WorldWideScience

Sample records for prevention strategies directed

  1. Prevention of Rheumatic Diseases: Strategies, Caveats and Future Directions

    Science.gov (United States)

    Finckh, Axel

    2014-01-01

    Rheumatic diseases affect a significant portion of the population and lead to increased health care costs, disability and even premature mortality; as such, effective preventive measures for these diseases could lead to substantial improvements in public health. Importantly, established and emerging data from natural history studies show that for most rheumatic diseases there is a period of ‘preclinical’ disease development during which abnormal biomarkers or other processes can be detected. These changes are useful to understand mechanisms of disease pathogenesis; in addition, they may be applied to estimate a personal risk of future disease, while individuals are still relatively asymptomatic. Based on this, a hope is to implement effective screening and preventive approaches for some rheumatic diseases, perhaps in the near future. However, a key part of such approaches is a deep understanding of the mechanisms of disease development as well as evidence-based and effective screening and preventive interventions that incorporate disease biology as well as ethical and public health concerns. PMID:25437291

  2. Direct marketing of parenting programs: comparing a promotion-focused and a prevention-focused strategy.

    Science.gov (United States)

    Salari, Raziye; Backman, Anna

    2017-06-01

    : For parenting programs to achieve a public health impact, it is necessary to develop more effective marketing strategies to increase public awareness of these programs and promote parental participation. In this article, we compared a promotion-focused and a prevention-focused strategy via two studies. : We designed two ads inviting parents to participate in a universal parenting program; one ad focused on the program increasing the likelihood of positive outcomes for children (promotion-focused) and the other on the program reducing the likelihood of negative outcomes (prevention-focused). In study I, the two ads were run online simultaneously. Those who clicked on an ad were directed to a website where they could read about and sign up for the program. In study II, a community sample of 706 parents answered a questionnaire about the ads. : In study I, over 85 days, the prevention ad generated more clicks. There was no difference in the number of pages visited on the website nor in the number of parents who signed up for the program. In study II, parents showed a preference for the promotion ad, perceiving it as more relevant and rating it as more effective in getting them interested in the program. : A prevention strategy may be more effective in drawing public attention, in general. However, a promotion strategy is more likely to reach parents, in particular, and inspire them to consider participating in parenting programs. These strategies should be developed further and tested in both general and clinical populations. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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

    Science.gov (United States)

    Van Orden, Kim; Deming, Charlene

    2017-09-08

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

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

    Directory of Open Access Journals (Sweden)

    Harmon CM

    2017-04-01

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

  5. Recruitment of young adults for weight gain prevention: randomized comparison of direct mail strategies.

    Science.gov (United States)

    Crane, Melissa M; LaRose, Jessica Gokee; Espeland, Mark A; Wing, Rena R; Tate, Deborah F

    2016-06-08

    Recruiting young adults (ages 18-35 years) into weight gain prevention intervention studies is challenging and men are particularly difficult to reach. This paper describes two studies designed to improve recruitment for a randomized trial of weight gain prevention interventions. Study 1 used a quasi-experimental design to test the effect of two types of direct mailings on their overall reach. Study 2 used a randomized design to test the effect of using targeted messages to increase recruitment of men into the trial. For Study 1, 60,000 male and female young-adult households were randomly assigned to receive either a recruitment brochure or postcard. Visits to recruitment websites during each mailing period were used to assess response to each mailing. Study 2 focused on postcard recruitment only. These households received either a targeted or generic recruitment postcard, where targeted postcards included the word "Men" in the headline text. Response rates to each type of card were categorized based on participant report of mailing received. The reach of the postcards and brochures were similar (421 and 386 website visits, respectively; P = 0.22). Individuals who received the brochure were more likely to initiate the online screener than those who received a postcard (P = 0.01). In Study 2, of those who completed the telephone screening, 60.9 % of men (n = 23) had received the targeted postcard as compared to the generic postcard (39.1 %, P = 0.30). The reverse was true for women (n = 62, 38.7 vs. 61.3 %, P = 0.08). These studies suggest there was little difference in the reach of postcards versus brochures. However, recipients of brochures were more likely to continue to the next stage of study participation. As expected, men's response to the weight gain prevention messages was lower than women's response; but using targeted messages appears to have modestly increased the proportion of male respondents. These studies add to the limited

  6. Prevention strategies in child maltreatment.

    Science.gov (United States)

    Scribano, Philip V

    2010-10-01

    Child maltreatment remains a prevalent problem for which notable best practices such as home visitation can be effective; however, most eligible families do not receive these beneficial services. Additionally, there are other promising prevention interventions to effectively address child maltreatment. This review focuses on the recent advances and strategies for child maltreatment prevention. Although home visiting does not have a single clearly defined methodology of providing service to children and families, the general supportive framework to improve maternal, child, and family factors makes this intervention the most widely studied and accepted prevention strategy. However, there has been limited effectiveness for most models. The Nurse-Family Partnership (NFP) has provided consistently positive results by targeting families with many risk factors by using highly trained professionals when implementing a research-based intervention. A promising public health approach to parent training (Triple P) may reduce maltreatment and out-of-home placement. Parent-child interaction therapy (PCIT), while a treatment model, is becoming an increasingly important approach to child maltreatment prevention. There may be an opportunity to reduce child maltreatment by enhancing care in the pediatric medical home setting. Effective child maltreatment prevention efforts exist; however, not all programs provide the same effectiveness, or target the same maltreatment issues. Pediatricians are in a key position to offer support to families in their own practice, as well as to direct families to the appropriate resources available.

  7. [Preventive strategies for dementia].

    Science.gov (United States)

    Müller, Patrick; Schmicker, Marlen; Müller, Notger G

    2017-05-01

    In the context of the demographically induced increase in the prevalence of dementia and the simultaneous lack of causal pharmacological therapies, preventive approaches are gaining in importance. By reducing risk factors and with measures which induce neuroplasticity successful aging can be supported. This article summarizes the current developments in preventing dementia by modification of life style factors. The main focus lies on the impact of cognitive and physical activity on neuroprotection. A promising approach combines both activities within a dance training program. Further studies that meet the demanding criteria of a randomized clinical trial are urgently needed.

  8. [Strategies for cardiovascular disease prevention].

    Science.gov (United States)

    Gabus, Vincent; Wuerzner, Grégoire; Saubade, Mathieu; Favre, Lucie; Jacot Sadowski, Isabelle; Nanchen, David

    2018-02-28

    Atherosclerosis is a disease which develops very gradually over decades. Under the influence of modifiable cardiovascular risk factors, such as blood pressure, LDL-cholesterol level, smoking or lifestyle, clinical symptoms of atherosclerosis manifest more or less early in life. When cardiovascular risk factors accumulate, the risk of having a cardiovascular event increases and the benefits of prevention measures are greater. This article summarizes existing strategies for controlling modifiable cardiovascular risk factors in primary prevention. The physician can rely on an interprofessional network of cardiovascular prevention. Managing risk factors while respecting the autonomy and priorities of the patient will bring the greatest benefit.

  9. Workplace prevention and promotion strategies.

    Science.gov (United States)

    Vézina, Michel; Bourbonnais, Renée; Brisson, Chantal; Trudel, Louis

    2004-01-01

    Psychosocial factors refer to all organizational factors and interpersonal relationships in the workplace that may affect the health of the workers. Currently, two psychosocial risk models are universally recognized for producing solid scientific knowledge regarding the vital link between social or psychological phenomena at work and the development of several diseases, such as cardiovascular diseases or depression. The first is the "job demand-contro-support" model, which was defined by Karasek and to which the concept of social support has been added; the second is the "effort/reward imbalance" model defined by Siegrist. The public health perspective calls for theoretical models based on certain psychosocial attributes of the work environment for which there is empirical evidence of their pathogenic potential for exposed workers. Not only do these models reduce the complexity of the psychosocial reality of the work to components that are significant in terms of health risks, but they also facilitate the development and implementation of workplace interventions. Psychosocial risk intervention strategies currently implemented by companies are predominantly individual-oriented and aim chiefly at reducing the effects of stressful work situations by improving individual ability to adapt to the situation and manage stress. Like personal protection equipment for exposure to physical or chemical risks, these secondary prevention measures are commendable but insufficient, because they aim to reduce only the symptoms and not the cause of problems. Any intervention program for these risks should necessarily include a primary prevention component with a view to eliminating, or at least reducing, the psychosocial pathogenic agents in the workplace. Several authors have suggested that well-structured organizational approaches are most effective and should generate more important, longer-lasting effects than individual approaches. However, the evidence should be strengthened by

  10. Diabetes Prevention and Treatment Strategies

    OpenAIRE

    Backholer, Kathryn; Peeters, Anna; Herman, William H.; Shaw, Jonathan E.; Liew, Danny; Ademi, Zanfina; Magliano, Dianna J.

    2013-01-01

    OBJECTIVE Effective interventions to prevent, delay, or remit diabetes are currently available. However, their impact on the prevalence of diabetes at the population level is unknown. This study aimed to estimate the impact of a range of diabetes interventions on the population prevalence of diabetes for Australian adults between 2010 and 2025. RESEARCH DESIGN AND METHODS We used the Australian Diabetes Projection Model to estimate the impact of a population-wide strategy, high-risk preventio...

  11. Global strategies to prevent chronic diseases1

    African Journals Online (AJOL)

    Nicky

    leading global causes of death and disability, are ... global strategies for the prevention and control of chronic ... Preventing Chronic Diseases: A Vital Investment, will ..... Millennium Development Goals for Health In Europe and Central Asia.

  12. Local strategies to prevent and treat osteoporosis.

    Science.gov (United States)

    Torstrick, F Brennan; Guldberg, Robert E

    2014-03-01

    Despite advances in systemic osteoporosis therapeutic outcomes, management of fragility fractures and implant fixation in osteoporotic bone remain difficult clinical challenges. Low initial bone density and a prolonged healing response can lead to fracture nonunion and aseptic implant loosening. Local treatment strategies could be used to prevent fracture, accelerate healing, and increase implant fixation by locally stimulating anabolic pathways or inhibiting catabolic pathways. Local strategies under investigation include direct drug release from injectable materials or implant surface coatings. Common locally delivered drugs include bisphosphonates, parathyroid hormone, and bone morphogenetic proteins, yet additional compounds targeting novel pathways in bone biology are also being actively explored. Mechanical stimulation via low intensity pulsed ultrasound, alone or in combination with drug therapy, may also prove effective to promote local bone healing and implant fixation within osteoporotic bone.

  13. Waste prevention strategy for 2007 in Helsinki

    International Nuclear Information System (INIS)

    Hahtala, R.M.; Blauberg, T.; Huu-htanen, S.R.S.; Kajaste, S.; Kemppainen, S.H.; Linsio, O.A.; Sten, S.T.E.

    2006-01-01

    In 2002, the Board of Directors of Helsinki Metropolitan Area Council (YTV) accepted the Waste Prevention Strategy. The target is to utilise advice and guidance, so as to motivate the residents, enterprises and the public sector to avoid waste production, so that less waste will be produced per resident and workplace in 2007 than in 2000. The main parts to include: 1) Waste prevention in companies, concentrating on co-operation networks to be formed for different sectors and on information acquired and distributed with them, on the use of the waste benchmarking system maintained by YTV. 2) The waste prevention in public administration covers offices, acquisitions and social and health care. The process stared by ecologising YTV's own operations, and proceeds towards waste reduction models to be prepared and introduced in co-operation with the municipalities other regions. 3) The information service and awareness education is directed towards households and schools. An awareness campaign has and will be arranged foe households in order to spread information on the reduction of waste. Education material and methods has produced so far for senior high school and will be produced for primary school and pre-school and vocational institutions together with the authorities in order to promote waste prevention [it

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

    African Journals Online (AJOL)

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

  15. Practical Strategies for Preventing Adolescent Suicide

    Science.gov (United States)

    King, Keith

    2006-01-01

    A comprehensive approach to suicide prevention is needed to effectively address the problem of teen suicide. This article describes three levels of prevention (primary prevention, intervention, and postvention) and provides practical strategies that community, mental, and social health professionals can use within each level to help prevent…

  16. Molecular Cancer Prevention: Current Status & Future Directions

    Science.gov (United States)

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

    2016-01-01

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

  17. Counterfeit Parts Prevention Strategies Guide

    Science.gov (United States)

    2014-06-24

    requirements of 252.211-7003, Item Unique Identification and Valuation .” This section establishes a recommended approach for requirements, polices, and...7003 Item Unique Identification and Valuation DoDI 4140.67 DoD Counterfeit Prevention Policy DoDI 5200.39 Critical Program Information (CPI...Deborah Valley deborah.valley@ll.mit.edu MIT Fred Van Milligen fvanmilligen@jdsu.com JDSU Marvin VanderWeg marvin.vanderwag@spacex.c om SpaceX Gerrit

  18. Occupational injury insurance - A strategy for prevention?

    DEFF Research Database (Denmark)

    Jacobsen, Thomas

    1993-01-01

    Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French.......Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French....

  19. Crucial elements in suicide prevention strategies

    DEFF Research Database (Denmark)

    Nordentoft, Merete

    2011-01-01

    Ways of conceptualizing suicide prevention are reviewed briefly, and the preventive model: Universal, Selected, and Indicated prevention (USI) is chosen as the structure for the literature review, and the discussion. Universal preventive interventions are directed toward entire population......; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. On the universal prevention level, an overview of the literature is presented with focus...... on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate...

  20. Educators' Perceptions on Bullying Prevention Strategies

    Science.gov (United States)

    de Wet, Corene

    2017-01-01

    I report on an investigation into a group of Free State educators' recognition of bullying, their reactions to incidences of bullying, and their perceptions of the effectiveness of a number of bullying prevention strategies. The research instrument was a synthesis of the Delaware Research Questionnaire and questions based on findings from previous…

  1. Crucial elements in suicide prevention strategies

    DEFF Research Database (Denmark)

    Nordentoft, Merete

    2011-01-01

    ; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. On the universal prevention level, an overview of the literature is presented with focus...... on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate...

  2. Cancer prevention strategies: use of cancer prevention research registries.

    OpenAIRE

    Anton-Culver, H

    1995-01-01

    We present a model to plan a rational strategy for cancer prevention that has two main functions--assessment and intervention. The assessment function includes three main components: to identify populations at high cancer risk, which may be due to their ethnic group, occupational and environmental exposures, family history, cigarette smoking, or other risk factors; to assess exposure to known carcinogens through the general and occupational environments, lifestyle factors, and the home as wel...

  3. Preventive strategies in child and adolescent psychiatry

    Directory of Open Access Journals (Sweden)

    Rajesh Sagar

    2017-01-01

    Full Text Available Childhood and adolescence are periods of growth and development that are critical to the formation of adult personality and psychopathology. Moreover, childhood psychopathology may differ significantly in presentation and risk factors from those seen among adults and may require different preventive strategies. Service-related characteristics such as the shortage of trained child and adolescent mental health professionals also demand that the focus should shift from resource-intensive treatment interventions, toward preventive measures that can be delivered at lower cost in terms of workforce, money, and time; and can lead to improved outcomes for a wide variety of conditions. Preventive strategies that have been implemented in this population have mostly included both preventive measures (aiming at reducing the prevalence of risk factors and promotive components (aimed at increasing resilience and positive mental health characteristics, usually in combination. Interventions have been shown to be most effective when they are targeted at underlying latent structures that predict risk; they are also more effective when delivered over a prolonged period. Interventions must also be formulated such that they are developmentally appropriate, and with clearly stated outcome parameters for evaluation. A few example interventions that have made use of these strategies are discussed in the course of this article.

  4. STD patients’ preferences for HIV prevention strategies

    Directory of Open Access Journals (Sweden)

    Castro JG

    2014-12-01

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

  5. Evaluation of strategies for severe accident prevention and mitigation

    International Nuclear Information System (INIS)

    Tokarz, R.

    1989-01-01

    The NRC is planning to establish regulatory oversight on severe accident management capability in the US nuclear reactor industry. Accident management includes certain preparatory and recovery measures that can be taken by the plant operating and technical personnel to prevent or mitigate the consequences of a severe accident. Following an initiating event, accident management strategies include measures to (1) prevent core damage, (2) arrest the core damage if it begins and retain the core inside the vessel, (3) maintain containment integrity if the vessel is breached, and (4) minimize offsite releases. Objectives of the NRC Severe Accident Management Program are to assure that technically sound strategies are identified and guidance to implement these strategies is provided to utilities. This paper will describe work performed to date by Pacific Northwest Laboratory (PNL) and Battelle Memorial Institute (BMI) relative to severe accident strategy evaluation, as well as work to be performed and expected results. Working with Brookhaven National Laboratory, PNL evaluated a series of NRC suggested accident management strategies. The evaluation of these strategies was divided between PNL and Brookhaven National Laboratory and a similar paper will be presented by Brookhaven regarding their strategy evaluation. This paper will stress the overall safety issues related to the research and emphasize the strategies that are applicable to major safety issues. The relationship of these research activities to other projects is discussed, as well as planning for future changes in the direction of work to be undertaken

  6. Strategies for preventing respiratory syncytial virus.

    Science.gov (United States)

    Forbes, Michael

    2008-12-01

    Prevention of respiratory syncytial virus (RSV) infection-crucial for decreasing the burden associated with this disease-is discussed. Predictable outbreaks of RSV occur annually throughout the U.S. During these outbreaks, RSV infection spreads readily among children through close contact with infected individuals or contact with contaminated surfaces or objects. RSV is the leading cause of infant hospitalization and is associated with life-changing and life-threatening complications. Prevention is important for reducing the associated morbidity and mortality. The American Academy of Pediatrics (AAP) has outlined ways to prevent RSV transmission. According to the AAP, frequent hand washing is the most important strategy for reducing the burden of RSV disease. Other methods for controlling nosocomial spread of RSV include the use of gloves, frequent glove changes, and isolating or cohorting patients. General prevention measures that can be undertaken by family members include smoking cessation, breastfeeding, and avoiding situations, whenever possible, where exposure to RSV cannot be controlled. Passive immunoprophylaxis with palivizumab, the only agent approved by the FDA, reduces hospitalization in high-risk children. Palivizumab is currently the only agent approved by the FDA for the prevention of RSV infections in high-risk children. Not every child is equally at risk for serious RSV disease, and immunoprophylaxis is indicated only for certain high-risk children. The AAP has issued specific guidelines for RSV immunoprophylaxis with palivizumab. Other therapies are emerging for the prevention of RSV, including a new, enhanced-potency, humanized RSV monoclonal antibody and several different types of vaccines. RSV causes an annual, predictable epidemic. Treatment remains exclusively supportive. Prevention remains the cornerstone of disease management. The AAP has issued guidelines to protect those at high risk.

  7. Photocarcinogenesis and Skin Cancer Prevention Strategies.

    Science.gov (United States)

    Seebode, Christina; Lehmann, Janin; Emmert, Steffen

    2016-03-01

    In this review the basic principles of UV-induced carcinogenesis are summarized and the state of the art diagnosis and therapeutic strategies are discussed. The prevalent keratinocyte-derived neoplasms of the skin are basal cell and squamous cell carcinomas. Cutaneous melanoma is less frequent but associated with high mortality. Common risk factors for all three tumor entities include sun exposure and DNA-repair deficiencies. Photocarcinogenesis follows a multistep model of cancer development in which ultraviolet-induced DNA damage leads to mutations resulting in activation of oncogenes or silencing of tumor-suppressor genes. This ends in a cellular mutator phenotype even more prone to mutation acquisition. DNA repair, especially the nucleotide excision repair (NER) pathway, counteracts mutation formation and skin cancer development. This is vividly demonstrated by the NER-defective disorder xeroderma pigmentosum. Primary skin cancer preventative strategies, therefore, include reduction of DNA photodamage by protection from the sun. Secondary preventative strategies include skin cancer screening. This implies standard examination techniques with the naked eye, an epiluminescence microscope, or digital epiluminescence microscopy. More advanced techniques include confocal laser scan microscopy. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  8. Uncovering effective strategies for hearing loss prevention

    Science.gov (United States)

    Morata, Thais C.; Meinke, Deanna

    2016-01-01

    Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968

  9. Fall prevention strategy in an emergency department.

    Science.gov (United States)

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

    2018-02-12

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

  10. Osteosarcopenic obesity and fall prevention strategies.

    Science.gov (United States)

    Hita-Contreras, Fidel; Martínez-Amat, Antonio; Cruz-Díaz, David; Pérez-López, Faustino R

    2015-02-01

    Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal women's balance, leading to a decreased risk of falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Tobacco use among adolescents. Strategies for prevention.

    Science.gov (United States)

    Epps, R P; Manley, M W; Glynn, T J

    1995-04-01

    Tobacco use is a major public health problem that has its onset during childhood and adolescence. To prevent the onset, physicians can reach children and their parents in their offices beginning in the prenatal period and continuing through adulthood. For pediatricians and other physicians who care for children, NCI recommends five office-based activities that begin with the letter A. The 5 As include anticipatory guidance, ask, advise, assist, and arrange follow-up visits. Elimination of tobacco use requires a comprehensive strategy that includes health professional interventions, policy changes, advertising restrictions, comprehensive school-based programs, community activities, and advocacy approaches. Physicians and health professionals have major roles to play in each of these interventions.

  12. OBESITY: health prevention strategies in school environments

    Directory of Open Access Journals (Sweden)

    Pâmela Ferreira Todendi

    2013-04-01

    Full Text Available At present, obesity configures a public health problem which calls for attention from different sectors, given the proportion it assumes all over the world. Several studies relate this problem to metabolic health problems, including endocrinal, cardiovascular, lung, gastrointestinal, psychiatric, hematological disturbances, among others. Obesity is not only associated with genetic and environmental factors, but also with unhealthy lifestyles. In view of its social importance, it is ascertained, through analyses of studies, that there are not many health prevention strategies focused on this situation. As a result of this ascertainment, the proposal is for updating prevention actions in the realm of obese schoolchildren, resulting from a work conducted during the Master’s Degree lessons in Health Promotion at the University of Santa Cruz do Sul (UNISC. The point in question is the fact that many schools pose no restrictions to products sold in their canteens. Food stuffs sold in schools should have adequate nutritional quality, and snacks prepared at school are extremely important in meeting all nutritional requirements. However, many children do not consume these school lunches, but they bring them from home or purchase them at the canteen, spending public resources, along with not taking in healthy foods and, as a consequence, leading to health problems over the years. For all this, it is of fundamental importance to carry out investigating processes with regard to how public actions and policies are being implemented towards this end, in view of the fact that obesity in schoolchildren is on a rising trend.

  13. Overweight and obesity interventions and prevention strategies.

    Science.gov (United States)

    ALBashtawy, Mohammed

    2015-09-01

    To determine what secondary schoolchildren in Jordan want from overweight and obesity intervention strategies and prevention programmes. A school-based, cross-sectional study using a quantitative design was carried out during October 2014. The participants were secondary schoolchildren in grades 11 and 12. Data were analysed using SPSS program version 17. Percentages, standard deviations and means were computed. The main suggestions were for programmes at school, during school hours (n=962, 85.4%), followed by one that involved family and friends (n=951, 84.5%), and a programme at a convenient time free of charge (n=919, 81.6%). The students also suggested many strategies to tackle overweight and obesity, such as: taking more physical exercise (n=925, 82.1%), increasing consumption of more fruit and vegetables (n=712, 63.2%) eating less fast food (n=689, 61.2%). Schools, families, health providers and community organisations should encourage students to adopt healthy lifestyles, and facilitate their selection and participation in health programmes.

  14. Stomal Closure: Strategies to Prevent Incisional Hernia

    Science.gov (United States)

    Harries, Rhiannon L.; Torkington, Jared

    2018-01-01

    Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias. PMID:29670882

  15. Stomal Closure: Strategies to Prevent Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Rhiannon L. Harries

    2018-04-01

    Full Text Available Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias.

  16. New welfare, new policies: towards preventive worker-directed active labour market policies?

    NARCIS (Netherlands)

    van Berkel, H.H.A.; van der Aa, P.H.J.

    2015-01-01

    Debates about the new welfare, and the new social policies that go (or should go) with it, share an emphasis on risk-prevention strategies and pluralistic risk management. Focusing specifically on the risk of unemployment, this article discusses the case for so-called preventive worker-directed

  17. Future Directions in Preventing Child Abuse.

    Science.gov (United States)

    Krugman, Richard D.

    1995-01-01

    Efforts to prevent the abuse and neglect of children requires: professionals and citizens who care to make a difference; development of multidisciplinary units, teams, or organizations to deal with specific parts of the problem; a clear statement of child protection policy; programs that work; commitment to research and program evaluation; and a…

  18. High School Teachers' Perceptions of Cyberbullying Prevention and Intervention Strategies

    Science.gov (United States)

    Stauffer, Sterling; Heath, Melissa Allen; Coyne, Sarah Marie; Ferrin, Scott

    2012-01-01

    Recent meta-analyses indicate that bully prevention programs produce minimal change in student behavior. This study examined 66 high school teachers' perceptions regarding the effect of cyberbullying on students, which intervening strategies teachers would use when dealing with cyberbullying, and which prevention strategies would assist in…

  19. Predicting Use of Outdoor Fall Prevention Strategies: Considerations for Prevention Practices.

    Science.gov (United States)

    Chippendale, Tracy

    2018-01-01

    Outdoor falls are just as common as indoor falls, but have received less attention in research and practice. Behavioral strategies play an important role in outdoor fall prevention. The purpose of this study was to examine predictors of strategy use. Backward stepwise regression was used to study factors associated with use of outdoor fall prevention strategies among a random sample ( N = 120) of community-dwelling seniors. Significant negative predictors of strategy use included higher education levels ( p outdoor fallers and nonfallers in the use of three different types of strategies ( ps outdoor fall prevention strategies. Further study of additional factors is warranted.

  20. Suicide Prevention Strategies for Improving Population Health.

    Science.gov (United States)

    Wilcox, Holly C; Wyman, Peter A

    2016-04-01

    Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Economic evaluation of pressure ulcer care: a cost minimization analysis of preventive strategies.

    NARCIS (Netherlands)

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; Engelshoven, I. van; Ramshorst, B. van; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was

  2. Economic evaluation of pressure ulcer care : A Cost Minimization Analysis of Preventive Strategies

    NARCIS (Netherlands)

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; van Engelshoven, I.; van Ramshorst, B.; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was

  3. Memory-n strategies of direct reciprocity.

    Science.gov (United States)

    Hilbe, Christian; Martinez-Vaquero, Luis A; Chatterjee, Krishnendu; Nowak, Martin A

    2017-05-02

    Humans routinely use conditionally cooperative strategies when interacting in repeated social dilemmas. They are more likely to cooperate if others cooperated before, and are ready to retaliate if others defected. To capture the emergence of reciprocity, most previous models consider subjects who can only choose from a restricted set of representative strategies, or who react to the outcome of the very last round only. As players memorize more rounds, the dimension of the strategy space increases exponentially. This increasing computational complexity renders simulations for individuals with higher cognitive abilities infeasible, especially if multiplayer interactions are taken into account. Here, we take an axiomatic approach instead. We propose several properties that a robust cooperative strategy for a repeated multiplayer dilemma should have. These properties naturally lead to a unique class of cooperative strategies, which contains the classical Win-Stay Lose-Shift rule as a special case. A comprehensive numerical analysis for the prisoner's dilemma and for the public goods game suggests that strategies of this class readily evolve across various memory- n spaces. Our results reveal that successful strategies depend not only on how cooperative others were in the past but also on the respective context of cooperation.

  4. Geriatric falls: prevention strategies for the staff.

    Science.gov (United States)

    Brady, R; Chester, F R; Pierce, L L; Salter, J P; Schreck, S; Radziewicz, R

    1993-09-01

    1. Multiple falls and injuries are more prevalent among elderly over the age of 75 and are the second leading cause of accidental death in the elderly. The risk for falling is noted to be significantly greater in the hospitalized elderly. 2. Review of retrospective quality improvement chart audits revealed that peak fall times were associated with the patient's need for toileting, rest, and obtaining nutrition and hydration. 3. The MetroHealth Falls Prevention Program is based on simple proactive measures to prevent falls in the elderly. 4. An effective falls prevention program has several implications for gerontological nursing practice, including less restraint use, increased patient autonomy, and decreased loss of self-esteem. There is also a sense of increased nursing control over patient safety and time management, as well as implications for further nursing research.

  5. Danish preventive measures and deradicalization strategies

    DEFF Research Database (Denmark)

    Bertelsen, Preben

    2015-01-01

    ) prevention and countering of threats to national security, by the Danish Security and Intelligence Service (PET). The last two elements are in line with measures adopted by the international community. The element (a) is well known in some countries; however, the Danish programme and in particular the so...

  6. Strategies used by individuals to prevent burnout

    NARCIS (Netherlands)

    Demerouti, E.

    2015-01-01

    Background: Burnout represents a syndrome that is related to demanding job characteristics combined with the absence of resources or motivational job characteristics. The aim of this position study was to present strategies that individuals use to minimize burnout and its unfavourable effects.

  7. Strategies for the prevention of knee osteoarthritis

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Arden, Nigel K

    2016-01-01

    , interfering with activities of daily living and the ability to work. Many patients tolerate pain, and many health-care providers accept pain and disability as inevitable corollaries of OA and ageing. Too often, health-care providers passively await final 'joint death', necessitating knee and hip replacements......-the regimes. Now is the time to begin the era of personalized prevention for knee OA....

  8. Tuberculosis preventive therapy: An underutilised strategy to reduce ...

    African Journals Online (AJOL)

    relative risk (RR) ... when used in combination with other treatment and prevention strategies, may ... analysis showed that a symptom screen of a cough (any duration), night ...... *Edge J. Pink ribbons for breast cancer awareness – a perspective.

  9. Research Program of Adolescent HIV Prevention Strategies | CRDI ...

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

    Globally, youth aged 15 to 24 account for almost one third of all new infections. There are ... More research is needed to inform HIV prevention strategies focusing on youth. Members of the ... Institution. Ottawa Hospital Research Institute.

  10. Research Program of Adolescent HIV Prevention Strategies | IDRC ...

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

    Globally, youth aged 15 to 24 account for almost one third of all new infections. There are ... More research is needed to inform HIV prevention strategies focusing on youth. Members of the ... Institution. Ottawa Hospital Research Institute.

  11. Law Enforcement Strategies for Preventing Rail Trespassing Risk Factors.

    Science.gov (United States)

    2016-03-01

    The Volpe Center has investigated law enforcement methods that have successfully prevented trespassing along the railroad right of way. The types of law enforcement strategies currently being used and procedures followed in the field are documented, ...

  12. Underutilization of preventive strategies in patients receiving NSAIDs.

    NARCIS (Netherlands)

    M.C.J.M. Sturkenboom (Miriam); T.A. Burke; J.P. Dieleman (Jeanne); M.J. Tangelder; F. Lee; J.L. Goldstein

    2003-01-01

    textabstractBACKGROUND: Multiple treatment guidelines for non-steroidal anti-inflammatory drugs (NSAIDs) suggest that patients with one or more risk factors for NSAID-associated upper gastrointestinal (UGI) ulcer complications should be prescribed preventive strategies such as

  13. Antioxidants as a Potential Preventive and Therapeutic Strategy for Cadmium.

    Science.gov (United States)

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

    2016-01-01

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

  14. Preventing and Coping Strategies for Cyber Bullying and Cyber Victimization

    OpenAIRE

    Erdinc Ozturk; Gizem Akcan

    2016-01-01

    Although there are several advantages of information and communication technologies, they cause some problems like cyber bullying and cyber victimization. Cyber bullying and cyber victimization have lots of negative effects on people. There are lots of different strategies to prevent cyber bullying and victimization. This study was conducted to provide information about the strategies that are used to prevent cyber bullying and cyber victimization. 120 (60 women, 60 men) university students w...

  15. Money laundering in Dubai: strategies and future directions

    OpenAIRE

    Belaisha, Belaisha; Brooks, Graham

    2014-01-01

    Purpose\\ud – This paper aims to highlight present strategies to prevent money laundering in Dubai.\\ud \\ud Design/methodology/approach\\ud – Thirty semi-structured interviews were conducted with Anti Money Laundering Suspicion Cases Unit (AMLSCU), Anti Organized Crime Department (AOCD) and Central Bank employees.\\ud \\ud Findings\\ud – This paper shows that AMLSCU, AOCD and Central Bank employees are aware that future strategies to prevent money laundering are needed.\\ud \\ud Research limitations/...

  16. Bullying among Young Children: Strategies for Prevention

    Science.gov (United States)

    Levine, Emily; Tamburrino, Melissa

    2014-01-01

    Bullying is an increasing problem within childcare facilities, preschool programs, and public schools. As a result, many districts are instituting anti-bullying intervention programs. This article defines bullying and explains the direct and indirect forms it can take. First, it examines research on bullying during the beginning years of school.…

  17. Research-Based Strategies and Best Practices for Dropout Prevention

    Science.gov (United States)

    Smink, Jay

    2009-01-01

    The National Dropout Prevention Center (NDPC) at Clemson University has been at the forefront of identifying model dropout prevention programs and promoting the use of best practices to increase the graduation rates in schools since 1986. The structure for these varied interventions and solutions takes the form of effective strategies, model…

  18. A Comprehensive Fracture Prevention Strategy in Older Adults

    DEFF Research Database (Denmark)

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

    2016-01-01

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS...

  19. An Emerging Strategy of "Direct" Research.

    Science.gov (United States)

    Mintzberg, Henry

    1979-01-01

    Discusses seven basic themes that underlie the author's "direct research" activities. These themes include reliance on research based on description and induction instead of prescription and deduction, and the measurement of many elements in real settings, supported by anecdote, instead of few variables in perceptual terms from a…

  20. Necessity of Rethinking about the Preventive Strategies of Addiction

    OpenAIRE

    Ali Riasaty

    2017-01-01

    According to the last official statistics of national organization, there are nearly 220 million addicted people in the world until 2008. Therefore, it seems that addiction has become a scourge of the world which cannot be dealt with by countries alone. Generally, social damages prevention has priority over other methods, especially in addiction. We can see two approaches in this field: community based and risk-awareness preventive strategies.1‎ Obviously, prevention approaches are develop...

  1. Effects of Direct and Indirect Instructional Strategies on Students ...

    African Journals Online (AJOL)

    First Lady

    2012-10-27

    Oct 27, 2012 ... Counseling, University of Port Harcourt, Rivers State. Phone: +234(0) ... Mathematics using Direct Instructional strategy, while Group B students were taught using ... strategy; significant difference existed between direct and indirect instruction ..... is to ensure individual student's mastery of the subject matter.

  2. Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

    Science.gov (United States)

    Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

    2012-01-01

    The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

  3. Strategies to prevent HIV transmission to serodiscordant couples.

    Science.gov (United States)

    Hallal, Ronaldo Campos; Raxach, Juan Carlos; Barcellos, Nêmora Tregnago; Maksud, Ivia

    2015-09-01

    The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples. This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil. A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde. The articles recovered exhibit four main strategies: (1) condom; (2) reduction of risks in sexual practices; (3) use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP) and pre-exposure prophylaxis (PrEP); (4) risk reduction in reproduction. TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies. When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

  4. Seeking HIV prevention strategies for women.

    Science.gov (United States)

    Townsend, S

    1993-05-01

    Women are biologically more susceptible to HIV infection than men through heterosexual penile-vaginal intercourse, and transmission by heterosexual means seems to be increasing. The use of male condoms and partner reduction are currently recommended to reduce the risk of contracting and transmitting HIV. Women can, however, only indirectly influence these behaviors. Many face social and emotional factors which make it impossible to negotiate condom use with an unwilling partner. Scientists are therefore paying greater attention to female barrier methods such as the female condom and spermicides as potential female- controlled ways to help women avoid infection. Noncontraceptive chemical methods in the form of jellies and topical creams are being explored. Limited in vivo scientific data exists on how these methods may prevent the transmission of HIV. The female condom is a thin, plastic sheath which covers the cervix, vagina, and women's external genitalia. It has gone to clinical trials in 1700 women at 71 sites. While many women are in favor of the method, objections to its use have been voiced due to its appearance, the noise made during intercourse, slippage, how it feels during intercourse, expense, reduced sensitivity, and embarrassment. Its potential for re-use must be explored. Only inconclusive results are available on the effectiveness of spermicides. While lab and animal research show nonoxynol-9 can kill HIV, it remains to be seen how much or how often it may be used before mucosal linings become irritated and potentially facilitate the entry of HIV. Many unresolved questions about the mechanics of HIV infection remain to be answered before these methods may be fully endorsed by a wide array of scientists.

  5. A comprehensive fracture prevention strategy in older adults

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  7. Strategies for the Prevention of Neonatal Candidiasis

    Directory of Open Access Journals (Sweden)

    Eugene Leibovitz

    2012-04-01

    Full Text Available Invasive fungal infections represent the third-leading cause of late-onset sepsis in very-low-birth-weight infants (VLBWI and have a high rate of infection-associated mortality. The infants at high risk for fungal sepsis are VLBWI with presence of additional risk factors that contribute to increased colonization and concentration of fungal organisms. Colonization with Candida spp. in neonates is secondary to either maternal vertical transmission or nosocomial acquisition in the nursery. Multiple sites may become colonized and a direct correlation between fungal colonization and subsequent progression to invasive candidemia was determined. Randomized, single and multiple-center, placebo-controlled trials found intravenous fluconazole prophylaxis to be effective in decreasing fungal colonization and sepsis for at-risk preterm infants <1500 g birth weight. The prophylactic use of fluconazole was found to be safe with no significant development of fungal resistance. Fluconazole prophylaxis administered to preterm neonates with birth weight <1000 g and/or 27 weeks’ gestation or less has the potential of reducing and potentially eliminating invasive fungal infections and Candida-related mortality.

  8. Economic evaluation of pressure ulcer care: A Cost Minimization Analysis of Preventive Strategies

    OpenAIRE

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; van Engelshoven, I.; van Ramshorst, B.; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was carried out alongside a prospective cohort study on the incidence and risk factors for pressure ulcers. Two large teaching hospitals in the Netherlands with (partly) opposing approaches in preventio...

  9. Urbanization and geographic expansion of zoonotic arboviral diseases: mechanisms and potential strategies for prevention

    OpenAIRE

    Weaver, Scott C.

    2013-01-01

    Arthropod-borne viruses (arboviruses) mainly infect people via direct spillover from enzootic cycles. However, dengue, chikungunya, and yellow fever viruses have repeatedly initiated urban transmission cycles involving human amplification and peridomestic mosquito vectors to cause major epidemics. Here, I review these urban emergences and potential strategies for their prevention and control.

  10. Urbanization and geographic expansion of zoonotic arboviral diseases: mechanisms and potential strategies for prevention.

    Science.gov (United States)

    Weaver, Scott C

    2013-08-01

    Arthropod-borne viruses (arboviruses) mainly infect people via direct spillover from enzootic cycles. However, dengue, chikungunya, and yellow fever viruses have repeatedly initiated urban transmission cycles involving human amplification and peridomestic mosquito vectors to cause major epidemics. Here, I review these urban emergences and potential strategies for their prevention and control. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Childhood obesity and cardiovascular disease: links and prevention strategies

    Science.gov (United States)

    Nadeau, Kristen J.; Maahs, David M.; Daniels, Stephen R.; Eckel, Robert H.

