataller, Ramil; Gatchalian, Janis Ruth; De La Calzada, Betty; Uy, Justine Alessandra; Dayrit, Manuel

    2017-10-01

    Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  11. A Tailored Approach to Launch Community Coalitions Focused on Achieving Structural Changes: Lessons Learned from a HIV Prevention Mobilization Study

    Science.gov (United States)

    Chutuape, Kate S.; Willard, Nancy; Walker, Bendu C.; Boyer, Cherrie B.; Ellen, Jonathan

    2014-01-01

    Public health HIV prevention efforts have begun to focus on addressing social and structural factors contributing to HIV risk, such as unstable housing, unemployment and access to healthcare. With a limited body of evidence-based structural interventions for HIV, communities tasked with developing structural changes need a defined process to clarify their purpose and goals. This paper describes the adaptations made to a coalition development model with the purpose of improving the start-up phase for a second group of coalitions. Modifications focused on preparing coalitions to more efficiently apply structural change concepts to their strategic planning activities, create more objectives that met study goals, and enhance coalition procedures, such as building distributed coalition leadership, to better support the mobilization process. We report on primary modifications to the process, findings for the coalitions and recommendations for public health practitioners that are seeking to start a similar coalition. PMID:26785397

  12. How do international trade obligations affect policy options for obesity prevention? Lessons from recent developments in trade and tobacco control.

    Science.gov (United States)

    von Tigerstrom, Barbara

    2013-06-01

    Regulatory measures, including taxes and subsidies on food and beverage products, food labelling requirements, regulation of food content and regulation of food marketing, have been proposed to encourage healthier eating and prevent obesity. The objective of this article is to explore the extent to which international trade agreements affect governments' choices to use such regulatory measures. It reviews key provisions of relevant World Trade Organization (WTO) agreements and their implications. Some insights can be gained by examining 2 recent developments in the WTO regarding tobacco control: a current dispute involving Australia's plain packaging law and its effect on trademarks, and a recent decision involving the United States law banning flavoured cigarettes. This decision said that the ban did not restrict trade more than necessary to fulfil its legitimate health objective, but it was discriminatory because it banned imported products (clove cigarettes) while exempting domestic products (menthol cigarettes) with similar characteristics. The conclusion we can draw from this decision is that WTO member states probably enjoy a significant degree of latitude in developing food regulations as part of an obesity prevention strategy, so long as those do not disproportionately affect imported products and therefore raise questions of discrimination. The approach taken in this case encourages the adoption of public health policies that are consistent with strong scientific evidence, but may restrict governments' ability to make political compromises, which could frustrate some proposals. The ongoing development of WTO law will continue to affect policy choices in public health. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  13. Asthma Prevention and Management for Aboriginal People: Lessons From Mi'kmaq Communities, Unama'ki, Canada, 2012.

    Science.gov (United States)

    Castleden, Heather; Watson, Robert; Bennett, Ella; Masuda, Jeffrey; King, Malcolm; Stewart, Miriam

    2016-01-14

    Asthma affects at least 10% of Aboriginal children (aged 11 or younger) in Canada, making it the second most common chronic disease suffered by this demographic group; yet asthma support strategies specific to Aboriginal peoples have only begun to be identified. This research builds on earlier phases of a recent study focused on identifying the support needs and intervention preferences of Aboriginal children with asthma and their parents or caregivers. Here, we seek to identify the implications of our initial findings for asthma programs, policies, and practices in an Aboriginal context and to determine strategies for implementing prevention programs in Aboriginal communities. Five focus groups were conducted with 22 recruited community health care professionals and school personnel in 5 Mi'kmaq communities in Unama'ki (Cape Breton), Nova Scotia, Canada, through a community-based participatory research design. Each focus group was first introduced to findings from a local "social support for asthma" intervention, and then the groups explored issues associated with implementing social support from their respective professional positions. Thematic analysis revealed 3 key areas of opportunity and challenges for implementing asthma prevention and management initiatives in Mi'kmaq communities in terms of 1) professional awareness, 2) local school issues, and 3) community health centers. Culturally relevant support initiatives are feasible and effective community-driven ways of improving asthma support in Mi'kmaq communities; however, ongoing assistance from the local leadership (ie, chief and council), community health directors, and school administrators, in addition to partnerships with respiratory health service organizations, is needed.

  14. Awareness of and compliance with healthy oral habits reported by children and their parents in Democratic People's Republic of Korea after a preventive programme.

    Science.gov (United States)

    Tarvonen, Pirkko-Liisa; Sipilä, Kirsi; Ri, Yon Sil; Jang, Jong Hyon; Kim, Jong Hyok; Suominen, Anna L

    2016-10-01

    The study aimed to examine awareness of and compliance with healthy oral habits reported by children and their parents in Pyongyang, Democratic People's Republic of Korea (DPRK), after a preventive programme. The data were collected in 2013 with self-completed, partly structured questionnaires from 1994 children aged 10 and 13 years and from 200 parents. Association between awareness of and compliance with healthy oral habits reported by the children and their parents was evaluated using Chi square tests and multivariate logistic regression analyses, children's oral health habits according to themselves and their parents were analysed using McNemar's test. Both children and their parents seemed to be familiar with healthy oral habits, although the awareness was not directly related to the reports of the children's oral practices. Most of the children reported brushing their teeth at least twice a day, using fluoride toothpaste and drinking water for thirst but frequent sweet snacking was common. Children's and their parents' reports were consistent with regard to sweet snacking frequency (p = 0.736) and the main thirst quencher (p = 0.349). Awareness of healthy oral habits appeared to be good among children and their parents. Unhealthy oral habits seemed to coincide with one another.

  15. 74. Cardiovascular risk assessment for Saudi university employees and their families: Developing a framework for provision of an evidence-based cardiovascular disease preventative programme

    Directory of Open Access Journals (Sweden)

    R. Alzeidan

    2016-07-01

    Full Text Available In the Kingdom of Saudi Arabia (KSA, cardiovascular diseases (CVDs are the primary cause of death among adults, representing 46% of total mortality in 2014. This study’s objectives were to assess the prevalence of cardiovascular risk factors (CVRFs, and calculate the cardiovascular risk (CVR among King Saud University employees and their families. Moreover, it aimed at assessing the possible effects of living in KSA on the heart health of expatriate employees and their families. A cross-sectional study was conducted on 4500 university employees and their families aged ⩾18 years old, using the World Health Organization STEPwise approach to surveillance of CVRFs. CVR was then calculated for participants using the Framingham Coronary Heart Risk Score calculator. The mean age of participants was 39.3 ± 13.4 years. The prevalence of CVRFs was as follows: low fruit/vegetable consumption of 10% risk to develop CVD within the following 10-years. Furthermore, this study showed that expatriates had significant negative effects on behavioural risk factors after residing in KSA, namely: high rate of physical inactivity, high consumption of fast food, low consumption of fruit and vegetable. However, there was no effect on the pattern of tobacco use. The prevalence of CVRFs is substantially high among the study population. To combat the future expected burden of CVDs, a proposed prevention programme for employees’ cardiovascular wellness is designed and recommended to be implemented and institutionalized within the university.