    2015-01-01

    The prevalence and severity of pediatric obesity have dramatically increased since the late 1980s, raising concerns about a subsequent increase in cardiovascular outcomes. Strong evidence, particularly from autopsy studies, supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. Lifestyle patterns also begin early and impact CVD risk. In addition, obesity and other CVD risk factors tend to persist over time. However, whether childhood obesity causes adult CVD directly, or does so by persisting as adult obesity, or both, is less clear. Regardless, sufficient data exist to warrant early implementation of both obesity prevention and treatment in youth and adults. In this Review, we examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, components of the metabolic syndrome, and the development of CVD. We also evaluate how obesity treatment strategies can improve risk factors and, ultimately, adverse clinical outcomes. PMID:21670745

  12. Preventive strike vs. false targets and protection in defense strategy

    International Nuclear Information System (INIS)

    Levitin, Gregory; Hausken, Kjell

    2011-01-01

    A defender allocates its resource between defending an object passively and striking preventively against an attacker seeking to destroy the object. With no preventive strike the defender distributes its entire resource between deploying false targets, which the attacker cannot distinguish from the genuine object, and protecting the object. If the defender strikes preventively, the attacker's vulnerability depends on its protection and on the defender's resource allocated to the strike. If the attacker survives, the object's vulnerability depends on the attacker's revenge attack resource allocated to the attacked object. The optimal defense resource distribution between striking preventively, deploying the false targets and protecting the object is analyzed. Two cases of the attacker strategy are considered: when the attacker attacks all of the targets and when it chooses a number of targets to attack. An optimization model is presented for making a decision about the efficiency of the preventive strike based on the estimated attack probability, dependent on a variety of model parameters.

  13. Prevention strategies for herpes zoster and post-herpetic neuralgia

    Science.gov (United States)

    Levin, Myron J.; Gershon, Anne A.; Dworkin, Robert H.; Brisson, Marc; Stanberry, Lawrence

    2017-01-01

    SUMMARY Impairment of varicella zoster virus (VZV)-specific cell-mediated immunity, including impairment due to immunosenescence, is associated with an increased risk of developing herpes zoster (HZ), whereas levels of anti-VZV antibodies do not correlate with HZ risk. This crucial role of VZV-specific cell-mediated immunity suggests that boosting these responses by vaccination will be an effective strategy for reducing the burden of HZ. Other strategies focus on preventing the major complication of HZ – post-herpetic neuralgia. These strategies include pre-emptive treatment with drugs such as tricyclic antidepressants, anticonvulsants and analgesics. PMID:20510262

  14. Influence of faith-based organisations on HIV prevention strategies ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... Keywords: Faith-based organisations, HIV prevention strategies, systematic review. ... 2017;17(3): 753-761. https://dx.doi.org/10.4314/ahs.v17i3.18. Introduction. HIV (Human ... checked, and citations in key papers were hand searched9. ... that answered our research question: What is the influ- ence of ...

  15. Comparison of Two Educational Strategies in Teaching Preventive Cardiology.

    Science.gov (United States)

    Stroup-Benham, Christine A.; And Others

    This study assessed the impact of two educational strategies: text only versus text plus small group discussion, among two groups of third-year internal medicine clerkship students in a preventive cardiology course. The course was a required, 12-week Internal Medical clerkship at the University of Texas Medical Branch. The first group reviewed…

  16. Prevention and Control Strategies to Counter Dengue Virus Infection.

    Science.gov (United States)

    Rather, Irfan A; Parray, Hilal A; Lone, Jameel B; Paek, Woon K; Lim, Jeongheui; Bajpai, Vivek K; Park, Yong-Ha

    2017-01-01

    Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV) has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  17. Suicide prevention: a proposed national strategy for South Africa

    African Journals Online (AJOL)

    The first is a multicentre programme targeting non-fatal suicidal behaviours, known as ... Keywords: Suicide; Prevention; National strategy; South Africa. Received: 16/08/2012 ... to enter university or the open labour market).2,5,7-8. Risk factors.

  18. Prevention and Control Strategies to Counter Dengue Virus Infection

    Directory of Open Access Journals (Sweden)

    Irfan A. Rather

    2017-07-01

    Full Text Available Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  19. Suicide prevention: A proposed national strategy for South Africa ...

    African Journals Online (AJOL)

    Suicidal behaviour is an important public health problem globally and in Africa. A brief overview of the nature and severity of the problem is provided, but the primary aim of this paper is to identify priorities and prevention strategies for reducing suicidal behaviour in South Africa by discussing a framework for a proposed ...

  20. Strategies for Prevention and Treatment of Trichomonas vaginalis Infections.

    Science.gov (United States)

    Bouchemal, Kawthar; Bories, Christian; Loiseau, Philippe M

    2017-07-01

    The last estimated annual incidence of Trichomonas vaginalis worldwide exceeds that of chlamydia and gonorrhea combined. This critical review updates the state of the art on advances in T. vaginalis diagnostics and strategies for treatment and prevention of trichomoniasis. In particular, new data on treatment outcomes for topical administration of formulations are reviewed and discussed. Copyright © 2017 American Society for Microbiology.

  1. Cancer in Nigerian Women: A Critical Need for Prevention Strategy ...

    African Journals Online (AJOL)

    Cancer in Nigeria is assuming an alarming proportion. Recent public awareness on common female cancer such as breast, cervix, liver etc has shown an upsurge of cancer in women. This study aims to describe common cancers in Nigerian women and highlight strategy for cancer prevention. All records of histologically ...

  2. Some aspects of strategies and solutions in accident prevention.

    Science.gov (United States)

    Häkkinen, K

    1983-04-01

    Accident prevention measures are traditionally classified into technical, organizational and behavioral solutions. A review of some commonly used strategies for accident prevention illustrates some discrepancies between different approaches and the need to develop more comprehensive strategies. Several factors, including protective efficiency and disadvantages at work, must be taken into account when the solutions are evaluated. Some solutions to prevent load disengagement from cranes were evaluated. Measurements of the pressing force showed that the efficiency of the safety latch of a clamp for plate lifting is inadequate to provide protection under all exceptional lifting conditions and in all situations for which the safety latch is intended. The delay caused by the attachment of a lifting hook equipped with a safety latch was measured. The handling of some of the most reliable and technically safe latches requires additional operations and thereby limits their practical application.

  3. [The new German prevention act: an effective strategy?].

    Science.gov (United States)

    Garlichs, Dietrich

    2015-10-01

    The new German prevention act attempts to deal with the influx of obesity and chronic diseases by educating and informing. It seeks to change individual behaviour and supress lifestyle-related risk factors. In the past, however this behavioural prevention strategy has proved ineffective. A structural prevention strategy, as requested by the WHO, should additionally be put into effect with measures that reach all walks of life, not just the health-conscious people in society. It proposes the following: · At least one hour of daily physical activity or sport at school and kindergarten. · A differential food tax that makes unhealthy foods more expensive and healthy foods cheaper (taxing sugary / fatty foods). · Mandatory quality standards for kindergarten and school meals. · Banning food advertising targeted at children. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Economic evaluation of pressure ulcer care: a cost minimization analysis of preventive strategies.

    Science.gov (United States)

    Schuurman, Jaap-Peter; Schoonhoven, Lisette; Defloor, Tom; van Engelshoven, Ilse; van Ramshorst, Bert; Buskens, Erik

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was carried out alongside a prospective cohort study on the incidence and risk factors for pressure ulcers. Two large teaching hospitals in the Netherlands with (partly) opposing approaches in prevention, a technological versus a human approach, were analyzed. The main outcome measures were resource use, costs of preventive measures and treatment, and pressure ulcer incidence in both hospitals. Pressure ulcer prevention through a predominantly technical approach resulted in a similar incidence rate as prevention through a predominantly human approach. However, the technical approach was considerably less expensive.

  5. Search for Directed Networks by Different Random Walk Strategies

    Science.gov (United States)

    Zhu, Zi-Qi; Jin, Xiao-Ling; Huang, Zhi-Long

    2012-03-01

    A comparative study is carried out on the efficiency of five different random walk strategies searching on directed networks constructed based on several typical complex networks. Due to the difference in search efficiency of the strategies rooted in network clustering, the clustering coefficient in a random walker's eye on directed networks is defined and computed to be half of the corresponding undirected networks. The search processes are performed on the directed networks based on Erdös—Rényi model, Watts—Strogatz model, Barabási—Albert model and clustered scale-free network model. It is found that self-avoiding random walk strategy is the best search strategy for such directed networks. Compared to unrestricted random walk strategy, path-iteration-avoiding random walks can also make the search process much more efficient. However, no-triangle-loop and no-quadrangle-loop random walks do not improve the search efficiency as expected, which is different from those on undirected networks since the clustering coefficient of directed networks are smaller than that of undirected networks.

  6. Suicide prevention strategies revisited: 10-year systematic review.

    Science.gov (United States)

    Zalsman, Gil; Hawton, Keith; Wasserman, Danuta; van Heeringen, Kees; Arensman, Ella; Sarchiapone, Marco; Carli, Vladimir; Höschl, Cyril; Barzilay, Ran; Balazs, Judit; Purebl, György; Kahn, Jean Pierre; Sáiz, Pilar Alejandra; Lipsicas, Cendrine Bursztein; Bobes, Julio; Cozman, Doina; Hegerl, Ulrich; Zohar, Joseph

    2016-07-01

    Many countries are developing suicide prevention strategies for which up-to-date, high-quality evidence is required. We present updated evidence for the effectiveness of suicide prevention interventions since 2005. We searched PubMed and the Cochrane Library using multiple terms related to suicide prevention for studies published between Jan 1, 2005, and Dec 31, 2014. We assessed seven interventions: public and physician education, media strategies, screening, restricting access to suicide means, treatments, and internet or hotline support. Data were extracted on primary outcomes of interest, namely suicidal behaviour (suicide, attempt, or ideation), and intermediate or secondary outcomes (treatment-seeking, identification of at-risk individuals, antidepressant prescription or use rates, or referrals). 18 suicide prevention experts from 13 European countries reviewed all articles and rated the strength of evidence using the Oxford criteria. Because the heterogeneity of populations and methodology did not permit formal meta-analysis, we present a narrative analysis. We identified 1797 studies, including 23 systematic reviews, 12 meta-analyses, 40 randomised controlled trials (RCTs), 67 cohort trials, and 22 ecological or population-based investigations. Evidence for restricting access to lethal means in prevention of suicide has strengthened since 2005, especially with regard to control of analgesics (overall decrease of 43% since 2005) and hot-spots for suicide by jumping (reduction of 86% since 2005, 79% to 91%). School-based awareness programmes have been shown to reduce suicide attempts (odds ratio [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and suicidal ideation (0·5, 0·27-0·92; p=0·025). The anti-suicidal effects of clozapine and lithium have been substantiated, but might be less specific than previously thought. Effective pharmacological and psychological treatments of depression are important in prevention. Insufficient evidence exists to assess the

  7. Therapeutic and prevention strategies against human enterovirus 71 infection

    Science.gov (United States)

    Kok, Chee Choy

    2015-01-01

    Human enterovirus 71 (HEV71) is the cause of hand, foot and mouth disease and associated neurological complications in children under five years of age. There has been an increase in HEV71 epidemic activity throughout the Asia-Pacific region in the past decade, and it is predicted to replace poliovirus as the extant neurotropic enterovirus of highest global public health significance. To date there is no effective antiviral treatment and no vaccine is available to prevent HEV71 infection. The increase in prevalence, virulence and geographic spread of HEV71 infection over the past decade provides increasing incentive for the development of new therapeutic and prevention strategies against this emerging viral infection. The current review focuses on the potential, advantages and disadvantages of these strategies. Since the explosion of outbreaks leading to large epidemics in China, research in natural therapeutic products has identified several groups of compounds with anti-HEV71 activities. Concurrently, the search for effective synthetic antivirals has produced promising results. Other therapeutic strategies including immunotherapy and the use of oligonucleotides have also been explored. A sound prevention strategy is crucial in order to control the spread of HEV71. To this end the ultimate goal is the rapid development, regulatory approval and widespread implementation of a safe and effective vaccine. The various forms of HEV71 vaccine designs are highlighted in this review. Given the rapid progress of research in this area, eradication of the virus is likely to be achieved. PMID:25964873

  8. [Integrated prevention and control strategy for dengue in Mesoamerica].

    Science.gov (United States)

    Gómez-Dantés, Héctor; San Martín, José Luis; Danis-Lozano, Rogelio; Manrique-Saide, Pablo

    2011-01-01

    Dengue in the Americas is a public health problem in ascent. The control strategies have not been effective when sustained in the intensive use of insecticides and poor community participation. The Mesoamerican Initiative for the Prevention and the Integrated Control of Dengue synthesizes the works generated by the Integrated Strategy of the Pan-American Health Organization (PAHO) and the risks stratification strategy designed by the countries of the Mesoamerican region. The objective is to progressively reduce the incidence of dengue cases until a 50% reduction is reached over a five years period. This document describes the elements for the risk stratification, the activities for prevention and control organized by levels of intensity and frequency and the indicators used to pursuit the objectives. To face the dispersion of the problem a concentration of efforts for control in the areas of greater risk is presented; the opportunity in the detection of cases is highlighted to tackle the fast dissemination of the infection; focus on the most productive breeding sites is proposed to battle against the vast dissemination of the breeding sites; and the severity of the infection must be addressed by capable clinical human resources. This strategy was designed along with the national representatives of the control programs to create master plans that provided the basis for the integrated prevention and control of dengue in the Mesoamerican region.

  9. Strategies to prevent HIV transmission to serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Ronaldo Campos Hallal

    2015-09-01

    Full Text Available ABSTRACTIntroduction:The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples.Objective:This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil.Methods:A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde.Results:The articles recovered exhibit four main strategies: (1 condom; (2 reduction of risks in sexual practices; (3 use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP and pre-exposure prophylaxis (PrEP; (4 risk reduction in reproduction.Discussion:TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies.Conclusions:When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

  10. Pressure ulcer prevention and management strategies in Turkey.

    Science.gov (United States)

    Acaroglu, Rengin; Sendir, Merdiye

    2005-01-01

    Pressure ulcers are a serious problem that can lead to pain and delayed recovery. In Turkey, the selection of dressing products is usually left to the nurse managing the patient and depends on several factors, including the condition of the wound, the nurse's knowledge, and the nurse's experience. The aim of this study was to determine prevention and management strategies for pressure ulcer care in hospitalized patients in Turkey and to identify the factors that influence the selection of products by nurses. The descriptive study was carried out in various departments (orthopedic, neurological, oncology, and intensive care) where bedridden patients were found. A total of 110 nurses volunteered to participate. Data were collected by means of a questionnaire developed after a review of the literature. Only 32% of the nurses made use of a pressure ulcer care risk evaluation scale (Norton scale), and air mattresses were used by 89% as a preventive measure with patients who were at risk. When pressure ulcers occurred, advanced wound care products were preferred by most of the nurses. Seventy four percent of nurses considered the condition of wound for selection of products. Despite correctly noting several strategies for prevention of pressure ulcers, 9% of nurses also described massage around boney prominence and the use of inflatable rings as effective preventive strategies. This descriptive study shows that nurses in Turkey are primarily responsible for prevention and management of pressure ulcer care and that both traditional dressing products and advanced wound care products are used in the care of all stages of pressure ulcers in Turkey. It also illustrates the need for ongoing pressure ulcer education to promote evidence-based practice and reduce the use of ineffective (or harmful) strategies.

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

    Science.gov (United States)

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

    2018-05-01

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

  12. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies.

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina Del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F; Vieta, Eduard

    2017-08-01

    Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients' psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  13. Prevention of OHSS: Current strategies and new insights

    Directory of Open Access Journals (Sweden)

    Cristiano E. Busso

    2010-10-01

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

  14. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

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

    Directory of Open Access Journals (Sweden)

    Gerald V. Naccarelli, MD

    2016-02-01

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

  16. Prevention strategies for ureteral stricture following ureteroscopic lithotripsy

    Directory of Open Access Journals (Sweden)

    Hao Dong

    2018-04-01

    Full Text Available Ureteral stricture formation after ureteroscopic lithotripsy is a late complication that can lead to hydronephrosis and a subsequent risk of renal deterioration. The specific incidence is unknown, and the mechanism of stricture formation has not been completely explained. In this review, we summarize the current evidence regarding the incidence of this condition and discuss its pathogenesis. We then list preventive strategies to reduce the morbidity of ureteral strictures. Keywords: Ureteroscopy, Ureteral stricture, Lithotripsy, Complications

  17. Design strategies for pollution prevention in industries (life cycle design)

    International Nuclear Information System (INIS)

    Saleemi, A.R.

    1997-01-01

    Pollution prevention and adoption of clean technologies in the industry are to be the proper strategies to flight against the growing industrial pollution in Pakistan. These strategies will not only reduce the existing pollution load and will also help to have sustainable industrial development in Pakistan in is well established that the concept of pollution prevention demands use of minimum, resources with maximum efficiency to achieve double benefits such as resource conservation and environmental protection. The application of cleaner production and waste minimization in thousand of industries in other part of world has proved beyond doubt that the use of cleaner technology is cheaper as compared to installation of waste treatment plants for end of pipe treatment. Waste treatment plants have been blamed not to solve any pollution problem, but only to transfer pollution from one environmental media to another. The adoption of waste treatment technologies have also created lot of other problems. Thousand of industries in the world have change their focus of activities from end of pipe treatment to pollution prevention techniques. It is the right time to start pollution prevention activities in industry. The design of a product system in the industry can be represented logically as a series of decision and choices made individually and collectively by design participant. The choices range from the selection of materials and manufacturing processes to choices relating to shape, from and function of a product. The product life cycle design provides a logical system for addressing pollution prevention because the full range of environmental consequence associated with the product can be considered and it is a powerful tool for identifying and maximizing the environmental benefits of pollution prevention. The life cycle assesment (LCA) concept suggests that decision making should be based on consideration of the cradle-to grave characteristics of the product, process

  18. Vocabulary Acquisition through Direct and Indirect Learning Strategies

    Science.gov (United States)

    Naeimi, Maki; Foo, Thomas Chow Voon

    2015-01-01

    Vocabulary learning has long been considered as one of the essential components for developing language learning. However, language learners are required to not just concern about memorizing definitions but also integrating vocabulary meaning into their present knowledge. Many strategies such as direct or indirect ones may be integrated to enhance…

  19. Effects of Direct and Indirect Instructional Strategies on Students ...

    African Journals Online (AJOL)

    This is a quasi experimental research designed to determine the effects of Direct and Indirect instructional strategies on Mathematics achievement among junior secondary school students. The population consisted of students in a Public Secondary School in Owerri, Imo State. A sample of 102 students from two (2) intact ...

  20. Educational strategies for the prevention of diabetes, hypertension, and obesity

    Directory of Open Access Journals (Sweden)

    Alexandre Paulo Machado

    Full Text Available Summary Objective: The main goal of this work was to produce a review of educational strategies to prevent diabetes, hypertension, and obesity. Method: PubMed database was consulted using combined descriptors such as [Prevention], [Educational Activities], [Diabetes], [Hypertension], and [Obesity]. Data from randomized trials published between 2002 and 2014 were included in spreadsheets for analysis in duplicate by the reviewers. Results: A total of 8,908 articles were found, of which 1,539 were selected about diabetes mellitus (DM, n=369, arterial systemic hypertension (ASH, n=200, and obesity (OBES, n=970. The number of free full text articles available was 1,075 (DM = 276, ASH = 118 and OBES = 681. In most of these studies, demographic characteristics such as gender and age were randomized, and the population mainly composed by students, ethnic groups, family members, pregnant, health or education professionals, patients with chronic diseases (DM, ASH, OBES or other comorbidities. Group dynamics, physical activity practices, nutritional education, questionnaires, interviews, employment of new technologies, people training and workshops were the main intervention strategies used. Conclusion: The most efficient interventions occurred at community level, whenever the intervention was permanent or maintained for long periods, and relied on the continuous education of community health workers that had a constant interference inside the population covered. Many studies focused their actions in children and adolescents, especially on students, because they were more influenced by educational activities of prevention, and the knowledge acquired by them would spread more easily to their family and to society.

  1. Direct harmonic voltage control strategy for shunt active power filter

    DEFF Research Database (Denmark)

    Munir, Hafiz Mudassir; Zou, JianXiao; Xie, Chuan

    2017-01-01

    generation system (DPGS) where the nonlinear loads are highly dispersed. Local harmonic voltage detection based Resistive-APF (R-APF) seems more suitable to be applied in the DPGS, however, R-APF suffers from poor compensation performance and difficulty of parameter tuning. In this paper, a direct harmonic...... voltage control strategy for the S-APF is proposed with local point of common coupling (PCC) voltage detection only. The control strategy design procedure is given in detail. Simulation is conducted in Matlab/Simulink to compare the performance between the R-APF and the proposed method. The results...

  2. Novel Therapeutic Strategy for the Prevention of Bone Fractures

    Science.gov (United States)

    2015-02-01

    therapeutic potential for improving muscle function in older adults , perhaps leading to the prevention of falls and fractures. Body Aim 1 (months 1-12...directly to postural instability, which in turn increases the risk for falls , and falls are the main etiolog ical factor inmore than 90% of bone...vitamin D supplementation (Girgis et al., 2013) may improve muscle strength and/or neuromuscular control and proprioception, perhaps reducing fall risk

  3. The microbiome and HIV prevention strategies in women.

    Science.gov (United States)

    Abdool Karim, Salim S; Passmore, Jo-Ann S; Baxter, Cheryl

    2018-01-01

    HIV prevention approaches that women can use and control are a priority. Results from topical and oral preexposure prophylaxis (PrEP) HIV prevention trials have produced inconsistent results in women. One of the main behavioural factors impacting effectiveness of PrEP has been suboptimal adherence. In this review, we examine biological factors that modulate topical PrEP efficacy, with particular focus on the vaginal microbiome. Genital inflammation is an independent risk factor for HIV acquisition in women. Using 16S rRNA sequencing of the vaginal microbiota, anaerobic bacteria linked with bacterial vaginosis have been shown to be associated with both genital inflammation and HIV risk. Using proteomics, it was recently discovered that a dysbiotic vaginal microbiome, comprising less than 50% Lactobacillus spp., directly influenced topical PrEP efficacy. Gardnerella vaginalis, the dominant vaginal species in dysbiotic women, was able to directly degrade tenofovir, but not dapivirine, an antiretroviral also being developed for topical PrEP. The link between bacterial vaginosis-associated organisms with HIV risk and altered tenofovir gel effectiveness underscores the importance of good vaginal health and good adherence for women to benefit maximally from topical PrEP. Altering the vaginal microbiome is one of the new directions being pursued for HIV prevention.

  4. Ventilator associated pneumonia: evolving definitions and preventive strategies.

    Science.gov (United States)

    Mietto, Cristina; Pinciroli, Riccardo; Patel, Niti; Berra, Lorenzo

    2013-06-01

    Ventilator-associated pneumonia (VAP) is one of the most frequent hospital-acquired infections occurring in intubated patients. Because VAP is associated with higher mortality, morbidity, and costs, there is a need to solicit further research for effective preventive measures. VAP has been proposed as an indicator of quality of care. Clinical diagnosis has been criticized to have poor accuracy and reliability. Thus, the Centers for Disease Control and Prevention has introduced a new definition based upon objective and recordable data. Institutions are nowadays reporting a VAP zero rate in surveillance programs, which is in discrepancy with clinical data. This reduction has been highlighted in epidemiological studies, but it can only be attributed to a difference in patient selection, since no additional intervention has been taken to modify pathogenic mechanisms in these studies. The principal determinant of VAP development is the presence of the endotracheal tube (ETT). Contaminated oropharyngeal secretions pool over the ETT cuff and subsequently leak down to the lungs through a hydrostatic gradient. Impairment of mucociliary motility and cough reflex cannot counterbalance with a proper clearance of secretions. Lastly, biofilm develops on the inner ETT surface and acts as a reservoir for microorganism inoculum to the lungs. New preventive strategies are focused on the improvement of secretions drainage and prevention of bacterial colonization. The influence of gravity on mucus flow and body positioning can facilitate the clearance of distal airways, with decreased colonization of the respiratory tract. A different approach proposes ETT modifications to limit the leakage of oropharyngeal secretions: subglottic secretion drainage and cuffs innovations have been addressed to reduce VAP incidence. Moreover, coated-ETTs have been shown to prevent biofilm formation, although there is evidence that ETT clearance devices (Mucus Shaver) are required to preserve the

  5. EDUCATIONAL ACTIONS TO PREVENT DENGUE: EXPERIENCES AND STRATEGIES WITH ELDERLY

    Directory of Open Access Journals (Sweden)

    Rosamaria Rodrigues Garcia

    2015-04-01

    Full Text Available Objective: Describe the activities performed on apublic specialized ambulatory care for dengue prevention among elderly. Case report: the epidemiological outlook of dengue is scaring being characterized as a public health problem. The elderly are most at risk for hospitalization and severe forms of the disease, thus health education activities are essential to improve awareness of the need to fight and prevent the disease. A Health Education project was created, evolving communication strategies to raise awareness on the issue. They were performed by a post graduate Gerontology group in activities such as interactive puppet show, myths and truths dynamic, informative folder, parody, posters, training seniors, caregivers and family members, internal and external health professionals, staff and residents of nearby long term care facilities. The materials were available in print and digital version. 2,500 elderly and 350 professionals were trained and encouraged to multiply the information and inspire adoption of preventive measures. The actions provided intergenerational interaction and empowerment of the elderly, whom trained, had the opportunity to exercise social participation and disseminate recommendations for other users. Conclusion: the project enabled the construction of knowledge through interactive educational activities that contributed to strengthen the individual and collective awareness, awareopinion leaderstothe importance of communication/education in the fight against dengue, which emphasized social responsibility in rescuing citizenship in a perspective thateach citizen is responsible for himself and for community. DESCRIPTORS: Dengue. Aged. Disease prevention. Health education.

  6. Strategies for application of scientific findings in prevention.

    Science.gov (United States)

    Wei, S H

    1995-07-01

    Dental research in the last 50 years has accomplished numerous significant advances in preventive dentistry, particularly in the area of research in fluorides, periodontal diseases, restorative dentistry, and dental materials, as well as craniofacial development and molecular biology. The transfer of scientific knowledge to clinical practitioners requires additional effort. It is the responsibility of the scientific communities to transfer the fruits of their findings to society through publications, conferences, media, and the press. Specific programs that the International Association for Dental Research (IADR) has developed to transmit science to the profession and the public have included science transfer seminars, the Visiting Lecture Program, and hands-on workshops. The IADR Strategic Plan also has a major outreach goal. In addition, the Federation Dentaire Internationale (FDI) and the World Health Organization (WHO) have initiated plans to celebrate World Health Day and the Year of Oral Health in 1994. These are important strategies for the application of scientific findings in prevention.

  7. An Injury Prevention Strategy for Teen Restaurant Workers

    Science.gov (United States)

    Ward, Julie A.; de Castro, A. B.; Tsai, Jenny Hsin-Chun; Linker, Darren; Hildahl, Lyle; Miller, Mary E.

    2011-01-01

    High levels of youth employment, workplace hazards, and characteristics unique to adolescents contribute to a relatively high incidence of injuries among teens in the restaurant industry. This article discusses the ProSafety model of injury prevention among teen restaurant workers. Through integration with an existing career and technical education program, the ProSafety project seeks to prevent occupational injuries among the teen worker population through classroom safety education and internship skills reinforcement. ProSafety is the product of an innovative collaboration with occupational health nurses, business professionals, educators, and government. Its approach is derived from Social Cognitive Theory, is consistent with key values and strategies of occupational health nurses, and provides lessons for practitioners seeking to reduce occupational injuries in food service or among other populations of adolescent workers. PMID:20180503

  8. Strategic Directions for the Bucharest Strategy and City Brand

    Directory of Open Access Journals (Sweden)

    Ana-Claudia Ţapardel

    2012-11-01

    Full Text Available On the international stage, public administration has become an essential factor, capable of providing a nation with the competitive advantage. Improving standards in local administration in our country has included not only a vigorous and sustained process of reform, but also a drive to modernise and perfect management within the public sector. These aspects are essential, since decisions made by partners and investors are to an ever larger extent influenced by the quality, efficiency and credibility of public administration. Following these considerations, and based upon an empirical research conducted with the aid of a survey and a comparative analysis between the manner in which the branding and development strategies were developed in Vancouver and Bucharest, the present paper aims to identify the main strategic directions and branding elements necessary in elaborating a strategy and in accumulating a dossier of best practices, in order to implement successfully the strategic planning process and the branding strategy in the local communities of Romania.

  9. Coronary artery disease - strategies for primary prevention in Pakistan

    International Nuclear Information System (INIS)

    Khan, M.H.

    2000-01-01

    Coronary artery disease is the leading cause of death among middle aged and elderly population. The increase in prevalence of coronary artery disease in Pakistan, has also involved the younger population and about 30% of the patients of coronary artery disease are below the age of 40 years. It seems that with this high prevalence of coronary artery disease, we will be entering in the new millennium with coronary artery disease as number one killer in young adults in Pakistan. This is the time, though belated, we must embark on strategies for primary prevention of this disease so that we are able to reduce the incidence of the disease and the economic burden it entails on the national exchequer. Before suggesting the strategies for the prevention of coronary artery disease in Pakistan, let us briefly review the significance of modifiable risk factors for coronary artery disease. Several studies have been found a significant relationship between physical inactivity and coronary artery disease. (A.B./orig.)

  10. Assessing implementation of evidence-based childhood obesity prevention strategies in schools

    Directory of Open Access Journals (Sweden)

    Christine M.W. Totura

    2015-01-01

    Conclusion: Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place.

  11. Strategy for preventing the waste of human resources

    Science.gov (United States)

    Jones, William E.

    1992-05-01

    Rapid technological advances and the declining educational preparedness of industrial workers has established a need for new training strategies and initiatives regarding human resource development. The productivity, competitiveness, motivation, and creativity of our people determines whether our business enterprises succeed or fail during the next decade. Due to a change process that many organizations have undertaken to become more competitive toward the year 2000, many of the previous styles of engineering leadership that involves the management of projects and human resources require new approaches. It is also important to recognize that technology has its limits and a broader focus to include the human aspects of accomplishing jobs over the long term is more critical than ever before. More autonomy and the responsibility for broader practices by the professional staff requires that the professional worker operate differently. Business planning and development of the organization's future strategic intent requires a high priority on the human resource linkage to the business plans and strategies. A review of past practices to motivate the worker toward higher productivity clearly shows that past techniques are not as effective in today's work environment. Many practices of organizational and individual leadership don't fit today's approach of worker involvement because they were designed for administrative supervisory control processes. Therefore, if we are going to organize a business strategy that prevents the `waste of human resources,' we need to develop a strategy that is appropriate for the times which considers the attitude of the employees and their work environment. Having worked with scientists and engineers for the majority of my twenty-five year career, I know they see and appreciate the logic of a formula. A formula fits when developing a future strategy because a formula can become a model to enhance balanced planning. In this paper, I want to

  12. Hepatocellular carcinoma in Asia: Prevention strategy and planning.

    Science.gov (United States)

    Ashtari, Sara; Pourhoseingholi, Mohamad Amin; Sharifian, Afsaneh; Zali, Mohamad Reza

    2015-06-28

    To review all of epidemiological and etiological aspects of hepatocellular carcinoma (HCC) and examined the prevention of this disease in Asia. We conducted a systematic review according to the PRISMA guidelines. We were chosen articles that published previously, from PubMed (MEDLINE), the Cochrane database and Scopus. The key words used in this research were as follows: HCC in Asia and the way of prevention of this disease, with no language limitations. We selected those papers published before 2014 that we considered to be most important and appropriate. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. More than 70% of all new cases of liver cancer were diagnosed in Asia, a region that 75% of all those chronically infected with hepatitis B virus (HBV) in the world. Chronic HBV infection is the main cause of HCC in Asia, where the virus is endemic and vertical transmission is common. Japan, Saudi Arabia, Egypt and Pakistan are exception because of high prevalence of HCV infection in these regions. The prevalence of this cancer is high in Eastern and South-Eastern Asia, But Middle Eastern countries are characterized as moderate prevalence rate of HCC region and Central Asia and some part of Middle Eastern countries are known as low prevalence rate of HCC. In addition of HBV and HCV the other factors such as aflatoxin, alcohol, obesity, diabetes and non-alcoholic fatty liver disease (NAFLD) might be responsible for a low prevalence of HCC in Asian countries. Currently available HCC therapies, chemotherapy, surgical are inefficient, mainly due to usually late diagnosis and high recurrence rates after surgical resection, and usually end with treatment failure. Liver transplantation also remains as a difficult strategy in patients with HCC. Thus prevention of HCC by treating and prevention HBV and HCV infection, the major causative agents of HCC, and the other risk factors such as aflatoxin, alcohol, obesity

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

    Science.gov (United States)

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

    2016-04-01

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

  14. Primary prevention of cardiovascular disease through population-wide motivational strategies: insights from using smartphones in stroke prevention

    Science.gov (United States)

    Feigin, Valery L; Norrving, Bo; Mensah, George A

    2017-01-01

    The fast increasing stroke burden across all countries of the world suggests that currently used primary stroke and cardiovascular disease (CVD) prevention strategies are not sufficiently effective. In this article, we overview the gaps in, and pros and cons of, population-wide and high-risk prevention strategies. We suggest that motivating and empowering people to reduce their risk of having a stroke/CVD by using increasingly used smartphone technologies would bridge the gap in the population-wide and high-risk prevention strategies and reduce stroke/CVD burden worldwide. We emphasise that for primary stroke prevention to be effective, the focus should be shifted from high-risk prevention to prevention at any level of CVD risk, with the focus on behavioural risk factors. Such a motivational population-wide strategy could open a new page in primary prevention of not only stroke/CVD but also other non-communicable disorders worldwide. PMID:28589034

  15. Viruses and human cancers: challenges for preventive strategies.

    Science.gov (United States)

    de The, G

    1995-01-01

    Virus-associated human cancers provide unique opportunities for preventive strategies. The role of human papilloma viruses (HPV 16 and 18), hepatitis B virus (HBV), Epstein-Barr herpes virus (EBV), and retroviruses (human immunodeficiency virus [HIV] and human T-cell leukemia/lymphoma virus [HTLV]) in the development of common carcinomas and lymphomas represents a major cancer threat, particularly among individuals residing in developing countries, which account for 80% of the world's population. Even though these viruses are not the sole etiological agents of these cancers (as would be the case for infectious diseases), different approaches can be implemented to significantly decrease the incidence of virus-associated malignancies. The first approach is vaccination, which is available for HBV and possibly soon for EBV. The long delay between primary viral infection and development of associated tumors as well as the cost involved with administering vaccinations detracts from the feasibility of such an approach within developing countries. The second approach is to increase efforts to detect pre-cancerous lesions or early tumors using immunovirological means. This would allow early diagnosis and better treatment. The third strategy is linked to the existence of disease susceptibility genes, and suggests that counseling be provided for individuals carrying these genes to encourage them to modify their lifestyles and other conditions associated with increased cancer risks (predictive oncology). Specific recommendations include: a) increase international studies that explore the causes of the large variations in prevalence of common cancers throughout the world; b) conduct interdisciplinary studies involving laboratory investigation and social sciences, which may suggest hypotheses that may then be tested experimentally; and c) promote more preventive and health enhancement strategies in addition to curative and replacement therapies. PMID:8741797

  16. Obesity and cardiovascular risk: a call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity: part B: obesity-induced cardiovascular disease, early prevention strategies and future research directions.

    Science.gov (United States)

    Kotsis, Vasilios; Tsioufis, Konstantinos; Antza, Christina; Seravalle, Gino; Coca, Antonio; Sierra, Cristina; Lurbe, Empar; Stabouli, Stella; Jelakovic, Bojan; Redon, Josep; Redon, Pau; Nilsson, Peter M; Jordan, Jens; Micic, Dragan; Finer, Nicholas; Leitner, Deborah R; Toplak, Hermann; Tokgozoglu, Lale; Athyros, Vasilios; Elisaf, Moses; Filippatos, Theodosios D; Grassi, Guido

    2018-04-12

    : Obesity predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke, which are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications.

  17. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines.

    Science.gov (United States)

    Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

    2016-01-01

    to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

  18. The Explicit Instruction of Reading Strategies: Directed Reading Thinking Activity vs. Guided Reading Strategies

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Yazdani

    2015-05-01

    Full Text Available Investigating the efficiencies and deficiencies of reading strategies is one of the noticeable issues in the related theory and research in reading comprehension instruction. This study was to examine the impact of Directed Reading Thinking Activity (DRTA and Guided Reading (GR on reading comprehension. Sixty three Iranian students of grade one in Shahed high school in the city of Bojnourd took part in the study. They were assigned in three groups, one control and two experimental groups. The instruction lasted for ten weeks. This study utilized a pretest posttest control group in quantitative quasi- experimental design. The same reading comprehension test was administered as pre-test and post-test. The results were twofold: First, the instruction of learning strategies could foster reading comprehension skill. Second, while the explicit instruction of both strategies could improve the students' reading comprehension skill, Directed Reading Thinking Activity had a more significant positive effect than Guided Reading.

  19. Novel strategy for prevention of esophageal stricture after endoscopic surgery.

    Science.gov (United States)

    Mizutani, Taro; Tadauchi, Akimitsu; Arinobe, Manabu; Narita, Yuji; Kato, Ryuji; Niwa, Yasumasa; Ohmiya, Naoki; Itoh, Akihiro; Hirooka, Yoshiki; Honda, Hiroyuki; Ueda, Minoru; Goto, Hidemi

    2010-01-01

    Recently, novel endoscopic surgery, including endoscopic submucosal dissection (ESD), was developed to resect a large superficial gastrointestinal cancer. However, circumferential endoscopic surgery in the esophagus can lead to esophageal stricture that affects the patient's quality of life. This major complication is caused by scar formation, and develops during the two weeks after endoscopic surgery. We hypothesized that local administration of a controlled release anti-scarring agent can prevent esophageal stricture after endoscopic surgery. The aims of this study were to develop an endoscopically injectable anti-scarring drug delivery system, and to verify the efficacy of our strategy to prevent esophageal stricture. We focused on 5-Fluorouracil (5-FU) as an anti-scarring agent, which has already been shown to be effective not only for treatment of cancers, but also for treatment of hypertrophic skin scars. 5-FU was encapsulated by liposome, and then mixed with injectable 2% atelocollagen (5FLC: 5FU-liposome-collagen) to achieve sustained release. An in vitro 5-FU releasing test from 5FLC was performed using high-performance liquid chromatography (HPLC). Inhibition of cell proliferation was investigated using normal human dermal fibroblast cells (NHDF) with 5FLC. In addition, a canine esophageal mucosal resection was carried out, and 5FLC was endoscopically injected into the ulcer immediately after the operation, and compared with a similar specimen injected with saline as a control. 5-FU was gradually released from 5FLC for more than 2 weeks in vitro. The solution of 5-FU released from 5FLC inhibited NHDF proliferation more effectively than 5-FU alone. In the canine model, no findings of stricture were observed in the 5FLC-treated dog at 4 weeks after the operation and no vomiting occurred. In contrast, marked esophageal strictures were observed with repeated vomiting in the control group. Submucosal fibrosis was markedly reduced histologically in the 5FLC

  20. Direct and indirect welfare chauvinism as party strategies

    DEFF Research Database (Denmark)

    Careja, Romana; Elmelund-Præstekær, Christian; Klitgaard, Michael Baggesen

    2016-01-01

    welfare chauvinism occurs as a result of legislative changes that explicitly exclude recipients from social protection or reduce the level thereof on the basis of ethnicity. Indirect welfare chauvinism is the result of policy measures that apply to both natives and immigrants, but which deliberately...... and deliberate policy-making strategies of the party. It shows that the distinction between direct and indirect chauvinism is a useful theoretical tool for understanding how the Danish People's Party can fulfill the expectations of both its electorate and its coalition partners, even if they point in different...

  1. Direct and indirect welfare chauvinism as party strategies

    DEFF Research Database (Denmark)

    Careja, Romana; Elmelund-Præstekær, Christian; Klitgaard, Michael Baggesen

    2016-01-01

    negatively affect immigrants the most. Combining quantitative and qualitative analysis of labour market reforms in Denmark, where one of the most successful populist right-wing parties in Europe – the Danish People's Party – held a pivotal position in the period 2001–11, the article traces the intentions...... and deliberate policy-making strategies of the party. It shows that the distinction between direct and indirect chauvinism is a useful theoretical tool for understanding how the Danish People's Party can fulfill the expectations of both its electorate and its coalition partners, even if they point in different...

  2. Nonpharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Paweena Susantitaphong

    2014-01-01

    Full Text Available Contrast-induced AKI (CI-AKI has been one of the leading causes for hospital-acquired AKI and is associated with independent risk for adverse clinical outcomes including morbidity and mortality. The aim of this review is to provide a brief summary of the studies that focus on nonpharmacological strategies to prevent CI-AKI, including routine identification of at-risk patients, use of appropriate hydration regimens, withdrawal of nephrotoxic drugs, selection of low-osmolar contrast media or isoosmolar contrast media, and using the minimum volume of contrast media as possible. There is no need to schedule dialysis in relation to injection of contrast media or injection of contrast agent in relation to dialysis program. Hemodialysis cannot protect the poorly functioning kidney against CI-AKI.

  3. Dental caries: Strategies to control this preventable disease

    Directory of Open Access Journals (Sweden)

    Andrew Rugg-Gunn

    2013-11-01

    Full Text Available Objective. To provide a brief commentary review of strategies to control dental caries. Dental decay is one of man’s most prevalent diseases. In many counties, severity increased in parallel with importation of sugar, reaching its zenith about 1950s and 1960s. Since then, severity has declined in many countries, due to the wide use of fluoride especially in toothpaste, but dental caries remains a disease of medical, social and economic importance. Within the EU in 2011, the cost of dental treatment was estimated to be €79 billion. The pathogenesis is well understood: bacteria in dental plaque (biofilm metabolise dietary sugars to acids which then dissolve dental enamel and dentine. Possible approaches to control caries development, therefore, involve: removal of plaque, reducing the acidogenic potential of plaque, reduction in sugar consumption, increasing the tooth’s resistance to acid attack, and coating the tooth surface to form a barrier between plaque and enamel. At the present time, only three approaches are of practical importance: sugar control, fluoride, and fissure sealing. The evidence that dietary sugars are the main cause of dental caries is extensive, and comes from six types of study. Without sugar, caries would be negligible. Fluoride acts in several ways to aid caries prevention. Ways of delivering fluoride can be classed as: ‘automatic’, ‘home care’ and ‘professional care’: the most important of these are discussed in detail in four articles in this issue of the Acta Medica Academica. Conclusion. Dental caries is preventable – individuals, communities and countries need strategies to achieve this.

  4. Recruitment strategy cost and impact on minority accrual to a breast cancer prevention trial.

    Science.gov (United States)

    Dew, Alexander; Khan, Seema; Babinski, Christie; Michel, Nancy; Heffernan, Marie; Stephan, Stefanie; Jordan, Neil; Jovanovic, Borko; Carney, Paula; Bergan, Raymond

    2013-04-01

    Recruitment of minorities to cancer prevention trials is difficult and costly. Early-phase cancer prevention trials have fewer resources to promote recruitment. Identifying cost-effective strategies that can replace or supplement traditional recruitment methods and improve minority accrual to small, early-phase cancer prevention trials are of critical importance. To compare the costs of accrual strategies used in a small breast cancer prevention trial and assess their impact on recruitment and minority accrual. A total of 1196 potential subjects with a known recruitment source contacted study coordinators about the SOY study, a breast cancer prevention trial. Recruitment strategies for this study included recruitment from within the Northwestern University network (internal strategy), advertisements placed on public transportation (Chicago Transit Authority (CTA)), health-related events, media (print/radio/television), and direct mail. Total recruitment strategy cost included the cost of study personnel and material costs calculated from itemized receipts. Incremental cost-effectiveness ratios (ICERs) were calculated to compare the relative cost-effectiveness of each recruitment strategy. If a strategy was more costly and less effective than its comparator, then that strategy was considered dominated. Scenarios that were not dominated were compared. The primary effectiveness measure was the number of consents. Separate ICERs were calculated using the number of minority consents as the effectiveness measure. The total cost of SOY study recruitment was US$164,585, which included the cost of materials (US$26,133) and personnel (US$138,452). The internal referral strategy was the largest source of trial contacts (748/1196; 63%), consents (107/150; 71%), and minority consents (17/34; 50%) and was the most expensive strategy (US$139,033). CTA ads generated the second largest number of trial contacts (326/1196; 27%), the most minority contacts (184/321; 57%), and 16

  5. Prosperity without pollution: The prevention strategy for industry and consumers

    International Nuclear Information System (INIS)

    Hirschhorn, J.S.; Oldenburg, K.V.

    1990-01-01

    Here is the first book to explain why only a preventative environmental strategy can work: because growing population, consumption and industrialization cripple current, rather haphazard, remedial efforts. This book shows how our society can make more with less, be more competitive and less polluting, while maintaining our standard of living by reducing and eventually eliminating the production of wastes and pollutants from industry, commerce, homes, farms, and institutions. This may seem far-fetched, but be prepared to discover in this book that there can be a middle ground between ecology and economy - and that you can help achieve it. You'll find data and examples that any person can use, from engineers in industry to office workers to activists. Every concerned citizen will also want to consider the authors' innovative suggestions for taxing wastes and using the proceeds to help companies and communities switch to new industrial processes. Also, you should evaluate their proposals to reburies meaningful waste and toxicity information on product labels, to make bans on chemicals and products a more credible and available corrective measure, and to secure permanent, high-level government support for pollution prevention

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

    Directory of Open Access Journals (Sweden)

    Prasanta K. Bhattacharya

    2016-04-01

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

  7. Changing the Direction of Suicide Prevention in the United States.

    Science.gov (United States)

    Reidenberg, Dan; Berman, Alan L

    2017-08-01

    It is axiomatic that the goal of suicide prevention is the prevention of suicide. Yet in spite of significant efforts to this end since the middle of the last century, and most notably in the last decade, the rate of suicide in the U.S. has not declined; rather, it has increased. To address this issue, Suicide Awareness Voices of Education (SAVE) brought together leading prevention specialists from other public health problems where successes have been achieved, representatives from countries where suicide rates have declined, and U.S. based suicide prevention researchers and program directors, to "think outside the box" and propose innovative, scalable approaches that might better drive success in achieving desired results from U.S. suicide prevention efforts. The recommendations should challenge our preconceptions and force us outside our own mental constraints to broaden our perspectives and suggest catalysts for real change in suicide prevention. © 2016 The American Association of Suicidology.

  8. Creating a comprehensive strategy to prevent nuclear smuggling

    International Nuclear Information System (INIS)

    Luongo, K.

    1998-01-01

    The end of the Cold War has raised awareness in the international community about the threat posed by large, global stockpiles of weapon usable nuclear material. Particular focus has been directed at the level of protection provided to the fissile materials produced by the Soviet Union and concern has been raised about the growing stockpile of plutonium worldwide. Reported incidents of the diversion of nuclear material have raised the specter of potential nuclear terrorism and of countries of proliferation concern being provided a shortcut to the bomb. In order to address this problem, the international community needs to agree on the rapid implementation of a comprehensive, mutually reinforcing strategy to control existing stockpiles of fissile material, constrain future production and use of these materials, and address the underlying causes of this threat

  9. Strategies for the prevention and mitigation of severe accidents

    International Nuclear Information System (INIS)

    Ader, C.; Heusener, G.; Snell, V.G.

    1999-01-01

    The currently operating nuclear power plants have, in general, achieved a high level of safety, as a result of design philosophies that have emphasized concepts such as defense-in-depth. This type of an approach has resulted in plants that have robust designs and strong containments. These designs were later found to have capabilities to protect the public from severe accidents (accidents more severe than traditional design basis in which substantial damage is done to the reactor core). In spite of this high level of safety, it has also been recognized that future plants need to be designed to achieve an enhanced level of safety, in particular with respect to severe accidents. This has led both regulatory authorities and utilities to develop guidance and/or requirements to guide plant designers in achieving improved severe accident performance through prevention and mitigation. The considerable research programs initiated after the TMI-2 accident have provided a large body of technical data, analytical methods, and the expertise necessary to provide for an understanding of a range of severe accident phenomena. This understanding of the ways severe accidents can progress and challenge containments, combined with the wide use of probabilistic safety assessments, have provided designers of evolutionary water cooled reactors opportunities to develop designs that minimize the challenges to the plant and to the public from severe accidents, including the development of accident management strategies intended to further reduce the risk of severe accidents. This paper describes some of the recent progress made in the understanding of severe accidents and related safety assessment methodology and how this knowledge has supported the incorporation of features into representative evolutionary designs that will prevent or mitigate many of the severe accident challenges present in current plants. (author)

  10. Key challenges in the combat of human trafficking : Evaluating the EU trafficking strategy and EU trafficking directive

    NARCIS (Netherlands)

    Bosma, Alice; Rijken, Conny

    2016-01-01

    The problem of trafficking in human beings (THB) is still omnipresent in Europe, despite the numerous preventive and retributive actions taken. This article evaluates the two most important EU-instruments to combat trafficking: the EU Directive and the EU Strategy. Based on secondary analysis of

  11. [Vaping: a new strategy to prevent smoking-related diseases?].

    Science.gov (United States)

    Polosa, Riccardo

    2014-01-01

    By quitting, smokers of all ages can gain substantial health benefits. No other single effort of public health is able to achieve an advantage comparable to smoking cessation on a large scale. However, conventional approaches to smoking cessation require tobacco users to completely abstain, and many smokers are unable - or have not the willingness - to achieve this goal, and then continue to smoke despite the looming negative consequences for health. But it is possible to consider another option: the reduction of harm caused by tobacco smoking (tobacco harm reduction) through the intake of nicotine from alternative sources safer than tobacco smoke, such as the electronic cigarette (e-cig). It is a promising product for the reduction of harm caused by tobacco smoking. In addition to providing nicotine through the vapour without the typical toxic and carcinogenic substances derived from combustion, the e-cig is also a good substitute for the rituals associated with the behaviour of the smoker. In this article, the author suggests that the wide dissemination of vaping behaviour can become a successful strategy to reduce smoking and preventing smoking-related diseases, advancing on how to succeed with this matter.

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

    Science.gov (United States)

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

    2016-07-01

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

  13. [Congenital toxoplasmosis: randomised comparison of strategies for retinochoroiditis prevention].

    Science.gov (United States)

    Wallon, Martine; Kieffer, François; Binquet, Christine; Thulliez, Philippe; Garcia-Méric, Patricia; Dureau, Pascal; Franck, Jacqueline; Peyron, François; Bonnin, Alain; Villena, Isabelle; Bonithon-Kopp, Claire; Gouyon, Jean-Bernard; Masson, Sandrine; Félin, Alexandrin; Cornu, Catherine

    2011-01-01

    In France, children with confirmed congenital toxoplasmosis receive a treatment for a period of 12 to 24 months. Such prolonged treatment may generate potentially severe risks, in particular hematologic and cutaneous. Our objective is to compare the effectiveness of two therapeutic strategies on the prevention of retinochoroiditis by a randomized, non-inferiority, open-label, parallel study including 486 children, 3 to 6 months of age with a non-severe form of congenital toxoplasmosis. Following randomization, pyrimethamine-sulphonamide treatment is initiated for a period of three months, followed by a treatment with Fansidar(®) for 9 months, or therapeutic abstention. Follow-up visits during a two-year period will include an examination of the eye, a blood test, and questionnaires to evaluate the children's quality of life and their parents' anxiety. Confirming the non-inferiority of the effectiveness of a short-term treatment will improve the quality of life of parents and children. © 2011 Société Française de Pharmacologie et de Thérapeutique.

  14. Optimizing individual iron deficiency prevention strategies in physiological pregnancy

    Directory of Open Access Journals (Sweden)

    Kramarskiy V.A.

    2018-04-01

    Full Text Available Sideropenia by the end of pregnancy takes place in all mothers without exception. Moreover, the selective administration of iron preparations, in contrast to the routine, makes it possible to avoid hemochromatosis, frequency of which in the general population makes from 0.5 to 13 %. The aim of the study was to optimize the individual strategy for the prevention of iron deficiency in physiological pregnancy. A prospective pre-experimental study was conducted, the criterion of inclusion in which was the mother’s extragenital and obstetrical pathology during the first half of pregnancy, a burdened obstetric and gynecological anamnesis. The study group of 98 women with a physiological pregnancy in the period of 20 to 24 weeks was recruited by simple ran- dom selection. Serum ferritin, hemoglobin, and serum iron were used to estimate iron deficiency. In the latent stage of iron deficiency against a background of monthly correction with Fenules ® in a dose of 90 mg of elemental iron per day, there was a significant increase in ferritin and iron in the blood rotor. In healthy mothers, during the gestational period of 20–24 weeks, a regularity arises in the replenishment of iron status, especially in the case of repeated pregnancy, which is successfully satisfied during the month of Fenules ® intake in doses of 45 mg or 90 mg per day with a serum ferritin level of, respectively, 30 up to 70 μg/l or less than 30 μg/l.

  15. Prevention and control of zebra mussels: proactive and reactive strategies

    International Nuclear Information System (INIS)

    Claudi, R.

    1998-01-01

    Most plant people would agree that having zebra mussels in any raw water system is not desirable. System blockage, loss of heat transfer and other associated safety hazards are not pleasant to deal with. Therefore most industries strive to minimise the effect of infestation. Opinions differ as to how to do this most efficiently and economically. Some facilities are committed to preventing the settlement of veligers in their piping systems and on some of the external structures they consider critical. This is the proactive approach. Others allow settlement and only treat the system or surface after fouling has occurred. This is the reactive approach. Which is the best and most economical treatment will depend on the individual facility and sometimes on the individual system. The paper examines the different proactive and reactive strategies available to-date and how they are being used. It will also discuss some of the criteria for choosing a proactive vs. reactive approach and why the decision has to be made individually by each facility. (author)

  16. Prevention and control of zebra mussels: proactive and reactive strategies

    Energy Technology Data Exchange (ETDEWEB)

    Claudi, R. [Ontario Hydro Nuclear, Toronto, ON (Canada)

    1998-07-01

    Most plant people would agree that having zebra mussels in any raw water system is not desirable. System blockage, loss of heat transfer and other associated safety hazards are not pleasant to deal with. Therefore most industries strive to minimise the effect of infestation. Opinions differ as to how to do this most efficiently and economically. Some facilities are committed to preventing the settlement of veligers in their piping systems and on some of the externalstructures they consider critical. This is the proactive approach. Others allow settlement and only treat the system or surface after fouling has occurred. This is the reactive approach. Which is the best and most economical treatment will depend on the individual facility and sometimes on the individual system. The paper examines the different proactive and reactive strategies available to-date and how they are being used. It will also discuss some of the criteria for choosing a proactive vs. reactive approach and why the decision has to be made individually by each facility. (author)

  17. Necessity of Rethinking about the Preventive Strategies of Addiction

    Directory of Open Access Journals (Sweden)

    Ali Riasaty

    2017-07-01

    Full Text Available According to the last official statistics of national organization, there are nearly 220 million addicted people in the world until 2008. Therefore, it seems that addiction has become a scourge of the world which cannot be dealt with by countries alone. Generally, social damages prevention has priority over other methods, especially in addiction. We can see two approaches in this field: community based and risk-awareness preventive strategies.1‎ Obviously, prevention approaches are developed on theoretical basis. Some of the theories on which the first strategy is based are as follows: Talkot Parsons had the opinion that if social institutions like family, school and media don’t have proper functioning, the society will be suffering from the ravages and it will be deviant. Travis Hirsch’s social control theory is generally based on the Durkheim’s social cohesion. Social control theory, instead of focusing on the main causes of social deviations, focuses on the explanation of the need to avoid criminal activities: interest, obligation, partnership, and belief. Sutherland believes that more criminal behaviors prevail among the first groups, such as peer groups. Delinquency primarily takes place through social interaction with intimate groups. One of the important theories was suggested by Lyder. He combined theories of sociology and social psychology. He processed the difficulty of distinguishing individual and social fields; the concept of a bio-psycho refers to the “personality as a unique individual identity who immersed in social processes”. Various elements such as mental bio-psycho, social reality of social domain theory and bio-psychological domain will be used in developing a prevention program which is based on social harms of this theory.2,3 On the other hand,‎ awareness-raising approaches are developed on the basis of theories such as “Rational Choice Theory”, “Value-Rational Action”, “Health Belief Model”, and

  18. [Composite prevention strategy for shoulder dystocia: meta-analysis].

    Science.gov (United States)

    Wang, Shaowei; Zhao, Xiaodong; Chu, Defa; Li, Min; Liang, Lin; Zhang, Junrong

    2015-01-01

    To investigate the composite prevention strategy for shoulder dystocia. The published articles of randomized controlled trial (RCT) of comparison about the prevention of shoulder dystocia were searched in PubMed, EMBASE, EBSCO databases and Cochrane Library, and these studies were screened under inclusion and exclusion criteria. The quality of included studies were evaluated. And the Meta-analysis using statistic software RevMan 5.1 was completed. Totally 16 articles, all English published with no one Chinese article being searched out, were included in this analysis, published from 1993 to 2009. ( 1)To the gestational diabetes mellitus (GDM) patients, reviewed from 2 articles, it was found that the incidence of shoulder dystocia was reduced significantly by prenatal intervention versus usual care (OR = 0.40, 95% CI:0.21- 0.75, P = 0.004). (2)To the GDM patients with intensive prenatal intervention, reviewed form 5 articles, it was found that the incidence of shoulder dystocia was reduced significantly by intensive intervention(diet control combined with insulin if necessary)versus less intensive intervention (only diet control), OR = 0.29 (95%CI:0.11-0.73, P = 0.009). (3) To the non-GDM patients with suspected macrosomia, reviewed from 4 articles, it was found that the incidence of shoulder dystocia was not reduced by early artificial induction of parturition (OR = 0.85, 95%CI:0.41-1.75, P = 0.660). (4)To the GDM patients, reviewed form 2 articles, it was found that the incidence of shoulder dystocia was reduced marginal significantly by artificial induction of parturition in 38-39 gestational weeks compared with all spontaneous parturition patients (OR = 0.18, 95%CI:0.03-0.97, P = 0.050) and significantly reduced when compared with those spontaneous parturition patients after 40 gestational weeks (OR = 0.13, 95%CI: 0.02-0.75, P = 0.020). (5)To the GDM patients with suspected macrosomia, reviewed from only one article, it was found that the incidence of shoulder

  19. Depressurization as an accident management strategy to minimize the consequences of direct containment heating

    International Nuclear Information System (INIS)

    Hanson, D.J.; Golden, D.W.; Chambers, R.; Miller, J.D.; Hallbert, B.P.; Dobbe, C.A.

    1990-10-01

    Probabilistic Risk Assessments (PRAs) have identified severe accidents for nuclear power plants that have the potential to cause failure of the containment through direct containment heating (DCH). Prevention of DCH or mitigation of its effects may be possible using accident management strategies that intentionally depressurize the reactor coolant system (RCS). The effectiveness of intentional depressurization during a station blackout TMLB' sequence was evaluated considering the phenomenological behavior, hardware performance, and operational performance. Phenomenological behavior was calculated using the SCDAP/RELAP5 severe accident analysis code. Two strategies to mitigate DCH by depressurization of the RCS were considered. One strategy, called early depressurization, assumed that the reactor head vent and pressurizer power-operated relief valves (PORVs) were latched open at steam generator dryout. The second strategy, called late depression, assumed that the head vent and PORVs were latched open at a core exit temperature of ∼922 K (1200 degree F). Depressurization of the RCS to a low value that may mitigate DCH was predicted prior to reactor pressure vessel breach for both early and late depressurization. The strategy of late depressurization is preferred over early depressurization because there are greater opportunities to recover plant functions prior to core damage and because failure uncertainties are lessened. 22 refs., 38 figs., 6 tabs

  20. Depressurization as an accident management strategy to minimize the consequences of direct containment heating

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, D.J.; Golden, D.W.; Chambers, R.; Miller, J.D.; Hallbert, B.P.; Dobbe, C.A. (EG and G Idaho, Inc., Idaho Falls, ID (USA))

    1990-10-01

    Probabilistic Risk Assessments (PRAs) have identified severe accidents for nuclear power plants that have the potential to cause failure of the containment through direct containment heating (DCH). Prevention of DCH or mitigation of its effects may be possible using accident management strategies that intentionally depressurize the reactor coolant system (RCS). The effectiveness of intentional depressurization during a station blackout TMLB' sequence was evaluated considering the phenomenological behavior, hardware performance, and operational performance. Phenomenological behavior was calculated using the SCDAP/RELAP5 severe accident analysis code. Two strategies to mitigate DCH by depressurization of the RCS were considered. One strategy, called early depressurization, assumed that the reactor head vent and pressurizer power-operated relief valves (PORVs) were latched open at steam generator dryout. The second strategy, called late depression, assumed that the head vent and PORVs were latched open at a core exit temperature of {approximately}922 K (1200{degree}F). Depressurization of the RCS to a low value that may mitigate DCH was predicted prior to reactor pressure vessel breach for both early and late depressurization. The strategy of late depressurization is preferred over early depressurization because there are greater opportunities to recover plant functions prior to core damage and because failure uncertainties are lessened. 22 refs., 38 figs., 6 tabs.

  1. A typology for campus-based alcohol prevention: moving toward environmental management strategies.

    Science.gov (United States)

    DeJong, William; Langford, Linda M

    2002-03-01

    This article outlines a typology of programs and policies for preventing and treating campus-based alcohol-related problems, reviews recent case studies showing the promise of campus-based environmental management strategies and reports findings from a national survey of U.S. colleges and universities about available resources for pursuing environmentally focused prevention. The typology is grounded in a social ecological framework, which recognizes that health-related behaviors are affected through multiple levels of influence: intrapersonal (individual) factors, interpersonal (group) processes, institutional factors, community factors and public policy. The survey on prevention resources and activities was mailed to senior administrators responsible for their school's institutional response to substance use problems. The study sample was an equal probability sample of 365 2- and 4-year U.S. campuses. The response rate was 76.9%. Recent case studies suggest the value of environmentally focused alcohol prevention approaches on campus, but more rigorous research is needed to establish their effectiveness. The administrators' survey showed that most U.S. colleges have not yet installed the basic infrastructure required for developing, implementing and evaluating environmental management strategies. The typology of campus-based prevention options can be used to categorize current efforts and to inform strategic planning of multilevel interventions. Additional colleges and universities should establish a permanent campus task force that reports directly to the president, participate actively in a campus-community coalition that seeks to change the availability of alcohol in the local community and join a state-level association that speaks out on state and federal policy issues.

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

    Science.gov (United States)

    Hong, Jun Sung

    2016-01-01

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

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

    Science.gov (United States)

    Espelage, Dorothy L; Hong, Jun Sung

    2017-06-01

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

  4. Alcohol Prevention Strategies on College Campuses and Student Alcohol Abuse and Related Problems

    Science.gov (United States)

    Ringwalt, Christopher L.; Paschall, Mallie J.; Gitelman, Amy M.

    2011-01-01

    This study examined the relationship between colleges' alcohol abuse prevention strategies and students' alcohol abuse and related problems. Alcohol prevention coordinators and first year students in 22 colleges reported whether their schools were implementing 48 strategies in six domains, and students (N = 2041) completed another survey…

  5. Direct Detection of Protein Biomarkers in Human Fluids Using Site-Specific Antibody Immobilization Strategies

    Directory of Open Access Journals (Sweden)

    Maria Soler

    2014-01-01

    Full Text Available Design of an optimal surface biofunctionalization still remains an important challenge for the application of biosensors in clinical practice and therapeutic follow-up. Optical biosensors offer real-time monitoring and highly sensitive label-free analysis, along with great potential to be transferred to portable devices. When applied in direct immunoassays, their analytical features depend strongly on the antibody immobilization strategy. A strategy for correct immobilization of antibodies based on the use of ProLinker™ has been evaluated and optimized in terms of sensitivity, selectivity, stability and reproducibility. Special effort has been focused on avoiding antibody manipulation, preventing nonspecific adsorption and obtaining a robust biosurface with regeneration capabilities. ProLinker™-based approach has demonstrated to fulfill those crucial requirements and, in combination with PEG-derivative compounds, has shown encouraging results for direct detection in biological fluids, such as pure urine or diluted serum. Furthermore, we have implemented the ProLinker™ strategy to a novel nanoplasmonic-based biosensor resulting in promising advantages for its application in clinical and biomedical diagnosis.

  6. Direct detection of protein biomarkers in human fluids using site-specific antibody immobilization strategies.

    Science.gov (United States)

    Soler, Maria; Estevez, M-Carmen; Alvarez, Mar; Otte, Marinus A; Sepulveda, Borja; Lechuga, Laura M

    2014-01-29

    Design of an optimal surface biofunctionalization still remains an important challenge for the application of biosensors in clinical practice and therapeutic follow-up. Optical biosensors offer real-time monitoring and highly sensitive label-free analysis, along with great potential to be transferred to portable devices. When applied in direct immunoassays, their analytical features depend strongly on the antibody immobilization strategy. A strategy for correct immobilization of antibodies based on the use of ProLinker™ has been evaluated and optimized in terms of sensitivity, selectivity, stability and reproducibility. Special effort has been focused on avoiding antibody manipulation, preventing nonspecific adsorption and obtaining a robust biosurface with regeneration capabilities. ProLinker™-based approach has demonstrated to fulfill those crucial requirements and, in combination with PEG-derivative compounds, has shown encouraging results for direct detection in biological fluids, such as pure urine or diluted serum. Furthermore, we have implemented the ProLinker™ strategy to a novel nanoplasmonic-based biosensor resulting in promising advantages for its application in clinical and biomedical diagnosis.

  7. Examination of sustainability indicators for fall prevention strategies in three states.

    Science.gov (United States)

    Smith, Matthew Lee; Durrett, Nicholas K; Schneider, Ellen C; Byers, Imani N; Shubert, Tiffany E; Wilson, Ashley D; Towne, Samuel D; Ory, Marcia G

    2018-06-01

    With 1-in-4 older adults suffering a fall each year, fall prevention efforts have emerged as a public health priority. Multi-level, evidence-based fall prevention programs have been promoted by the CDC and other government agencies. To ensure participants and communities receive programs' intended benefits, organizations must repeatedly deliver the programs over time and plan for program sustainability as part of 'scaling up' the initiative. The State Falls Prevention Project (SFPP) began in 2011 when the CDC provided 5 years of funding to State Departments of Health in Colorado, New York, and Oregon to simultaneously implement four fall prevention strategies: 1) Tai Chi: Moving for Better Balance; 2) Stepping On; 3) Otago Exercise Program; and 4) STEADI (STopping Elderly Accidents, Deaths, and Injuries) toolkit. Surveys were performed to examine systems change and perceptions about sustainability across states. The purposes of this study were to: 1) examine how funding influenced the capacity for program implementation and sustainability within the SFPP; and 2) assess reported Program Sustainability Assessment Tool (PSAT) scores to learn about how best to sustain fall preventing efforts after funding ends. Data showed that more organizations offered evidence-based fall prevention programs in participants' service areas with funding, and the importance of programming implementation, evaluation, and reporting efforts were likely to diminish once funding concluded. Participants' reported PSAT scores about perceived sustainability capacity did not directly align with previously reported perceptions about PSAT domain importance or modifiability. Findings suggest the importance of grantees to identify potential barriers and enablers influencing program sustainability during the planning phase of the programs. Copyright © 2018. Published by Elsevier Ltd.

  8. Examination of Preventive Resources, Life Events, and Coping Strategies.

    Science.gov (United States)

    McCarthy, Christopher J.; Lambert, Richard G.; Beard, Michelle; Canipe, Kara

    The Preventive Coping Resources Inventory (PRI) was developed to assess specific coping resources most useful for stress prevention and also applicable to education settings. Undergraduates (N=501) at a large, southwestern university completed the inventory and other measures of adjustment and coping. Exploratory factor analysis revealed five…

  9. CDC's DELTA FOCUS Program: Identifying Promising Primary Prevention Strategies for Intimate Partner Violence.

    Science.gov (United States)

    Armstead, Theresa L; Rambo, Kirsten; Kearns, Megan; Jones, Kathryn M; Dills, Jenny; Brown, Pamela

    2017-01-01

    According to 2011 data, nearly one in four women and one in seven men in the United States experience severe physical violence by an intimate partner, creating a public health burden requiring population-level solutions. To prevent intimate partner violence (IPV) before it occurs, the CDC developed Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States to identify promising community- and societal-level prevention strategies to prevent IPV. The program funds 10 state domestic violence coalitions for 5 years to implement and evaluate programs and policies to prevent IPV by influencing the environments and conditions in which people live, work, and play. The program evaluation goals are to promote IPV prevention by identifying promising prevention strategies and describing those strategies using case studies, thereby creating a foundation for building practice-based evidence with a health equity approach.

  10. A Bioterrorism Prevention Strategy for the 21st Century

    National Research Council Canada - National Science Library

    Lein, Brian

    2003-01-01

    .... The results of the anthrax attack and multiple wargames revealed that the United States is currently ill prepared to prevent or deter a bioterrorism attack against it's homeland and protect the citizens...

  11. Snip and prevent! Medically performed circumcision – a strategy for ...

    African Journals Online (AJOL)

    ... prevent urinary tract and sexually transmitted infections, and for the treatment of phimosis. .... possible that this view might change, given the latest evidence from the ... clearance for circumference loss and cellulite reduction! The VelaShape ...

  12. "Healthy Eating - Healthy Action": evaluating New Zealand's obesity prevention strategy

    Directory of Open Access Journals (Sweden)

    Tanuvasa Ausaga

    2009-12-01

    Full Text Available Abstract Background New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous Māori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA Strategy ('the Strategy', launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create an evidence base to support future initiatives, the Ministry of Health has commissioned a Consortium of researchers to evaluate the Strategy as a whole. Methods This paper discusses the Consortium's approach to evaluating the HEHA Strategy. It includes an outline of the conceptual framework underpinning the evaluation, and describes the critical components of the evaluation which are: judging to what extent stakeholders were engaged in the process of the strategy implementation and to what extent their feedback was incorporated in to future iterations of the Strategy (continuous improvement, to what extent the programmes, policies, and initiatives implemented span the target populations and priority areas, whether there have been any population changes in nutrition and/or physical activity outcomes or behaviours relating to those outcomes, and to what extent HEHA Strategy and spending can be considered value for money. Discussion This paper outlines our approach to evaluating a complex national health promotion strategy. Not only does the Evaluation have the potential to identify interventions that could be adopted internationally, but also the development of the Evaluation design can inform other complex evaluations.

  13. Counterproliferation Strategy: The Role of Preventive War, Preventive Strikes, and Interdiction

    National Research Council Canada - National Science Library

    Rak, Claire

    2003-01-01

    This thesis analyzes the potential effectiveness of preventive war, preventive strikes, and interdiction as tools for the United States to counter the proliferation of weapons of mass destruction (WMD...

  14. Can GWOT Primary Prevention Strategy More Effectively Impede Religious Extremism?

    National Research Council Canada - National Science Library

    Meyers, Michael A

    2007-01-01

    .... This concept, when related to the Global War on Terrorism (GWOT) in the Middle East, provides insights on the current strategy's effort and effectiveness in staying ahead of religious extremism expansion. Current U.S...

  15. Promotional Strategies Direct Marketing and Technological Innovations in Banking

    OpenAIRE

    Valeria Arina BALACEANU

    2011-01-01

    Modern advertising strategies involve the use of a bank's media and consumer incentives, so that banking institution, and thus offer products/services to cause favorable changes in mentality and their consumption habits, also important is the establishment an effective communication with employees, shareholders, competitors. Promotion strategies are essential to business success. Success is guaranteed if the message is sent to the right people at the right time. Promotion has a special place ...

  16. Looking Ahead Toward Community-Level Strategies to Prevent Sexual Violence

    Science.gov (United States)

    DeGue, Sarah; Holt, Melissa K.; Massetti, Greta M.; Matjasko, Jennifer L.; Tharp, Andra Teten; Valle, Linda Anne

    2018-01-01

    The Division of Violence Prevention within CDC’s National Center for Injury Prevention and Control recently undertook a systematic review of primary prevention strategies for sexual violence (SV) perpetration. This review identified the lack of community-level strategies to prevent SV as a critical gap in the literature. Community-level strategies function by modifying the characteristics of settings (e.g., schools, workplaces, neighborhoods) that increase the risk for violence victimization and perpetration. Identification of evidence-based strategies at the community level would allow implementation of ecologic approaches to SV prevention with a greater potential for reducing the prevalence of SV perpetration. The field will face several challenges in identifying and evaluating the effectiveness of promising community-level strategies to prevent SV. These challenges include limited knowledge of community-level and societal-level risk factors for SV, a lack of theoretical or empirical guidance in the SV literature for identification of promising community-level approaches, and challenges in evaluating SV outcomes at the community level. Recognition of these challenges should guide future research and foster dialogue within the SV prevention field. The development and evaluation of community-level approaches to SV prevention represent a vital and logical next step toward the implementation of effective, multilevel prevention efforts and a population-level reduction in the prevalence of SV. PMID:22185587

  17. Depression in the workplace: a systematic review of evidence-based prevention strategies.

    Science.gov (United States)

    Dietrich, Sandra; Deckert, Stefanie; Ceynowa, Martin; Hegerl, Ulrich; Stengler, Katarina

    2012-01-01

    Depression is one of the most common mental disorders, causing enormous personal and economic burden. In its early stages, however, it is the most manageable of mental disorders. The workplace, where a large proportion of the adult population can be reached, might be a good setting for prevention interventions that target depression directly. Identify evidence-based indicated/secondary prevention strategies for depression in the workplace. Systematic review of articles published until February 2010 using PubMed, EbscoHost and the Cochrane Library. Studies were selected based on different inclusion criteria, such as diagnosis of depression with validated screening instruments and presence of a control group. A total of 9,173 articles were found. One evaluated intervention study in the workplace met all inclusion criteria (French APRAND programme). The intervention, which combined the provision of diagnosis and psychoeducation, had a positive effect on people with depression, with a significant trend towards chances of recovery or remission after 1 year. The remaining studies did not meet the predefined inclusion criteria of this systematic review. The findings are quite sobering given the high prevalence of depression and the individual and societal burden caused by it. More tailor-made interventions in the workplace targeting depression directly are needed.

  18. Radiation-related caries. Etiology and possible preventive strategies. What should the radiotherapist know?

    International Nuclear Information System (INIS)

    Schweyen, R.; Hey, J.; Fraenzel, W.; Vordermark, D.; Hildebrandt, G.; Kuhnt, T.

    2012-01-01

    After radiation treatment of head-and-neck cancer, the impairment of patient's quality of life still remains an issue. After completion of the treatment course, a substantial number of patients develop so-called radiation caries. In addition, almost 50% of all cases of infectious osteoradionecrosis (iORN) of the jaws are directly associated with radiation caries. This review addresses our current knowledge on the etiology and pathogenesis of radiation caries including possible preventive strategies. Materials and methods A PubMed search using the terms ''radiation caries'' (''radiation related caries'', ''radiation related damage to dentition'') and ''radiogenic caries'' (''postradiation caries'', ''dental complications and radiotherapy'') was performed. The analysis of its content focused on the etiology, the pathogenesis, and the available knowledge on prophylaxis as well as treatment of radiation caries. Results For this review, 60 publications were selected. As main causal factors for radiogenic caries, either indirect impairment, resulting from alterations in the oral environment (e.g., radiation-induced xerostomia) or direct radiation-induced damage in teeth hard tissues are discussed. Radiation caries remains a lifelong threat and, therefore, requires permanent prevention programs. Conclusion To enable optimal medical care of the patients during the time course of radiotherapy as well as afterwards, close interdisciplinary cooperation between radiotherapists, oral surgeons, otorhinolaryngologists, and dentists is absolutely essential. (orig.)

  19. Educators' perceptions on bullying prevention strategies | de Wet ...

    African Journals Online (AJOL)

    I rep ort on an inve stigatio n into a group of Free State educators' recognition of bullying, their reaction s to incidences of b ullying, and the ir perceptions of the effectiveness of a number o f bul lying prevention s trategies. The research instrument was a synthesis of the Delaware Research Questionnaire and questions ...

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

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

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

  1. Risk Factors and Prevention Strategies for Suicide among the Elderly

    Science.gov (United States)

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

    2012-01-01

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

  2. Falls in older people: risk factors and strategies for prevention

    National Research Council Canada - National Science Library

    Lord, Stephen R. (Stephen Ronald)

    2007-01-01

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

  3. Prevention and Firesetting: Juvenile Justice and Intervention Strategies.

    Science.gov (United States)

    Slavkin, Michael L.

    2003-01-01

    Examines the literature on preventing firesetting behavior in preadolescents and adolescents, suggesting the need for policies and programs designed to help juveniles by providing community support and stability. Alternatives to juvenile justice interventions include making changes in the home environment, acquiring a greater sense of self, and…

  4. Teen Depression and Suicide: Effective Prevention and Intervention Strategies

    Science.gov (United States)

    King, Keith A.; Vidourek, Rebecca A.

    2012-01-01

    Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

  5. Targeting activator protein 1 signaling pathway by bioactive natural agents: Possible therapeutic strategy for cancer prevention and intervention.

    Science.gov (United States)

    Tewari, Devesh; Nabavi, Seyed Fazel; Nabavi, Seyed Mohammad; Sureda, Antoni; Farooqi, Ammad Ahmad; Atanasov, Atanas G; Vacca, Rosa Anna; Sethi, Gautam; Bishayee, Anupam

    2018-02-01

    Activator protein 1 (AP-1) is a key transcription factor in the control of several cellular processes responsible for cell survival proliferation and differentiation. Dysfunctional AP-1 expression and activity are involved in several severe diseases, especially inflammatory disorders and cancer. Therefore, targeting AP-1 has recently emerged as an attractive therapeutic strategy for cancer prevention and therapy. This review summarizes our current understanding of AP-1 biology and function as well as explores and discusses several natural bioactive compounds modulating AP-1-associated signaling pathways for cancer prevention and intervention. Current limitations, challenges, and future directions of research are also critically discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. The national suicide prevention strategy for England: the reality of a national strategy for the nursing profession.

    Science.gov (United States)

    Anderson, M; Jenkins, R

    2006-12-01

    Suicide is recognized as a global phenomenon and many countries now have national suicide prevention strategies. International guidance on suicide prevention and accepted epidemiological and treatment-based research underpins healthcare policy relating to suicide reduction. There has been an established comprehensive strategy in England since 2002. However, the rate of suicide continues to be a concern and nurses hold a key role in the implementation of national, regional and local policy into practice. The aim of this paper is to consider the current implications of the national suicide prevention strategy in England for nursing. This discussion paper draws upon both empirical evidence-based literature, governmental guidance and policy-related documentation. The national suicide prevention strategy for England currently continues to have a multifaceted impact on the nursing profession. This ranges from clinical practice issues such as risk assessment through to broader public health responsibilities. If nurses and allied health professionals are to be effective in their role within suicide prevention, they will need to be supported in building awareness of the wider context of the national policy. In particular, this will mean working effectively and collaboratively with the voluntary sector, service users and other non-medical agencies.

  7. Strategies for the prevention and containment of antibiotic resistance ...

    African Journals Online (AJOL)

    Antibiotic resistance may emerge by antibiotic selection pressure but is perpetuated by diverse risk factors and maintained within environments as a result of poor infection control. Population-specific drug pharmacokinetics and pharmacodynamics also play a role. The WHO, US, UK and EU have initiated strategies for the ...

  8. Cost-effectiveness analysis of infant feeding strategies to prevent ...

    African Journals Online (AJOL)

    Changing feeding practices is beneficial, depending on context. Breastfeeding is dominant (less costly, more effective) in rural settings, whilst formula feeding is a dominant strategy in urban settings. Cost-effectiveness was most sensitive to proportion of women on lifelong antiretroviral therapy (ART) and infant mortality rate ...

  9. The politics and strategy of industry self-regulation: the pharmaceutical industry's principles for ethical direct-to-consumer advertising as a deceptive blocking strategy.