  16. 26. Cardiovascular risk assessment for Saudi university employees and their families: developing a framework for provision of an evidence-based cardiovascular disease preventative programme.

    Directory of Open Access Journals (Sweden)

    R. Alzeidan

    2016-07-01

    Full Text Available In the Kingdom of Saudi Arabia (KSA, cardiovascular diseases (CVDs are the primary cause of death among adults, representing 46% of total mortality in 2014. This study’s objectives were to assess the prevalence of cardiovascular risk factors (CVRFs, and calculate the cardiovascular risk (CVR among King Saud University employees and their families. Moreover, it aimed at assessing the possible effects of living in KSA on the heart health of expatriate employees and their families.A cross-sectional study was conducted on 4500 university employees and their families aged ⩾18 years old, using the World Health Organization STEPwise approach to surveillance of CVRFs. CVR was then calculated for participants using the Framingham Coronary Heart Risk Score calculator. The mean age of participants was 39.3±13.4 years. The prevalence of CVRFs was as follows: low fruit/vegetable consumption of 10% risk to develop CVD within the following 10-years. Furthermore, this study showed that expatriates had significant negative effects on behavioural risk factors after residing in KSA, namely: high rate of physical inactivity, high consumption of fast food, low consumption of fruit and vegetable. However, there was no effect on the pattern of tobacco use. The prevalence of CVRFs is substantially high among the study population. To combat the future expected burden of CVDs, a proposed prevention programme for employees’ cardiovascular wellness is designed and recommended to be implemented and institutionalized within the university.

  17. Increasing community capacity to prevent childhood obesity: challenges, lessons learned and results from the Romp & Chomp intervention

    Directory of Open Access Journals (Sweden)

    de Groot Florentine P

    2010-08-01

    Full Text Available Abstract Background Obesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp. Methods A mixed methods evaluation with three data sources was utilised. 1 Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development; 2 Thematic analysis of key informant interviews (n = 16; and 3 the quantitative Community Capacity Index Survey. Results Document analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures

  18. Eighteen years of recommendations to prevent industrial chemical incidents: results and lessons learned of the US Chemical Safety Board.

    Science.gov (United States)

    Tinney, V A; Anenberg, S C; Kaszniak, M; Robinson, B

    2016-10-01

    The US Chemical Safety Board (CSB), a federal agency that investigates significant chemical incidents and hazards, is interested in determining the impact of the recommendations resulting from its investigations, and how to better more effective recommendations to prevent chemical incidents. This is a descriptive study of the US Chemical Safety Board's safety recommendations. The CSB coded and analysed its safety recommendations according to potential impact on reducing incidents, implementation status, purpose and recipient type. As of March 31, 2015, the CSB has issued 733 recommendations, 75% (548) of which are closed and 25% (185) of which remain open. For recommendations categorised as having high, medium, and low impact, 38% (78), 76% (160), and 78% (245) were implemented, respectively. CSB recommendations have led to important and lasting safety changes through regulations, industry guidance and voluntary consensus standards, and individual companies; however, coding recommendations by potential impact do not fully capture the influence of CSB recommendations. While this methodology serves as a preliminary way to determine the effect of recommendations, further data are needed to determine the extent to which these safety changes have reduced the frequency or severity of industrial accidents. Copyright © 2016 The Royal Society for Public Health. All rights reserved.

  19. Preventing deaths and injuries from house fires: a cost-benefit analysis of a community-based smoke alarm installation programme.

    Science.gov (United States)

    Yellman, Merissa A; Peterson, Cora; McCoy, Mary A; Stephens-Stidham, Shelli; Caton, Emily; Barnard, Jeffrey J; Padgett, Ted O; Florence, Curtis; Istre, Gregory R

    2018-02-01

    Operation Installation (OI), a community-based smoke alarm installation programme in Dallas, Texas, targets houses in high-risk urban census tracts. Residents of houses that received OI installation (or programme houses) had 68% fewer medically treated house fire injuries (non-fatal and fatal) compared with residents of non-programme houses over an average of 5.2 years of follow-up during an effectiveness evaluation conducted from 2001 to 2011. To estimate the cost-benefit of OI. A mathematical model incorporated programme cost and effectiveness data as directly observed in OI. The estimated cost per smoke alarm installed was based on a retrospective analysis of OI expenditures from administrative records, 2006-2011. Injury incidence assumptions for a population that had the OI programme compared with the same population without the OI programme was based on the previous OI effectiveness study, 2001-2011. Unit costs for medical care and lost productivity associated with fire injuries were from a national public database. From a combined payers' perspective limited to direct programme and medical costs, the estimated incremental cost per fire injury averted through the OI installation programme was $128,800 (2013 US$). When a conservative estimate of lost productivity among victims was included, the incremental cost per fire injury averted was negative, suggesting long-term cost savings from the programme. The OI programme from 2001 to 2011 resulted in an estimated net savings of $3.8 million, or a $3.21 return on investment for every dollar spent on the programme using a societal cost perspective. Community smoke alarm installation programmes could be cost-beneficial in high-fire-risk neighbourhoods. 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/.

  20. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska

    Directory of Open Access Journals (Sweden)

    Kathryn Hohman-Billmeier

    2016-12-01

    Full Text Available In 2010, Alaska Department of Health and Social Services (DHSS received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14–19 instead of the original curriculum intended age range of 12–14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a the professional growth of peer educators and development of peer education, (b difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  1. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska.

    Science.gov (United States)

    Hohman-Billmeier, Kathryn; Nye, Margaret; Martin, Stephanie

    2016-01-01

    In 2010, Alaska Department of Health and Social Services (DHSS) received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT) to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14-19 instead of the original curriculum intended age range of 12-14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a) the professional growth of peer educators and development of peer education, (b) difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c) the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  2. Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a multinational medical-student-delivered smoking prevention programme for secondary schools in Germany.

    Science.gov (United States)

    Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Klingelhöfer, Doris; Groneberg, David A

    2015-09-18

    To evaluate the multinational medical-student-delivered tobacco prevention programme for secondary schools for its effectiveness to reduce the smoking prevalence among adolescents aged 11-15 years in Germany at half year follow-up. We used a prospective quasi-experimental study design with measurements at baseline (t1) and 6 months postintervention (t2) to investigate an intervention in 8 German secondary schools. The participants were split into intervention and control classes in the same schools and grades. A total of 1474 eligible participants of both genders at the age of 11-15 years were involved within the survey for baseline assessment of which 1200 completed the questionnaire at 6-month follow-up (=longitudinal sample). The schools participated voluntarily. The inclusion criteria were age (10-15 years), grade (6-8) and school type (regular secondary schools). Two 60 min school-based modules delivered by medical students. The primary end point was the difference from t1 to t2 of the smoking prevalence in the control group versus the difference from t1 to t2 in the intervention group (difference of differences approach). The percentage of former smokers and new smokers in the two groups were studied as secondary outcome measures. In the control group, the percentage of students who claimed to be smokers doubled from 4.2% (t1) to 8.1% (t2), whereas it remained almost the same in the intervention group (7.1% (t1) to 7.4% (t2); p=0.01). The likelihood of quitting smoking was almost six times higher in the intervention group (total of 67 smokers at t1; 27 (4.6%) and 7 (1.1%) in the control group; OR 5.63; 95% CI 2.01 to 15.79; p<0.01). However, no primary preventive effect was found. We report a significant secondary preventive (smoking cessation) effect at 6-month follow-up. Long-term evaluation is planned. 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.