    Science.gov (United States)

    Arnold, Denis G; Oakley, James L

    2013-06-01

    As the pharmaceutical industry lobbies European regulators to permit direct-to-consumer advertising (DTCA) of prescription drugs in the European Union, we found that five leading companies violated industry-developed and -promulgated standards for ethical advertising in the United States. Utilizing multiple data sources and methods, we demonstrate a consistent failure by companies that market erectile dysfunction drugs to comply with the industry's guiding principles for ethical DTCA over a four-year period despite pledges of compliance by company leaders. Noncompliance resulted in children being exposed to sexually themed promotional messages more than 100 billion times. We argue that the guidelines are a coordinated effort by the industry to prevent unwanted federal regulation, and we introduce the concept of a blocking strategy to explain company behavior and to advance theoretical understanding of firms' public affairs strategies. We recommend policy responses to prevent deceptive practices, protect children from adult content, and promote genuine health care education.

  10. Immune Checkpoint Targets for Host-Directed Therapy to Prevent and Treat Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Rajiv Kumar

    2017-11-01

    Full Text Available Leishmaniasis encompasses a group of diseases caused by protozoan parasites belonging to the genus Leishmania. These diseases range from life threatening visceral forms to self-healing cutaneous lesions, and each disease manifestations can progress to complications involving dissemination of parasites to skin or mucosal tissue. A feature of leishmaniasis is the key role host immune responses play in disease outcome. T cells are critical for controlling parasite growth. However, they can also contribute to disease onset and progression. For example, potent regulatory T cell responses can develop that suppress antiparasitic immunity. Alternatively, hyperactivated CD4+ or CD8+ T cells can be generated that cause damage to host tissues. There is no licensed human vaccine and drug treatment options are often limited and problematic. Hence, there is an urgent need for new strategies to improve the efficacy of current vaccine candidates and/or enhance both antiparasitic drug effectiveness and subsequent immunity in treated individuals. Here, we describe our current understanding about host immune responses contributing to disease protection and progression in the various forms of leishmaniasis. We also discuss how this knowledge may be used to develop new strategies for host-directed immune therapy to prevent or treat leishmaniasis. Given the major advances made in immune therapy in the cancer and autoimmune fields in recent years, there are significant opportunities to ride on the back of these successes in the infectious disease domain. Conversely, the rapid progress in our understanding about host immune responses during leishmaniasis is also providing opportunities to develop novel immunotherapy strategies that could have broad applications in diseases characterized by inflammation or immune dysfunction.

  11. Evaluating the combined effectiveness of influenza control strategies and human preventive behavior.

    Directory of Open Access Journals (Sweden)

    Liang Mao

    Full Text Available Control strategies enforced by health agencies are a major type of practice to contain influenza outbreaks. Another type of practice is the voluntary preventive behavior of individuals, such as receiving vaccination, taking antiviral drugs, and wearing face masks. These two types of practices take effects concurrently in influenza containment, but little attention has been paid to their combined effectiveness. This article estimates this combined effectiveness using established simulation models in the urbanized area of Buffalo, NY, USA. Three control strategies are investigated, including: Targeted Antiviral Prophylaxis (TAP, workplace/school closure, community travel restriction, as well as the combination of the three. All control strategies are simulated with and without regard to individual preventive behavior, and the resulting effectiveness are compared. The simulation outcomes suggest that weaker control strategies could suffice to contain influenza epidemics, because individuals voluntarily adopt preventive behavior, rendering these weaker strategies more effective than would otherwise have been expected. The preventive behavior of individuals could save medical resources for control strategies and avoid unnecessary socio-economic interruptions. This research adds a human behavioral dimension into the simulation of control strategies and offers new insights into disease containment. Health policy makers are recommended to review current control strategies and comprehend preventive behavior patterns of local populations before making decisions on influenza containment.

  12. [Relationship between self-directed learning with learning styles and strategies in medical students].

    Science.gov (United States)

    Márquez U, Carolina; Fasce H, Eduardo; Pérez V, Cristhian; Ortega B, Javiera; Parra P, Paula; Ortiz M, Liliana; Matus B, Olga; Ibáñez G, Pilar

    2014-11-01

    Self-directed learning (SDL) skills are particularly important in medical education, considering that physicians should be able to regulate their own learning experiences. To evaluate the relationship between learning styles and strategies and self-directed learning in medical students. One hundred ninety nine first year medical students (120 males) participated in the study. Preparation for Independent Learning (EPAI) scale was used to assess self-direction. Schmeck learning strategies scale and Honey and Alonso (CHAEA) scales were used to evaluate learning styles and strategies. Theoretical learning style and deep processing learning strategy had positive correlations with self-direct learning. Medical students with theoretical styles and low retention of facts are those with greater ability to self-direct their learning. Further studies are required to determine the relationship between learning styles and strategies with SDL in medical students. The acquired knowledge will allow the adjustment of teaching strategies to encourage SDL.

  13. Gamification strategy on prevention of STDs for youth.

    Science.gov (United States)

    Gabarron, Elia; Schopf, Thomas; Serrano, J Artur; Fernandez-Luque, Luis; Dorronzoro, Enrique

    2013-01-01

    Sexually transmitted diseases (STDs) and especially chlamydia is a worrying problem among North-Norwegian youngsters. Gamified web applications should be valued for sexual health education, and thus STDs prevention, for their potential to get users engaged and involved with their healthcare. Aiming to achieve that youngsters become more aware of STDs we have developed "sjekkdeg.no", a gamified web application focused on sexual health targeting North-Norwegian youngsters. Gamification techniques like avatars, achievement-based gifts and social network sharing buttons have been implemented in the site that includes educational content on sexual health and a STDs symptom checker. Preliminary results show that the game-style web app could be useful to encourage users to learn more on sexual health and STDs and thus changing their risky behaviors and preventing sexually transmitted diseases.

  14. Memory game as educative strategy for preventing enteroparasitosis: experience report

    OpenAIRE

    Emanuella Silva Joventino; Lydia Vieira Freitas; Raul Feitoza Rogério; Thaís Marques Lima; Levânia Maria Benevides Dias; Lorena Barbosa Ximenes

    2011-01-01

    The purpose of this study was to describe the experience of nursing students in education interaction with preschoolers’ caregivers as far as prevention of enteroparasitosis in preschoolers is concerned.This is a descriptive study, like a reporting experience. This activity counted with the participation of 09 caregivers, in the months of June and October 2006. The group had active participation in the experiment and the knowledge shared from a Giant Memory Game with pictures dealing with the...

  15. Road traffic crashes and risk groups in India: Analysis, interpretations, and prevention strategies

    Directory of Open Access Journals (Sweden)

    Raj V. Ponnaluri

    2012-03-01

    Recommended prevention strategies include: developing a road accident recording system and an access management policy; integrating safety into corridor design and road construction; undertaking capacity-building efforts; and expanding emergency response services.

  16. Comparative effectiveness of long term drug treatment strategies to prevent asthma exacerbations: network meta-analysis

    NARCIS (Netherlands)

    Loymans, Rik J. B.; Gemperli, Armin; Cohen, Judith; Rubinstein, Sidney M.; Sterk, Peter J.; Reddel, Helen K.; Jüni, Peter; ter Riet, Gerben

    2014-01-01

    To determine the comparative effectiveness and safety of current maintenance strategies in preventing exacerbations of asthma. Systematic review and network meta-analysis using Bayesian statistics. Cochrane systematic reviews on chronic asthma, complemented by an updated search when appropriate.

  17. Life skills as a behaviour change strategy in the prevention of HIV ...

    African Journals Online (AJOL)

    2017-09-21

    Sep 21, 2017 ... aSenior Lecturer, Department of Social Work, University of South Africa, Pretoria, South ..... HIV and AIDS prevention good practice: Strategies for public ... sector of the expanded public works programme to empower women,.

  18. Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies.

    Science.gov (United States)

    Sasaki, Nobuo; Meyer, Matthew J; Eikermann, Matthias

    2013-04-01

    Postoperative pulmonary complications are responsible for significant increases in hospital cost as well as patient morbidity and mortality; respiratory muscle dysfunction represents a contributing factor. Upper airway dilator muscles functionally resist the upper airway collapsing forces created by the respiratory pump muscles. Standard perioperative medications (anesthetics, sedatives, opioids, and neuromuscular blocking agents), interventions (patient positioning, mechanical ventilation, and surgical trauma), and diseases (lung hyperinflation, obesity, and obstructive sleep apnea) have differential effects on the respiratory muscle subgroups. These effects on the upper airway dilators and respiratory pump muscles impair their coordination and function and can result in respiratory failure. Perioperative management strategies can help decrease the incidence of postoperative respiratory muscle dysfunction. Such strategies include minimally invasive procedures rather than open surgery, early and optimal mobilizing of respiratory muscles while on mechanical ventilation, judicious use of respiratory depressant anesthetics and neuromuscular blocking agents, and noninvasive ventilation when possible.

  19. Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

    Science.gov (United States)

    Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

    2016-05-01

    Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

  20. Fluorides and Other Preventive Strategies for Tooth Decay.

    Science.gov (United States)

    Horst, Jeremy A; Tanzer, Jason M; Milgrom, Peter M

    2018-04-01

    We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Youth and Adult Perspectives on Violence Prevention Strategies: A Community-Based Participatory Study

    Science.gov (United States)

    Dodington, James; Mollen, Cynthia; Woodlock, Joseph; Hausman, Alice; Richmond, Therese S.; Fein, Joel A.

    2012-01-01

    This project explores the beliefs and perspectives of urban adults and youth regarding community violence prevention strategies and identifies points of overlap and differences of opinion that can contribute to the development of successful youth violence prevention programs. We coded transcript data from adults and 10-16-year-old youth from the…

  2. The Unequal Burden of Suicide among Minnesotans: Three Strategies for Prevention.

    Science.gov (United States)

    Wright, Nate; Roesler, Jon; Heinen, Melissa

    2015-10-01

    Minnesota's suicide rate has been increasing for more than 10 years. This article describes the demographic groups at highest risk for suicide and suicide attempts in the state. It also highlights prevention strategies outlined in the Minnesota State Suicide Prevention Plan 2015-2020.

  3. Mounting dengue awareness: A cost effective Strategy for prevention

    Directory of Open Access Journals (Sweden)

    Kajal Srivastava

    2015-12-01

    Full Text Available Background: Dengue is a serious illness which takes toll on human health every year. The best way to prevent it is by increasing awareness among common people. This study was conducted to assess the level of knowledge, attitudes and practices regarding dengue fever in people urban heath training centre in Pune, Maharashtra. Methods: A cross-sectional study was conducted among patients attending OPD of Urban heath training centre of department of community medicine, Pune situated in Ajmera, Pimpri, Pune. Through convenience sampling, a questionnaire was administered to patients after taking their informed consent. Results: A total of 100 patients were interviewed. Among knowledge 83% had heard about dengue and the most common source of information was TV & radio (72.3% Most of them were aware regarding mosquito bite being the mode of dengue transmission (80.7%. 22% were unaware regarding biting time of mosquito while 22% said night is the biting time of dengue mosquito. 62.7% were using coils for mosquito bite prevention followed by mosquito net (43.4% and spray (31.3%.. Conclusion: This study revealed that most of the study population is aware of dengue illness and increasing education level is having positive attitude on dengue illness.

  4. Mounting dengue awareness: A cost effective Strategy for prevention

    Directory of Open Access Journals (Sweden)

    Kajal Srivastava

    2015-12-01

    Full Text Available Background: Dengue is a serious illness which takes toll on human health every year. The best way to prevent it is by increasing awareness among common people. This study was conducted to assess the level of knowledge, attitudes and practices regarding dengue fever in people urban heath training centre in Pune, Maharashtra. Methods: A cross-sectional study was conducted among patients attending OPD of Urban heath training centre of department of community medicine, Pune situated in Ajmera, Pimpri, Pune. Through convenience sampling, a questionnaire was administered to patients after taking their informed consent. Results: A total of 100 patients were interviewed. Among knowledge 83% had heard about dengue and the most common source of information was TV & radio (72.3% Most of them were aware regarding mosquito bite being the mode of dengue transmission (80.7%. 22% were unaware regarding biting time of mosquito while 22% said night is the biting time of dengue mosquito. 62.7% were using coils for mosquito bite prevention followed by mosquito net (43.4% and spray (31.3%.. Conclusion: This study revealed that most of the study population is aware of dengue illness and increasing education level is having positive attitude on dengue illness.

  5. History, genetics, and strategies for cancer prevention in Lynch syndrome.

    Science.gov (United States)

    Kastrinos, Fay; Stoffel, Elena M

    2014-05-01

    Colorectal cancer (CRC) is the most common gastrointestinal malignancy and the third cause of cancer death in men and women in the United States. The majority of CRC cases diagnosed annually are due to sporadic events, but up to 6% are attributed to known monogenic disorders that confer a markedly increased risk for the development of CRC and multiple extracolonic malignancies. Lynch syndrome is the most common inherited CRC syndrome and is associated with mutations in DNA mismatch repair genes, mainly MLH1 and MSH2 but also MSH6, PMS2, and EPCAM. Although the risk of CRC and endometrial cancer may approach near 75% and 50%, respectively, in gene mutation carriers, the identification of these individuals and at-risk family members through predictive genetic testing provides opportunities for cancer prevention including specialized cancer screening, intensified surveillance, and/or prophylactic surgeries. This article will provide a review of the major advances in risk assessment, molecular genetics, DNA mutational analyses, and cancer prevention and management made since Lynch syndrome was first described 100 years ago. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. Cross-site scripting attacks procedure and Prevention Strategies

    Directory of Open Access Journals (Sweden)

    Wang Xijun

    2016-01-01

    Full Text Available Cross-site scripting attacks and defense has been the site of attack and defense is an important issue, this paper, the definition of cross-site scripting attacks, according to the current understanding of the chaos on the cross-site scripting, analyzes the causes and harm cross-site scripting attacks formation of attacks XXS complete process XSS attacks made a comprehensive analysis, and then for the web program includes Mobility there are cross-site scripting filter laxity given from ordinary users browse the web and web application developers two the defense cross-site scripting attacks effective strategy.

  7. Message strategies in direct-to-consumer pharmaceutical advertising: a content analysis using Taylor's six-segment message strategy wheel.

    Science.gov (United States)

    Tsai, Wan-Hsiu Sunny; Lancaster, Alyse R

    2012-01-01

    This exploratory study applies Taylor's (1999) six-segment message strategy wheel to direct-to-consumer (DTC) pharmaceutical television commercials to understand message strategies adopted by pharmaceutical advertisers to persuade consumers. A convenience sample of 96 DTC commercial campaigns was analyzed. The results suggest that most DTC drug ads used a combination approach, providing consumers with medical and drug information while simultaneously appealing to the viewer's ego-related needs and desires. In contrast to ration and ego strategies, other approaches including routine, acute need, and social are relatively uncommon while sensory was the least common message strategy. Findings thus recognized the educational value of DTC commercials.

  8. THE STRATEGY OF DIRECT INFLATION TARGETING – EPERIENCES OF THE COUNTRIES OF MIDDLE-EAST EUROPE

    OpenAIRE

    Dorota Zbierzchowska

    2009-01-01

    This paper aims at presenting theoretical assumptions of the strategy of direct inflation targeting as well as profits and potential threats stemming from the acceptance of that strategy. Empirical analysis compares the results of implementation of the BCI strategy in the Central and Eastern European countries (Poland, Czech Republic, Romania, Slovakia, Hungary).

  9. National Strategy for Violence Prevention in the Austrian Public School System: Development and Implementation

    Science.gov (United States)

    Spiel, Christiane; Strohmeier, Dagmar

    2011-01-01

    As a result of a quick succession of several spectacular events in schools, and the ensuing public discussion on the high rates of bullying in Austria, a national strategy for violence prevention in schools and preschools has been developed. In formulating the strategy, a systematic procedure involving international experts and a number of local…

  10. Obesity prevention strategies: could food or soda taxes improve health?

    Science.gov (United States)

    Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S

    2016-03-01

    Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?

  11. HIV and smoking: associated risks and prevention strategies

    Directory of Open Access Journals (Sweden)

    Kariuki W

    2015-12-01

    Full Text Available Wanjiku Kariuki,1 Jennifer I Manuel,2 Ngaruiya Kariuki,3 Ellen Tuchman,2 Johnnie O'Neal,4 Genevieve A Lalanne2 1University of Texas School of Public Health, Department of Management, Policy, and Community Health, Houston, TX, 2Silver School of Social Work, New York University, New York, 3Internal Medicine Department, Maimonides Medical Center, Brooklyn, 4Department of Social Work, The College of New Rochelle, New Rochelle, NY, USA Abstract: High rates of smoking among persons living with HIV (PLWH may reduce the effectiveness of HIV treatment and contribute to significant morbidity and mortality. Factors associated with smoking in PLWH include mental health comorbidity, alcohol and drug use, health-related quality of life, smoking among social networks and supports, and lack of access to care. PLWH smokers are at a higher risk of numerous HIV-associated infections and non-HIV related morbidity, including a decreased response to antiretroviral treatment, impaired immune functioning, reduced cognitive functioning, decreased lung functioning, and cardiovascular disease. Seventeen smoking cessation interventions were identified, of which seven were randomized controlled trials. The most effective studies combined behavioral and pharmacotherapy treatments that incorporated comprehensive assessments, multiple sessions, and cognitive-behavioral and motivational strategies. Smoking cessation interventions that are tailored to the unique needs of diverse samples and incorporate strategies to reduce the risk of relapse are essential to advancing health outcomes in PLWH. Keywords: HIV, AIDS, smoking, health risks, smoking cessation interventions

  12. [Communication skills and their influence on prevention strategies in workplace].

    Science.gov (United States)

    Messineo, A; Sanna, S; Dimitri, L; Di Geronimo, M

    2010-01-01

    Communication is a process which enables groups and individuals to increase their control over determining health factors acting on people's lifestyles to promote health. Good communication is fundamental to the health sector in a globalized world, since it may influence national and local policies, health promotion campaigns and correct operational practices. Our study analyses four significant incidents related to instances of bad communication and covers questions which have produced rather incoherent results provoking unjustified alarm. It is therefore necessary to prescribe a way of approaching these issues which will firstly lead to a more careful analysis of the risk involved and therefore to make known correct public information. It is necessary to improve the skills of experts in prevention, to promote educational initiatives at school, universities and in workplaces always focussing more on interdisciplinarity and developing new ways of approaching problems concerning health and safety.

  13. Exosomes: A Novel Strategy for Treatment and Prevention of Diseases

    Directory of Open Access Journals (Sweden)

    Jiaqi Wang

    2017-06-01

    Full Text Available An “exosome” is a nanoscale membrane vesicle derived from cell endocytosis that functions as an important intercellular communication mediator regulating the exchange of proteins and genetic materials between donor and surrounding cells. Exosomes secreted by normal and cancer cells participate in tumor initiation, progression, invasion, and metastasis. Furthermore, immune cells and cancer cells exert a two-way bidirectional regulatory effect on tumor immunity by exchanging exosomes. Current studies on exosomes have further expanded their known functions in physiological and pathological processes. The purpose of this review is to describe their discovery and biological functions in the context of their enormous potential in the clinical diagnosis, prevention, and treatment of cancer as well as bacterial and viral infectious diseases.

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

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2013-01-01

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

  15. Prevention Strategies Against HIV Transmission: A Proactive Approach.

    Science.gov (United States)

    Carrion, Antonio J; Miles, Jovan D; Mosley, Juan F; Smith, Lillian L; Prather, April S; Gurley, Marcus M; Phan, Linh D; Everton, Emily C

    2018-02-01

    Human immunodeficiency virus (HIV) has now transformed into a manageable chronic condition. Highly active antiretroviral therapy (HAART) has proven efficacious at controlling the disease progression. Based on compelling evidence, the Department of Health and Human Services (DHHS) and the Infectious Disease Society of America (IDSA) developed guidelines for the management of persons infected with HIV. However, there are approximately 50 000 new cases of HIV in the United States each year. In this article, we review proactive methods to reduce the transmission of HIV, which include reinforcing patient education, gel-coated condoms that destroy HIV, HIV vaccinations, and adequately utilizing pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Further development and consistent utilization of innovative prevention tools can significantly reduce the incidence of HIV infections regardless of HIV status.

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

    Science.gov (United States)

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

    2017-09-01

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

  17. Effects of the integrated pollution prevention and control directive on environmental protection

    Energy Technology Data Exchange (ETDEWEB)

    Kat, W. [Corus Staal BV, Evironmental Manangement Dept. (Netherlands)

    2005-06-01

    The Integrated Pollution Prevention and Control Directive (IPPC) published in the EU in 1996 is presented within an approach based on source-targeted measures. The Directive implementation is based on the granting of permits and it introduces new concepts like Best Available Technique (BAT), Best Reference Document (BREF) and Level Playing Field (LPF). The consequences for the EU steel industry are discussed. (author)

  18. Strategies for prevention and treatment of staphylococcal biofilms

    DEFF Research Database (Denmark)

    Meyer, Rikke Louise

    Biofilm formation by bacteria that colonize biomedical implants cause infections that cannot be eradicated by antibiotic therapy. Bacteria in biofilms are tolerant to every antibiotic known today, and this tolerance is partly due to their low metabolic activity, the occurrence of persister cells...... in biofilms. Innovative biomaterials may at best delay biofilm formation and an important question in this context is to understand how the material can contribute to more successful antibiotic treatment by not providing the cues that trigger the onset of antibiotic tolerance in the attached bacteria...... treatments that more effectively tackle biofilm infections. We have explored how the combination of antibiotic therapy with matrix-targeting enzymes can enhance the efficacy of antibiotics. The matrix composition is highly variable among different bacterial species, and this strategy will not produce a one...

  19. Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

    Science.gov (United States)

    SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

    2017-01-01

    Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational 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 programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (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 operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972

  20. 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.

  1. School-based violence prevention strategy: a pilot evaluation.

    Science.gov (United States)

    Thakore, Rachel V; Apfeld, Jordan C; Johnson, Ronald K; Sathiyakumar, Vasanth; Jahangir, A Alex; Sethi, Manish K

    2015-07-01

    Violence has recently been reported among a primarily young, minority population in Nashville, Tennessee. School-based programs have been proven as effective methods of reducing violent behavior, beliefs, and actions that lead to violence among adolescents. Investigators implemented a rigorous search for an appropriate school-based violence prevention program for Metropolitan Nashville middle school students utilizing a systematic review and discussion group with victims of violence. 27 programs nation-wide were reviewed and 2 discussion groups with African American males under the age of 25 admitted to a level 1 trauma center for assault-related injuries were conducted. Our findings led to a single, evidence-based conflict resolution program. In conjunction with educators, we evaluated the program's effectiveness in a pilot study in a Nashville middle school with high rates of violence. 122 students completed the conflict resolution program and described their behavior and experiences with violence in a pre-test/post-test self-rate questionnaire. Results showed a significant decrease in violent behavior and an increase in students' competencies to deal with violence (p less than 0.05). This study shows that a reduction in violent behavior and beliefs among middle school students can be achieved through the implementation of a targeted violence intervention program. A larger-scale intervention is needed to develop more conclusive evidence of effectiveness. © 2015 KUMS, All rights reserved.

  2. Strategies for cancer prevention: the role of diet.

    Science.gov (United States)

    Milner, J A

    2002-05-01

    Linkages between diet habits and cancer risk have surfaced from a multitude of epidemiological and preclinical studies. Collectively these studies provide rather compelling evidence that dietary components modify the incidence and biological behavior of tumors. While the risk of breast, prostate, colon, lung and liver cancers are frequently associated with dietary patterns, inconsistencies are not uncommon. These inconsistencies likely reflect the multi-factorial and complex nature of cancer and the specificity that individual dietary constituents have in modifying cancer related genetic pathways. The complexity of defining the role of diet is underscored by the numerous and diverse essential and non-essential components that may alter one or more phases of the cancer process. The explosive increase in the recognition of genes and pathways for regulating cell growth and development, and evaluating the response to hormones and other chemicals synthesized by the body, offers exciting opportunities for unraveling the molecular targets by which dietary components influence cancer prevention. It is recognized that all cells have unique 'signatures' that are characterized by active and inactive genes and cellular products. It is certainly plausible that bridging knowledge about these unique cellular characteristics with the molecular targets for nutrients can be used to assist in optimizing nutrition and minimizing cancer risk.

  3. Antibody-Based Strategies to Prevent and Treat Influenza

    Directory of Open Access Journals (Sweden)

    Ram eSasisekharan

    2015-07-01

    Full Text Available Passive immunization using antibodies has been suggested to offer several benefits in comparison to other antiviral treatment options. The potential for seasonal protection arising from a single injection of antibodies is appealing and has been pursued for a number of infectious agents. However, until recently, antibody-based strategies to combat infectious agents has been hampered due to the fact that typical antibodies have been found to be strain-specific, with the virus evolving resistance in many cases. The discovery of broadly neutralizing antibodies (bNAbs in, for example, influenza, dengue virus, and HIV, which bind to multiple, structurally-diverse strains has provided renewed interest in this area. This review will focus on new technologies that enable the discovery of bNAbs, the challenges and opportunities of immunotherapies as an important addition to existing antiviral therapy, and the role of antibody discovery in informing rational vaccine discovery – with agents targeting influenza specifically addressed. Multiple agents have entered the clinic and raise the possibility that a single antibody or small combination of antibodies can effectively neutralize a wide variety of strains. However, challenges remain - including combating escape variants, pharmacodynamics of antibody distribution, and development of efficacy biomarkers beyond virologic endpoints.

  4. Using direct-to-consumer marketing strategies with obsessive-compulsive disorder in the nonprofit sector.

    Science.gov (United States)

    Szymanski, Jeff

    2012-06-01

    Three to four million individuals struggle with obsessive-compulsive disorder (OCD) in the United States at any given time. OCD can be a debilitating disorder associated with significant quality-of-life and occupational impairment. First-line treatments for OCD (selective serotonin reuptake inhibitors and exposure and response prevention therapy) have been shown to be effective; yet, many individuals suffering from OCD experience multiple barriers to accessing these treatments. In fact, it can take as many as 17 years from onset of symptoms to effective treatment. Given the need to increase access to and utilization of effective treatments, direct-to-consumer marketing in the context of OCD appears crucial. The International OCD Foundation (formerly the Obsessive Compulsive Foundation) was established as a nonprofit organization with a mission to educate the public and mental health professionals about appropriate practice guidelines, raise awareness of the disorder, and ensure that individuals looking for treatment find the necessary resources. This paper reviews the obstacles those struggling with OCD face in their attempts to alleviate suffering, as well as the direct-to-consumer strategies and tactics used by the International OCD Foundation to improve access to empirically supported, effective treatment. Copyright © 2011. Published by Elsevier Ltd.

  5. Mine water pollution in Scotland. Nature, extent and preventative strategies

    Energy Technology Data Exchange (ETDEWEB)

    Younger, P.L. [Water Resource Systems Research Laboratory, Department of Civil Engineering, University of Newcastle, NE1 7RU Newcastle Upon Tyne (United Kingdom)

    2001-01-29

    Scotland was one of the world's first industrialised countries, and has therefore also been one of the first countries to experience wholesale post-industrial dereliction. Water pollution arising from abandoned mines, particularly abandoned coal mines, is second only to sewage as a source of freshwater pollution nation-wide, and in many coalfield catchments it is the pre-eminent source. Most of the pollution is due to net-alkaline ferruginous waters emerging from deep mines. Scrutiny of records from 80 deep mine discharges reveals that iron concentrations in these waters are only likely to exceed 20 mg/l, and the pH to be below 6.5, where the discharge emerges within 0.5 km of the outcrop of the shallowest mined seam. The bulk of mature near-outcrop mine water discharges in Scotland have<50 mg/l total Fe, and concentrations>100 mg/l are only likely where a marine bed lies within 25 m of the worked seam. Where the nearest marine bed is more than 80 m above or below the seam, then the total iron will be less than 4 mg/l, and in most cases less than 1 mg/l. Net-acidic mine waters are far more rare than net-alkaline waters in Scotland, and are most commonly associated with unreclaimed spoil heaps (bings). Both net-alkaline and net-acidic discharges have detrimental effects on the hydrochemistry and biological integrity of receiving waters. Scotland has recently pioneered the use of pre-emptive pump-and-treat solutions to prevent mine water pollution, and has also experienced the successful introduction of passive treatment technology for both abandoned and active workings.

  6. Mitigating concerns and maximizing returns: social media strategies for injury prevention non-profits.

    Science.gov (United States)

    McMillan-Cottom, Tressie

    2014-08-01

    Injury prevention programs can use social media to disseminate information and recruit participants. Non-profit organizations have also used social media for fundraising and donor relationship management. Non-profit organizations (NPOs) with injury prevention missions often serve vulnerable populations. Social media platforms have varied levels of access and control of shared content. This variability can present privacy and outreach challenges that are of particular concern for injury prevention NPOs. This case report of social media workshops for injury prevention NPOs presents concerns and strategies for successfully implementing social media campaigns.

  7. Mitigating Concerns and Maximizing Returns: Social Media Strategies for Injury Prevention Non-profits

    Directory of Open Access Journals (Sweden)

    Tressie McMillan-Cottom

    2014-08-01

    Full Text Available Injury prevention programs can use social media to disseminate information and recruit participants. Non-profit organizations have also used social media for fundraising and donor relationship management. Non-profit organizations (NPOs with injury prevention missions often serve vulnerable populations. Social media platforms have varied levels of access and control of shared content. This variability can present privacy and outreach challenges that are of particular concern for injury prevention NPOs. This case report of social media workshops for injury prevention NPOs presents concerns and strategies for successfully implementing social media campaigns.

  8. Reducing hospital readmission rates: current strategies and future directions.

    Science.gov (United States)

    Kripalani, Sunil; Theobald, Cecelia N; Anctil, Beth; Vasilevskis, Eduard E

    2014-01-01

    New financial penalties for institutions with high readmission rates have intensified efforts to reduce rehospitalization. Several interventions that involve multiple components (e.g., patient needs assessment, medication reconciliation, patient education, arranging timely outpatient appointments, and providing telephone follow-up) have successfully reduced readmission rates for patients discharged to home. The effect of interventions on readmission rates is related to the number of components implemented; single-component interventions are unlikely to reduce readmissions significantly. For patients discharged to postacute care facilities, multicomponent interventions have reduced readmissions through enhanced communication, medication safety, advanced care planning, and enhanced training to manage medical conditions that commonly precipitate readmission. To help hospitals direct resources and services to patients with greater likelihood of readmission, risk-stratification methods are available. Future work should better define the roles of home-based services, information technology, mental health care, caregiver support, community partnerships, and new transitional care personnel.

  9. What drives successful implementation of pollution prevention and cleaner technology strategy? The role of innovative capability.

    Science.gov (United States)

    Bhupendra, Kumar Verma; Sangle, Shirish

    2015-05-15

    Firms that are dynamic and prepared to implement environmental strategies have a potential competitive advantage over their industry counterparts. Therefore, it is important to understand, what capabilities are required to implement proactive environmental strategies. The paper discusses the attributes of innovative capability required by firms in order to adopt pollution prevention and cleaner technology strategies. Empirical results show that process and behavioral innovativeness are required by firms to implement a pollution prevention strategy. In addition to process and behavioral innovativeness, firms need a top management with high risk-taking ability as well as market, product, and strategic innovativeness to implement a cleaner technology strategy. The paper proposes some important managerial implications on the basis of the above research findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Effect of candesartan on prevention (DIRECT-Prevent 1) and progression (DIRECT-Protect 1) of retinopathy in type 1 diabetes: randomised, placebo-controlled trials

    DEFF Research Database (Denmark)

    Chaturvedi, N.; Porta, M.; Klein, R.

    2008-01-01

    of retinopathy in type 1 diabetes. METHODS: Two randomised, double-blind, parallel-design, placebo-controlled trials were done in 309 centres worldwide. Participants with normotensive, normoalbuminuric type 1 diabetes without retinopathy were recruited to the DIRECT-Prevent 1 trial and those with existing...... retinopathy were recruited to DIRECT-Protect 1, and were assigned to candesartan 16 mg once a day or matching placebo. After 1 month, the dose was doubled to 32 mg. Investigators and participants were unaware of the treatment allocation status. The primary endpoints were incidence and progression......BACKGROUND: Results of previous studies suggest that renin-angiotensin system blockers might reduce the burden of diabetic retinopathy. We therefore designed the DIabetic REtinopathy Candesartan Trials (DIRECT) Programme to assess whether candesartan could reduce the incidence and progression...

  11. [Prevention of Chronic Kidney Disease and strategies to counteract chronic diseases in Italy].

    Science.gov (United States)

    Mastrilli, Valeria; D'Elia, Roberto; Galeone, Daniela

    2016-01-01

    The Prevention of Chronic Kidney Disease (CKD) is placed in the more general context of prevention of major chronic Non Communicable Diseases (NCDs): cardiovascular diseases, diabetes, chronic lung diseases and tumors that are the main problem for public health worldwide. Any health policy strategy aimed to the prevention of NCDs has to provide knowledge of health and socioeconomic status of the population, to reduce the level of exposure to risk factors and to adapt health services to the request for assistance. To this purpose, population monitoring systems have been implemented in the last years. The NCDs share some risk factors that are related, in large part, to unhealthy individual behaviours: smoking, alcohol abuse, unhealthy diet and physical inactivity. NCDs prevention has to be understood as the set of all actions, sanitary and not, aiming to prevent or delay the onset of diseases or their complications. Preventive measures should, therefore, involve not only the health sector but also all the actors that can help to prevent that disease. As for the Prevention of CKD, the Ministry of Health has established a working table, which handled the Drafting of the "Position paper for the CKD", approved in the State-Regions Conference on august 8th 2014. The document draws a national strategy to combat this disease through primary prevention, early diagnosis and the establishment of diagnostic - therapeutic pathways (DTP).

  12. A systematic review of primary prevention strategies for sexual violence perpetration.

    Science.gov (United States)

    DeGue, Sarah; Valle, Linda Anne; Holt, Melissa K; Massetti, Greta M; Matjasko, Jennifer L; Tharp, Andra Teten

    2014-01-01

    This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates (Foshee et al., 2004); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003).

  13. Assessment of Food Waste Prevention and Recycling Strategies Using a Multilayer Systems Approach.

    Science.gov (United States)

    Hamilton, Helen A; Peverill, M Samantha; Müller, Daniel B; Brattebø, Helge

    2015-12-15

    Food waste (FW) generates large upstream and downstream emissions to the environment and unnecessarily consumes natural resources, potentially affecting future food security. The ecological impacts of FW can be addressed by the upstream strategies of FW prevention or by downstream strategies of FW recycling, including energy and nutrient recovery. While FW recycling is often prioritized in practice, the ecological implications of the two strategies remain poorly understood from a quantitative systems perspective. Here, we develop a multilayer systems framework and scenarios to quantify the implications of food waste strategies on national biomass, energy, and phosphorus (P) cycles, using Norway as a case study. We found that (i) avoidable food waste in Norway accounts for 17% of sold food; (ii) 10% of the avoidable food waste occurs at the consumption stage, while industry and retailers account for only 7%; (iii) the theoretical potential for systems-wide net process energy savings is 16% for FW prevention and 8% for FW recycling; (iv) the theoretical potential for systems-wide P savings is 21% for FW prevention and 9% for FW recycling; (v) while FW recycling results in exclusively domestic nutrient and energy savings, FW prevention leads to domestic and international savings due to large food imports; (vi) most effective is a combination of prevention and recycling, however, FW prevention reduces the potential for FW recycling and therefore needs to be prioritized to avoid potential overcapacities for FW recycling.

  14. A systematic review of primary prevention strategies for sexual violence perpetration☆

    Science.gov (United States)

    DeGue, Sarah; Valle, Linda Anne; Holt, Melissa K.; Massetti, Greta M.; Matjasko, Jennifer L.; Tharp, Andra Teten

    2018-01-01

    This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates (Foshee et al., 2004); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003). PMID:29606897

  15. Implementing exertional heat illness prevention strategies in US high school football.

    Science.gov (United States)

    Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

    2014-01-01

    Approximately 6500 high school football athletes are treated annually for exertional heat illness (EHI). In 2009, the National Athletic Trainers Association (NATA)-led Inter-Association Task Force (NATA-IATF) released preseason heat acclimatization guidelines to help athletes become accustomed to environmental factors contributing to EHI. This study examines compliance with NATA-IATF guidelines and related EHI prevention strategies. The study used a cross-sectional survey completed by 1142 certified athletic trainers (AT), which captured compliance with 17 NATA-IATF guidelines and EHI prevention strategies in high school football during the 2011 preseason. On average, AT reported football programs complying with 10.4 NATA-IATF guidelines (SD = 3.2); 29 AT (2.5%) reported compliance with all 17. Guidelines with the lowest compliance were as follows: "Single-practice days consisted of practice no more than three hours in length" (39.7%); and "During days 3-5 of acclimatization, only helmets and shoulder pads should be worn" (39.0%). An average of 7.6 EHI prevention strategies (SD = 2.5) were used. Common EHI prevention strategies were as follows: having ice bags/cooler available (98.5%) and having a policy with written instructions for initiating emergency medical service response (87.8%). Programs in states with mandated guidelines had higher levels of compliance with guidelines and greater prevalence of EHI prevention strategies. A low proportion of surveyed high school football programs fully complied with all 17 NATA-IATF guidelines. However, many EHI prevention strategies were voluntarily implemented. State-level mandated EHI prevention guidelines may increase compliance with recognized best practices recommendations. Ongoing longitudinal monitoring of compliance is also recommended.

  16. Direct aperture deformation: An interfraction image guidance strategy

    International Nuclear Information System (INIS)

    Feng Yuanming; Castro-Pareja, Carlos; Shekhar, Raj; Yu, Cedric

    2006-01-01

    A new scheme, called direct aperture deformation (DAD), for online correction of interfraction geometric uncertainties under volumetric imaging guidance is presented. Using deformable image registration, the three-dimensional geometric transformation matrix can be derived that associates the planning image set and the images acquired on the day of treatment. Rather than replanning or moving the patient, we use the deformation matrix to morph the treatment apertures as a potential online correction method. A proof-of-principle study using an intensity-modulated radiation therapy plan for a prostate cancer patient was conducted. The method, procedure, and algorithm of DAD are described. The dose-volume histograms from the original plan, reoptimized plan, and rigid-body translation plan are compared with the ones from the DAD plan. The study showed the feasibility of the DAD as a general method for both target dislocation and deformation. As compared with using couch translation to move the patient, DAD is capable of correcting both target dislocation and deformations. As compared with reoptimization, online correction using the DAD scheme could be completed within a few minutes rather than tens of minutes and the speed gain would be at a very small cost of plan quality

  17. A Novel Strategy for landslide displacement and its direction monitoring

    Science.gov (United States)

    Zhu, Z.-W.; Yuan, Q.-Y.; Liu, D.-Y.; Liu, B.; Liu, J.-C.; Luo, H.

    2013-12-01

    Landslide monitoring is important in predicting the behavior of landslides, thereby ensuring environmental, life, and property safety. On the basis of our previous studies, we conducted the double shear test by using a third-generation optical fiber transducer that uses expandable polystyrene (EPS) as base material. However, the third-generation transducer has poor performance when cohesive force is present between the grout and capillary stainless steel pipe of the transducer. Thus, the fourth-generation optical fiber transducer was invented. Similar to the third-generation transducer, the fourth-generation transducer also used EPS as its base material. Single shear test was conducted on the fourth-generation transducer after being grouted with cement mortar (1:1 mix ratio). The micro-bend loss mechanism of the optical fiber was considered, and the optical time domain reflectometry instrument was used. The fact that the loss sequence of optical fibers subjected to loading is different at various locations is found. The relationship of the loading-point displacement VS. optical fiber sliding distance and optical loss were measured. Results show that the maximum initial measurement precision of the newly proposed device is 1mm, the corresponding sliding distance is 21 mm, and the dynamic range is 0-20 mm. The fourth-generation transducer can measure the movement direction of loadings, thus making this transducer applicable for landslide monitoring.

  18. School Programs To Prevent Smoking: The National Cancer Institute Guide to Strategies That Succeed.

    Science.gov (United States)

    Glynn, Thomas J.

    This guide to school-based smoking prevention programs for educators is the product of five years of work to prevent cancer. The National Cancer Institute (NCI) is currently funding 23 coordinated intervention trials directed at youth. Although not all the studies are complete, sufficient results are available to recommend the most effective…

  19. Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries.

    Science.gov (United States)

    Ocampo, Wrechelle; Cheung, Amanda; Baylis, Barry; Clayden, Nancy; Conly, John M; Ghali, William A; Ho, Chester H; Kaufman, Jaime; Stelfox, Henry T; Hogan, David B

    2017-07-01

    To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review

  20. Ionizing radiation: future etiologic research and preventive strategies.

    Science.gov (United States)

    Darby, S C; Inskip, P D

    1995-11-01

    Estimates of cancer risks following exposure to ionizing radiation traditionally have been based on the experience of populations exposed to substantial (and known) doses delivered over short periods of time. Examples include survivors of the atomic bombings at Hiroshima and Nagasaki, and persons treated with radiation for benign or malignant disease. Continued follow-up of these populations is important to determine the long-term effects of exposure in childhood, to characterize temporal patterns of excess risk for different types of cancer, and to understand better the interactions between radiation and other host and environmental factors. Most population exposure to radiation occurs at very low dose rates. For low linear energy transfer (LET) radiations, it often has been assumed that cancer risks per unit dose are lower following protracted exposure than following acute exposure. Studies of nuclear workers chronically exposed over a working lifetime provide data that can be used to test this hypothesis, and preliminary indications are that the risks per unit dose for most cancers other than leukemia are similar to those for acute exposure. However, these results are subject to considerable uncertainty, and further information on this question is needed. Residential radon is the major source of population exposure to high-LET radiation. Current estimates of the risk of lung cancer due to residential exposure to radon and radon daughters are based on the experience of miners exposed to much higher concentrations. Data indicate that lung cancer risk among miners is inversely associated with exposure rate, and also is influenced by the presence of other lung carcinogens such as arsenic in the mine environment. Further study of populations of radon-exposed miners would be informative, particularly those exposed at below-average levels. More direct evidence on the effects of residential exposure to radon also is desirable but might be difficult to come by, as risks

  1. Designing System Reforms: Using a Systems Approach to Translate Incident Analyses into Prevention Strategies

    Science.gov (United States)

    Goode, Natassia; Read, Gemma J. M.; van Mulken, Michelle R. H.; Clacy, Amanda; Salmon, Paul M.

    2016-01-01

    Advocates of systems thinking approaches argue that accident prevention strategies should focus on reforming the system rather than on fixing the “broken components.” However, little guidance exists on how organizations can translate incident data into prevention strategies that address the systemic causes of accidents. This article describes and evaluates a series of systems thinking prevention strategies that were designed in response to the analysis of multiple incidents. The study was undertaken in the led outdoor activity (LOA) sector in Australia, which delivers supervised or instructed outdoor activities such as canyoning, sea kayaking, rock climbing and camping. The design process involved workshops with practitioners, and focussed on incident data analyzed using Rasmussen's AcciMap technique. A series of reflection points based on the systemic causes of accidents was used to guide the design process, and the AcciMap technique was used to represent the prevention strategies and the relationships between them, leading to the creation of PreventiMaps. An evaluation of the PreventiMaps revealed that all of them incorporated the core principles of the systems thinking approach and many proposed prevention strategies for improving vertical integration across the LOA system. However, the majority failed to address the migration of work practices and the erosion of risk controls. Overall, the findings suggest that the design process was partially successful in helping practitioners to translate incident data into prevention strategies that addressed the systemic causes of accidents; refinement of the design process is required to focus practitioners more on designing monitoring and feedback mechanisms to support decisions at the higher levels of the system. PMID:28066296

  2. Rib stress fractures among rowers: definition, epidemiology, mechanisms, risk factors and effectiveness of injury prevention strategies.

    Science.gov (United States)

    McDonnell, Lisa K; Hume, Patria A; Nolte, Volker

    2011-11-01

    Rib stress fractures (RSFs) can have serious effects on rowing training and performance and accordingly represent an important topic for sports medicine practitioners. Therefore, the aim of this review is to outline the definition, epidemiology, mechanisms, intrinsic and extrinsic risk factors, injury management and injury prevention strategies for RSF in rowers. To this end, nine relevant books, 140 journal articles, the proceedings of five conferences and two unpublished presentations were reviewed after searches of electronic databases using the keywords 'rowing', 'rib', 'stress fracture', 'injury', 'mechanics' and 'kinetics'. The review showed that RSF is an incomplete fracture occurring from an imbalance between the rate of bone resorption and the rate of bone formation. RSF occurs in 8.1-16.4% of elite rowers, 2% of university rowers and 1% of junior elite rowers. Approximately 86% of rowing RSF cases with known locations occur in ribs four to eight, mostly along the anterolateral/lateral rib cage. Elite rowers are more likely to experience RSF than nonelite rowers. Injury occurrence is equal among sweep rowers and scullers, but the regional location of the injury differs. The mechanism of injury is multifactorial with numerous intrinsic and extrinsic risk factors contributing. Posterior-directed resultant forces arising from the forward directed force vector through the arms to the oar handle in combination with the force vector induced by the scapula retractors during mid-drive, or repetitive stress from the external obliques and rectus abdominis in the 'finish' position, may be responsible for RSF. Joint hypomobility, vertebral malalignment or low bone mineral density may be associated with RSF. Case studies have shown increased risk associated with amenorrhoea, low bone density or poor technique, in combination with increases in training volume. Training volume alone may have less effect on injury than other factors. Large differences in seat and handle

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  4. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit.

    Science.gov (United States)

    Borghesi, A; Stronati, M

    2008-04-01

    Nosocomial infections are among the leading causes of mortality and morbidity in neonatal intensive care units. Prevention of healthcare-associated infections is based on strategies that aim to limit susceptibility to infections by enhancing host defences, interrupting transmission of organisms by healthcare workers and by promoting the judicious use of antimicrobials. Several strategies are available and include: hand hygiene practices; prevention of central venous catheter-related bloodstream infections; judicious use of antimicrobials for therapy and prophylaxis; enhancement of host defences; skin care; and early enteral feeding with human milk.

  5. Proposed national strategies for the prevention of leading work-related diseases and injuries. Part 1

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    Preliminary strategies developed at the National Symposium on the Prevention of Leading Work Related Diseases and Injuries, held in Atlanta, Georgia on May 1 to 3, 1985 were revised, elaborated, and further developed. Strategies were developed for the prevention of occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. Lung diseases considered included silicosis, asbestosis, lung cancer mesothelioma, coal workers' pneumoconiosis, byssinosis, occupational asthma, hypersensitivity pneumonitis, asphyxiation, irritation, pulmonary edema, brucellosis, psitticosis, anthrax, mycobacterioses, histoplasmosis, aspergillosis, and coccidioidomycosis. Occupational cancers were discussed as they occur in the lung, pleura, peritoneum, bladder, kidneys, blood, nasal cavity, skin, nasal sinuses, and liver.

  6. The Stability Analysis and New Torque Control Strategy of Direct-Driven PMSG Wind Turbines

    OpenAIRE

    Jun Liu; Feihang Zhou; Gungyi Wang

    2016-01-01

    This paper expounds on the direct-driven PMSG wind power system control strategy, and analyses the stability conditions of the system. The direct-driven PMSG wind power system may generate the intense mechanical vibration, when wind speed changes dramatically. This paper proposes a new type of torque control strategy, which increases the system damping effectively, mitigates mechanical vibration of the system, and enhances the stability conditions of the system. The simulation results verify ...

  7. Effects of direct instruction and strategy modeling on upper-primary students' writing development

    NARCIS (Netherlands)

    López, P.; Torrance, M.; Rijlaarsdam, G.; Fidalgo, R.

    Strategy-focused instruction is one of the most effective approaches to improve writing skills. It aims to teach developing writers strategies that give them executive control over their writing processes. Programs under this kind of instruction tend to have multiple components that include direct

  8. Outward Foreign Direct Investment from Emerging Economies and National Development Strategies

    DEFF Research Database (Denmark)

    Gammeltoft, Peter; Kokko, Ari

    2013-01-01

    Foreign direct investment (FDI) is an integral part of national development strategy throughout the developing world. However, while traditionally strategies have focused on the role of inward flows only, today, outward FDI is used on a larger scale and more deliberately to access markets...

  9. Evolving strategies, opportunistic implementation: HIV risk reduction in Tanzania in the context of an incentive-based HIV prevention intervention.

    Directory of Open Access Journals (Sweden)

    Laura Packel

    Full Text Available Behavior change communication (BCC interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection.In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction.We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence.Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting the latent demand for

  10. Communication Strategies in Direct-to-Consumer Prescription Drug Advertising (DTCA): Application of the Six Segment Message Strategy Wheel.

    Science.gov (United States)

    Ju, Ilwoo; Park, Jin Seong

    2015-01-01

    This study addresses a void in the literature on direct-to-consumer prescription drug advertising (DTCA) with a theory-based content analysis. The findings indicate that Taylor's communication strategy wheel provides insight into what and how pharmaceutical marketers communicate with consumers by means of DTCA. Major findings are summarized as follows: (a) In most DTC ads, informational and transformational message themes and creative approaches were simultaneously used, indicating a combination strategy; (b) DTCA message themes were associated with creative strategies in alignment with Taylor's framework; and (c) message themes and creative strategies varied across therapeutic categories and DTCA categories with different levels of ad spending. Theoretical and practical implications of the findings are discussed.

  11. Direct costs associated with a nosocomial outbreak of Salmonella infection: an ounce of prevention is worth a pound of cure.

    Science.gov (United States)

    Spearing, N M; Jensen, A; McCall, B J; Neill, A S; McCormack, J G

    2000-02-01

    Nosocomial outbreaks of Salmonella infections in Australia are an infrequent but significant source of morbidity and mortality. Such an outbreak results in direct, measurable expenses for acute care management, as well as numerous indirect (and less quantifiable) costs to those affected, the hospital, and the wider community. This article describes the significant direct costs incurred as a result of a nosocomial outbreak of Salmonella infection involving patients and staff. Information on costs incurred by the hospital was gathered from a number of sources. The data were grouped into 4 sections (medical costs, investigative costs, lost productivity costs, and miscellaneous) with use of an existing tool for calculating the economic impact of foodborne illness. The outbreak cost the hospital more than AU $120, 000. (US $95,000). This amount is independent of more substantial indirect costs. Salmonella infections are preventable. Measures to aid the prevention of costly outbreaks of nosocomial salmonellosis, although available, require an investment of both time and money. We suggest that dedication of limited resources toward such preventive strategies as education is a practical and cost-effective option for health care facilities.

  12. Setting strategy for system change: using concept mapping to prioritise national action for chronic disease prevention.

    Science.gov (United States)

    Wutzke, Sonia; Roberts, Nick; Willis, Cameron; Best, Allan; Wilson, Andrew; Trochim, William

    2017-08-08

    Chronic diseases are a serious and urgent problem, requiring at-scale, multi-component, multi-stakeholder action and cooperation. Despite numerous national frameworks and agenda-setting documents to coordinate prevention efforts, Australia, like many countries internationally, is yet to substantively impact the burden from chronic disease. Improved evidence on effective strategies for the prevention of chronic disease is required. This research sought to articulate a priority set of important and feasible action domains to inform future discussion and debate regarding priority areas for chronic disease prevention policy and strategy. Using concept mapping, a mixed-methods approach to making use of the best available tacit knowledge of recognised, diverse and well-experienced actors, and national actions to improve the prevention of chronic disease in Australia were identified and then mapped. Participants (ranging from 58 to 78 in the various stages of the research) included a national sample of academics, policymakers and practitioners. Data collection involved the generation and sorting of statements by participants. A series of visual representations of the data were then developed. A total of 95 statements were distilled into 12 clusters for action, namely Inter-Sectoral Partnerships; Systems Perspective/Action; Governance; Roles and Responsibilities; Evidence, Feedback and Learning; Funding and Incentive; Creating Demand; Primary Prevention; Social Determinants and Equity; Healthy Environments; Food and Nutrition; and Regulation and Policy. Specific areas for more immediate national action included refocusing the health system to prevention over cure, raising the profile of public health with health decision-makers, funding policy- and practice-relevant research, improving communication about prevention, learning from both global best-practice and domestic successes and failures, increasing the focus on primary prevention, and developing a long-term prevention

  13. Future Directions in Etiologic, Prevention, and Treatment Research for Eating Disorders

    Science.gov (United States)

    Stice, Eric; South, Kelsey; Shaw, Heather

    2012-01-01

    Significant advances have occurred regarding the understanding of etiologic processes that give rise to eating disorders and the design and evaluation of efficacious prevention programs and treatment interventions. Herein we offer suggestions regarding potentially fruitful directions for future research in these areas. We suggest it would be…

  14. Preventing malaria in pregnancy through community-directed interventions: evidence from Akwa Ibom State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ishola Gbenga

    2011-08-01

    Full Text Available Abstract Background Despite massive anti-malaria campaigns across the subcontinent, effective access to intermittent preventive treatment (IPTp and insecticide-treated nets (ITNs among pregnant women remain low in large parts of sub-Saharan Africa. The slow uptake of malaria prevention products appears to reflect lack of knowledge and resistance to behavioural change, as well as poor access to resources, and limited support of programmes by local communities and authorities. Methods A recent community-based programme in Akwa Ibom State, Nigeria, is analysed to determine the degree to which community-directed interventions can improve access to malaria prevention in pregnancy. Six local government areas in Southern Nigeria were selected for a malaria in pregnancy prevention intervention. Three of these local government areas were selected for a complementary community-directed intervention (CDI programme. Under the CDI programme, volunteer community-directed distributors (CDDs were appointed by each village and kindred in the treatment areas and trained to deliver ITNs and IPTp drugs as well as basic counseling services to pregnant women. Findings Relative to women in the control area, an additional 7.4 percent of women slept under a net during pregnancy in the treatment areas (95% CI [0.035, 0.115], p-value Conclusion The presented results suggest that the inclusion of community-based programmes can substantially increase effective access to malaria prevention, and also increase access to formal health care access in general, and antenatal care attendance in particular in combination with supply side interventions. Given the relatively modest financial commitments they require, community-directed programmes appear to be a cost-effective way to improve malaria prevention; the participatory approach underlying CDI programmes also promises to strengthen ties between the formal health sector and local communities.

  15. Academic Self-Concept and Learning Strategies: Direction of Effect on Student Academic Achievement

    Science.gov (United States)

    McInerney, Dennis M.; Cheng, Rebecca Wing-yi; Mok, Magdalena Mo Ching; Lam, Amy Kwok Hap

    2012-01-01

    This study examined the prediction of academic self-concept (English and Mathematics) and learning strategies (deep and surface), and their direction of effect, on academic achievement (English and Mathematics) of 8,354 students from 16 secondary schools in Hong Kong. Two competing models were tested to ascertain the direction of effect: Model A…

  16. Strategies for the prevention of MP3-induced hearing loss among adolescents : Expert opinions from a Delphi study

    NARCIS (Netherlands)

    Vogel, I.; Brug, J.; Ploeg, C.P.B. van der; Raat, H.

    2009-01-01

    OBJECTIVE. To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. METHODS. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth

  17. Experiences of Peer Evaluation of the Leicester Teenage Pregnancy Prevention Strategy

    Science.gov (United States)

    Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison

    2009-01-01

    The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…

  18. Smoking Prevention Strategies for Urban and Minority Youth. ERIC/CUE Digest, Number 120.

    Science.gov (United States)

    Schwartz, Wendy

    Urban areas are the sites of many smoking prevention strategies targeting special populations. This digest provides an overview of these initiatives. Adolescents smoke for the same reasons that they use alcohol and other drugs. Personal factors that contribute to risk are enhanced by tobacco company advertising that makes smoking seem attractive.…

  19. Children, Teachers, and Families Working Together to Prevent Childhood Obesity: Intervention Strategies

    Science.gov (United States)

    Stegelin, Dolores A.

    2008-01-01

    Obesity rates for children, adolescents, and adults continue to escalate in the United States and globally. Educators, health specialists, psychologists, and sociologists are studying the complex problems related to early obesity. Like other health problems, prevention and early detection are the most effective strategies. The causes and…

  20. What Would You Do? Strategies for Bystander Intervention to Prevent Sexual Violence by College Students

    Science.gov (United States)

    McMahon, Sarah; Hoffman, Melanie Lowe; McMahon, Sheila M.; Zucker, Sharon; Koenick, Ruth Anne

    2013-01-01

    Bystander education is an increasingly utilized strategy for addressing sexual assault prevention and intervention on U.S. college campuses. Given the paramount importance of peers among college students, what types of pro-social bystander interventions do students themselves deem feasible in the campus context? Drawing on self-reports from…

  1. Evaluating Community Readiness to Implement Environmental and Policy-Based Alcohol Abuse Prevention Strategies in Wisconsin

    Science.gov (United States)

    Paltzer, Jason; Black, Penny; Moberg, D. Paul

    2013-01-01

    Background: Matching evidence-based alcohol prevention strat- egies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the implementation of…

  2. Perceived Stressors of Suicide and Potential Prevention Strategies for Suicide among Youths in Malaysia

    Science.gov (United States)

    Kok, Jin Kuan; van Schalkwyk, Gertina J.; Chan, Andrea Huan Wen

    2015-01-01

    The suicide rate among youths in Malaysia has increased over the years, giving rise to considerable public concern. The purpose of this study was to explore and describe potential stressors of suicide and suicide prevention strategies as perceived by youths in Malaysia aged 15-25 years. A qualitative approach was adopted and 625 students from…

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

    Science.gov (United States)

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

    1992-02-01

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

  4. YELLOW FEVER PREVENTION STRATEGIES AWARENESS AMONG HIV-INFECTED PATIENTS IN SÃO PAULO, BRAZIL

    Directory of Open Access Journals (Sweden)

    Vivian Iida Avelino-Silva

    2014-09-01

    Full Text Available Introduction: Vaccination is the main preventive strategy against Yellow Fever (YF, which is a public health concern in Brazil. However, HIV-infected patients might have insufficient knowledge regarding YF, YF prevention, and vaccines in general. Methods: In this questionnaire-based study, data from 158 HIV-infected individuals were addressed in three distinct outpatient clinics in São Paulo. Information was collected on demographic and clinical characteristics, as well as patients' knowledge of vaccines, YF and YF preventive strategies. In addition, individual YF vaccine recommendations and vaccine status were investigated. Results: Although most participants adequately ascertain the vaccine as the main prevention strategy against YF, few participants were aware of the severity and lack of specific treatment for YF. Discrepancy in YF vaccine (patients who should have taken the vaccine, but did not was observed in 18.8% of participants. Conclusion: YF is an important and preventable public health concern, and these results demonstrate that more information is necessary for the HIV-infected population.

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

    Directory of Open Access Journals (Sweden)

    Astrid Zech

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

  6. FUNCTIONAL STRATEGIES OF THE SOUTH AFRICAN POLICESERVICEIN PREVENTION AND COMBATING OF SUBSTANCEABUSEIN A SOUTH AFRICAN TOWNSHIP

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    Petrus Machethe

    2017-01-01

    Full Text Available This paper focused on the functional strategies and initiatives takenby SouthAfrican Police Service(SAPStowards prevention and combating of substanceabusein a South African Township. The study made useof mainly quantitative(survey methodto collect relevant data from 80participants who were selectedfrom the SAPS, local churches,Non-governmental organisations (NGOsandcommunity members.The findings of this study indicate an array of strategies inuse. Police regular conduct of stop and search in certain sectors than others,regular patrols, use of reliable volunteer informants (informants, secret detection,tracking and investigation, sharing of crime information tips and education ofpublic, and police partnership with civilorganisations were revealed as thesustaining strategies by the SAPS.Critical analysis of these strategies in the studyrevealed a mixed bag of functionality. Pragmaticsuggestions to improve on thelagging strategies were made by this study.

  7. Strategies for prevention or reduction of drug use for adolescents: systematic literature review

    Directory of Open Access Journals (Sweden)

    Thamyris Alexandre Salles

    2016-06-01

    Full Text Available A systematic review was conducted with the objective of identifying scientific evidence of strategies for prevention or reduction of drug use among adolescents. Searches were conducted in databases LILACS, CINAHL, MEDLINE, Scopus and Cochrane Library, with descriptors Ensino, Educação em Saúde, Transtornos relacionados ao uso de substâncias, Adolescentes and Enfermagem Psiquiátrica. Twenty-seven articles were chosen. Results pointed to a variety of software, projects and interventions that are used as strategies for prevention or reduction of drug use among adolescents. Among the studies, 74.1% (n=20 reached satisfactory results and 25.9% (n=7 reached partially satisfactory results. Only Narconon Project and Brief Intervention were widely effective in reducing use of a variety of drugs among adolescents, since the other studies were focused on specific drugs or were limited to use prevention among non-using adolescents.

  8. Youth audience segmentation strategies for smoking-prevention mass media campaigns based on message appeal.

    Science.gov (United States)

    Flynn, Brian S; Worden, John K; Bunn, Janice Yanushka; Dorwaldt, Anne L; Connolly, Scott W; Ashikaga, Takamaru

    2007-08-01

    Mass media interventions are among the strategies recommended for youth cigarette smoking prevention, but little is known about optimal methods for reaching diverse youth audiences. Grades 4 through 12 samples of youth from four states (n = 1,230) rated smoking-prevention messages in classroom settings. Similar proportions of African American, Hispanic, and White youth participated. Impact of audience characteristics on message appeal ratings was assessed to provide guidance for audience segmentation strategies. Age had a strong effect on individual message appeal. The effect of gender also was significant. Message ratings were similar among the younger racial/ethnic groups, but differences were found for older African American youth. Lower academic achievement was associated with lower appeal scores for some messages. Age should be a primary consideration in developing and delivering smoking-prevention messages to youth audiences. The unique needs of boys and girls and older African American adolescents should also be considered.

  9. Strategies to prevent the occurrence of resistance against antibiotics by using advanced materials.

    Science.gov (United States)

    Bassegoda, Arnau; Ivanova, Kristina; Ramon, Eva; Tzanov, Tzanko

    2018-03-01

    Drug resistance occurrence is a global healthcare concern responsible for the increased morbidity and mortality in hospitals, time of hospitalisation and huge financial loss. The failure of the most antibiotics to kill "superbugs" poses the urgent need to develop innovative strategies aimed at not only controlling bacterial infection but also the spread of resistance. The prevention of pathogen host invasion by inhibiting bacterial virulence and biofilm formation, and the utilisation of bactericidal agents with different mode of action than classic antibiotics are the two most promising new alternative strategies to overcome antibiotic resistance. Based on these novel approaches, researchers are developing different advanced materials (nanoparticles, hydrogels and surface coatings) with novel antimicrobial properties. In this review, we summarise the recent advances in terms of engineered materials to prevent bacteria-resistant infections according to the antimicrobial strategies underlying their design.

  10. Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.

    Science.gov (United States)

    Tayyib, Nahla; Coyer, Fiona

    2016-12-01

    Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.

  11. Young people and snowmobiling in northern Norway: accidents, injury prevention and safety strategies.

    Science.gov (United States)

    Mehus, Grete; Mehus, Alf Gunnar; Germeten, Sidsel; Henriksen, Nils

    2016-01-01

    Snowmobiling among young people in Scandinavia frequently leads to accidents and injuries. Systematic studies of accidents exist, but few studies have addressed young drivers' experiences. The aim of this article is to reveal how young people experience and interpret accidents, and to outline a prevention strategy. Thirty-one girls and 50 boys aged 16-23 years from secondary schools in Northern Norway and on Svalbard, a Norwegian archipelago in the Arctic Ocean, participated in 17 focus groups segregated by gender. A content analysis identified themes addressing the research questions. Participants described risk as being inherent to snowmobiling, and claimed that accidents followed from poor risk assessment, careless driving or mishaps. Evaluation of accidents and recommendations for preventive measures varied. Girls acknowledged the risks and wanted knowledge about outdoor life, navigation and external risks. Boys underestimated or downplayed the risks, and wanted knowledge about safety precautions while freeriding. Both genders were aware of how and why accidents occurred, and took precautions. Boys tended to challenge norms in ways that contradict the promotion of safe driving behaviour. Stories of internal justice regarding driving under the influence of alcohol occurred. Adolescents are aware of how accidents occur and how to avoid them. Injury prevention strategies should include a general population strategy and a high-risk strategy targeted at extreme risk-seekers. Drivers, snowmobilers' organisations and the community should share local knowledge in an effort to define problem areas, set priorities and develop and implement preventive measures. Risk prevention should include preparation of safe tracks and focus on safety equipment and safe driving behaviour, but should also pay increased attention to the potential of strengthening normative regulation within peer groups regarding driving behaviour and mutual responsibility for preventing accidents.

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

    Science.gov (United States)

    Schneider, Madeline; Hirsch, Jennifer S

    2018-01-01

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

  13. The use of benthic indicators in Europe: from the Water Framework Directive to the Marine Strategy Framework Directive.

    Science.gov (United States)

    Van Hoey, Gert; Borja, Angel; Birchenough, Silvana; Buhl-Mortensen, Lene; Degraer, Steven; Fleischer, Dirk; Kerckhof, Francis; Magni, Paolo; Muxika, Iñigo; Reiss, Henning; Schröder, Alexander; Zettler, Michael L

    2010-12-01

    The Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD) are the European umbrella regulations for water systems. It is a challenge for the scientific community to translate the principles of these directives into realistic and accurate approaches. The aim of this paper, conducted by the Benthos Ecology Working Group of ICES, is to describe how the principles have been translated, which were the challenges and best way forward. We have tackled the following principles: the ecosystem-based approach, the development of benthic indicators, the definition of 'pristine' or sustainable conditions, the detection of pressures and the development of monitoring programs. We concluded that testing and integrating the different approaches was facilitated during the WFD process, which led to further insights and improvements, which the MSFD can rely upon. Expert involvement in the entire implementation process proved to be of vital importance. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2011-05-01

    Full Text Available Abstract Background We need to know the scale and underlying causes of surgical adverse events (AEs in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rapidly. The objective of this study was to provide more recent data on the incidence, consequences, preventability, causes and potential strategies to prevent AEs among hospitalized patients in surgical units. Methods A structured record review study of 7,926 patient records was carried out by trained nurses and medical specialist reviewers in 21 Dutch hospitals. The aim was to determine the presence of AEs during hospitalizations in 2004 and to consider how far they could be prevented. Of all AEs, the consequences, responsible medical specialty, causes and potential prevention strategies were identified. Surgical AEs were defined as AEs attributable to surgical treatment and care processes and were selected for analysis in detail. Results Surgical AEs occurred in 3.6% of hospital admissions and represented 65% of all AEs. Forty-one percent of the surgical AEs was considered to be preventable. The consequences of surgical AEs were more severe than for other types of AEs, resulting in more permanent disability, extra treatment, prolonged hospital stay, unplanned readmissions and extra outpatient visits. Almost 40% of the surgical AEs were infections, 23% bleeding, and 22% injury by mechanical, physical or chemical cause. Human factors were involved in the causation of 65% of surgical AEs and were considered to be preventable through quality assurance and training. Conclusions Surgical AEs occur more often than other types of AEs, are more often preventable and their consequences are more severe. Therefore, surgical AEs have a major impact on the burden of AEs during hospitalizations

  15. Triple surveillance: a proposal for an integrated strategy to support and accelerate birth defect prevention.

    Science.gov (United States)

    Botto, Lorenzo D; Mastroiacovo, Pierpaolo

    2018-02-01

    Preventing neural tube defects (NTDs) easily qualifies as a high-value opportunity to improve childhood survival and health: the unmet need is significant (major preventable burden), the intervention is transformative (providing sufficient folic acid), and delivery strategies (e.g., fortification) are effective in low-resource countries. Yet, NTD prevention is lagging. Can public health surveillance help fix this problem? Critics contend that surveillance is largely unnecessary, that limited resources are best spent on interventions, and that surveillance is unrealistic in developing countries. The counterargument is twofold: (1) in the absence of surveillance, interventions will provide fewer benefits and cost more and (2) effective surveillance is likely possible nearly everywhere, with appropriate strategies. As a base strategy, we propose "triple surveillance:" integrating surveillance of cause (folate insufficiency), of disease occurrence (NTD prevalence), and of health outcomes (morbidity, mortality, and disability). For better sustainability and usefulness, it is crucial to refocus and streamline surveillance activities (no recreational data collection), weave surveillance into clinical care (integrate in clinical workflow), and, later, work on including additional risk factors and pediatric outcomes (increase benefits at low marginal cost). By doing so, surveillance becomes not a roadblock but a preferential path to prevention and better care. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.

  16. Implemented Crime Prevention Strategies of PNP in Salug Valley, Zamboanga Del Sur, Philippines

    Directory of Open Access Journals (Sweden)

    Mark E. Patalinghug

    2017-05-01

    Full Text Available This study aimed primarily to determine the effectiveness of crime prevention strategies implemented by the Salug Valley Philippine National Police (PNP in terms of Police Integrated Patrol System, Barangay Peacekeeping Operation, Anti - Criminality Operation, Integrated Area Community Public Safety services, Bantay Turista and Scho ol Safety Project as evaluated by 120 inhabitants and 138 PNP officers from four Municipalities of Salug Valley Zamboanga del Sur. Stratified random sampling was utilized in determining the respondents. Index crime rate were correlated with the crime preve ntion strategies of the PNP in town of Salug Valley. A descriptive method of research was applied in this study utilizing self - made questionnaire. The data collected were analyzed using the main statistical tools like frequency count, percentage, mean com putation, Kruskal Wallis Analysis of Variance and simple correlation. Findings of the study revealed that the crime prevention strategies in four (4 municipalities were “much effective” to include Integrated Patrol System, Barangay Peace Keeping Operation s, Anti - Criminality Operations, Integrated Area Community Public Safety Services, Bantay Turista and School Safety Project in connection to the responses of 158 participants. There is a significant relationship between crime prevention strategies employed and index crime rate.

  17. Dairy farmers' perceptions toward the implementation of on-farm Johne's disease prevention and control strategies.

    Science.gov (United States)

    Ritter, C; Jansen, J; Roth, K; Kastelic, J P; Adams, C L; Barkema, H W

    2016-11-01

    Implementation of specific management strategies on dairy farms is currently the most effective way to reduce the prevalence of Johne's disease (JD), an infectious chronic enteritis of ruminants caused by Mycobacterium avium subspecies paratuberculosis (MAP). However, dairy farmers often fail to implement recommended strategies. The objective of this study was to assess perceptions of farmers participating in a JD prevention and control program toward recommended practices, and explore factors that influence whether or not a farmer adopts risk-reducing measures for MAP transmission. Semi-structured interviews were conducted with 25 dairy farmers enrolled in a voluntary JD control program in Alberta, Canada. Principles of classical grounded theory were used for participant selection, interviewing, and data analysis. Additionally, demographic data and MAP infection status were collected and analyzed using quantitative questionnaires and the JD control program database. Farmers' perceptions were distinguished according to 2 main categories: first, their belief in the importance of JD, and second, their belief in recommended JD prevention and control strategies. Based on these categories, farmers were classified into 4 groups: proactivists, disillusionists, deniers, and unconcerned. The first 2 groups believed in the importance of JD, and proactivists and unconcerned believed in proposed JD prevention and control measures. Groups that regarded JD as important had better knowledge about best strategies to reduce MAP transmission and had more JD risk assessments conducted on their farm. Although not quantified, it also appeared that these groups had more JD prevention and control practices in place. However, often JD was not perceived as a problem in the herd and generally farmers did not regard JD control as a "hot topic" in communications with their herd veterinarian and other farmers. Recommendations regarding how to communicate with farmers and motivate various

  18. Health promotion and disease prevention strategies in older adults with Intellectual and Developmental Disabilities

    Directory of Open Access Journals (Sweden)

    Eli eCarmeli

    2014-04-01

    Full Text Available The rapid growth in the number of individuals living with Intellectual and Developmental Disabilities (IDD along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals’ health risks, address primary and secondary disease prevention and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities and nutrition.

  19. Evolving Use of Natriuretic Peptides as Part of Strategies for Heart Failure Prevention.

    Science.gov (United States)

    McDonald, Ken; Wilkinson, Mark

    2017-01-01

    Heart failure (HF) remains one of the major cardiovascular challenges to the Western world. Once established, HF is characterized by compromised life expectancy and quality of life with considerable dependence on hospital care for episodic clinical deterioration. Much is understood about the risk factors that predispose to the development of HF. With such a broad range of factors, it is clear that there is a large population at risk, potentially in excess of 25% of the adult population. Therein lies the major challenge at the outset of our efforts to prevent HF. With such a large population at risk, how do we develop an effective prevention strategy? HF prevention requires a multimodal approach. In this review, we focus primarily on the role of natriuretic peptide (NP) as a tool in a prevention strategy. Prevention of HF is a major public health challenge, underlined by the concerning epidemiological trends, the associated costs, and the continued difficulty to find effective therapies for the growing number of patients with preserved systolic function HF. Population-based approaches focusing on lifestyle and risk factor control have made some impact but not to a satisfactory level and also tend to result in a uniform approach across a population with different risk profiles. Individualizing risk is therefore required, with emerging data indicating that NP-guided risk stratification and intervention can reduce downstream incident HF and other cardiovascular events. © 2016 American Association for Clinical Chemistry.

  20. Optimizing the prevention of venous thromboembolism: recent quality initiatives and strategies to drive improvement.

    Science.gov (United States)

    Amin, Alpesh N; Deitelzweig, Steven B

    2009-11-01

    Venous thromboembolism (VTE) is associated with a substantial health care and economic burden, yet many VTE events are preventable. Despite the availability of evidence-based guidelines derailing effective thromboprophylaxis strategies, the underuse and inappropriate prescribing of VTE prophylaxis are common. Current national quality initiatives were reviewed to identify strategies that may help hospitals and health care professionals optimize current VTE prophylaxis practices. A computerized literature search was performed using PubMed and MEDLINE, and this was complemented by hand searches of relevant journals and Web sites to identify additional literature related to VTE prevention and quality improvement. Many organizations, including the Centers for Medicare & Medicaid Services, the National Quality Forum, the Joint Commission, and the Agency for Healthcare Research and Quality have developed performance measures, quality indicators, public reporting initiatives, incentive programs, and "negative reimbursement" that are designed to help improve VTE prevention. It remains the responsibility of individual hospitals to identify specific areas in which they can improve their VTE prophylaxis rates to obtain positive results from the reporting initiatives and incentive programs. If performance measures are to be met, all hospital departments will need to implement effective VTE prevention policies, including early risk assessment, appropriate prophylaxis prescribing, monitoring, and follow-up. Multifaceted, integrated initiatives involving risk assessment tools, decision support, electronic alert systems, and hospitalwide education, with a mechanism for audit and feedback, may help ensure that all health care professionals comply with VTE-prevention policies and initiatives.

  1. TRADE AND FOREIGN DIRECT INVESTMENT MANAGEMENT STRATEGIES FOR U.S. PROCESSED FOOD FIRMS IN CHINA

    OpenAIRE

    Marchant, Mary A.; Saghaian, Sayed H.; Vickner, Steven S.

    1999-01-01

    This research examines the relationship between U.S. foreign direct investment (FDI) and exports of processed foods to China and identifies management strategies to enhance U.S. competitiveness. Two-stage least-squares empirical econometric results from a simultaneous equation system indicate that there exists a strong complementary relationship between U.S exports and FDI into China. Therefore, the appropriate managerial strategy to access Chinese processed foods markets is to increase overa...

  2. Insider Threat: Preventing Direct Action Attacks Within the United States Army

    Science.gov (United States)

    2017-06-09

    Intelligence Agency, 2012. Joint Chiefs of Staff. Joint Publication (JP) 3-07.2, Antiterrorism. Washington, DC: Government Printing Office, 2010. 81...Federal Bureau of Investigation GEN General (Army rank, O-10) HIPAA Health Insurance Portability and Accountability Act of 1996 INSCOM Intelligence and...commanders, and the intelligence community to prevent insider threats from developing into direct action attacks, this study sought to answer the

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

    Science.gov (United States)

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

    2013-01-01

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

  4. [Social marketing: applying commercial strategies to the prevention of nosocomial infections].

    Science.gov (United States)

    Sax, Hugo; Longtin, Yves; Alvarez-Ceyssat, Raymonde; Bonfillon, Chantal; Cavallero, Sabrina; Dayer, Pierre; Ginet, Claude; Herrault, Pascale

    2009-04-01

    Although a large proportion of healthcare-associated infections are avoidable, healthcare workers do not always practice evidence-based preventive strategies. Marketing technologies might help to improve patient safety. This article presents the basic principles of marketing and its potential use to promote good infection control practices. The marketing mix (Product, Price, Place, and Promotion) should be taken into account to induce behaviour change. By placing the emphasis on the perceived "profits" for healthcare workers the approach might lose its moral aspect and gain in effectiveness. VigiGerme, a non-commercial registered trademark, applies social marketing techniques to infection control and prevention.

  5. Nurses' use of pliable and directed strategies when encountering children in child and school healthcare.

    Science.gov (United States)

    Harder, Maria; Enskär, Karin; Golsäter, Marie

    2017-03-01

    Nurses in Swedish child and school healthcare need to balance their assignment of promoting children's health and development based on the national health-monitoring programme with their responsibility to consider each child's needs. In this balancing act, they encounter children through directed and pliable strategies to fulfil their professional obligations. The aim of this study was to analyse the extent to which nurses use different strategies when encountering children during their recurrent health visits throughout childhood. A quantitative descriptive content analysis was used to code 30 video recordings displaying nurses' encounters with children (3-16 years of age). A constructed observation protocol was used to identify the codes. The results show that nurses use pliable strategies (58%) and directed strategies (42%) in encounters with children. The action they use the most within the pliable strategy is encouraging (51%), while in the directed strategy, the action they use most is instructing (56%). That they primarily use these opposing actions can be understood as trying to synthesize their twofold assignment. However, they seem to act pliably to be able to fulfil their public function as dictated by the national health-monitoring programme, rather than to meet each child's needs.

  6. Benfotiamine exhibits direct antioxidative capacity and prevents induction of DNA damage in vitro.

    Science.gov (United States)

    Schmid, Ursula; Stopper, Helga; Heidland, August; Schupp, Nicole

    2008-01-01

    Complications in diabetes mellitus are partially mediated by enhanced formation of reactive oxygen species. Among the factors involved in reactive oxygen species formation, advanced glycation end products play a key role. Owing to a reduced activity of the enzyme transketolase, which requires diphosphorylated thiamine (vitamin B(1)) as cofactor, an accumulation of those deleterious glucose metabolites especially in diabetic patients can be observed. Benfotiamine, a lipophilic thiamine diphosphate prodrug, prevented early renal and retinal changes in animal studies, and reduced neuropathic pain in clinical studies. Several mechanisms for these activities have been described. We investigated for the first time direct antioxidant abilities of benfotiamine. Additionally, a potential DNA protective effect of benfotiamine was analysed. Oxidative stress was detected by flow cytometry, antioxidative capacity was measured with the ferric reducing ability of plasma (FRAP) assay, two endpoints for genomic damage were assessed: the comet assay and the micronucleus test, and the expression and activity of transketolase was quantified. Benfotiamine prevented oxidative stress induced by the mutagen 4-nitroquinoline-1-oxide (NQO), the uremic toxin indoxyl sulfate, and the peptide hormone angiotensin II in three different kidney cell lines. Cell-free experiments showed a direct antioxidant effect of benfotiamine, which might account for the protective effect. Oxidative DNA damage, induced by angiotensin II, was completely prevented by benfotiamine. Incubation with benfotiamine increased transketolase expression and activity in the cells. Benfotiamine shows a direct antioxidant action. This effect of benfotiamine may be involved in the improvement of diabetic late complications, including peripheral neuropathy.