  3. The implementation of musculoskeletal injury-prevention exercise programmes in team ball sports: a systematic review employing the RE-AIM framework.

    Science.gov (United States)

    O'Brien, James; Finch, Caroline F

    2014-09-01

    Team ball sports such as soccer, basketball and volleyball have high participation levels worldwide. Musculoskeletal injuries are common in team ball sports and are associated with significant treatment costs, participation loss and long-term negative side effects. The results of recent randomized controlled trials provide support for the protective effect of injury-prevention exercise programmes (IPEPs) in team ball sports, but also highlight that achieving adequate compliance can be challenging. A key process in enhancing the ultimate impact of team ball sport IPEPs is identifying the specific implementation components that influence the adoption, execution and maintenance of these interventions. Despite this, no systematic review focussing on the specific implementation components of team ball sport IPEPs has been conducted. Our objective was to assess the reporting of specific implementation components in the published literature on team ball sport IPEPs using the Reach Efficacy Adoption Implementation Maintenance (RE-AIM) framework. Six electronic databases were systematically searched from inception to December 2012 for papers reporting team ball sport IPEP trials. All eligible papers were independently evaluated by two raters before reaching consensus on the reporting of individual RE-AIM items, using the RE-AIM Model Dimension Items Checklist (RE-AIM MDIC). A total of 60 papers, reporting 52 unique intervention trials, met eligibility criteria. Before consensus, the level of agreement across all trials between reviewers using the RE-AIM MDIC ranged from 81 to 91%. The RE-AIM MDIC dimension of 'efficacy' had the highest level of reporting, with the five individual items in this dimension reported in 19-100% of eligible trials (mean 58%). The RE-AIM MDIC dimension 'maintenance-setting level' had the lowest level of reporting, with none of the four individual items in this dimension reported. For other dimensions, the mean level of reporting and range across

  4. Coping with Accident Reactions (CARE) early intervention programme for preventing traumatic stress reactions in young injured children: study protocol for two randomised controlled trials.

    Science.gov (United States)

    De Young, Alexandra C; Haag, Ann-Christin; Kenardy, Justin A; Kimble, Roy M; Landolt, Markus A

    2016-07-28

    Accidental injury represents the most common type of traumatic event experienced by children under the age of 6 years. Around 10-30 % of young injured children will go on to develop post-traumatic stress disorder (PTSD) and other co-morbid conditions. Parents of injured children are also at risk of PTSD, and this is associated with short- and long-term consequences for their children's physical and psychological recovery. Despite the significance of this problem, to date, the mental health needs of injured young children have been neglected. One reason for this is due to the uncertainty and considerable debate around how to best provide early psychological intervention to traumatised children and adults. To address these gaps, researchers and psychologists in Australia and Switzerland have developed the Coping with Accident Reactions (CARE) programme, which is a two-session early intervention designed to prevent persistent PTSD reactions in young injured children screened as 'at risk'. Two separate international studies are being conducted to evaluate the effectiveness and feasibility of this programme. The study design for the two proposed studies will employ a randomised controlled trial design and children (aged 1-6 years) who are screened as at risk for PTSD 1 week after an unintentional injury, and their parents will be randomised to either (1) CARE intervention or (2) treatment as usual. Assessment will be completed at baseline (2 weeks) and 3 and 6 months post-injury. This international collaboration provides an excellent opportunity to test the benefit of screening and providing early intervention to young children in two different countries and settings. It is expected that outcomes from this research will lead to significant original contributions to the scientific evidence base and clinical treatment and recovery of very young injured children. The Australian study was registered with the Australian New Zealand Clinical Trials Registry ( ACTRN

  5. Tracing defaulters in HIV prevention of mother-to-child transmission programmes through community health workers: results from a rural setting in Zimbabwe.

    Science.gov (United States)

    Vogt, Florian; Ferreyra, Cecilia; Bernasconi, Andrea; Ncube, Lewis; Taziwa, Fabian; Marange, Winnie; Wachi, David; Becher, Heiko

    2015-01-01

    High retention in care is paramount to reduce vertical human immunodeficiency virus (HIV) infections in prevention of mother-to-child transmission (PMTCT) programmes but remains low in many sub-Saharan African countries. We aimed to assess the effects of community health worker-based defaulter tracing (CHW-DT) on retention in care and mother-to-child HIV transmission, an innovative approach that has not been evaluated to date. We analyzed patient records of 1878 HIV-positive pregnant women and their newborns in a rural PMTCT programme in the Tsholotsho district of Zimbabwe between 2010 and 2013 in a retrospective cohort study. Using binomial regression, we compared vertical HIV transmission rates at six weeks post-partum, and retention rates during the perinatal PMTCT period (at delivery, nevirapine [NVP] initiation at three days post-partum, cotrimoxazole (CTX) initiation at six weeks post-partum, and HIV testing at six weeks post-partum) before and after the introduction of CHW-DT in the project. Median maternal age was 27 years (inter-quartile range [IQR] 23 to 32) and median CD4 count was 394 cells/µL(3) (IQR 257 to 563). The covariate-adjusted rate ratio (aRR) for perinatal HIV transmission was 0.72 (95% confidence intervals [95% CI] 0.27 to 1.96, p=0.504), comparing patient outcomes after and before the intervention. Among fully retained patients, 11 (1.9%) newborns tested HIV positive. ARRs for retention in care were 1.01 (95% CI 0.96 to 1.06, p=0.730) at delivery; 1.35 (95% CI 1.28 to 1.42, pHIV testing. Cumulative retention after and before the intervention was 496 (85.7%) and 1083 (87.3%) until delivery; 480 (82.9%) and 1005 (81.0%) until NVP initiation; 303 (52.3%) and 517 (41.7%) until CTX initiation; 272 (47.0%) and 427 (34.4%) until infant HIV testing; and 172 (29.7%) and 405 (32.6%) until HIV test result collection. The CHW-DT intervention did not reduce perinatal HIV transmission significantly. Retention improved moderately during the post

  6. Results and lessons learned from a prevention of weight gain program for low-income overweight and obese young mothers: Mothers In Motion

    Directory of Open Access Journals (Sweden)