  7. Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective.

    Science.gov (United States)

    Carlson, Juliana; Casey, Erin; Edleson, Jeffrey L; Tolman, Richard M; Walsh, Tova B; Kimball, Ericka

    2015-11-01

    This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic, and contextual concerns of the local community, with nuanced messages and appropriate messengers. In addition, respondents reported key principles informing their organizational strategies to deepen men and boys' engagement. Attention is also paid to respondents' caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves. © The Author(s) 2015.

  8. Volatility measurement with directional change in Chinese stock market: Statistical property and investment strategy

    Science.gov (United States)

    Ma, Junjun; Xiong, Xiong; He, Feng; Zhang, Wei

    2017-04-01

    The stock price fluctuation is studied in this paper with intrinsic time perspective. The event, directional change (DC) or overshoot, are considered as time scale of price time series. With this directional change law, its corresponding statistical properties and parameter estimation is tested in Chinese stock market. Furthermore, a directional change trading strategy is proposed for invest in the market portfolio in Chinese stock market, and both in-sample and out-of-sample performance are compared among the different method of model parameter estimation. We conclude that DC method can capture important fluctuations in Chinese stock market and gain profit due to the statistical property that average upturn overshoot size is bigger than average downturn directional change size. The optimal parameter of DC method is not fixed and we obtained 1.8% annual excess return with this DC-based trading strategy.

  9. The Relationship of Abortion and Violence Against Women: Violence Prevention Strategies and Research Needs.

    Science.gov (United States)

    Coyle, Catherine T; Shuping, Martha W; Speckhard, Anne; Brightup, Jennie E

    2015-01-01

    From the perspective of peace psychology, the role of abortion in acts of violence against women is explored, with a focus on violence-prevention strategies. Setting aside the political debate, this task force report takes the conflict-transformation approach of considering all perspectives that have concern for the right of women to avoid being victims of violence. The evidence that victims of Intimate Partner Violence are disproportionately represented in women presenting for abortion suggests a need for screening at clinics. Coerced abortion is a form of violence and has occurred by government policy in China and as a result of other violence against women: sex trafficking and war situations. Sex-selection abortion of female fetuses, referred to as "gendercide," has reached pandemic proportions and caused a gender imbalance in some countries. Psychology, through empirical research, can make unique contributions to understanding the relationship between abortion and violence and in developing prevention strategies.

  10. Strategies for prevention of road traffic injuries (RTIs) in Pakistan: situational analysis.

    Science.gov (United States)

    Khan, Adeel Ahmed; Fatmi, Zafar

    2014-05-01

    Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet wearing is poor. National Highway and Motorway Police Ordinance (2000) was one of the few legislative measure so far taken in Pakistan. Using SAF, efforts are required to implement interventions targeting human, vehicle design and also making environment safer for road users.

  11. Strategies of the Brazilian chronic kidney disease prevention campaign (2003-2009).

    Science.gov (United States)

    Mastroianni-Kirsztajn, Gianna; Bastos, Marcus G; Burdmann, Emmanuel A

    2011-01-01

    In Brazil, as in the rest of the world, the prevalence of chronic kidney disease (CKD) is increasing. In order to alert the population, health professionals and authorities to this risk, in 2003, the Brazilian Society of Nephrology launched a CKD prevention campaign called 'Previna-se'. In addition, since its onset, Brazil has participated in the World Kidney Day efforts and has developed several prevention strategies. Here, we summarize the main strategies adopted in this campaign (population screening, events and meetings, distribution of educational materials, routine report of estimated glomerular filtration rate) and our initial results, sharing practical experience that could be useful in other developing countries. Copyright © 2010 S. Karger AG, Basel.

  12. Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices

    Directory of Open Access Journals (Sweden)

    Susan Philliber

    2015-09-01

    Full Text Available This paper reviews the changing strategies for both process and outcome evaluations of teen pregnancy prevention programs over the past few decades. Implementation evaluations have emphasized discovery of what program attributes are most effective in reducing teen pregnancy and its antecedents. Outcome evaluations have moved from collecting data to measure knowledge, attitudes, and program satisfaction to measuring behavior change including postponement of sexual involvement, increased used of contraception, or reduction in teen pregnancy. High quality randomized control trials or quasi-experimental designs are being increasingly emphasized, as are sophisticated analysis techniques using multi-variate analyses, controls for cluster sampling, and other strategies designed to build a more solid knowledge base about how to prevent early pregnancy.

  13. Win-win strategies in directing low-carbon resilient development path

    International Nuclear Information System (INIS)

    Masui, Toshihiko; Kainuma, Mikiko

    2015-01-01

    This section explores big win-win strategies in directing low carbon resilient development path. There are lots of “leapfrog” development possibilities in developing countries, which go directly from a status of under-development through to efficient and environmentally benign lifestyle. To achieve low carbon resilient paths, not only technology development but also institutional and behavioral changes are required. Science-policy nexus is also discussed.

  14. Relationship between self-directed learning with learning styles and strategies in medical students

    OpenAIRE

    Márquez U, Carolina; Fasce H, Eduardo; Pérez V, Cristhian; Ortega B, Javiera; Parra P, Paula; Ortiz M, Liliana; Matus B, Olga; Ibáñez G, Pilar

    2014-01-01

    Background: Self-directed learning (SDL) skills are particularly important in medical education, considering that physicians should be able to regulate their own learning experiences. Aim: To evaluate the relationship between learning styles and strategies and self-directed learning in medical students. Material and Methods: One hundred ninety nine first year medical students (120 males) participated in the study. Preparation for Independent Learning (EPAI) scale was used to assess self-direc...

  15. [Obesity in children: Risk factors and strategies for its prevention in Peru].

    Science.gov (United States)

    Villar, Carlos M Del Águila

    2017-01-01

    The prevalence of overweight and obesity in children and adolescents represents an emerging public health problem in Peru, so it is necessary to be aware of the different risk factors in order to establish suitable and efficient prevention measures. These should contribute to health strategies such as promoting physical activity and a healthy diet to ensure that the infant population reaches adulthood without chronic diseases and with an adequate quality of life.

  16. Recruitment and group composition strategies for family-based substance misuse prevention interventions: an exploratory evaluation

    OpenAIRE

    Segrott, Jeremy

    2013-01-01

    Purpose – This paper aims to report findings from an evaluation of the Strengthening Families Programme 10-14 (UK) (SFP 10-14 UK), focusing on the strategies used to recruit families into a universal prevention intervention, the approach taken to group composition, and the experiences of participating families.\\ud \\ud Design/methodology/approach – Methods comprised interviews with programme coordinating team members, a focus group with programme facilitators, focus groups with parents and you...

  17. Prevention of type 2 diabetes; a systematic review and meta-analysis of different intervention strategies.

    Science.gov (United States)

    Merlotti, C; Morabito, A; Pontiroli, A E

    2014-08-01

    Different intervention strategies can prevent type 2 diabetes (T2DM). Aim of the present systematic review and meta-analysis was to evaluate the effectiveness of different strategies. Studies were grouped into 15 different strategies: 1: diet plus physical activity; 2: physical activity; 3-6: anti-diabetic drugs [glitazones, metformin, beta-cell stimulating drugs (sulphanylureas, glinides), alfa-glucosidase inhibitors]; 7-8: cardiovascular drugs (ACE inhibitors, ARB, calcium antagonists); 9-14 [diets, lipid-affecting drugs (orlistat, bezafibrate), vitamins, micronutrients, estrogens, alcohol, coffee]; 15: bariatric surgery. Only controlled studies were included in the analysis, whether randomized, non-randomized, observational studies, whether primarily designed to assess incident cases of diabetes, or performed with other purposes, such as control of hypertension, of ischemic heart disease or prevention of cardiovascular events. Appropriate methodology [preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement] was used. Seventy-one studies (490 813 subjects), published as full papers, were analysed to identify predictors of new cases of T2DM, and were included in a meta-analysis (random-effects model) to study the effect of different strategies. Intervention effect (new cases of diabetes) was expressed as odds ratio (OR), with 95% confidence intervals (C.I.s). Publication bias was formally assessed. Body mass index was in the overweight range for 13 groups, obese or morbidly obese in lipid-affecting drugs and in bariatric surgery. Non-surgical strategies, except for beta-cell stimulating drugs, estrogens and vitamins, were able to prevent T2DM, with different effectiveness, from 0.37 (C.I. 0.26-0.52) to 0.85 (C.I. 0.77-0.93); the most effective strategy was bariatric surgery in morbidly obese subjects [0.16 (C.I. 0.11,0.24)]. At meta-regression analysis, age of subjects and amount of weight lost were associated with effectiveness of

  18. A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers.

    Science.gov (United States)

    Marsden, Grace; Jones, Katie; Neilson, Julie; Avital, Liz; Collier, Mark; Stansby, Gerard

    2015-12-01

    To assess the cost effectiveness of two repositioning strategies and inform the 2014 National Institute for Health and Care Excellence clinical guideline recommendations on pressure ulcer prevention. Pressure ulcers are distressing events, caused when skin and underlying tissues are placed under pressure sufficient to impair blood supply. They can have a substantial impact on quality of life and have significant resource implications. Repositioning is a key prevention strategy, but can be resource intensive, leading to variation in practice. This economic analysis was conducted to identify the most cost-effective repositioning strategy for the prevention of pressure ulcers. The economic analysis took the form of a cost-utility model. The clinical inputs to the model were taken from a systematic review of clinical data. The population in the model was older people in a nursing home. The economic model was developed with members of the guideline development group and included costs borne by the UK National Health Service. Outcomes were expressed as costs and quality adjusted life years. Despite being marginally more clinically effective, alternating 2 and 4 hourly repositioning is not a cost-effective use of UK National Health Service resources (compared with 4 hourly repositioning) for this high risk group of patients at a cost-effectiveness threshold of £20,000 per quality adjusted life years. These results were used to inform the clinical guideline recommendations for those who are at high risk of developing pressure ulcers. © 2015 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Chippendale, Tracy; Boltz, Marie

    2015-08-01

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

  20. Domestic burns prevention and first aid awareness in and around Jamshedpur, India: strategies and impact.

    Science.gov (United States)

    Ghosh, A; Bharat, R

    2000-11-01

    This article highlights the strategy for awareness creation regarding burns prevention and first aid and its impact in and around the steel-producing city of Jamshedpur, India. This is a joint venture of the Burns Centre and the Medico Social Welfare Unit of the Tata Main Hospital, Jamshedpur in collaboration with the Social Service Division of Tata Steel and city schools. The first phase of 5 years has been devoted to general awareness building in the population through two main programmes, namely "Community Awareness Programmes" for the target group of ladies and teenage girls and "School Education Programmes" for the target group of school children of Standard 8 in the steel-producing city. These programmes include audio-visual presentations as well as face to face interactions regarding structure and arrangements in the kitchen, floor level cooking, clothing while cooking, careful use of electrical appliances, pressure stoves, etc. The discussions also include suicidal and homicidal burns prevention strategies. Various competitions for the target group provide feedback on programmes. The growing awareness about burns prevention among school children and community members, and steady increase in the number of patients who use water as first aid, speak about the success of the strategies.

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

    Science.gov (United States)

    Sedighi, Iraj; Karimi, Abdollah; Amanati, Ali

    2016-01-01

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

  2. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

    Science.gov (United States)

    Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann-Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

    2014-01-01

    PURPOSE Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,”1 published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.2 PMID:24799638

  3. Gaps in clinical prevention and treatment for alcohol use disorders: costs, consequences, and strategies.

    Science.gov (United States)

    Willenbring, Mark L

    2013-01-01

    Heavy drinking causes significant morbidity, premature mortality, and other social and economic burdens on society, prompting numerous prevention and treatment efforts to avoid or ameliorate the prevalence of heavy drinking and its consequences. However, the impact on public health of current selective (i.e., clinical) prevention and treatment strategies is unclear. Screening and brief counseling for at-risk drinkers in ambulatory primary care has the strongest evidence for efficacy, and some evidence indicates this approach is cost-effective and reduces excess morbidity and dysfunction. Widespread implementation of screening and brief counseling of nondependent heavy drinkers outside of the medical context has the potential to have a large public health impact. For people with functional dependence, no appropriate treatment and prevention approaches currently exist, although such strategies might be able to prevent or reduce the morbidity and other harmful consequences associated with the condition before its eventual natural resolution. For people with alcohol use disorders, particularly severe and recurrent dependence, treatment studies have shown improvement in the short term. However, there is no compelling evidence that treatment of alcohol use disorders has resulted in reductions in overall disease burden. More research is needed on ways to address functional alcohol dependence as well as severe and recurrent alcohol dependence.

  4. Using biological effects tools to define Good Environmental Status under the Marine Strategy Framework Directive

    NARCIS (Netherlands)

    Lyons, B.P.; Thain, J.E.; Hylland, K.; Davis, I.; Vethaak, A.D.

    2010-01-01

    The use of biological effects tools offer enormous potential to meet the challenges outlined by the European Union Marine Strategy Framework Directive (MSFD) whereby Member States are required to develop a robust set of tools for defining 11 qualitative descriptors of Good Environmental Status

  5. The Application of Self-Directed Learning in a Marketing Strategy Capstone Course

    Science.gov (United States)

    Gray, David M.

    2011-01-01

    Capstone courses can create a space for students and educators to act as co-producers of desired learning outcomes which are directly relevant to the world of work. This study uses an auto-ethnographic case study approach to demonstrate how a mixed model learning approach evolved in a capstone marketing strategy unit in a marketing major at an…

  6. EFL Learners' Use of Direct Strategies in Competitive and Cooperative Learning Contexts

    Science.gov (United States)

    Zarei, Abbas Ali; Layeq, Hamide

    2016-01-01

    This study investigated the effects of competitive and cooperative teaching techniques on Iranian adult EFL learners' use of direct strategies. To this end, a sample of 88 non-English major university students at Sohrevardi Nonprofit College in Qazvin were assigned to two groups, and each group received instruction under one of the treatment…

  7. INTERNATIONALIZATION STRATEGIES OF THE BRAZILIAN MEAT AGRIBUSINESS SECTOR: EXPORTS OR DIRECT INVESTMENT ABROAD?

    Directory of Open Access Journals (Sweden)

    Eva Stal

    2010-11-01

    Full Text Available The article analyzes the internationalization strategies of the four largest Brazilian companies in the meat (beef, pork and poultry agribusiness sector, by considering the comparative and competitive advantages of the country and the companies. JBS, Marfrig, Sadia and Perdigão were studied, of which the last two merged in May 2009, forming Brasil Foods. The authors looked into what led these companies to start investing  abroad directly, as from 2005, as a complement to their exports, the preferred strategy for placing products in foreign markets. The research method used was the multiple case study, drawing on primary data (interviews, corporate annual reports, financial statements, press releases and shareholder information and secondary data (theses, dissertations, academic articles, reports in newspapers and business journals, using bibliographic and documentary research. Everything was analyzed in the light of international business and strategy theories. The results show that exports still predominate and that investing directly abroad was, in principle, a reactive strategy to sanitary barriers against Brazilian products. However, the acquisition of companies in restriction-free countries has increased as part of a forward-looking strategy for gaining access to new markets and strengthening brands. Key-words: Agribusiness. Internationalization. Strategy

  8. A strategy of clinical tolerance for the prevention of HIV and AIDS in China.

    Science.gov (United States)

    Wang, Y

    2000-02-01

    HIV infection and AIDS create many dilemmas in Chinese AIDS/HIV prevention policy. A strategy of clinical tolerance is proposed to address these dilemmas. The immediate purpose of the strategy of clinical tolerance is to win the cooperation of members of stigmatized groups at high risk for contracting HIV infection and AIDS, which occurs as a result of acts done in private and thus beyond the reach of regulation. The strategy of clinical tolerance differs from both tolerance as liberal tolerance and tolerance as a moral ideal of tolerance. A strategy of clinical tolerance does not ask the government, health worker, health official or the public to change either laws or the disapproval of prostitution, homosexuality and drug use. A strategy of clinical tolerance asks, instead, that we weigh what we may regard as the wrong involved in prostitution, homosexuality, and drug use against the greater evil of an HIV/AIDS epidemic. A strategy of clinical tolerance offers the most effective and practical way to confront a growing and significant public health problem in China.

  9. Building communication strategy on health prevention through the human-centered design

    Directory of Open Access Journals (Sweden)

    Karine de Mello Freire

    2016-03-01

    Full Text Available It has been identified a latent need for developing efficient communication strategies for prevention of diseases and also, design as a potential agent to create communications artifacts that are able to promote self-care. In order to analyze a design process that develops this kind of artifact, an action research in IAPI Health Center in Porto Alegre was done. The action’s goal was to design a strategy to promote self-care to prevent cervical cancer. The process was conducted from the human centered design approach - HCD, which seeks to create solutions desirable for people and feasible for organizations from three main phases: a Hear, in which inspirations are originated from stories collected from people; b Create, which aims to translate these knowledge into prototypes; and, c Deliver, where the prototypes are tested and developed with users. Communication strategies were supported by design studies about visual-verbal rhetoric. As results, this design approach has shown adequate to create communication strategies targeted at self-care behaviors, aiming to empower users to change their behavior.

  10. Stability Analysis and Optimal Control Strategy for Prevention of Pine Wilt Disease

    Directory of Open Access Journals (Sweden)

    Kwang Sung Lee

    2014-01-01

    Full Text Available We propose a mathematical model of pine wilt disease (PWD which is caused by pine sawyer beetles carrying the pinewood nematode (PWN. We calculate the basic reproduction number R0 and investigate the stability of a disease-free and endemic equilibrium in a given mathematical model. We show that the stability of the equilibrium in the proposed model can be controlled through the basic reproduction number R0. We then discuss effective optimal control strategies for the proposed PWD mathematical model. We demonstrate the existence of a control problem, and then we apply both analytical and numerical techniques to demonstrate effective control methods to prevent the transmission of the PWD. In order to do this, we apply two control strategies: tree-injection of nematicide and the eradication of adult beetles through aerial pesticide spraying. Optimal prevention strategies can be determined by solving the corresponding optimality system. Numerical simulations of the optimal control problem using a set of reasonable parameter values suggest that reducing the number of pine sawyer beetles is more effective than the tree-injection strategy for controlling the spread of PWD.

  11. Performance deterioration modeling and optimal preventive maintenance strategy under scheduled servicing subject to mission time

    Directory of Open Access Journals (Sweden)

    Li Dawei

    2014-08-01

    Full Text Available Servicing is applied periodically in practice with the aim of restoring the system state and prolonging the lifetime. It is generally seen as an imperfect maintenance action which has a chief influence on the maintenance strategy. In order to model the maintenance effect of servicing, this study analyzes the deterioration characteristics of system under scheduled servicing. And then the deterioration model is established from the failure mechanism by compound Poisson process. On the basis of the system damage value and failure mechanism, the failure rate refresh factor is proposed to describe the maintenance effect of servicing. A maintenance strategy is developed which combines the benefits of scheduled servicing and preventive maintenance. Then the optimization model is given to determine the optimal servicing period and preventive maintenance time, with an objective to minimize the system expected life-cycle cost per unit time and a constraint on system survival probability for the duration of mission time. Subject to mission time, it can control the ability of accomplishing the mission at any time so as to ensure the high dependability. An example of water pump rotor relating to scheduled servicing is introduced to illustrate the failure rate refresh factor and the proposed maintenance strategy. Compared with traditional methods, the numerical results show that the failure rate refresh factor can describe the maintenance effect of servicing more intuitively and objectively. It also demonstrates that this maintenance strategy can prolong the lifetime, reduce the total lifetime maintenance cost and guarantee the dependability of system.

  12. Preventing Radicalisation: A Systematic Review of Literature Considering the Lived Experiences of the UK's Prevent Strategy in Educational Settings

    Science.gov (United States)

    Taylor, Laura; Soni, Anita

    2017-01-01

    This article surveys relevant literature on experiences of the Prevent Strategy in the UK in order to explore the role of schools in preventing radicalisation. The first section explores the concept of radicalisation and how this is positioned within UK policy and legislation followed by a review and critical appraisal of seven relevant articles.…

  13. Strategy for Meeting the Secretary of Energy and Hanford Site FY 2001 Pollution Prevention Goals

    International Nuclear Information System (INIS)

    CLARK, D.E.

    2000-01-01

    The purpose of this strategy is to identify the Fiscal Year (FY) 2001 Hanford Site waste reduction, sanitary recycling and affirmative procurement goals and identify the action required to ensure that the Secretary of Energy's FY 2005 pollution prevention and the FY 2001 Hanford Site goals are met. The strategy and plan to ensure that the Secretary of Energy's routine waste reduction, recycling, cleanup/stabilization waste and affirmative procurement goals are met consists of four phases. The first phase is to ensure that the infrastructure is in place to support planning and organization. This phase involves ensuring that roles and responsibilities are identified; requirement documents are current; goals and successes are communicated; and accurate and current waste information is available. Roles and responsibilities are identified and the RL requirement documents (i.e., the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan and Hanford Site Guide for Preparing and Maintaining Generator Group Pollution Prevention Program Documentation) will specify the Secretary of Energy's goals. Goals will be communicated formally and informally via the Hanford Reach, training sessions, meetings and correspondence. Sharing of pollution prevention successes and goal progress are encouraged at the Pollution Prevention/Waste Minimization (PZ/WMin) quarterly meetings. Existing site waste generation databases will be utilized to provide current waste generation data. The second phase of the strategy and plan is to establish and allocate goals by prime contractor (i.e. Fluor Hanford, Inc. (FH), Pacific Northwest National Laboratory (PNNL), Bechtel Hanford Inc. (BHI), and CH2MHill Hanford Group (CHG)). This requires determining current status toward meeting the Secretary of Energy's goals; establishing the Hanford Site FY goals, and allocating waste reduction goals by prime contractor. The third phase of the strategy and plan is goal implementation. This

  14. Complete Expulsion of Testicular Prosthesis via the Scrotum: A Case-Based Review of the Preventive Surgical Strategies

    Directory of Open Access Journals (Sweden)

    Jack Donati-Bourne

    2015-01-01

    Full Text Available Testicular prostheses are regularly used in urological surgery and are important for postoperative psychological well-being in many patients undergoing orchiectomy. One of the recognised complications of this procedure is graft extrusion, which can result in significant morbidity for patients and require operative reintervention. Whilst most cases of extrusion involve upward graft migration to the external inguinal ring or direct displacement through the scrotal skin, we present an unusual case of complete expulsion of testicular implant three weeks postoperatively through a previously healthy scrotum. During surgical insertion of testicular prostheses, the urological surgeon must carefully consider the different surgical strategies at each step of the operation to prevent future extrusion of the graft. A stepwise review of the preventive surgical strategies to reduce the risk of graft extrusion encompasses the choice of optimal surgical incision, the technique of dissection to create the receiving anatomical pouch, the method of fixation of the implant within the receiving hemiscrotum, and the adoption of good postoperative care measures in line with the principles of sound scrotal surgery.

  15. Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions

    Directory of Open Access Journals (Sweden)

    Ramesh Rajagopalan

    2017-11-01

    Full Text Available Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems.

  16. Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

    Science.gov (United States)

    Rajagopalan, Ramesh; Litvan, Irene; Jung, Tzyy-Ping

    2017-11-01

    Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT) and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems.

  17. Different strategies for sports injury prevention in an America's Cup yachting crew.

    Science.gov (United States)

    Hadala, Michal; Barrios, Carlos

    2009-08-01

    To analyze the effectiveness in reducing the number of sport injuries after application of different strategies of preventive physiotherapy during competition periods in an America's Cup yachting crew. A prospective physiotherapy intervention study during competition periods for three seasons was conducted on an America's Cup yachting race crew of 30 professional sailors. In the first two acts (2004), athletes did not receive any preventive physiotherapy. In the two acts celebrated in 2005, preventive intervention (phase 1) consisted of stretching exercises before the yacht race and preventative taping. During the four acts corresponding to the 2006 season, the physiotherapy program was implemented adding articular mobilization before competition, ice baths after competition, and kinesiotaping (phase 2). In the last act and the Louis Vuitton Cup (2007), a recovery program with "core stability" exercises, postcompetition stretching exercises, and 12 h of compressive clothing were added (phase 3). In the preintervention phase (2004), the rate of injured sailors/competition day was 1.66, decreasing to 0.60 in 2007 (phase 3). The number of athletes with more than one injury was significantly reduced from 53% (8 of 15) to 6.5% (2 of 12). In the preintervention period, mastmen, grinders, and bowmen showed a rate of 2.88 injuries per competition day. After phase 3, this group only suffered 0.35 injuries per competition day. The implementation of a program of preventive physiotherapy decreased the risk of injuries suffered during competition by an America's Cup yacht crew.

  18. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

    Science.gov (United States)

    Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

    2014-08-01

    Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

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

    Science.gov (United States)

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

    2001-11-01

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

  20. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

    Science.gov (United States)

    Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

    2015-07-01

    Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. 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.

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

    Science.gov (United States)

    Sarmadi, Roxana; Gahnberg, Lars; Gabre, Pia

    2011-05-01

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

  2. Mitigating the risk of musculoskeletal injury: A systematic review of the most effective injury prevention strategies for military personnel.

    Science.gov (United States)

    Wardle, Sophie L; Greeves, Julie P

    2017-11-01

    To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury. We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel. Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008-2015 were selected for systematic review. The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts. Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies. Copyright © 2017. Published by Elsevier Ltd.

  3. Poverty, Stress, and Brain Development: New Directions for Prevention and Intervention

    Science.gov (United States)

    Blair, Clancy; Raver, C. Cybele

    2018-01-01

    We review some of the growing evidence of the costs of poverty to children’s neuroendocrine function, early brain development, and cognitive ability. We underscore the importance of addressing the negative consequences of poverty-related adversity early in children’s lives, given evidence supporting the plasticity of executive functions and associated physiologic processes in response to early intervention and the importance of higher order cognitive functions for success in school and in life. Finally, we highlight some new directions for prevention and intervention that are rapidly emerging at the intersection of developmental science, pediatrics, child psychology and psychiatry, and public policy. PMID:27044699

  4. Poverty, Stress, and Brain Development: New Directions for Prevention and Intervention.

    Science.gov (United States)

    Blair, Clancy; Raver, C Cybele

    2016-04-01

    We review some of the growing evidence of the costs of poverty to children's neuroendocrine function, early brain development, and cognitive ability. We underscore the importance of addressing the negative consequences of poverty-related adversity early in children's lives, given evidence supporting the plasticity of executive functions and associated physiologic processes in response to early intervention and the importance of higher order cognitive functions for success in school and in life. Finally, we highlight some new directions for prevention and intervention that are rapidly emerging at the intersection of developmental science, pediatrics, child psychology and psychiatry, and public policy. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  5. Diagnosis and prevention of overtraining syndrome: an opinion on education strategies

    Directory of Open Access Journals (Sweden)

    Kreher JB

    2016-09-01

    Full Text Available Jeffrey B Kreher Department of Orthopaedics, Division of Pediatric Orthopaedics, Massachusetts General Hospital and Massachusetts General Hospital for Children, Boston, MA, USA Abstract: Overtraining syndrome is a condition of maladapted physiology in the setting of excessive exercise without adequate rest. The exact etiology and pathogenesis are unknown and being investigated. Symptoms are multisystem in nature and often representative of underlying hormonal, immunologic, neurologic, and psychologic disturbances. Unfortunately, systematic review of the literature does not clearly direct diagnosis, management, or prevention. However, given the severity of symptoms and impairment to quality of life, prevention of overtraining syndrome should be considered by all who interact with endurance athletes. This article will provide suggestions for management of at-risk athletes despite absence of validated diagnostic tests and preventative measures. Keywords: overreaching, unexplained underperformance, burnout, muscle failure syndrome

  6. Probabilistic sensitivity analysis of optimised preventive maintenance strategies for deteriorating infrastructure assets

    International Nuclear Information System (INIS)

    Daneshkhah, A.; Stocks, N.G.; Jeffrey, P.

    2017-01-01

    Efficient life-cycle management of civil infrastructure systems under continuous deterioration can be improved by studying the sensitivity of optimised preventive maintenance decisions with respect to changes in model parameters. Sensitivity analysis in maintenance optimisation problems is important because if the calculation of the cost of preventive maintenance strategies is not sufficiently robust, the use of the maintenance model can generate optimised maintenances strategies that are not cost-effective. Probabilistic sensitivity analysis methods (particularly variance based ones), only partially respond to this issue and their use is limited to evaluating the extent to which uncertainty in each input contributes to the overall output's variance. These methods do not take account of the decision-making problem in a straightforward manner. To address this issue, we use the concept of the Expected Value of Perfect Information (EVPI) to perform decision-informed sensitivity analysis: to identify the key parameters of the problem and quantify the value of learning about certain aspects of the life-cycle management of civil infrastructure system. This approach allows us to quantify the benefits of the maintenance strategies in terms of expected costs and in the light of accumulated information about the model parameters and aspects of the system, such as the ageing process. We use a Gamma process model to represent the uncertainty associated with asset deterioration, illustrating the use of EVPI to perform sensitivity analysis on the optimisation problem for age-based and condition-based preventive maintenance strategies. The evaluation of EVPI indices is computationally demanding and Markov Chain Monte Carlo techniques would not be helpful. To overcome this computational difficulty, we approximate the EVPI indices using Gaussian process emulators. The implications of the worked numerical examples discussed in the context of analytical efficiency and organisational

  7. Breast cancer prevention strategies in lobular carcinoma in situ: A decision analysis.

    Science.gov (United States)

    Wong, Stephanie M; Stout, Natasha K; Punglia, Rinaa S; Prakash, Ipshita; Sagara, Yasuaki; Golshan, Mehra

    2017-07-15

    Women diagnosed with lobular carcinoma in situ (LCIS) have a 3-fold to 10-fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk-reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS. A Markov simulation model was constructed to determine average LE and quality-adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk-reduction strategies. Probabilities for invasive breast cancer, breast cancer-specific mortality, other-cause mortality and the effectiveness of preventive strategies were derived from published studies and from the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Assuming a breast cancer incidence from 1.02% to 1.37% per year under active surveillance, a woman aged 50 years diagnosed with LCIS would have a total LE of 32.78 years and would gain 0.13 years (1.6 months) in LE by adding chemoprevention and 0.25 years (3.0 months) in LE by adding bilateral prophylactic mastectomy. After quality adjustment, chemoprevention resulted in the greatest QALE for women ages 40 to 60 years at LCIS diagnosis, whereas surveillance remained the preferred strategy for optimizing QALE among women diagnosed at age 65 years and older. In this model, among women with a diagnosis of LCIS, breast cancer prevention strategies only modestly affected overall survival, whereas chemoprevention was modeled as the preferred management strategy for optimizing invasive disease-free survival while prolonging QALE form women younger than 65 years. Cancer 2017;123:2609-17. © 2017 American Cancer Society. © 2017 American Cancer Society.

  8. Pharmacologic strategies in the prevention and treatment of corneal transplant rejection.

    Science.gov (United States)

    Tabbara, Khalid F

    2008-06-01

    Corneal transplantation remains one of the most successful organ transplantation procedures in humans. The unique structure of the cornea, with its absence of blood vessels and corneal lymphatic, allows the survival of corneal allograft. Recent advances in sutures, storage media, microsurgical instrumentation, and new pharmacological strategies have greatly improved the success of corneal transplantation and the prevention of corneal allograft rejection. Our strategies in the management and prevention of corneal graft rejection can modify and improve the survival of corneal allografts. Preoperative evaluation, understanding the risk factors, and management of ocular surface disorders may greatly improve the survival of the corneal transplant. Early recognition of corneal allograft rejection and aggressive treatment may improve the survival of the corneal graft. Furthermore, patients who undergo corneal transplantation should be maintained under close ophthalmic surveillance and patients should be informed to report immediately whenever symptoms of corneal graft rejection occur. The mainstay of therapy is topical corticosteroids. In severe cases, periocular, intravenous, and oral corticosteroids therapy can be rendered. New therapeutic modalities such as cyclosporine, tacrolimus, daclizumab, mycophenolate mofetil, leflunomide, rapamycin, and others may prove to be of help in the prevention and treatment of corneal graft rejection. Early recognition of corneal graft rejection and prompt treatment are mandatory for the successful survival of the corneal allograft.

  9. Strategies and Challenges in Preventing Violence Against Canadian Indoor Sex Workers

    Science.gov (United States)

    Guta, Adrian

    2018-01-01

    Objectives. To examine indoor sex workers’ strategies in preventing workplace violence and influential socio-structural conditions. Methods. Data included qualitative interviews with 85 sex workers in British Columbia, Canada, from 2014 through 2016. For analyses, we used interpretive thematic techniques informed by World Health Organization position statements on violence. Results. Robbery, nonpayment, financial exploitation, and privacy violations were frequent types of violence perpetrated by clients, landlords, and neighbors. We identified 2 themes that depicted how sex workers prevented violence and mitigated its effects: (1) navigating physical spaces and (2) navigating client relationships. Conclusions. Sex workers’ diverse strategies to prevent violence and mitigate its effects are creative and effective in many circumstances. These are limited, however, by the absence of legal and public health regulations governing occupational health and safety and stigma associated with sex work. Public Health Implications. Occupational health and safety regulatory policies that set conditions for clients’ substance and condom use within commercial sex transactions are required. Revisions to the current legal regulations governing prostitution are critical to support optimal work environments that reduce the likelihood of violence. These revisions must recognize sex work as a form of labor versus victimization. PMID:29346001

  10. Direct fitness of group living mammals varies with breeding strategy, climate and fitness estimates.

    Science.gov (United States)

    Ebensperger, Luis A; Rivera, Daniela S; Hayes, Loren D

    2012-09-01

    1. Understanding how variation in fitness relates to variation in group living remains critical to determine whether this major aspect of social behaviour is currently adaptive. 2. Available evidence in social mammals aimed to examine this issue remains controversial. Studies show positive (i.e. potentially adaptive), neutral or even negative fitness effects of group living. 3. Attempts to explain this variation rely on intrinsic and extrinsic factors to social groups. Thus, relatively more positive fitness effects are predicted in singularly breeding as opposed to plural breeding species. Fitness effects of sociality in turn may depend on ecological conditions (i.e. extrinsic factors) that influence associated benefits and costs. 4. We used meta-analytic tools to review how breeding strategy or ecological conditions influence the effect size associated with direct fitness-sociality relationships reported in the mammalian literature. Additionally, we determined how taxonomic affiliation of species studied, different fitness and sociality measures used, and major climatic conditions of study sites explained any variation in direct fitness effect size. 5. We found group living had modest, yet positive effects on direct fitness. This generally adaptive scenario was contingent not only upon breeding strategy and climate of study sites, but also on fitness measures examined. Thus, positive and significant effects characterized singular as opposed to plural breeding strategies. 6. We found more positive fitness effects on studies conducted in tropical as opposed to temperate or arid climates. More positive and significant effects were noted on studies that relied on group fecundity, male fecundity and offspring survival as measures of fitness. 7. To conclude, direct fitness consequences of mammalian group living are driven by interspecific differences in breeding strategy and climate conditions. Other factors not examined in this study, namely individual variation in

  11. A Pan American Health Organization strategy for cervical cancer prevention and control in Latin America and the Caribbean.

    Science.gov (United States)

    Luciani, Silvana; Andrus, Jon Kim

    2008-11-01

    Cervical cancer is the leading cause of cancer deaths among women in Latin America and the Caribbean, and disproportionately affects poorer women. Mortality rates in the region are seven times greater than in North America. In light of the significant public health burden, the Pan American Health Organization has drafted a Regional Strategy for Cervical Cancer Prevention and Control. The Strategy calls for increased action to strengthen programmes through an integrated package of services: health information and education; screening and pre-cancer treatment; invasive cervical cancer treatment and palliative care; and evidence-based policy decisions on whether and how to introduce human papillomavirus (HPV) vaccines. It calls for a seven-point plan of action: conduct a situation analysis; intensify information, education and counselling; scale up screening and link to pre-cancer treatment; strengthen information systems and cancer registries; improve access to and quality of cancer treatment and palliative care; generate evidence to facilitate decision-making regarding HPV vaccine introduction; and advocate for equitable access and affordable HPV vaccines. This proposed strategy, approved by the PAHO Directing Council on 1 October 2008, has the possibility of stimulating and accelerating the introduction of new screening technology and HPV vaccines into programmes throughout Latin America and the Caribbean.

  12. Biological prevention and/or treatment strategies for radiation myelopathy. Discussion of a new perspective

    International Nuclear Information System (INIS)

    Nieder, C.; Ataman, F.; Price, R.E.; Kian Ang, K.

    1999-01-01

    Background: Radiosensitivity of the spinal cord makes both curative first-line treatment of numerous malignancies and re-irradiation of recurrent or second tumors more difficult. This review discusses recent advances in basic research that alter the view on the pathogenesis of radiation myelopathy, possibly offering strategies for prevention and/or therapy. Results: Available data of developmental neurobiology and preclinical studies of demyelinating diseases revealed interesting insights into oligodendrocyte development, intercellular signaling pathways, and myelination processes. Current findings suggest that administration of cytokines could increase proliferation of oligodendrocyte progenitor cells, enhance their differentiation, upregulate synthesis of myelin constituents, and promote myelin regeneration in the adult central nervous system. Other compounds might also be able to modulate progression of pathogenic processes that eventually lead to radiation myelopathy. This offers several possible biological prevention and/or treatment strategies, which currently are being investigated in animal studies. Conclusions: Technical options as well as optimization of fractionation parameters should be given priority in the attempt to reduce iatrogenic neurotoxicity. However, rational biological strategies could offer a new perspective for many patients. (orig.) [de

  13. Awareness among Indian professional football players about injury prevention strategies: A national survey.

    Science.gov (United States)

    Nair, Rohit; Rajasekar, Sannasi; Abraham, Allan; Samuel, Asir John

    2018-03-01

    To determine the awareness and application of the injury prevention strategies by professional Indian football players through Standard Questionnaire Based Survey. Descriptive Epidemiological Study. Professional football clubs in India. Among 150 professional footballers playing in India, 109 football players participated.. The online questionnaire was made in the Google drive application. An online URL (www.tinyurl.com/futbolscptrc) was made in Google accounts by Google drive. 150 professional footballers playing in India were identified and invited to participate in this descriptive epidemiological online survey. All duly filled questionnaire responses were automatically reached in the Google drive inbox. Descriptive analysis was used for the data analysis. Questionnaires were distributed to 150 professional players at nine Indian League clubs. 109 players responded, which represents a response rate of 73%. The player age and number of years as a professional footballers were 25 (4) years (range 18-38 years) and 6 (4) years (range 1-16 years) respectively. The players were from one Premier (9), two Division One (6 and 16), and two Division Two (9 and 15) teams. Most of the professional Indian football players are aware about the injury prevention strategies. However, the application of these strategies is consistently followed by Premier division players.

  14. Persuasion strategies and sexual solicitations and interactions in online sexual grooming of adolescents: Modeling direct and indirect pathways.

    Science.gov (United States)

    Gámez-Guadix, Manuel; Almendros, Carmen; Calvete, Esther; De Santisteban, Patricia

    2018-02-01

    Online sexual grooming and exploitation of adolescents is receiving increasing social attention. Drawing on a social influence framework, the aim of this study was to test a model of the direct and mediated relationships between an adult's use of persuasion strategies and online sexual grooming of early adolescents. The initial sample of the study consisted of 2731 early Spanish adolescents between 12 and 15 years old (50.6% female). Of these, 196 adolescents (7.17% of the total; 53% girls) were involved in online grooming (mean age = 14.93, SD = 0.90). Persuasion strategies by the adult through internet increased the probability of using deceit, bribery, and the minor's nonsexual involvement. In addition, deceit and bribery were associated with higher rates of sexual solicitation, which in turn increased abusive sexual interactions. Understanding strategies used by adults to groom minors contributes to the prevention of and intervention in this crucial societal problem. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  15. Flexibility to contingency changes distinguishes habitual and goal-directed strategies in humans.