    Mei-Wei Chang

    2017-02-01

    Full Text Available Abstract Background Mothers In Motion (MIM, a community-based lifestyle behavioral intervention, was designed and conducted to help low-income overweight and obese young mothers prevent further weight gain via promotion of stress management, healthy eating, and physical activity. This paper presents intervention effect on body weight (primary outcome and summarizes lessons learned. Methods Participants (N = 612 were recruited from 7 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC offices in Michigan and were individually randomized to an intervention n= 410 or a comparison (n =202 group (2: 1 ratio. During the 16-week intervention, intervention participants watched theory-based culturally sensitive videos (in DVD format featuring peers from the target audience to learn skills for managing stress, eating healthier, and being more physically active. They also dialed into peer support group teleconferences to enhance skills learned in the videos and increase motivation for lifestyle behavioral changes. Body weight, the primary outcome, was measured at baseline, immediately after the 16-week intervention, and 3 months after the 16-week intervention. Intervention effect was tested via general linear mixed model for repeated measures, using baseline measures as adjusting covariates. Results At baseline, the mean age of the participants was 28.5 ± 5.0 years (intervention: 28.4 ± 5.0, comparison: 28.9 ± 5.0; the mean body weight was 190.2 ± 1.4 lbs (intervention: 191.8 ± 30.0, comparison: 188.5 ± 29.1; and the mean body mass index (BMI was 32.2 ± 4.4 (intervention: 32.2 ± 4.4, comparison: 31.7 ± 4.2. Of sample, 64.7% were obese. At 3 months after the 16-week intervention, no significant weight differences were found between the intervention (188.3 ± 10.6 lbs, BMI: 31.6 ± 1.8 and comparison groups (187.7 ± 10.6 lbs, BMI: 31.53 ± 1.8 when controlling

  7. 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, ...

  8. Promoting Well-Being and Preventing Burnout in Teacher Education: A Pilot Study of a Mindfulness-Based Programme for Pre-Service Teachers in Hong Kong

    Science.gov (United States)

    Hue, Ming-tak; Lau, Ngar-sze

    2015-01-01

    The stress that negatively affects teachers has been found to influence the turnover rate in the teaching profession. Recent research has shown that mindfulness-based programmes effectively promote well-being while addressing psychological distress. In this study, the authors investigated the effects of a six-week mindfulness-based programme on…

  9. The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.

    Science.gov (United States)

    Sundgot-Borgen, Christine; Bratland-Sanda, Solfrid; Engen, Kethe M E; Pettersen, Gunn; Friborg, Oddgeir; Torstveit, Monica Klungland; Kolle, Elin; Piran, Niva; Sundgot-Borgen, Jorunn; Rosenvinge, Jan H

    2018-03-06

    Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating. Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme. The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services. The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.

  10. Patients' perceptions and experiences of cardiovascular disease and diabetes prevention programmes: A systematic review and framework synthesis using the Theoretical Domains Framework.

    Science.gov (United States)

    Shaw, Rachel L; Holland, Carol; Pattison, Helen M; Cooke, Richard

    2016-05-01

    This review provides a worked example of 'best fit' framework synthesis using the Theoretical Domains Framework (TDF) of health psychology theories as an a priori framework in the synthesis of qualitative evidence. Framework synthesis works best with 'policy urgent' questions. The review question selected was: what are patients' experiences of prevention programmes for cardiovascular disease (CVD) and diabetes? The significance of these conditions is clear: CVD claims more deaths worldwide than any other; diabetes is a risk factor for CVD and leading cause of death. A systematic review and framework synthesis were conducted. This novel method for synthesizing qualitative evidence aims to make health psychology theory accessible to implementation science and advance the application of qualitative research findings in evidence-based healthcare. Findings from 14 original studies were coded deductively into the TDF and subsequently an inductive thematic analysis was conducted. Synthesized findings produced six themes relating to: knowledge, beliefs, cues to (in)action, social influences, role and identity, and context. A conceptual model was generated illustrating combinations of factors that produce cues to (in)action. This model demonstrated interrelationships between individual (beliefs and knowledge) and societal (social influences, role and identity, context) factors. Several intervention points were highlighted where factors could be manipulated to produce favourable cues to action. However, a lack of transparency of behavioural components of published interventions needs to be corrected and further evaluations of acceptability in relation to patient experience are required. Further work is needed to test the comprehensiveness of the TDF as an a priori framework for 'policy urgent' questions using 'best fit' framework synthesis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. HIV transmission and retention in care among HIV-exposed children enrolled in Malawi's prevention of mother-to-child transmission programme.

    Science.gov (United States)

    Haas, Andreas D; van Oosterhout, Joep J; Tenthani, Lyson; Jahn, Andreas; Zwahlen, Marcel; Msukwa, Malango T; Davies, Mary-Ann; Tal, Kali; Phiri, Nozgechi; Spoerri, Adrian; Chimbwandira, Frank; Egger, Matthias; Keiser, Olivia

    2017-09-04

    In Malawi, HIV-infected pregnant and breastfeeding women are offered lifelong antiretroviral therapy (ART) regardless of CD4 count or clinical stage (Option B+). Their HIV-exposed children are enrolled in the national prevention of mother-to-child transmission (PMTCT) programme, but many are lost to follow-up. We estimated the cumulative incidence of vertical HIV transmission, taking loss to follow-up into account. We abstracted data from HIV-exposed children enrolled into care between September 2011 and June 2014 from patient records at 21 health facilities in central and southern Malawi. We used competing risk models to estimate the probability of loss to follow-up, death, ART initiation and discharge, and used pooled logistic regression and inverse probability of censoring weighting to estimate the vertical HIV transmission risk. A total of 11,285 children were included; 9285 (82%) were born to women who initiated ART during pregnancy. At age 30 months, an estimated 57.9% (95% CI 56.6-59.2) of children were lost to follow-up, 0.8% (0.6-1.0) had died, 2.6% (2.3-3.0) initiated ART, 36.5% (35.2-37.9) were discharged HIV-negative and 2.2% (1.5-2.8) continued follow-up. We estimated that 5.3% (95% CI 4.7-5.9) of the children who enrolled were HIV-infected by the age of 30 months, but only about half of these children (2.6%; 95% CI 2.3-2.9) were diagnosed. Confirmed mother-to-child transmission rates were low, but due to poor retention only about half of HIV-infected children were diagnosed. Tracing of children lost to follow-up and HIV testing in outpatient clinics should be scaled up to ensure that all HIV-positive children have access to early ART.

  12. Screening Cervical Cancer by the Pap Test – Relevance of Age Ranges Recommended by the Brazilian Programme for Prevention and Control

    Science.gov (United States)

    Franco, Diogo Do Nascimento; Tomáz, Adriana Cunha Vargas; Gravena, Angela Andréia Franca; Pelloso, Sandra Marisa; Consolaro, Márcia Edilaine Lopes

    2017-09-27

    Objective: To evaluate screening by the Papanicolaou smear (Pap) and the frequency of cervical abnormalities in the age range recommended by the Brazilian programme for prevention and control of cervical cancer (CC) in the years 2012 and 2013 in a high prevalence city. Methods: This retrospective study covered results of Pap examinations performed on women aged ≥12 years residing in urban areas of the city of Maringá, Paraná in Brazil. The examinations were performed in the years 2012 and 2013 for the System of Public Health (SPH) which maintains a city database. The age ranges were grouped as recommended into 64 years. Results: A total 40,866 women were screened, 19,606 in 2012 and 21,260 in 2013. The Pap exams performed for the age range 25-64 years accounted for 80.7% of the total in 2012 and 80.3% in 2013 (p=0.13), while those for tests performed in the >64 years age group in 2013 (8.46%) than in 2012 (7.52%) (ptest results, with atypical squamous cells of undetermined significance (ASC-US) as the most prevalent finding (2.12%) in 2012, while in 2013 it was LSIL (1.56%) (p<0.001 for both). Women with ASC-US showed a lower mean age than did those with other lesions in both years. Conclusions: This study detected a significant expansion of women screened for CC in age ranges not recommended by the Brazilian government. Creative Commons Attribution License

  13. Changes in the oral-health-related quality of life of Brazilian children after an educational preventive programme: an 1-month longitudinal evaluation.

    Science.gov (United States)

    Amato, J N; Barbosa, T S; Kobayashi, F Y; Gavião, M B D

    2014-08-01

    This 1-month longitudinal study assessed whether the oral status and the oral-health-related quality of life (OHRQoL) of children changed after four sessions of an educational preventive programme. Fifty Brazilian students (11-12 year old) were examined for signs and symptoms of gingivitis using the Community Periodontal Index and two questions about gingival bleeding. The OHRQoL was measured using the Brazilian Portuguese version of the Child Oral Impacts on Daily Performances (Child-OIDP). Higher scores indicated worse OHRQoL. The results were analysed using the Shapiro-Wilk, Chi-square, Wilcoxon signed-rank and Mann-Whitney tests. The magnitude of the mean change was calculated using the effect size. Twenty-four percentage of children had more than six sites with bleeding at follow-up compared with 58% at baseline. There was a significant decline in the intensity and extension of impacts at follow-up. A significant improvement in the clinical status and oral hygiene was observed for both transitional categories. There was a significant decline in the Child-OIDP scores of those reporting 'much improved'. A significant improvement in the global ratings of oral health was observed at follow-up. In the studied sample, an improvement occurred with respect to the severity of disease, intensity and extension of impacts and global ratings of oral health after 1-month follow-up. These results suggest that improving the global transition in health by enhancing coping and management skills while inducing slight changes in the clinical status and the specific aspects of health compromised by the disease is possible. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. The Implementation of a Behavioural Support Programme: Teachers' Perceptions of the Programme and Themselves as Providers

    Science.gov (United States)

    Ingemarson, Maria; Bodin, Maria; Rubenson, Birgitta; Guldbrandsson, Karin

    2016-01-01

    Purpose: The purpose of this paper is to investigate how teachers received and perceived the school programme Prevention in School (PS), a positive behavioural support programme; how did the teachers perceive the programme characteristics and themselves as providers; and how did this affect programme implementation? Design/methodology/approach:…

  15. Lessons from Goiania

    International Nuclear Information System (INIS)

    Nazari Alves, R.

    2000-01-01

    The lessons learned from the radiological accident of Goiania in 1987 derived from the observations from the Regulatory Agency which was in charge of the decontamination tasks may be consolidated into four classes: Preventive Actions, characterised as those that aim to minimise the probability of occurrence of a radiological accident; Minimisation of time between the moment of the accident occurrence and the beginning of intervention, in case a radiological accident does occur, despite all preventive measures; Intervention, which is correlated to the type of installation, its geographical location, the social classes involved and their contamination vectors; and Follow up, for which well established rules to allow continuing monitoring of the victims and rebuilding of homes are necessary. The greatest lesson of all was the need for integration of the professionals involved, from all organizations. (author)

  16. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

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

  17. The WHO AFRO external quality assessment programme (EQAP: Linking laboratory networks through EQA programmes

    Directory of Open Access Journals (Sweden)

    Debrah I. Boeras

    2016-10-01

    Full Text Available External Quality Assessment (EQA surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO revealed the need for the strengthening of publichealth microbiology laboratories, particularly for testing of epidemic-prone diseases in theAfrican Region. These surveys revealed common issues such as supply chain managementskilled personnel, logistical support and overall lack of quality standards. For sustainableimprovements to health systems as well as global health security, deficiencies identified needto be actively corrected through robust quality assurance programmes and implementation oflaboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programmewith a focus on vaccine-preventable diseases and emerging and re-emerging dangerouspathogens is important, and should not be stand-alone, but integrated within laboratorynetworks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Preventionthe London School of Hygiene & Tropical Medicine and partners in a series of consultationswith countries and national and regional EQA providers for the development of qualityassurance models to support HIV point-of-care testing and monitoring. These consultationsrevealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forthits experience in implementing quality standards for health programmes, and also openeddiscussions on how lessons learned through such established programmes can be utilised tosupporting and strengthening the introduction of early infant diagnosis of HIV and viralload point-of-care testing. An optimised external quality assessment programme will impact the ability of countries tomeet core capacities, providing improved quality management systems, improving theconfidence of diagnostic network services in Africa, and including capacities to detect eventsof

  18. Physically Active Lessons: Evaluation Report and Executive Summary

    Science.gov (United States)

    Miller, Sarah; Gildea, Aideen Gildea; Sloan, Seaneen; Thurston, Allen

    2015-01-01

    This is a report of a pilot study of the Physically Active Lessons (PAL) programme, which was piloted in five primary schools in Hertfordshire between February and July 2014. PAL involves adapting lesson plans to combine short bursts of physical activity with academic content. The study had two aims: (1) to explore the feasibility of adapting a…

  19. Lessons Learnt on Rain Forest Management for Wood Production in ...

    African Journals Online (AJOL)

    The study was carried out with the aim of analyzing and establishing what lessons have been learnt from positive and negative experiences of various initiatives, projects and programmes aiming at sustainable management, use and conservation of rain forests in Sub-Saharan Africa. The lessons learnt from the case ...

  20. Health services for Buruli ulcer control: lessons from a field study in Ghana.

    Directory of Open Access Journals (Sweden)

    Mercy M Ackumey

    2011-06-01

    Full Text Available BACKGROUND: Buruli ulcer (BU, caused by Mycobacterium ulcerans infection, is a debilitating disease of the skin and underlying tissue. The first phase of a BU prevention and treatment programme (BUPaT was initiated from 2005-2008, in the Ga-West and Ga-South municipalities in Ghana to increase access to BU treatment and to improve early case detection and case management. This paper assesses achievements of the BUPaT programme and lessons learnt. It also considers the impact of the programme on broader interests of the health system. METHODS: A mixed-methods approach included patients' records review, review of programme reports, a stakeholder forum, key informant interviews, focus group discussions, clinic visits and observations. PRINCIPAL FINDINGS: Extensive collaboration existed across all levels, (national, municipality, and community, thus strengthening the health system. The programme enhanced capacities of all stakeholders in various aspects of health services delivery and demonstrated the importance of health education and community-based surveillance to create awareness and encourage early treatment. A patient database was also created using recommended World Health Organisation (WHO forms which showed that 297 patients were treated from 2005-2008. The proportion of patients requiring only antibiotic treatment, introduced in the course of the programme, was highest in the last year (35.4% in the first, 23.5% in the second and 42.5% in the third year. Early antibiotic treatment prevented recurrences which was consistent with programme aims. CONCLUSIONS: To improve early case management of BU, strengthening existing clinics to increase access to antibiotic therapy is critical. Intensifying health education and surveillance would ultimately increase early reporting and treatment for all cases. Further research is needed to explain the role of environmental factors for BU contagion. Programme strategies reported in our study: collaboration