    Science.gov (United States)

    Lee, Julie J; Keramati, Mehdi

    2017-09-01

    Decision-making in the real world presents the challenge of requiring flexible yet prompt behavior, a balance that has been characterized in terms of a trade-off between a slower, prospective goal-directed model-based (MB) strategy and a fast, retrospective habitual model-free (MF) strategy. Theory predicts that flexibility to changes in both reward values and transition contingencies can determine the relative influence of the two systems in reinforcement learning, but few studies have manipulated the latter. Therefore, we developed a novel two-level contingency change task in which transition contingencies between states change every few trials; MB and MF control predict different responses following these contingency changes, allowing their relative influence to be inferred. Additionally, we manipulated the rate of contingency changes in order to determine whether contingency change volatility would play a role in shifting subjects between a MB and MF strategy. We found that human subjects employed a hybrid MB/MF strategy on the task, corroborating the parallel contribution of MB and MF systems in reinforcement learning. Further, subjects did not remain at one level of MB/MF behaviour but rather displayed a shift towards more MB behavior over the first two blocks that was not attributable to the rate of contingency changes but rather to the extent of training. We demonstrate that flexibility to contingency changes can distinguish MB and MF strategies, with human subjects utilizing a hybrid strategy that shifts towards more MB behavior over blocks, consequently corresponding to a higher payoff.

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

    Directory of Open Access Journals (Sweden)

    William A. Satariano

    2017-08-01

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

  17. Applying theories to better understand socio-political challenges in implementing evidence-based work disability prevention strategies.

    Science.gov (United States)

    Ståhl, Christian; Costa-Black, Katia; Loisel, Patrick

    2018-04-01

    This article explores and applies theories for analyzing socio-political aspects of implementation of work disability prevention (WDP) strategies. For the analysis, theories from political science are explained and discussed in relation to case examples from three jurisdictions (Sweden, Brazil and Québec). Implementation of WDP strategies may be studied through a conceptual framework that targets: (1) the institutional system in which policy-makers and other stakeholders reside; (2) the ambiguity and conflicts regarding what to do and how to do it; (3) the bounded rationality, path dependency and social systems of different stakeholders; and (4) coalitions formed by different stakeholders and power relations between them. In the case examples, the design of social insurance systems, the access to and infrastructure of healthcare systems, labor market policies, employers' level of responsibility, the regulatory environment, and the general knowledge of WDP issues among stakeholders played different roles in the implementation of policies based on scientific evidence. Future research may involve participatory approaches focusing on building coalitions and communities of practice with policy-makers and stakeholders, in order to build trust, facilitate cooperation, and to better promote evidence utilization. Implications for Rehabilitation Implementation of work disability prevention policies are subject to contextual influences from the socio-political setting and from relationships between stakeholders Stakeholders involved in implementing strategies are bound to act based on their interests and previous courses of action To promote research uptake on the policy level, stakeholders and researchers need to engage in collaboration and translational activities Political stakeholders at the government and community levels need to be more directly involved as partners in the production and utilization of evidence.

  18. Prevention strategies for antimicrobial resistance: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Whitney P Caron

    2010-05-01

    Full Text Available Whitney P Caron1, Shaker A Mousa1,21The Pharmaceutical Research Institute, Center of Excellence of Infection Prevention (CEIP, Albany College of Pharmacy and Health Sciences, Albany, NY, USA; 2King Saud University, Riyadh, Saudi ArabiaAbstract: Antibiotics offer great benefits by reducing the duration and severity of illnesses and aiding in infection transmission control. With this being said, the inexorable process of antimicrobial drug resistance is to some degree unavoidable. Although drug resistance will likely persist and is to be expected, the overall level can be dramatically decreased with increased attention to antibiotic overuse and the pharmacokinetic and pharmacodynamic properties of different drug formulations, and the use of proper hygiene and protective barriers. Implementation of such practices as microbial surveillance and prophylaxis has been shown to result in decreased hospital length of stay, health care costs and mortality due to drug-resistant infections. This review will summarize current progress in preventative techniques aimed at reducing the incidence of infection by antimicrobial-resistant bacteria and the emergence and spread of antimicrobial-resistant strains. By employing a variety of prevention strategies, including proper personal hygiene, prescreening for carrier status before hospital admission, disinfection of hospital rooms, and careful monitoring of antimicrobial prescribing, marked progress can be achieved in the control of drug-resistant pathogens, which can translate into more effective antimicrobial therapy.Keywords: infection prevention, antibiotic, personal hygiene, disinfection, microbial surveillance, drug-resistant pathogen

  19. Preventive Strategies against Bleeding due to Nonvitamin K Antagonist Oral Anticoagulants

    Directory of Open Access Journals (Sweden)

    Lessire Sarah

    2014-01-01

    Full Text Available Dabigatran etexilate (DE, rivaroxaban, and apixaban are nonvitamin K antagonist oral anticoagulants (NOACs that have been compared in clinical trials with existing anticoagulants (warfarin and enoxaparin in several indications for the prevention and treatment of thrombotic events. All NOACs presented bleeding events despite a careful selection and control of patients. Compared with warfarin, NOACs had a decreased risk of intracranial hemorrhage, and apixaban and DE (110 mg BID had a decreased risk of major bleeding from any site. Rivaroxaban and DE showed an increased risk of major gastrointestinal bleeding compared with warfarin. Developing strategies to minimize the risk of bleeding is essential, as major bleedings are reported in clinical practice and specific antidotes are currently not available. In this paper, the following preventive approaches are reviewed: improvement of appropriate prescription, identification of modifiable bleeding risk factors, tailoring NOAC’s dose, dealing with a missed dose as well as adhesion to switching, bridging and anesthetic procedures.

  20. An alternate HIV preventive strategy: sex scripts in media for women of color.

    Science.gov (United States)

    Medina, Catherine; Rios, Diana I

    2011-01-01

    New cases of HIV/AIDS among women of color in the United States highlight the continuing need for the public and private sectors to develop alternate preventive strategies. The author discusses the conceptual basis for using television sex scripts to incorporate women of color relational needs (trust, romance, sexual pressure) to promote HIV risk-reduction messages through a process of association with the television storyline. Sex scripts are a source of implicit knowledge about how to behave in situations that involve sexual intimacy. The article suggests that sexual scripts prevention messages build on the agency of women through the use of power theory-that is supporting woman's self-power by participating in sexual behavioral change. Implications for sexual equality in media programming are discussed.

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

    Science.gov (United States)

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

    2018-05-11

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

  2. Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

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    Pan Lianjun

    2012-09-01

    Full Text Available Abstract Background Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China. Methods Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son. Results Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”. The major reason for EIMC was for health (44.8%, followed by doctor’s advice (31.2%. The major reason not to agree to EIMC was concern about pain (50.5%, followed by the risk of the procedure (23.5%. Conclusion The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

  3. Direct anti-atherosclerotic therapy; development of natural anti-atherosclerotic drugs preventing cellular cholesterol retention.

    Science.gov (United States)

    Orekhov, Alexander N

    2013-01-01

    The results of numerous clinical trials with statins and other drugs have demonstrated the principal possibility of the prevention and regression of atherosclerosis by pharmacotherapy. This review describes the use of cultured human arterial cells for the mass screening of anti-atherosclerotic substances, the investigation of the mechanisms responsible for their atherosclerosis-related effects, and the optimization of anti-atherosclerotic and anti-atherogenic drug and dietary therapies. Natural products can be considered promising drugs for anti-atherosclerotic therapy. Our basic studies have shown that cellular lipidosis is the principal event in the genesis of atherosclerotic lesions. Using cellular models and natural products, we have developed an approach to prevent lipid accumulation in arterial cells. Based on our knowledge of atherosclerosis, we developed drugs that possess direct anti-atherosclerotic activity. Two-year treatment with allicor (garlic powder) has a direct anti-atherosclerotic effect on carotid atherosclerosis in asymptomatic men. Inflaminat (calendula, elder, and violet), which possesses anti-cytokine activity, has been shown to cause the regression of carotid atherosclerosis following the treatment of asymptomatic men for one year. The phytoestrogen-rich drug karinat (garlic powder, extract of grape seeds, green tea leaves, hop cones, β-carotene, α-tocopherol, and ascorbic acid) prevents the development of carotid atherosclerosis in postmenopausal women. Thus, our basic findings were successfully translated into clinical practice. Because of this translation, a novel approach to antiatherosclerotic therapy was developed. Our clinical trial confirmed the efficacy of both the novel approach and the novel drugs.

  4. Youth violence prevention comes of age: research, training and future directions.

    Science.gov (United States)

    Williams, Kara; Rivera, Lourdes; Neighbours, Robert; Reznik, Vivian

    2007-01-01

    Youth violence is recognized as a major public health problem in the United States and the world. Over the past ten years, progress has been made in documenting the factors that contribute to violent behavior. Emerging research is deepening our understanding of the individual and societal influences that contribute to and protect against youth violence. However, much work still remains to be done in this field, both in examining potential causes and in designing effective intervention strategies. This chapter highlights specific dimensions of youth violence prevention selected by the authors because these dimensions are the focus of public attention, are emerging as critical issues in the study of youth violence, or have a unique place in the current political and social context. We focus on the developmental pathways to violence, factors that mediate and moderate youth violence, the role of culture and media in youth violence, school-based violence such as school shootings and bullying, and the training of health care professionals.

  5. The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention.

    Science.gov (United States)

    Safdar, Nasia; Crnich, Christopher J; Maki, Dennis G

    2005-06-01

    Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the intensive care unit and is associated with major morbidity and attributable mortality. Strategies to prevent VAP are likely to be successful only if based upon a sound understanding of pathogenesis and epidemiology. The major route for acquiring endemic VAP is oropharyngeal colonization by the endogenous flora or by pathogens acquired exogenously from the intensive care unit environment, especially the hands or apparel of health-care workers, contaminated respiratory equipment, hospital water, or air. The stomach represents a potential site of secondary colonization and reservoir of nosocomial Gram-negative bacilli. Endotracheal-tube biofilm formation may play a contributory role in sustaining tracheal colonization and also have an important role in late-onset VAP caused by resistant organisms. Aspiration of microbe-laden oropharyngeal, gastric, or tracheal secretions around the cuffed endotracheal tube into the normally sterile lower respiratory tract results in most cases of endemic VAP. In contrast, epidemic VAP is most often caused by contamination of respiratory therapy equipment, bronchoscopes, medical aerosols, water (eg, Legionella) or air (eg, Aspergillus or the severe acute respiratory syndrome virus). Strategies to eradicate oropharyngeal and/or intestinal microbial colonization, such as with chlorhexidine oral care, prophylactic aerosolization of antimicrobials, selective aerodigestive mucosal antimicrobial decontamination, or the use of sucralfate rather than H(2) antagonists for stress ulcer prophylaxis, and measures to prevent aspiration, such as semirecumbent positioning or continuous subglottic suctioning, have all been shown to reduce the risk of VAP. Measures to prevent epidemic VAP include rigorous disinfection of respiratory equipment and bronchoscopes, and infection-control measures to prevent contamination of medical aerosols. Hospital water should be

  6. Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods.

    Science.gov (United States)

    Brandt, Mary; Brown, Clive; Burkhart, Joe; Burton, Nancy; Cox-Ganser, Jean; Damon, Scott; Falk, Henry; Fridkin, Scott; Garbe, Paul; McGeehin, Mike; Morgan, Juliette; Page, Elena; Rao, Carol; Redd, Stephen; Sinks, Tom; Trout, Douglas; Wallingford, Kenneth; Warnock, David; Weissman, David

    2006-06-09

    Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for health effects in susceptible persons regardless of the type of mold or the extent of contamination. For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.

  7. Self-harm in British South Asian women: psychosocial correlates and strategies for prevention

    OpenAIRE

    Waheed W; Husain MI; Husain Nusrat

    2006-01-01

    Abstract Objective To review the rates of self-harm in British South Asian women, look into the factors that contribute to these high rates of self-harm and discuss possible strategies for prevention and provision of culturally sensitive service for South Asian women who harm themselves. Method Review. Results South Asian women are significantly more likely to self harm between ages 16–24 years than white women. Across all age groups the rates of self harm are lower in South Asian men as comp...

  8. A systematic review investigating the behaviour change strategies in interventions to prevent misuse of anabolic steroids.

    Science.gov (United States)

    Bates, Geoff; Begley, Emma; Tod, David; Jones, Lisa; Leavey, Conan; McVeigh, Jim

    2017-10-01

    We examined intervention effectiveness of strategies to prevent image- and performance-enhancing drug use. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow-up times. However, studies with components in addition to information provision may be more promising. Interventions outside of sport settings are required to reflect the transition of this form of substance use to the general population.

  9. [Digestive and extra-digestive complications of nonsteroidal anti-inflammatory drugs. Preventive and curative strategies].

    Science.gov (United States)

    Sternon, J; Adler, M

    1997-04-01

    The authors review the digestive ulceration risk factors and the criteria for selecting a non steroidal antiinflammatory (NSAI), included the most recent drugs, such as selective anti-cyclo-oxygenases 2. They actualize the preventive strategies and insist on the values of misoprostol and of slow acting anti-rheumatic drugs. In the case of digestive ulcerations, they plead for the immediate stop of the NSAI and its replacement if necessary by corticosteroids, for the prescription of a proton pump inhibitor (PPI) or mesalazine according to the localisation of the lesion, finally for the eradication within 8 days of Helicobacter pylori.

  10. Strategies to Engage Adolescents in Digital Health Interventions for Obesity Prevention and Management

    Directory of Open Access Journals (Sweden)

    Stephanie R. Partridge

    2018-06-01

    Full Text Available Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behavior change interventions. Despite the rapid growth in digital health interventions, effective engagement with adolescents remains a pertinent issue. Key strategies for effective engagement include co-designing interventions with adolescents, personalization of interventions, and just-in-time adaptation using data from wearable devices. The aim of this paper is to appraise these strategies, which may be used to improve effective engagement and thereby improve the dietary behaviors of adolescents now and in the future.

  11. [Network Prevention of Accidents at Work: a strategy for distance education].

    Science.gov (United States)

    Marziale, Maria Helena; Zapparoli, Amanda dos Santos; Felli, Vanda Elisa; Anabuki, Marina Hideko

    2010-01-01

    Quasi-experimental study that aimed at evaluating the proposed interactive training, as a strategy for change in the behavior of workers, seeking the appropriate use of gloves in the administration of intravenous drugs. The interactive training was structured in the Model of Health Promotion of Pender, conducted through access to the web site of the Network Prevention of Accidents at Work (REPAT) available from: http://repat.eerp.usp.br/estrategia/index.php and applied in 60 workers nursing from two hospitals in the state of Sao Paulo. On the week before the training 58.3% of the workers were wearing gloves to administrate intravenous drugs and 83.3% of the workers informed the intention of wearing gloves after the training. the use of interactive tool facilitated the implementation of educational strategy in work and showed that training can help in changing behavior.

  12. Direct versus indirect psychosocial and behavioural interventions to prevent suicide and suicide attempts: a systematic review and meta-analysis.

    Science.gov (United States)

    Meerwijk, Esther L; Parekh, Amrita; Oquendo, Maria A; Allen, I Elaine; Franck, Linda S; Lee, Kathryn A

    2016-06-01

    Psychosocial and behavioural interventions that address suicidal thoughts and behaviour during treatment (direct interventions) might be more effective in preventing suicide and suicide attempts than indirect interventions that address symptoms associated with suicidal behaviour only (eg, hopelessness, depression, anxiety, quality of life). To test this hypothesis, we did a systematic review and meta-analysis of psychosocial and behavioural interventions aimed at preventing suicide and suicide attempts. For this systematic review and meta-analysis, we searched MEDLINE and PsycINFO from inception to Dec 25, 2015, for randomised controlled trials that reported suicides or suicide attempts as an outcome, irrespective of participants' diagnoses or the publication language. We excluded studies with pharmacological or device-based interventions, those that targeted communities or clinicians, primary prevention trials, and trials that reported events of non-suicidal self-injury as suicide attempts. Trials that had no suicides or suicide attempts in both groups were also excluded. Data were extracted by one investigator and independently verified by a second investigator. We used random-effects models of the odds ratio (OR) based on a pooled measure of suicides and the number of individuals who attempted suicide, immediately post-treatment and at longer-term follow-up. Of 2024 unique abstracts screened, 53 articles met eligibility criteria and reported on 44 studies; 31 studies provided post-treatment data with 6658 intervention group participants and 6711 control group participants at baseline, and 29 studies provided follow-up data. The post-treatment difference between direct interventions and indirect interventions did not reach statistical significance at the 0·05 level (OR 0·62 [95% CI 0·45-0·87] vs 0·93 [0·77-1·12], p=0·06) and represented a large effect size (Cohen's d=0·77). At longer-term follow-up, the difference was not significant (OR 0·65 [0·46-0

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

    Science.gov (United States)

    Nuttall, Jeremy

    2010-07-09

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

  14. A Research Strategy Case Study of Alcohol and Drug Prevention by Non-Governmental Organizations in Sweden 2003-2009

    Directory of Open Access Journals (Sweden)

    Larsson Madelene

    2011-04-01

    Full Text Available Abstract Background Alcohol and drug prevention is high on the public health agenda in many countries. An increasing trend is the call for evidence-based practice. In Sweden in 2002 an innovative project portfolio including an integrated research and competence-building strategy for non-governmental organisations (NGOs was designed by the National Board of Health and Welfare (NBHW. This research strategy case study is based on this initiative. Methods The embedded case study includes 135 projects in 69 organisations and 14 in-depth process or effect studies. The data in the case study has been compiled using multiple methods - administrative data; interviews and questionnaires to project leaders; focus group discussions and seminars; direct and participatory observations, interviews, and documentation of implementation; consultations with the NBHW and the NGOs; and a literature review. Annual reports have been submitted each year and three bi-national conferences Reflections on preventions have been held. Results A broad range of organisations have been included in the NBHW project portfolio. A minority of the project were run by Alcohol or drug organisations, while a majority has children or adolescents as target groups. In order to develop a trustful partnership between practitioners, national agencies and researchers a series of measures were developed and implemented: meeting with project leaders, project dialogues and consultations, competence strengthening, support to documentation, in-depth studies and national conferences. A common element was that the projects were program-driven and not research-driven interventions. The role of researchers-as-technical advisors was suitable for the fostering of a trustful partnership for research and development. The independence of the NGOs was regarded as important for the momentum in the project implementation. The research strategy also includes elements of participatory research. Conclusions This

  15. Concise review: reprogramming strategies for cardiovascular regenerative medicine: from induced pluripotent stem cells to direct reprogramming.

    Science.gov (United States)

    Budniatzky, Inbar; Gepstein, Lior

    2014-04-01

    Myocardial cell-replacement therapies are emerging as novel therapeutic paradigms for myocardial repair but are hampered by the lack of sources of autologous human cardiomyocytes. The recent advances in stem cell biology and in transcription factor-based reprogramming strategies may provide exciting solutions to this problem. In the current review, we describe the different reprogramming strategies that can give rise to cardiomyocytes for regenerative medicine purposes. Initially, we describe induced pluripotent stem cell technology, a method by which adult somatic cells can be reprogrammed to yield pluripotent stem cells that could later be coaxed ex vivo to differentiate into cardiomyocytes. The generated induced pluripotent stem cell-derived cardiomyocytes could then be used for myocardial cell transplantation and tissue engineering strategies. We also describe the more recent direct reprogramming approaches that aim to directly convert the phenotype of one mature cell type (fibroblast) to another (cardiomyocyte) without going through a pluripotent intermediate cell type. The advantages and shortcomings of each strategy for cardiac regeneration are discussed, along with the hurdles that need to be overcome on the road to clinical translation.

  16. Adolescent Cellphone Use While Driving: An Overview of the Literature and Promising Future Directions for Prevention

    Directory of Open Access Journals (Sweden)

    M. Kit Delgado

    2016-06-01

    Full Text Available Motor vehicle crashes are the leading cause of death in adolescents, and drivers aged 16–19 are the most likely to die in distracted driving crashes. This paper provides an overview of the literature on adolescent cellphone use while driving, focusing on the crash risk, incidence, risk factors for engagement, and the effectiveness of current mitigation strategies. We conclude by discussing promising future approaches to prevent crashes related to cellphone use in adolescents. Handheld manipulation of the phone while driving has been shown to have a 3 to 4-fold increased risk of a near crash or crash, and eye glance duration greater than 2 seconds increases crash risk exponentially. Nearly half of U.S. high school students admit to texting while driving in the last month, but the frequency of use according to vehicle speed and high-risk situations remains unknown. Several risk factors are associated with cell phone use while driving including: parental cellphone use while driving, social norms for quick responses to text messages, and higher levels of temporal discounting. Given the limited effectiveness of current mitigation strategies such as educational campaigns and legal bans, a multi-pronged behavioral and technological approach addressing the above risk factors will be necessary to reduce this dangerous behavior in adolescents.

  17. Adolescent Cellphone Use While Driving: An Overview of the Literature and Promising Future Directions for Prevention

    Science.gov (United States)

    Delgado, M. Kit; Wanner, Kathryn J.; McDonald, Catherine

    2016-01-01

    Motor vehicle crashes are the leading cause of death in adolescents, and drivers aged 16–19 are the most likely to die in distracted driving crashes. This paper provides an overview of the literature on adolescent cellphone use while driving, focusing on the crash risk, incidence, risk factors for engagement, and the effectiveness of current mitigation strategies. We conclude by discussing promising future approaches to prevent crashes related to cellphone use in adolescents. Handheld manipulation of the phone while driving has been shown to have a 3 to 4-fold increased risk of a near crash or crash, and eye glance duration greater than 2 seconds increases crash risk exponentially. Nearly half of U.S. high school students admit to texting while driving in the last month, but the frequency of use according to vehicle speed and high-risk situations remains unknown. Several risk factors are associated with cell phone use while driving including: parental cellphone use while driving, social norms for quick responses to text messages, and higher levels of temporal discounting. Given the limited effectiveness of current mitigation strategies such as educational campaigns and legal bans, a multi-pronged behavioral and technological approach addressing the above risk factors will be necessary to reduce this dangerous behavior in adolescents. PMID:27695663

  18. PGD for all cystic fibrosis carrier couples: novel strategy for preventive medicine and cost analysis.

    Science.gov (United States)

    Tur-Kaspa, I; Aljadeff, G; Rechitsky, S; Grotjan, H E; Verlinsky, Y

    2010-08-01

    Over 1000 children affected with cystic fibrosis (CF) are born annually in the USA. Since IVF with preimplantation genetic diagnosis (PGD) is an alternative to raising a sick child or to aborting an affected fetus, a cost-benefit analysis was performed for a national IVF-PGD program for preventing CF. The amount spent to deliver healthy children for all CF carrier-couples by IVF-PGD was compared with the average annual and lifetime direct medical costs per CF patient avoided. Treating annually about 4000 CF carrier-couples with IVF-PGD would result in 3715 deliveries of non-affected children at a cost of $57,467 per baby. Because the average annual direct medical cost per CF patient was $63,127 and life expectancy is 37 years, savings would be $2.3 million per patient and $2.2 billion for all new CF patients annually in lifetime treatment costs. Cumulated net saving of an IVF-PGD program for all carrier-couples for 37 years would be $33.3 billion. A total of 618,714 cumulative years of patients suffering because of CF and thousands of abortions could be prevented. A national IVF-PGD program is a highly cost-effective novel modality of preventive medicine and would avoid most births of individuals affected with debilitating genetic disease. 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Hope and self-regulatory goals applied to an advertising context : promoting prevention stimulates goal-directed behavior.

    NARCIS (Netherlands)

    Poels, K.; Dewitte, S.

    2008-01-01

    This article proposes the existence of two types of hope which differ in terms of self-regulatory goals: prevention hope and promotion hope. Consistent with the functional emotion approach and regulatory focus theory, we show that prevention hope generates more goal-directed behavior compared to

  20. Hope and self regulatory goals applied to an advertising context : promoting prevention stimulates goal-directed behavior

    NARCIS (Netherlands)

    Poels, K.; Dewitte, S.; Astregaard, S.; Dwight, M.

    2007-01-01

    This article proposes the existence of two types of hope which differ in terms of self-regulatory goals: prevention hope and promotion hope. Consistent with the functional emotion approach and regulatory focus theory, we show that prevention hope generates more goal-directed behavior compared to

  1. Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

    Science.gov (United States)

    Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

    2008-01-01

    To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p prevention and control (p support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

  2. Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV infection: a general trend

    Directory of Open Access Journals (Sweden)

    Frédéric Gervais

    2017-03-01

    Full Text Available Abstract Background Due to the arrival of multi-valent HPV vaccines, it is more and more important to have a better understanding of the relationship between vaccination and screening programmes. This review aimed to: (1 collect published evidence on the cost-effectiveness profile of different HPV prevention strategies and, in particular, those combining vaccination with changes in screening practices; (2 explore the cost-effectiveness of alternative preventive strategies based on screening and vaccination. Methods A systematic literature review was conducted in order to identify the relevant studies regarding the cost-effectiveness of prevention strategies against HPV infection. Analysis comparing the modelling approaches between studies was made along with an assessment of the magnitude of impact of several factors on the cost-effectiveness of different screening strategies. Results A total of 18 papers were quantitatively summarised within the narrative. A high degree of heterogeneity was found in terms of how HPV prevention strategies have been assessed in terms of their economic and epidemiological impact, with variation in screening practice and valence of HPV vaccination found to have large implications in terms of cost-effectiveness. Conclusions This review demonstrated synergies between screening and vaccination. New prevention strategies involving multi-valence vaccination, HPV DNA test screening, delayed commencement and frequency of screening could be implemented in the future. Strategies implemented in the future should be chosen with care, and informed knowledge of the potential impact of all possible prevention strategies. Highlighted in this review is the difficulty in assessing multiple strategies. Appropriate modelling techniques will need to be utilised to assess the most cost-effective strategies.

  3. Promotion and Prevention Focused Feeding Strategies: Exploring the Effects on Healthy and Unhealthy Child Eating

    Directory of Open Access Journals (Sweden)

    Elisabeth L. Melbye

    2015-01-01

    Full Text Available There is a general lack of research addressing the motivations behind parental use of various feeding practices. Therefore, the present work aims to extend the current literature on parent-child feeding interactions by integrating the traditional developmental psychological perspective on feeding practices with elements of Regulatory Focus Theory (RFT derived from the field of motivational psychology. In this paper, we seek to explain associations between parental feeding practices and child (unhealthy eating behaviors by categorizing parental feeding practices into promotion and prevention focused strategies, thus exploring parent-child feeding interactions within the framework of RFT. Our analyses partly supported the idea that (1 child healthy eating is positively associated with feeding practices characterized as promotion focused, and (2 child unhealthy eating is negatively associated with feeding practices characterized as prevention focused. However, a general observation following from our results suggests that parents’ major driving forces behind reducing children’s consumption of unhealthy food items and increasing their consumption of healthy food items are strategies that motivate rather than restrict. In particular, parents’ provision of a healthy home food environment seems to be essential for child eating.

  4. Internet and people with intellectual disability: an approach to caregivers’ concerns, prevention strategies and training needs

    Directory of Open Access Journals (Sweden)

    Esther Chiner

    2017-07-01

    Full Text Available The aim of this study was to explore caregivers’ views about the risks of the Internet for people with intellectual disabilities and their preparation and ability to use prevention strategies to address them. The participants (20 family members and 24 staff members belonged to a non-profit association working with people with developmental and intellectual disabilities and were asked to respond to a questionnaire about Internet safety and risks. Findings show some concerns from caregivers with regard to the use of the Internet by people with intellectual disabilities and suggest that this group is more vulnerable to online risks. Participants use different kinds of strategies to prevent the risks but they have not received any formal training. They think that this training should come from the Administration and other organisations. Some differences were found between family and staff members’ responses. Training programmes for all the groups involved in this process (i.e. people with intellectual disabilities, staff and family members should be designed, implemented and assessed to promote the inclusion of people with intellectual disabilities in the digital arena.

  5. Implementing the European Marine Strategy Framework Directive: Scientific challenges and opportunities

    Science.gov (United States)

    Newton, Alice; Borja, Angel; Solidoro, Cosimo; Grégoire, Marilaure

    2015-10-01

    The Marine Strategy Framework Directive (MSFD; EC, 2008) is an ambitious European policy instrument that aims to achieve Good Environmental Status (GES) in the 5,720,000 km2 of European seas by 2020, using an Ecosystem Approach. GES is to be assessed using 11 descriptors and up to 56 indicators (European Commission, 2010), and the goal is for clean, healthy and productive seas that are the basis for marine-based development, known as Blue-Growth. The MSFD is one of many policy instruments, such as the Water Framework Directive, the Common Fisheries Policy and the Habitats Directive that, together, should result in "Healthy Oceans and Productive Ecosystems - HOPE". Researchers working together with stakeholders such as the Member States environmental agencies, the European Environmental Agency, and the Regional Sea Conventions, are to provide the scientific knowledge basis for the implementation of the MSFD. This represents both a fascinating challenge and a stimulating opportunity.

  6. Make a Difference at Your School! CDC Resources Can Help You Implement Strategies to Prevent Obesity Among Children and Adolescents

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2008

    2008-01-01

    The Centers for Disease Control and Prevention (CDC) reviews scientific evidence to determine which school-based policies and practices are most likely to improve key health behaviors among young people, including physical activity and healthy eating. In this document, the CDC identifies ten strategies to help schools prevent obesity by promoting…

  7. Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix

    NARCIS (Netherlands)

    Vriend, Ingrid; Gouttebarge, Vincent; Finch, Caroline F.; van Mechelen, Willem; Verhagen, Evert A. L. M.

    2017-01-01

    Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered.

  8. Exercise and Life-Satisfactory-Fitness: Complementary Strategies in the Prevention and Rehabilitation of Illnesses

    Directory of Open Access Journals (Sweden)

    Christiane Jennen

    2004-01-01

    Full Text Available Moderate training of an endurance nature, but also other exercise activities, not only has a preventive effect on various illnesses and pre-illness states such as the metabolic syndrome and cancer, but is also effective in treating patients in the rehabilitation phase after illness, e.g. cardiovascular or cancer. Our investigation demonstrates that even low level physical activity has a very good preventive effect too, which is enhanced when it is accompanied by mental activity and psychological well-being. In total, we investigated 13 000 people on the basis of socio-economic panel polls with respect to life contentment, health status and leisure-time activities. Life contentment is positively linked to contentment with labor, which seems to be an essential aspect with regard to the increasing number of unemployed people in Europe. The second important factor is health-promoting activities during leisure time. Exercise, especially, has a significant influence on life satisfaction as a feeling of physical fitness feeling is regarded as synonymous with good health. The results underline the psycho-neuroimmunological network, which stabilizes our health and shows that different activities in older adults have a significant effect on the aging process and age-related illnesses. Besides the various activities that are important in this arena, namely muscle and mental mobility (‘brawn and brain’, a third component must be taken into consideration: life contentment in the form of a successful retrospective view and a positive outlook, embedded in a psychosocial family environment (‘brood’ and integrated in a stress-free biotope, where life does make sense. Alternative and complementary strategies should be considered in light of these three aspects when we think about additional anti-inflammatory strategies in preventing diseases or treating them and their relapses.

  9. Development of an effective communication strategy for the prevention of burns in children: the PRIUS project.

    Science.gov (United States)

    Cedri, S; Briguglio, E; Cedri, C; Masellis, A; Crenca, A; Pitidis, A

    2015-06-30

    This study has developed a learning kit for the prevention of domestic burns in childhood. The main objective was to trial an educational package for children (nursery and primary classes), for the prevention of burns, to be implemented through education in schools. The educational kit comprises posters, information leaflets, comic books, and pre and post education evaluation materials for school children, parents and teachers. Recipients of the preliminary study were the students of nine schools in the eight Italian cities where Burn Centers are located. In order to reach the target groups of children, it was necessary to identify the most effective communication strategy to convey the burn prevention message. For nursery school children, it was not possible to use tools with written texts alone, as they were not yet literate. Moreover, even for older children, it was necessary to find an attractive tool to catch their attention and interest, promoting the understanding and memorization of lessons learned. The most suitable means was found to be comic strips, allowing the messages to be conveyed through images as well as words. A total of 370 children (195 from nurseries and 175 from primary schools) participated in the trial of the educational kit. Overall, for every environment represented in the evaluation table, the ability to recognize the dangers among both the pre-school and primary school children increased significantly after the training activity. In conclusion, the educational kit has been positively assessed.

  10. [Epidemic situation and prevention and control strategy of clonorchiasis in Guangdong Province, China].

    Science.gov (United States)

    Zhuo-Hui, Deng; Yue-Yi, Fang

    2016-05-24

    Clonorchiasis is one of the food-borne parasitic diseases. Adult parasites live in the human liver and gallbladder tube system, causing serious complications, such as gallstones, cholecystitis and cholangitis, and even bile duct cancer. The disease is very popular in our country, and the population infection rate is high. It is an important public health problem. Guangdong Province is the earliest province being found of clonorchiasis and with serious epidemic. In the second national human parasitic diseases distribution survey, the results showed that the average infection rate of Clonorchis sinensis in the epidemic areas in Guangdong was 16.42%. It is estimated that the population of C. sinensis infection is over 6 million. The prevention and control of clonorchiasis in China is still in the initial stage currently and we face many challenges such as unclear epidemic characteristics and transmission mode, and lack of long-term prevention and control mechanism. This article introduces the epidemic situation of clonorchiasis and prevention and control strategies and measures in Guangdong.

  11. Development of an effective communication strategy for the prevention of burns in children: the PRIUS project

    Science.gov (United States)

    Cedri, S.; Briguglio, E.; Cedri, C.; Masellis, A.; Crenca, A.; Pitidis, A.

    2015-01-01

    Summary This study has developed a learning kit for the prevention of domestic burns in childhood. The main objective was to trial an educational package for children (nursery and primary classes), for the prevention of burns, to be implemented through education in schools. The educational kit comprises posters, information leaflets, comic books, and pre and post education evaluation materials for school children, parents and teachers. Recipients of the preliminary study were the students of nine schools in the eight Italian cities where Burn Centers are located. In order to reach the target groups of children, it was necessary to identify the most effective communication strategy to convey the burn prevention message. For nursery school children, it was not possible to use tools with written texts alone, as they were not yet literate. Moreover, even for older children, it was necessary to find an attractive tool to catch their attention and interest, promoting the understanding and memorization of lessons learned. The most suitable means was found to be comic strips, allowing the messages to be conveyed through images as well as words. A total of 370 children (195 from nurseries and 175 from primary schools) participated in the trial of the educational kit. Overall, for every environment represented in the evaluation table, the ability to recognize the dangers among both the pre-school and primary school children increased significantly after the training activity. In conclusion, the educational kit has been positively assessed. PMID:27252606

  12. Influence of faith-based organisations on HIV prevention strategies in Africa: a systematic review.

    Science.gov (United States)

    Ochillo, Marylyn A; van Teijlingen, Edwin; Hind, Martin

    2017-09-01

    The HIV/AIDS epidemic remains of global significance and there is a need to target sub-Saharan Africa since it is the hardest hit region worldwide. Religion and more specifically faith-based organisations can have an effect on socio-cultural factors that increase or decrease the risk of infection; and offer preventative interventions to the wider community. To understand the influence of faith-based organisations on HIV prevention in Africa. The main search engine of a British university 'mysearch' was used as this incorporates all relevant databases. Studies were also retrieved by searches within Google scholar, PubMed and reference lists of included papers were hand searched. The authors assessed the relevance of each article separately against the inclusion criteria. The data extraction form was piloted by the first author and cross-checked by the other authors. Seven studies met all inclusion criteria and were reviewed. Seven individual themes were identified. However, for the purposes of focus within this paper only two themes were focused on. Given the accessibility of faith-based organisations (FBOs) and the coverage of religion among the population, FBOs are potentially important players in HIV prevention. Therefore, more resources and support should be given to support their health promotion strategies.

  13. A STUDY ON STUDENTS’ DIRECT LISTENING STRATEGIES IN COMPREHENDING A PASSAGE AT THE SECOND GRADE STUDENTS OF SMAN OLAHRAGA RIAU

    Directory of Open Access Journals (Sweden)

    Kurniawan Kurniawan

    2016-04-01

    Full Text Available The purpose of this research was to identify the students’ directlistening strategies in comprehending a passage at the second grade students ofSMAN Olahraga Riau. The design of this research was survey attitudes andpractices. Sample of the research was 50 students at the second grade students ofSMAN Olahraga Riau. The instrument that was used was questionnaire. Thequestionnaire was design the students’ direct listening. The questionnaire wasanalyzed by using descriptive statistics and Likert scale. The result of analyzingdata in terms of memory strategy, the students’ mean score was 3.99 in moderatelevel. In terms of cognitive strategy, the students’ mean score was 3.74 inmoderate level, while in terms of compensation strategy, the students had meanscore 3.86 in moderate level. In conclusion, the students were interested usingmemory strategy as the main direct strategy in comprehending a passage at thesecond grade students of SMAN Olahraga Riau.Keywords : Direct Listening Strategy, Comprehension, and Passage

  14. Using a Problem-Solving Strategy to Prevent Work-Related Accidents Due to Unsafe Worker Behavior.

    Science.gov (United States)

    Martella, Ronald C.; And Others

    1992-01-01

    A two-stage problem-solving strategy involving cue cards and their gradual withdrawal was used to teach nine sheltered workshop employees how to prevent work-related accidents. Results indicated that participants used the strategy appropriately and generalized their skills to similar and dissimilar situations up to eight weeks after training.…

  15. Coordinated Low Voltage Ride through strategies for Permanent Magnet Direct Drive Synchronous Generators

    Directory of Open Access Journals (Sweden)

    Zhang Ge

    2016-01-01

    Full Text Available By analyzing the mechanism of the low voltage ride through on the permanent magnet direct drive synchronous wind power generating units, this paper proposes a coordinated control strategy for permanent magnet synchronous generator. In order to avoid over speed operation of the generation units, over voltage on DC capacitor and over current on convert, the improved pitch angle control and inverter control are used. When the grid voltage drops, the captured wind power is cut down by the variable pitch system, which limits the speed of the generator, the generator side converter keeps the DC capacitor voltage stabile; and the grid side converter provides reactive power to the grid to help the grid voltage recover. The control strategy does not require any additional hardware equipment, with existing control means, the unit will be able to realize low voltage ride through. Finally, based on Matlab/Simulink to build permanent magnet direct drive wind power generation system, the simulation results verify the correctness and effectiveness of the control strategy.

  16. Regenerating the human heart: direct reprogramming strategies and their current limitations.

    Science.gov (United States)

    Ghiroldi, Andrea; Piccoli, Marco; Ciconte, Giuseppe; Pappone, Carlo; Anastasia, Luigi

    2017-10-27

    Cardiovascular diseases are the leading cause of death in the Western world. Unfortunately, current therapies are often only palliative, consequently essentially making heart transplantation necessary for many patients. However, several novel therapeutic approaches in the past two decades have yielded quite encouraging results. The generation of induced pluripotent stem cells, through the forced expression of stem cell-specific transcription factors, has inspired the most promising strategies for heart regeneration by direct reprogramming of cardiac fibroblasts into functional cardiomyocytes. Initial attempts at this reprogramming were conducted using a similar approach to the one used with transcription factors, but during years, novel strategies have been tested, e.g., miRNAs, recombinant proteins and chemical molecules. Although preliminary results on animal models are promising, the low reprogramming efficiency, as well as the incomplete maturation of the cardiomyocytes, still represents important obstacles. This review covers direct transdifferentiation strategies that have been proposed and developed and illustrates the pros and cons of each approach. Indeed, as described in the manuscript, there are still many unanswered questions and drawbacks that require a better understanding of the basic signaling pathways and transcription factor networks before functional cells, suitable for cardiac regeneration and safe for the patients, can be generated and used for human therapies.