  1. Health services for Buruli ulcer control: lessons from a field study in Ghana.

    Science.gov (United States)

    Ackumey, Mercy M; Kwakye-Maclean, Cynthia; Ampadu, Edwin O; de Savigny, Don; Weiss, Mitchell G

    2011-06-01

    Buruli ulcer (BU), caused by Mycobacterium ulcerans infection, is a debilitating disease of the skin and underlying tissue. The first phase of a BU prevention and treatment programme (BUPaT) was initiated from 2005-2008, in the Ga-West and Ga-South municipalities in Ghana to increase access to BU treatment and to improve early case detection and case management. This paper assesses achievements of the BUPaT programme and lessons learnt. It also considers the impact of the programme on broader interests of the health system. A mixed-methods approach included patients' records review, review of programme reports, a stakeholder forum, key informant interviews, focus group discussions, clinic visits and observations. Extensive collaboration existed across all levels, (national, municipality, and community), thus strengthening the health system. The programme enhanced capacities of all stakeholders in various aspects of health services delivery and demonstrated the importance of health education and community-based surveillance to create awareness and encourage early treatment. A patient database was also created using recommended World Health Organisation (WHO) forms which showed that 297 patients were treated from 2005-2008. The proportion of patients requiring only antibiotic treatment, introduced in the course of the programme, was highest in the last year (35.4% in the first, 23.5% in the second and 42.5% in the third year). Early antibiotic treatment prevented recurrences which was consistent with programme aims. To improve early case management of BU, strengthening existing clinics to increase access to antibiotic therapy is critical. Intensifying health education and surveillance would ultimately increase early reporting and treatment for all cases. Further research is needed to explain the role of environmental factors for BU contagion. Programme strategies reported in our study: collaboration among stakeholders, health education, community surveillance and

  2. International and national regulation of migrant workers and lessons to be learnt from migrant worker programmes in the United States of America and Germany : [bakalaureusetöö] / Maria Vassiljeva ; Tartu Ülikool, õigusteaduskond ; juhendaja: Ilon

    Index Scriptorium Estoniae

    Vassiljeva, Maria

    2006-01-01

    Välistööjõuga seotud õiguslikud probleemid, välistöötajate õigused, ILO 3 konventsiooni, ÜRO konventsioon, ülevaade Saksamaa (Gastarbeiter programm) ja Ameerika Ühendriikide (Bracero programm) kogemustest, ülevaade Eesti õigusaktidest

  3. Lessons Learned in Performing and Implementing the Results of TNA in a Newly Developed Regulatory Body with a Mandate to Regulate the Country's Expanding Nuclear Power Programme: A Case Study of PNRA no. 97

    International Nuclear Information System (INIS)

    Shahzad, Moazzam

    2014-01-01

    Conclusion: → It is essential that regulatory bodies apply a systematic approach to training need assessment; → Education and training requires capital investment, time and effort; it must be planned long in advance to be effective; → It is essential for a country considering a nuclear power programme to establish and implement a corresponding manpower development programme for its regulatory body

  4. Household point of care CD4 testing and isoniazid preventive therapy initiation in a household TB contact tracing programme in two districts of South Africa.

    Science.gov (United States)

    Page-Shipp, Liesl; Lewis, James J; Velen, Kavindhran; Senoge, Sedikanelo; Zishiri, Elizabeth; Popane, Flora; Chihota, Violet N; Clark, Dave; Churchyard, Gavin J; Charalambous, Salome

    2018-01-01

    In South Africa, TB household contact tracing provides an opportunity for increased TB and HIV case finding. We aimed to determine the effect of two new potential interventions for TB contact tracing programmes: Point of Care CD4 (PoC CD4) on HIV linkage to care and household Isoniazid Preventive Therapy (IPT) provision on uptake and retention of IPT. A pragmatic, three-arm, cluster-randomized trial was undertaken. TB Household contacts were randomised to 3 arms: 1) Standard of Care TB and HIV testing (SOC); 2) SOC with POC CD4 for those testing HIV positive; 3) SOC with POC CD4 and IPT for eligible household members. Linkage to care within 90 days was assessed either through patient visits (at 10 weeks and 6 months) or via telephonic contact. 2,243 index TB patients and 3,012 contacts (64,3% female, median age 30 years) were enrolled. On self-report, 26(1.2%) were currently receiving TB treatment and 1816 (60.3%) reported a prior HIV test. HIV testing uptake was 34.7% in the SoC arm, 40.2% in the PoC CD4 arm (RR1.16, CI 0.99-1.36, p-value = 0.060) and 39.9% in the PoC CD4 + HH-IPT arm (RR = 1.15, CI 0.99-1.35, p-value = 0.075). Linkage to care within 3 months was 30.8% in the SoC arm and 42.1% in the POC CD4 arms (RR 1.37; CI: 0.68-2.76, p-value = 0.382). 20/21 contacts (95.2%) initiated IPT in the PoC CD4 + HH-IPT arm, compared to 3/20 (15.0%) in the PoC CD4 arm (p = 0.004; p-value from Fisher's exact test TB with an overall yield of TB of 0.5% (95% CI: 0.3%, 0.8%). Household PoC CD4 testing and IPT initiation is feasible. There was only weak evidence that PoCCD4 led to a small increase in HCT uptake and no evidence for an increase in linkage-to-care. IPT initiation and completion was increased by the household intervention. Although feasible, these interventions had low impact due to the low uptake of HIV testing in households.

  5. Development of Nevirapine Resistance in Children Exposed to the Prevention of Mother-to-Child HIV-1 Transmission Programme in Maputo, Mozambique

    Science.gov (United States)

    Antunes, Francisco; Zindoga, Pereira; Gomes, Perpétua; Augusto, Orvalho; Mahumane, Isabel; Veloso, Luís; Valadas, Emília; Camacho, Ricardo

    2015-01-01

    Background Single-dose nevirapine (sd-NVP) has been the main option for prevention of mother-to-child transmission (PMTCT) of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM) in the context of PMTCT. Objectives To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique. Methods One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012) at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq). Sequencing was performed with ABI 3100 (Applied Biosystems). Logistic regression modelling was undertaken to identify the factors associated with NVP RAM. Results Seventy-nine children had their samples genotyped. Their median age was 7.0 (3–12) months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs) for PMTCT. ARV RAM were detected in 43 (54.4%) of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16) and Y181C (n = 15). NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93–186.34) and with mother’s CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02–9.32). In the multivariable analysis the mother’s exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33–253.66). Conclusions We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers’ exposure to PMTCT significantly increased the risk of NVP RAM. PMID:26161559

  6. Energy Management Programmes for Industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-05

    The IEA Policy Pathway publications provide details on how to implement specific recommendations drawn from the IEA 25 Energy Efficiency Policy Recommendations. This Policy Pathway, jointly produced by the International Energy Agency and the Institute for Industrial Productivity, develops the critical steps for policy makers implementing energy management programmes for industry. Optimising energy use in industry is essential to improve industrial competitiveness and achieve wider societal goals such as energy security, economic recovery and development, climate change mitigation and environmental protection. While there is significant potential to decrease energy consumption in this sector, opportunities to improve energy efficiency are still under-exploited. Energy management programmes have shown to be instrumental in addressing many of the barriers that inhibit wide-scale uptake of energy management in industry. The Policy Pathway builds on lessons learned from country experiences and provides actionable guidance on how to plan and design, implement, evaluate and monitor energy management programmes for industry.

  7. The effect of a smartphone-based coronary heart disease prevention (SBCHDP) programme on awareness and knowledge of CHD, stress, and cardiac-related lifestyle behaviours among the working population in Singapore: a pilot randomised controlled trial.

    Science.gov (United States)

    Zhang, Hui; Jiang, Ying; Nguyen, Hoang D; Poo, Danny Chiang Choon; Wang, Wenru

    2017-03-14

    Coronary heart disease (CHD) is the most prevalent type of cardiac disease among adults worldwide, including those in Singapore. Most of its risk factors, such as smoking, physical inactivity and high blood pressure, are preventable. mHealth has improved in the last decade, showing promising results in chronic disease prevention and health promotion worldwide. Our aim was to develop and examine the effect of a 4-week Smartphone-Based Coronary Heart Disease Prevention (SBCHDP) programme in improving awareness and knowledge of CHD, perceived stress as well as cardiac-related lifestyle behaviours in the working population of Singapore. The smartphone app "Care4Heart" was developed as the main component of the programme. App content was reviewed and validated by a panel of experts, including two cardiologists and two experienced cardiology-trained nurses. A pilot randomised controlled trial was conducted. Eighty working people were recruited and randomised to either the intervention group (n = 40) or the control group (n = 40). The intervention group underwent a 4-week SBCHDP programme, whereas the control group were offered health promotion websites only. The participants' CHD knowledge, perceived stress and behavioural risk factors were measured at baseline and on the 4th week using the Heart Disease Fact Questionnaire-2, Perceived Stress Scale, and Behavioural Risk Factor Surveillance System. After the SBCHDP programme, participants in the intervention group had a better awareness of CHD being the second leading cause of death in Singapore (X 2   = 6.486, p = 0.039), a better overall CHD knowledge level (t = 3.171, p = 0.002), and better behaviour concerning blood cholesterol control (X 2  = 4.54, p = 0.033) than participants in the control group. This pilot study partially confirmed the positive effects of the SBCHDP programme in improving awareness and knowledge of CHD among the working population. Due to the small sample size and

  8. A randomized controlled trial of eicosapentaenoic acid and/or aspirin for colorectal adenoma prevention during colonoscopic surveillance in the NHS Bowel Cancer Screening Programme (The seAFOod Polyp Prevention Trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Hull, Mark A; Sandell, Anna C; Montgomery, Alan A; Logan, Richard F A; Clifford, Gayle M; Rees, Colin J; Loadman, Paul M; Whitham, Diane

    2013-07-29

    The naturally-occurring omega (ω)-3 polyunsaturated fatty acid (PUFA) eicosapentaenoic acid (EPA) reduces colorectal adenoma (polyp) number and size in patients with familial adenomatous polyposis. The safety profile and potential cardiovascular benefits associated with ω-3 PUFAs make EPA a strong candidate for colorectal cancer (CRC) chemoprevention, alone or in combination with aspirin, which itself has recognized anti-CRC activity. Colorectal adenoma number and size are recognized as biomarkers of future CRC risk and are established as surrogate end-points in CRC chemoprevention trials. The seAFOod Polyp Prevention Trial is a randomized, double-blind, placebo-controlled, 2×2 factorial 'efficacy' study, which will determine whether EPA prevents colorectal adenomas, either alone or in combination with aspirin. Participants are 55-73 year-old patients, who have been identified as 'high risk' (detection of ≥5 small adenomas or ≥3 adenomas with at least one being ≥10 mm in diameter) at screening colonoscopy in the English Bowel Cancer Screening Programme (BCSP). Exclusion criteria include the need for more than one repeat endoscopy within the three-month BCSP screening period, malignant change in an adenoma, regular use of aspirin or non-aspirin non-steroidal anti-inflammatory drugs, regular use of fish oil supplements and concomitant warfarin or anti-platelet agent therapy. Patients are randomized to either EPA-free fatty acid 1 g twice daily or identical placebo AND aspirin 300 mg once daily or identical placebo, for approximately 12 months. The primary end-point is the number of participants with one or more adenomas detected at routine one-year BCSP surveillance colonoscopy. Secondary end-points include the number of adenomas (total and 'advanced') per patient, the location (left versus right colon) of colorectal adenomas and the number of participants re-classified as 'intermediate risk' for future surveillance. Exploratory end-points include levels of

  9. Crispv programme

    International Nuclear Information System (INIS)

    Marinkovicj, N.

    CRISPV (Criticality and Spectrum code) is a multigroup neutron spectrum code for homogeneous reactor cores and is actually a somewhat modified version of the original CRISP programme. It is a combination of DATAPREP-II and BIGG-II programmes. It is assumed that the reactor cell is a cylindrical fuel rod in the light or heavy water moderator. DATEPREP-II CODE forms the multigroup data for homogeneous reactor and prepares the input parameters for the BIGG-II code. It has its own nuclear data library on a separate tape in binary mode. BIGG-II code is a multigroup neutron spectrum and criticality code for a homogenized medium. It has as well its own separate data library. In the CRISPV programme the overlay structure enables automatic handling of data calculated in the DATAPREP-II programme and needed in the BIGG-II core. Both programmes are written in FORTRAN for CDC 3600. Using the programme is very efficient and simple

  10. Programme coverage, condom use and STI treatment among FSWs in a large-scale HIV prevention programme: results from cross-sectional surveys in 22 districts in southern India.

    Science.gov (United States)

    Ramakrishnan, Lakshmi; Gautam, Abhishek; Goswami, Prabuddhagopal; Kallam, Srinivasan; Adhikary, Rajatashuvra; Mainkar, Mandar K; Ramesh, Banadakoppa M; Morineau, Guy; George, Bitra; Paranjape, Ramesh S

    2010-02-01

    This paper evaluates Avahan programme's coverage of female sex workers (FSWs), focus on high-risk FSWs and intermediate outcomes. First round of cross-sectional survey data, Integrated Behavioral and Biological Assessments (IBBA), conducted in 22 districts, were aggregated into district categories: Solo, where Avahan was the sole service provider covering all FSWs and Major or Minor where Avahan was not the sole provider, but intended coverage was >50% or or=15 clients in the past week had a higher chance of being exposed to core services (AOR=1.56; 95% CI 1.03 to 2.35). Exposure to the three services in Solo Avahan districts was significantly associated with correct knowledge on condom use (AOR=1.36; 95% CI 1.05 to 1.78), consistent condom use with occasional clients (AOR=3.17; 95% CI 2.17 to 4.63) and regular clients (AOR=2.47; 95% CI 1.86 to 3.28) and STI treatment-seeking behaviour (AOR=3.00; 95% CI 1.94 to 4.65). Higher coverage of FSWs was achieved in districts where Avahan was the only intervention compared with districts having multiple and longstanding non-Avahan programmes. Exposure in Solo districts was associated with intermediate outcomes; this need to be further evaluated in comparison with non Avahan areas and substantiated through data from next IBBA.

  11. Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

    Science.gov (United States)

    Knoblauch, Astrid M; Divall, Mark J; Owuor, Milka; Nduna, Kennedy; Ng'uni, Harrison; Musunka, Gertrude; Pascall, Anna; Utzinger, Jürg; Winkler, Mirko S

    2017-07-04

    surveillance data to track HIV transmission in this specific context. Guided by the health impact assessment, the HIV prevention and control programme was readily adapted to the current setting through the identification of socioeconomic and environmental determinants of health.

  12. The 2BFit study: is an unsupervised proprioceptive balance board training programme, given in addition to usual care, effective in preventing ankle sprain recurrences? Design of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    van Mechelen Willem

    2008-05-01

    Full Text Available Abstract Background There is strong evidence that athletes have a twofold risk for re-injury after a previous ankle sprain, especially during the first year post-injury. These ankle sprain recurrences could result in disability and lead to chronic pain or instability in 20 to 50% of these cases. When looking at the high rate of ankle sprain recurrences and the associated chronic results, ankle sprain recurrence prevention is important. Objective To evaluate the effect of a proprioceptive balance board training programme on ankle sprain recurrences, that was applied to individual athletes after rehabilitation and treatment by usual care. Methods/Design This study was designed as a randomized controlled trial with a follow-up of one year. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain up to two months prior to inclusion, were eligible for inclusion in the study. The intervention programme was compared to usual care. The intervention programme consisted of an eight-week proprioceptive training, which started after finishing usual care and from the moment that sports participation was again possible. Outcomes were assessed at baseline and every month for 12 months. The primary outcome of this study was the incidence of recurrent ankle injuries in both groups within one year after the initial sprain. Secondary outcomes were severity and etiology of re-injury and medical care. Cost-effectiveness was evaluated from a societal perspective. A process evaluation was conducted for the intervention programme. Discussion The 2BFit trial is the first randomized controlled trial to study the effect of a non-supervised home-based proprioceptive balance board training programme in addition to usual care, on the recurrence of ankle sprains in sports. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains. Results will

  13. Favourable outcomes of a preventive screening and counselling programme for older people in underprivileged areas in the Netherlands: The PRIMUS project

    NARCIS (Netherlands)

    Dijk, D.J. van; Crone, M.R.; Empelen, P. van; Assendelft, W.J.; Middelkoop, B.J.

    2017-01-01

    An aging population is associated with an increased prevalence of diabetes, cardiovascular diseases and depression. Important aspects of programmes targeted at older people are: to reach those at risk, effective screening, optimising advice, and referral to local interventions. We examined the

  14. A school-based programme for tobacco and alcohol prevention in special education: effectiveness of the modified 'healthy school and drugs' intervention and moderation by school subtype

    NARCIS (Netherlands)

    Turhan, Abdullah; Onrust, Simone; ten Klooster, Peter M.; Pieterse, Marcel E.

    2017-01-01

    AIMS: To test the effectiveness of the Healthy School and Drugs (HSD) programme on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends upon subtypes of SE schools and the level of implementation. DESIGN: In a quasi-experimental design with baseline and

  15. Development of a training programme for home health care workers to promote preventive activities focused on a healthy lifestyle : an intervention mapping approach

    NARCIS (Netherlands)

    Walters, Maaike E.; Dijkstra, Arie; de Winter, Andrea F.; Reijneveld, Sijmen A.

    2015-01-01

    Background: Lifestyle is an important aspect in maintaining good health in older adults, and home health care (HHC) workers can play an important role in promoting a healthy lifestyle. However, there is limited evidence in the literature regarding how to develop an effective training programme to

  16. INTERCULTURAL FEATURES AND THE THEME OF TRAVELLING IN BILINGUAL MATHEMATICS LESSONS

    Directory of Open Access Journals (Sweden)

    Zuzana Naštická

    2016-08-01

    Full Text Available The present qualitative research is focused on bilingual mathematics education. The research presents findings of a case study of one bilingual Slovak and English mathematics 40-minute lesson within an after school elective bilingual mathematics course running weekly since October, 2015. The lesson took place in March, 2016, and was attended by nine learners aged 12-13, eight boys and one girl. The learners are cases of successive school additive bilingual education. The elective course as a whole is a case of immerse bilingual educational programme. In terms of sociolinguistic settings, the course lessons are cases of bilingual education with external second language. The researcher designed and realized the course lessons in terms of CLIL approach, i.e. Content and Language Integrated Learning. The main aim of the case study was to examine if bilingual mathematics instruction does or does not prevent learners from solving math word problems. Secondly, the analysis of transcription of the lesson audio-record served for identification of intercultural features which might hinder the learning process. The analysis of the transcribed audio-record indicates that the bilingual context did not prevent students from solving math word problems, although each of the students worked at their individual rate. On the other hand, some students were confused by the comma as a thousands-separator in multi-digit numbers, and this actually hindered their learning and problem solving process. This fact has been identified as an intercultural difference which had to be explicitly explained to the students. In order to lessen the possible negative influences of bilingual context on mathematics education, teachers need to predict students’ responses to various intercultural differences which students are unfamiliar with.

  17. Keynote on lessons from major radiation accidents

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz, P.; Oresegun, M.; Wheatley, J. [International Atomic Energy Agency (Austria)

    2000-05-01

    not include identifying and facing unusual events, c) an unbalanced striving for resuming or finishing work, which led to ignoring warnings and was often tolerated by management, d) poor maintenance programme or no programme at all leading to poor safety conditions, and non-investigated false alarms leading to distrust in wanting systems. This combination points primarily to an overall managerial failure. Licensing appraisals and inspections should be able to identify the degree of awareness of the management, its commitment reflected in written policy, procedures and supervision. Performance indicators should address these managerial arrangements and aim at identifying whether alertness, due thought and sense of responsibility are praised. Virtually each accident started with a degradation of alertness leading to deterioration of safety, much earlier than the event itself, and virtually all accidents could have been prevented. Preventive measures drawn from lessons learned from reported accidents should be complemented with a more