  17. Flexibility to contingency changes distinguishes habitual and goal-directed strategies in humans.

    Directory of Open Access Journals (Sweden)

    Julie J Lee

    2017-09-01

    Full Text Available Decision-making in the real world presents the challenge of requiring flexible yet prompt behavior, a balance that has been characterized in terms of a trade-off between a slower, prospective goal-directed model-based (MB strategy and a fast, retrospective habitual model-free (MF strategy. Theory predicts that flexibility to changes in both reward values and transition contingencies can determine the relative influence of the two systems in reinforcement learning, but few studies have manipulated the latter. Therefore, we developed a novel two-level contingency change task in which transition contingencies between states change every few trials; MB and MF control predict different responses following these contingency changes, allowing their relative influence to be inferred. Additionally, we manipulated the rate of contingency changes in order to determine whether contingency change volatility would play a role in shifting subjects between a MB and MF strategy. We found that human subjects employed a hybrid MB/MF strategy on the task, corroborating the parallel contribution of MB and MF systems in reinforcement learning. Further, subjects did not remain at one level of MB/MF behaviour but rather displayed a shift towards more MB behavior over the first two blocks that was not attributable to the rate of contingency changes but rather to the extent of training. We demonstrate that flexibility to contingency changes can distinguish MB and MF strategies, with human subjects utilizing a hybrid strategy that shifts towards more MB behavior over blocks, consequently corresponding to a higher payoff.

  18. Community therapy application in intervention with adolescents: new strategies for prevention and promotion

    Directory of Open Access Journals (Sweden)

    Flávia Cristina Zago

    2013-08-01

    Full Text Available Given adolescents vulnerability facing transformations and resistances, the group work used by Occupational Therapy through techniques and dynamics favors expression, anxiety control and biopsychosocial maturity in intervention. Currently, one strategy used with teenagers is Community Therapy (CT, because it provides a welcoming environment where all are equal and can share their sufferings, anxieties and affinities. Thus, this study examined the effectiveness of group activities used in occupational therapy as warm up strategies in Community Therapy circles. Eleven teenagers aged 12 to 14 years old participated in the research. The study was carried out in a social institution that aims to support children and youth in the municipality of Uberaba, Minas Gerais state. Video and photo images and handwritten records were used as data collection instruments during the application of the 12 strategies, divided into three categories: competition, cooperation, and self-knowledge/self-esteem, applied for warming up the CT circles. Data were analyzed and presented through the use of a chart for better visualization and understanding of the adolescents’ behavior during the warm up CT circles. The results obtained showed dispute, unrest, lack of attention and sociability; behaviors that are inherent to adolescence due to the several changes, emotional alterations and search for identity that these subjects experience. Based on the survey results, it was possible observe that the behaviors have triggered direct-indirect relationship with the strategies used as facilitators in the discussion development regarding the issues addressed in the CT circles.

  19. Victor and Erika Webnovela: An Innovative Generation @ Audience Engagement Strategy for Prevention.

    Science.gov (United States)

    Andrade, Elizabeth L; Evans, W Douglas; Edberg, Marc C; Cleary, Sean D; Villalba, Ricardo; Batista, Idalina Cubilla

    2015-01-01

    Entertainment-education (E-E) approaches for young audiences continue to evolve in order to keep stride with younger generations' affinity for technology. E-E and novelas have been used with a wide variety of audiences in the United States, in particular hard-to-reach Latino populations, and have demonstrated effectiveness in disseminating culturally relevant prevention information for a wide variety of health-related risk factors and behaviors. This study discusses the formative research and active engagement of Latino youth living in Langley Park, Maryland, for the development and filming of an innovative 6-episode webnovela titled Victor and Erika (V&E). V&E is part of a larger branding strategy of the Adelante Positive Youth Development intervention that seeks to prevent substance abuse, sexual risk, and interpersonal violence among Latino youth; V&E is also an intervention component. The V&E webnovela is a dramatic portrayal of the lives of 2 immigrant Latino teenagers that also disseminates risk prevention messages. The storyline represents the turning the corner (to a better life) theme that underlies the Adelante intervention brand. Formative research was conducted for character development (n = 20) and creative development of the episodes (n = 14). Results of the formative research showed that youth recommended inclusion of the following topics in V&E episodes: sex, unintended pregnancy, fidelity, trust, family dynamics, immigration status, violence, school dropout, respect, home life, and poverty. Detailed character and episode descriptions are provided, and the implications of using the V&E series as a tool for in-person and online engagement of youth and the dissemination of prevention messages are also discussed.

  20. [Urinary incontinence and other pelvic floor damages: ethilogy and prevention strategies].

    Science.gov (United States)

    Amóstegui Azcúe, J M; Ferri Morales, A; Lillo De La Quintana, C; Serra Llosa, M L

    2004-01-01

    Urinary incontinence, as well as additional pelvic floor damage, such as third and fourth degree muscular lacerations, as well as fecal incontinence, genital prolapse or dyspareunia, result from obstetric trauma, and are generally linked to the first delivery. The purpose of this study is to analyze, from a physiotherapeutic point of view, and therefore from the perspective of muscular physiology and biomechanics, why this damage occurs, while studying the birth process and the way it is currently performed in most hospitals in our country. Analysis of the birth process and, in short, of the different types of positions used for the first and second stage of labor, as well as of the care provided for women in the puerperium, leads us to propose a global prevention strategy to be carried out in three stages: --Ante-natal prevention: specific preparation of the pelvic floor and abdominal musculature during pregnancy, using massage techniques and manual stretching of the perineum. In addition, the pregnant woman learns these positions and methods of pushing, which makes the first and second stage of labour easier. An osteopathic treatment of the pelvis joints is performed in order to facilitate their mobility or to liberate blockades, if they exist. --Prevention during labour: During this stage, physiology is respected and manual, position-based and breathing techniques are implemented in order to enhance the protection of the baby and of the pelvic floor. --Postpartum prevention: The action is focused on the pelvic floor, through diaphragmatic and abdominal exercises or postures and, if necessary, osteopathic treatment in the early puerperium, in order to facilitate the correct involution of all soft tissues and the pelvic joints involved in labor. Early specific physiotherapeutic treatment will be proposed for women with functional pathology six weeks after delivery.

  1. Optimization of Key Parameters of Energy Management Strategy for Hybrid Electric Vehicle Using DIRECT Algorithm

    Directory of Open Access Journals (Sweden)

    Jingxian Hao

    2016-11-01

    Full Text Available The rule-based logic threshold control strategy has been frequently used in energy management strategies for hybrid electric vehicles (HEVs owing to its convenience in adjusting parameters, real-time performance, stability, and robustness. However, the logic threshold control parameters cannot usually ensure the best vehicle performance at different driving cycles and conditions. For this reason, the optimization of key parameters is important to improve the fuel economy, dynamic performance, and drivability. In principle, this is a multiparameter nonlinear optimization problem. The logic threshold energy management strategy for an all-wheel-drive HEV is comprehensively analyzed and developed in this study. Seven key parameters to be optimized are extracted. The optimization model of key parameters is proposed from the perspective of fuel economy. The global optimization method, DIRECT algorithm, which has good real-time performance, low computational burden, rapid convergence, is selected to optimize the extracted key parameters globally. The results show that with the optimized parameters, the engine operates more at the high efficiency range resulting into a fuel savings of 7% compared with non-optimized parameters. The proposed method can provide guidance for calibrating the parameters of the vehicle energy management strategy from the perspective of fuel economy.

  2. Development of goods movement strategic transportation directions : Workshop on opportunities and strategies : final workshop report

    Energy Technology Data Exchange (ETDEWEB)

    Advokaat, E. [Lura Consulting, Toronto, ON (Canada)

    2003-04-01

    This paper presents a newly developed strategy for the movement of goods that will support economic development and competitiveness in Central Ontario. The strategy was developed at a workshop which examined current and emerging conditions that influence the movement of goods in Central Ontario along with the challenges and opportunities for goods movement. Possible short-term actions and long-term directions that can be incorporated into a strategy were also discussed. Attendees included representatives from all levels of government as well as shippers, trucking firms, rail, air and marine carriers, and port authorities. The study area included the Greater Toronto Area, Hamilton, the Regional Municipality of Niagara, the Regional Municipality of Waterloo and surrounding counties. It was recommended that any movement of goods strategy should consider population increases, land use planning, cross-border issues, the Kyoto Protocol, traffic issues, rail transport, e-commerce and market competition. The workshop also provided a forum to discuss coordination efforts, intergovernmental complexity, lack of funding, data gaps, marine transport, travel demand management, the problem with 'business-as-usual' scenarios, and inconsistent support from the province of Ontario. Participants expressed the need for an institution such as the Freight Council which is dedicated to issues regarding the movement of goods. The notion of expanding and maintaining a rail network was also supported by many participants.

  3. Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized trials

    Science.gov (United States)

    2013-01-01

    Introduction The ideal measures to prevent postoperative delirium remain unestablished. We conducted this systematic review and meta-analysis to clarify the significance of potential interventions. Methods The PRISMA statement guidelines were followed. Two researchers searched MEDLINE, EMBASE, CINAHL and the Cochrane Library for articles published in English before August 2012. Additional sources included reference lists from reviews and related articles from 'Google Scholar'. Randomized clinical trials (RCTs) on interventions seeking to prevent postoperative delirium in adult patients were included. Data extraction and methodological quality assessment were performed using predefined data fields and scoring system. Meta-analysis was accomplished for studies that used similar strategies. The primary outcome measure was the incidence of postoperative delirium. We further tested whether interventions effective in preventing postoperative delirium shortened the length of hospital stay. Results We identified 38 RCTs with interventions ranging from perioperative managements to pharmacological, psychological or multicomponent interventions. Meta-analysis showed dexmedetomidine sedation was associated with less delirium compared to sedation produced by other drugs (two RCTs with 415 patients, pooled risk ratio (RR) = 0.39; 95% confidence interval (CI) = 0.16 to 0.95). Both typical (three RCTs with 965 patients, RR = 0.71; 95% CI = 0.54 to 0.93) and atypical antipsychotics (three RCTs with 627 patients, RR = 0.36; 95% CI = 0.26 to 0.50) decreased delirium occurrence when compared to placebos. Multicomponent interventions (two RCTs with 325 patients, RR = 0.71; 95% CI = 0.58 to 0.86) were effective in preventing delirium. No difference in the incidences of delirium was found between: neuraxial and general anesthesia (four RCTs with 511 patients, RR = 0.99; 95% CI = 0.65 to 1.50); epidural and intravenous analgesia (three RCTs with 167 patients, RR = 0.93; 95% CI = 0.61 to 1

  4. Stress Prevention@Work : A study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

    NARCIS (Netherlands)

    Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-vlasveld, M.C.; Anema, J.R.; van der Beek, A.J.; Boot, C.R.L.

    2018-01-01

    Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative

  5. Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

    NARCIS (Netherlands)

    Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-Vlasveld, M.C.; Anema, J.R.; Beek, A.J. van der; Boot, C.R.L.

    2017-01-01

    Background. Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and

  6. Renal Dysfunction after Off-Pump Coronary Artery Bypass Surgery- Risk Factors and Preventive Strategies

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2009-01-01

    Full Text Available Postoperative renal dysfunction is a relatively common and one of the serious complications of cardiac surgery. Though off-pump coronary artery bypass surgery technique avoids cardiopulmonary bypass circuit induced adverse effects on renal function, multiple other factors cause postoperative renal dysfunction in these groups of patients. Acute kidney injury is generally defined as an abrupt and sustained decrease in kidney function. There is no consen-sus on the amount of dysfunction that defines acute kidney injury, with more than 30 definitions in use in the literature today. Although serum creatinine is widely used as a marker for changes in glomerular filtration rate, the criteria used to define renal dysfunction and acute renal failure is highly variable. The variety of definitions used in clinical studies may be partly responsible for the large variations in the reported incidence. Indeed, the lack of a uniform definition for acute kidney injury is believed to be a major impediment to research in the field. To establish a uniform definition for acute kidney injury, the Acute Dialysis Quality Initiative formulated the Risk, Injury, Failure, Loss, and End-stage Kidney (RIFLE classification. RIFLE , defines three grades of increasing severity of acute kidney injury -risk (class R, injury (class I and failure (class F - and two outcome classes (loss and end-stage kidney disease. Various perioperative risk factors for postoperative renal dysfunction and failure have been identified. Among the important preoperative factors are advanced age, reduced left ventricular function, emergency surgery, preoperative use of intraaortic balloon pump, elevated preoperative serum glucose and creatinine. Most important intraoperative risk factor is the intraoperative haemodynamic instability and all the causes of postoperative low output syndrome com-prise the postoperative risk factors. The most important preventive strategies are the identification of the

  7. Recent progress in the direct synthesis of hierarchical zeolites: synthetic strategies and characterization methods

    KAUST Repository

    Liu, Zhaohui

    2017-06-16

    Hierarchically structured zeolites combine the merits of microporous zeolites and mesoporous materials to offer enhanced molecular diffusion and mass transfer without compromising the inherent catalytic activities and selectivity of zeolites. This short review gives an introduction to the synthesis strategies for hierarchically structured zeolites with emphasis on the latest progress in the route of ‘direct synthesis’ using various templates. Several characterization methods that allow us to evaluate the ‘quality’ of complex porous structures are also introduced. At the end of this review, an outlook is given to discuss some critical issues and challenges regarding the development of novel hierarchically structured zeolites as well as their applications.

  8. Surveillance indicators and their use in implementation of the Marine Strategy Framework Directive

    DEFF Research Database (Denmark)

    Shephard, Samuel; Greenstreet, Simon P. R.; Piet, GerJan J.

    2015-01-01

    The European Union Marine Strategy Framework Directive (MSFD) uses indicators to track ecosystem state in relation to Good Environmental Status (GES). These indicators were initially expected to be “operational”, i.e. to have well-understood relationships between state and specified anthropogenic...... pressure(s), and to have defined targets. Recent discussion on MSFD implementation has highlighted an additional class of “surveillance” indicators. Surveillance indicators monitor key aspects of the ecosystem for which there is: first, insufficient evidence to define targets and support formal state...

  9. Pressure Ulcer Prevention Program Study: a randomized, controlled prospective comparative value evaluation of 2 pressure ulcer prevention strategies in nursing and rehabilitation centers.

    Science.gov (United States)

    Shannon, Ronald J; Brown, Lynne; Chakravarthy, Debashish

    2012-10-01

    This article assesses the comparative prevention-effectiveness and economic implications of a Pressure Ulcer Prevention Program (PUPP) against standard practice of prevention using Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality [AHRQ]) guidelines and a mixture of commercial products. The study is a randomized, controlled, prospective cohort study with an accompanying economic evaluation. The economic evaluation is performed from the perspective of the nursing and rehabilitation centers. Two nursing and rehabilitation centers under the same quality and safety support organization. Both institutions are experiencing high nursing staff turnover and incidence of pressure ulcers (PrUs). 133 residents at risk of developing PrUs (EQUIP-for-Quality Risk Score Moderate to Very High [MVH]). All are Medicare-eligible residents with Minimum Data Set (MDS) 2.0 evaluations. The PUPP includes a strategic product bundle and decision algorithms driven by MDS 2.0 Resident Assessment Scores to assist in reducing or preventing PrUs and incontinence-associated skin conditions. The control group utilizes a different brand and assortment of commercial skin care products, briefs, pads, and mattresses, but without use of the decision algorithms driven by MDS 2.0 Resident Assessment Scores. Pressure ulcer prevention education was done for all nurses by a nurse certified in the PUPP program at the beginning and ad libitum by trained senior nursing staff at the end of the study. Comparative reduction in the incidence of nosocomial PrUs and average 6-month net cost savings per MVH-risk resident. Residents were assessed for PrU risk using EQUIP-for-Quality risk assessment algorithm based on data from their Minimum Data Set (MDS 2.0), then assigned to either the PUPP program or control group (standard practice following AHRQ guidelines). Residents were followed until discharge, death, development of PrU, or a maximum time period of 6 months. Direct

  10. Directed evolution combined with synthetic biology strategies expedite semi-rational engineering of genes and genomes.

    Science.gov (United States)

    Kang, Zhen; Zhang, Junli; Jin, Peng; Yang, Sen

    2015-01-01

    Owing to our limited understanding of the relationship between sequence and function and the interaction between intracellular pathways and regulatory systems, the rational design of enzyme-coding genes and de novo assembly of a brand-new artificial genome for a desired functionality or phenotype are difficult to achieve. As an alternative approach, directed evolution has been widely used to engineer genomes and enzyme-coding genes. In particular, significant developments toward DNA synthesis, DNA assembly (in vitro or in vivo), recombination-mediated genetic engineering, and high-throughput screening techniques in the field of synthetic biology have been matured and widely adopted, enabling rapid semi-rational genome engineering to generate variants with desired properties. In this commentary, these novel tools and their corresponding applications in the directed evolution of genomes and enzymes are discussed. Moreover, the strategies for genome engineering and rapid in vitro enzyme evolution are also proposed.

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

    Science.gov (United States)

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

    2012-08-01

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

  12. Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira

    Full Text Available Abstract OBJECTIVE To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. METHOD An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. RESULTS In 90 days, 188 actions were observed, of these, 36.70% (n=69 were related to catheter dressing. In 81.15% (n=56 of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. CONCLUSION Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care.

  13. A holistic food labelling strategy for preventing obesity and dental caries

    DEFF Research Database (Denmark)

    Cinar, A B; Murtomaa, H

    2009-01-01

    Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden...... of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy...... food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts...

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

    Directory of Open Access Journals (Sweden)

    Suk-yu Yau

    2014-01-01

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

  15. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies.

    Science.gov (United States)

    Borg, M A; Waisfisz, B; Frank, U

    2015-05-01

    It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. The primary prevention of cardiovascular disease: nurse practitioners using behaviour modification strategies.

    Science.gov (United States)

    Farrell, Todd Charles; Keeping-Burke, Lisa

    2014-01-01

    Cardiovascular disease (CVD) places great financial strain on the health care system and dramatically affects individual quality of life. As primary health care providers, nurse practitioners (NPs) are ideally positioned to advise clients on risk factor and lifestyle modifications that ameliorate the impact of CVD. While the lifestyle targets for CVD prevention are established, the most effective means of achieving these goals remain uncertain. Behaviour modification strategies, including motivational interviewing (MI) and the transtheoretical model (TTM), have been suggested, but neither approach is established as being more efficacious than the other. In this paper, evidence on the effectiveness of the two approaches for modifying smoking, diet, and exercise behaviour are presented, and a recommendation for NP practice is made.

  17. Waterborne microorganisms and biofilms related to hospital infections: strategies for prevention and control in healthcare facilities.

    Science.gov (United States)

    Capelletti, Raquel Vannucci; Moraes, Ângela Maria

    2016-02-01

    Water is the main stimulus for the development of microorganisms, and its flow has an important role in the spreading of contaminants. In hospitals, the water distribution system requires special attention since it can be a source of pathogens, including those in the form of biofilms often correlated with resistance of microorganisms to various treatments. In this paper, information relevant to cases of nosocomial infections involving water circuits as a source of contaminants is compiled, with emphasis on the importance of microbiological control strategies to prevent the installation, spreading and growth of microorganisms in hospitals. An overview of the worldwide situation is provided, with emphasis on Brazilian hospitals. Different approaches normally used to control the occurrence of nosocomial infections due to waterborne contaminants are analyzed, and the use of the polysaccharide chitosan for this specific application is briefly discussed.

  18. Methods and Strategies for Overvoltage Prevention in Low Voltage Distribution Systems with PV

    DEFF Research Database (Denmark)

    Hashemi Toghroljerdi, Seyedmostafa; Østergaard, Jacob

    2016-01-01

    to handle a high share of PV power. This paper provides an in-depth review of methods and strategies proposed to prevent overvoltage in LV grids with PV, and discusses the effectiveness, advantages, and disadvantages of them in detail. Based on the mathematical framework presented in the paper......, the overvoltage caused by high PV penetration is described, solutions to facilitate higher PV penetration are classified, and their effectiveness, advantages, and disadvantages are illustrated. The investigated solutions include the grid reinforcement, electrical energy storage application, reactive power...... absorption by PV inverters, application of active medium voltage to low voltage (MV/LV) transformers, active power curtailment, and demand response (DR). Coordination between voltage control units by localized, distributed, and centralized voltage control methods is compared using the voltage sensitivity...

  19. Identification of strategies to prevent death after pesticide self-poisoning using a Haddon matrix

    DEFF Research Database (Denmark)

    Eddleston, M; Buckley, N A; Gunnell, D

    2006-01-01

    Despite pesticide self-poisoning causing around 300 000 deaths each year in the rural Asia Pacific region, no comprehensive public health response has yet been formulated. The authors have developed a Haddon matrix to identify factors that increase the risk of fatal rather than non-fatal pesticide...... self-poisoning in Sri Lanka. Many important host factors such as age, gender, and genetics are not alterable; factors that could be changed-alcohol use and mental health-have previously proved difficult to change. Interventions affecting agent or environmental factors may be easier to implement...... and more effective, in particular those limiting the human toxicity and accessibility of the pesticides, and the quality, affordability, and accessibility of health care in the community. Controlled studies are required to identify effective strategies for prevention and harm minimization and to garner...

  20. Gastric tumours in hereditary cancer syndromes: clinical features, molecular biology and strategies for prevention.

    Science.gov (United States)

    Sereno, María; Aguayo, Cristina; Guillén Ponce, Carmen; Gómez-Raposo, César; Zambrana, Francisco; Gómez-López, Miriam; Casado, Enrique

    2011-09-01

    Gastric cancer is the major cause of cancer-related deaths worldwide. The majority of them are classified as sporadic, whereas the remaining 10% exhibit familial clustering. Hereditary diffuse gastric cancer (HDGC) syndrome is the most important condition that leads to hereditary gastric cancer. However, other hereditary cancer syndromes, such as hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, Peutz-Jeghers syndrome, Li-Fraumeni syndrome and hereditary breast and ovarian cancer, entail a higher risk compared to the general population for developing this kind of neoplasia. In this review, we describe briefly the most important aspects related to clinical features, molecular biology and strategies for prevention in hereditary gastric associated to different cancer syndromes.

  1. Effect of candesartan on prevention (DIRECT-Prevent 1) and progression (DIRECT-Protect 1) of retinopathy in type 1 diabetes: randomised, placebo-controlled trials

    DEFF Research Database (Denmark)

    Chaturvedi, Nish; Porta, Massimo; Klein, Ronald

    2008-01-01

    BACKGROUND: Results of previous studies suggest that renin-angiotensin system blockers might reduce the burden of diabetic retinopathy. We therefore designed the DIabetic REtinopathy Candesartan Trials (DIRECT) Programme to assess whether candesartan could reduce the incidence and progression of ...

  2. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Directory of Open Access Journals (Sweden)

    Kaberi Dasgupta

    Full Text Available OBJECTIVE: We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2 prevention program. RESEARCH DESIGN AND METHODS: Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. RESULTS: Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. CONCLUSIONS: Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  3. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Science.gov (United States)

    Dasgupta, Kaberi; Da Costa, Deborah; Pillay, Sabrina; De Civita, Mirella; Gougeon, Réjeanne; Leong, Aaron; Bacon, Simon; Stotland, Stephen; Chetty, V Tony; Garfield, Natasha; Majdan, Agnieszka; Meltzer, Sara

    2013-01-01

    We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program. Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  4. Stabilizing ER Ca2+ channel function as an early preventative strategy for Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Shreaya Chakroborty

    Full Text Available Alzheimer's disease (AD is a devastating neurodegenerative condition with no known cure. While current therapies target late-stage amyloid formation and cholinergic tone, to date, these strategies have proven ineffective at preventing disease progression. The reasons for this may be varied, and could reflect late intervention, or, that earlier pathogenic mechanisms have been overlooked and permitted to accelerate the disease process. One such example would include synaptic pathology, the disease component strongly associated with cognitive impairment. Dysregulated Ca(2+ homeostasis may be one of the critical factors driving synaptic dysfunction. One of the earliest pathophysiological indicators in mutant presenilin (PS AD mice is increased intracellular Ca(2+ signaling, predominantly through the ER-localized inositol triphosphate (IP(3 and ryanodine receptors (RyR. In particular, the RyR-mediated Ca(2+ upregulation within synaptic compartments is associated with altered synaptic homeostasis and network depression at early (presymptomatic AD stages. Here, we offer an alternative approach to AD therapeutics by stabilizing early pathogenic mechanisms associated with synaptic abnormalities. We targeted the RyR as a means to prevent disease progression, and sub-chronically treated AD mouse models (4-weeks with a novel formulation of the RyR inhibitor, dantrolene. Using 2-photon Ca(2+ imaging and patch clamp recordings, we demonstrate that dantrolene treatment fully normalizes ER Ca(2+ signaling within somatic and dendritic compartments in early and later-stage AD mice in hippocampal slices. Additionally, the elevated RyR2 levels in AD mice are restored to control levels with dantrolene treatment, as are synaptic transmission and synaptic plasticity. Aβ deposition within the cortex and hippocampus is also reduced in dantrolene-treated AD mice. In this study, we highlight the pivotal role of Ca(2+ aberrations in AD, and propose a novel strategy to

  5. Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England.

    Science.gov (United States)

    Malhotra, Aneil; Dhutia, Harshil; Gati, Sabiha; Yeo, Tee-Joo; Finocchiaro, Gherardo; Keteepe-Arachi, Tracey; Richards, Thomas; Walker, Mike; Birt, Robin; Stuckey, David; Robinson, Laurence; Tome, Maite; Beasley, Ian; Papadakis, Michael; Sharma, Sanjay

    2017-06-14

    To assess the emergency response planning and prevention strategies for sudden cardiac arrest (SCA) across a wide range of professional football clubs in England. A written survey was sent to all professional clubs in the English football league, namely the Premiership, Championship, League 1 and League 2. Outcomes included: (1) number of clubs performing cardiac screening and frequency of screening; (2) emergency planning and documentation; (3) automated external defibrillator (AED) training and availability; and (4) provision of emergency services at sporting venues. 79 clubs (86%) responded to the survey. 100% clubs participated in cardiac screening. All clubs had AEDs available on match days and during training sessions. 100% Premiership clubs provided AED training to designated staff. In contrast, 30% of lower division clubs with AEDs available did not provide formal training. Most clubs (n=66; 83%) reported the existence of an emergency action plan for SCA but formal documentation was variable. All clubs in the Premiership and League 1 provided an ambulance equipped for medical emergencies on match days compared with 75% of clubs in the Championship and 66% in League 2. The majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions. © 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.

  6. Evaluating HIV prevention strategies for populations in key affected groups: The example of Cabo Verde

    Science.gov (United States)

    Monteiro, João Filipe G.; Galea, Sandro; Flanigan, Timothy; Monteiro, Maria de Lourdes; Friedman, Samuel R.; Marshall, Brandon DL

    2015-01-01

    Objectives We used an individual-based model to evaluate the effects of hypothetical prevention interventions on HIV incidence trajectories in a concentrated, mixed epidemic setting from 2011 to 2021, and using Cabo Verde as an example. Methods Simulations were conducted to evaluate the extent to which early HIV treatment and optimization of care, HIV testing, condom distribution, and substance abuse treatment could eliminate new infections (i.e., reduce incidence to less than 10 cases per 10,000 person-years) among non-drug users, female sex workers (FSW), and people who use drugs (PWUD). Results Scaling up all four interventions resulted in the largest decreases in HIV, with estimates ranging from 1.4 (95%CI:1.36–1.44) per 10,000 person-years among non-drug users to 8.2 (95%CI:7.8–8.6) per 10,000 person-years among PWUD in 2021. Intervention scenarios targeting FWS and PWUD also resulted in HIV incidence estimates at or below 10 per 10,000 person-years by 2021 for all population sub-groups. Conclusions Our results suggest that scaling up multiple interventions among entire population is necessary to achieve elimination. However, prioritizing key populations with this combination prevention strategy may also result in a substantial decrease in total incidence. PMID:25838121

  7. Microbiological Surveillance and State of the Art Technological Strategies for the Prevention of Dialysis Water Pollution

    Directory of Open Access Journals (Sweden)

    Andrea Galfrè

    2012-08-01

    Full Text Available Methods: The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Results: Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Conclusions: Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections.

  8. Self-harm in British South Asian women: psychosocial correlates and strategies for prevention

    Directory of Open Access Journals (Sweden)

    Waheed W

    2006-05-01

    Full Text Available Abstract Objective To review the rates of self-harm in British South Asian women, look into the factors that contribute to these high rates of self-harm and discuss possible strategies for prevention and provision of culturally sensitive service for South Asian women who harm themselves. Method Review. Results South Asian women are significantly more likely to self harm between ages 16–24 years than white women. Across all age groups the rates of self harm are lower in South Asian men as compared to South Asian women. These women are generally younger, likely to be married and less likely to be unemployed or use alcohol or other drugs. They report more relationship problems within the family. South Asian women are less likely to attend the ER with repeat episode since they hold the view that mainstream services do not meet their needs. Conclusion South Asian women are at an increased risk of self harm. Their demographic characteristics, precipitating factors and clinical management are different than whites. There is an urgent need for all those concerned with the mental health services for ethnic minorities to take positive action and eradicate the barriers that prevent British South Asians from seeking help. There is a need to move away from stereotypes and overgeneralisations and start from the user's frame of reference, taking into account family dynamics, belief systems and cultural constraints.

  9. NSAID gastropathy and enteropathy: distinct pathogenesis likely necessitates distinct prevention strategies.

    Science.gov (United States)

    Wallace, John L

    2012-01-01

    The mechanisms underlying the ability of nonsteroidal anti-inflammatory drugs (NSAIDs) to cause ulceration in the stomach and proximal duodenum are well understood, and this injury can largely be prevented through suppression of gastric acid secretion (mainly with proton pump inhibitors). In contrast, the pathogenesis of small intestinal injury induced by NSAIDs is less well understood, involving more complex mechanisms than those in the stomach and proximal duodenum. There is clear evidence for important contributions to NSAID enteropathy of enteric bacteria, bile and enterohepatic recirculation of the NSAID. There is no evidence that suppression of gastric acid secretion will reduce the incidence or severity of NSAID enteropathy. Indeed, clinical data suggest little, if any, benefit. Animal studies suggest a significant exacerbation of NSAID enteropathy when proton pump inhibitors are co-administered with the NSAID. This worsening of damage appears to be linked to changes in the number and types of bacteria in the small intestine during proton pump inhibitor therapy. The distinct mechanisms of NSAID-induced injury in the stomach/proximal duodenum versus the more distal small intestine likely dictate distinct strategies for prevention. © 2011 The Author. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  10. Evaluating HIV prevention strategies for populations in key affected groups: the example of Cabo Verde.

    Science.gov (United States)

    Monteiro, João Filipe G; Galea, Sandro; Flanigan, Timothy; Monteiro, Maria de Lourdes; Friedman, Samuel R; Marshall, Brandon D L

    2015-05-01

    We used an individual-based model to evaluate the effects of hypothetical prevention interventions on HIV incidence trajectories in a concentrated, mixed epidemic setting from 2011 to 2021, and using Cabo Verde as an example. Simulations were conducted to evaluate the extent to which early HIV treatment and optimization of care, HIV testing, condom distribution, and substance abuse treatment could eliminate new infections (i.e., reduce incidence to less than 10 cases per 10,000 person-years) among non-drug users, female sex workers (FSW), and people who use drugs (PWUD). Scaling up all four interventions resulted in the largest decreases in HIV, with estimates ranging from 1.4 (95 % CI 1.36-1.44) per 10,000 person-years among non-drug users to 8.2 (95 % CI 7.8-8.6) per 10,000 person-years among PWUD in 2021. Intervention scenarios prioritizing FWS and PWUD also resulted in HIV incidence estimates at or below 10 per 10,000 person-years by 2021 for all population sub-groups. Our results suggest that scaling up multiple interventions among entire population is necessary to achieve elimination. However, prioritizing key populations with this combination prevention strategy may also result in a substantial decrease in total incidence.

  11. Microbiological surveillance and state of the art technological strategies for the prevention of dialysis water pollution.

    Science.gov (United States)

    Bolasco, Piergiorgio; Contu, Antonio; Meloni, Patrizia; Vacca, Dorio; Galfrè, Andrea

    2012-08-01

    The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections.

  12. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies.

    Science.gov (United States)

    Zhao, Siqi; Qu, Lijun; Liu, He; Gao, Lijun; Jiao, Mingli; Liu, Jinghua; Liang, Libo; Zhao, Yanming; Wu, Qunhong

    2016-01-01

    The study's objectives were to: 1) use social support theory to examine factors influencing healthcare workers' opinions about workplace violence (WPV) prevention strategies, and 2) to determine the types of support that general practitioners (GPs) and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention.

  13. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies

    Science.gov (United States)

    Liu, He; Gao, Lijun; Jiao, Mingli; Liu, Jinghua; Liang, Libo; Zhao, Yanming; Wu, Qunhong

    2016-01-01

    The study’s objectives were to: 1) use social support theory to examine factors influencing healthcare workers’ opinions about workplace violence (WPV) prevention strategies, and 2) to determine the types of support that general practitioners (GPs) and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention. PMID:27326460

  14. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies.

    Directory of Open Access Journals (Sweden)

    Siqi Zhao

    Full Text Available The study's objectives were to: 1 use social support theory to examine factors influencing healthcare workers' opinions about workplace violence (WPV prevention strategies, and 2 to determine the types of support that general practitioners (GPs and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention.

  15. Culturally Targeted Strategies for Diabetes Prevention in Minority Populations: A Systematic Review and Framework

    Science.gov (United States)

    Lagisetty, Pooja A.; Priyadarshini, Shubadra; Terrell, Stephanie; Hamati, Mary; Landgraf, Jessica; Chopra, Vineet; Heisler, Michele

    2017-01-01

    Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize four key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with four domains (FiLLM: Facilitating [i.e., delivering] Interventions through Language, Location and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were randomized controlled trials, and 22 were quasi-experimental trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved Hemoglobin A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least three culturally targeted domains. Seven studies used all four domains and were all successful. The least utilized domain was delivery (4/34) of the intervention’s key educational message. Conclusions Culturally tailoring interventions across the four domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain. Registration (PROSPERO registration: CRD42015016914) PMID:28118127

  16. Parameter Improved Particle Swarm Optimization Based Direct-Current Vector Control Strategy for Solar PV System

    Directory of Open Access Journals (Sweden)

    NAMMALVAR, P.

    2018-02-01

    Full Text Available This paper projects Parameter Improved Particle Swarm Optimization (PIPSO based direct current vector control technology for the integration of photovoltaic array in an AC micro-grid to enhance the system performance and stability. A photovoltaic system incorporated with AC micro-grid is taken as the pursuit of research study. The test system features two power converters namely, PV side converter which consists of DC-DC boost converter with Perturbation and Observe (P&O MPPT control to reap most extreme power from the PV array, and grid side converter which consists of Grid Side-Voltage Source Converter (GS-VSC with proposed direct current vector control strategy. The gain of the proposed controller is chosen from a set of three values obtained using apriori test and tuned through the PIPSO algorithm so that the Integral of Time multiplied Absolute Error (ITAE between the actual and the desired DC link capacitor voltage reaches a minimum and allows the system to extract maximum power from PV system, whereas the existing d-q control strategy is found to perform slowly to control the DC link voltage under varying solar insolation and load fluctuations. From simulation results, it is evident that the proposed optimal control technique provides robust control and improved efficiency.

  17. Prevention of Cyanobacterial Blooms Using Nanosilica: A Biomineralization-Inspired Strategy.

    Science.gov (United States)

    Xiong, Wei; Tang, Yiming; Shao, Changyu; Zhao, Yueqi; Jin, Biao; Huang, Tingting; Miao, Ya'nan; Shu, Lei; Ma, Weimin; Xu, Xurong; Tang, Ruikang

    2017-11-07

    Cyanobacterial blooms represent a significant threat to global water resources because blooming cyanobacteria deplete oxygen and release cyanotoxins, which cause the mass death of aquatic organisms. In nature, a large biomass volume of cyanobacteria is a precondition for a bloom, and the cyanobacteria buoyancy is a key parameter for inducing the dense accumulation of cells on the water surface. Therefore, blooms will likely be curtailed if buoyancy is inhibited. Inspired by diatoms with naturally generated silica shells, we found that silica nanoparticles can be spontaneously incorporated onto cyanobacteria in the presence of poly(diallyldimethylammonium chloride), a cationic polyelectrolyte that can simulate biosilicification proteins. The resulting cyanobacteria-SiO 2 complexes can remain sedimentary in water. This strategy significantly inhibited the photoautotrophic growth of the cyanobacteria and decreased their biomass accumulation, which could effectively suppress harmful bloom events. Consequently, several of the adverse consequences of cyanobacteria blooms in water bodies, including oxygen consumption and microcystin release, were significantly alleviated. Based on the above results, we propose that the silica nanoparticle treatment has the potential for use as an efficient strategy for preventing cyanobacteria blooms.

  18. Microenvironmental acidosis in carcinogenesis and metastases: new strategies in prevention and therapy.

    Science.gov (United States)

    Fais, Stefano; Venturi, Giulietta; Gatenby, Bob

    2014-12-01

    Much effort is currently devoted to developing patient-specific cancer therapy based on molecular characterization of tumors. In particular, this approach seeks to identify driver mutations that can be blocked through small molecular inhibitors. However, this approach is limited by extensive intratumoral genetic heterogeneity, and, not surprisingly, even dramatic initial responses are typically of limited duration as resistant tumor clones rapidly emerge and proliferate. We propose an alternative approach based on observations that while tumor evolution produces genetic divergence, it is also associated with striking phenotypic convergence that loosely correspond to the well-known cancer "hallmarks". These convergent properties can be described as driver phenotypes and may be more consistently and robustly expressed than genetic targets. To this purpose, it is necessary to identify strategies that are critical for cancer progression and metastases, and it is likely that these driver phenotypes will be closely related to cancer "hallmarks". It appears that an antiacidic approach, by targetting a driver phenotype in tumors, may be thought as a future strategy against tumors in either preventing the occurrence of cancer or treating tumor patients with multiple aims, including the improvement of efficacy of existing therapies, possibly reducing their systemic side effects, and controlling tumor growth, progression, and metastasis. This may be achieved with existing molecules such as proton pump inhibitors (PPIs) and buffers such as sodium bicarbonate, citrate, or TRIS.

  19. An Optimal Number-Dependent Preventive Maintenance Strategy for Offshore Wind Turbine Blades Considering Logistics

    Directory of Open Access Journals (Sweden)

    Mahmood Shafiee

    2013-01-01

    Full Text Available In offshore wind turbines, the blades are among the most critical and expensive components that suffer from different types of damage due to the harsh maritime environment and high load. The blade damages can be categorized into two types: the minor damage, which only causes a loss in wind capture without resulting in any turbine stoppage, and the major (catastrophic damage, which stops the wind turbine and can only be corrected by replacement. In this paper, we propose an optimal number-dependent preventive maintenance (NDPM strategy, in which a maintenance team is transported with an ordinary or expedited lead time to the offshore platform at the occurrence of the Nth minor damage or the first major damage, whichever comes first. The long-run expected cost of the maintenance strategy is derived, and the necessary conditions for an optimal solution are obtained. Finally, the proposed model is tested on real data collected from an offshore wind farm database. Also, a sensitivity analysis is conducted in order to evaluate the effect of changes in the model parameters on the optimal solution.

  20. Strategies to prevent positioning-related complications associated with the lateral suboccipital approach.

    Science.gov (United States)

    Furuno, Yuichi; Sasajima, Hiroyasu; Goto, Yukihiro; Taniyama, Ichita; Aita, Kazuyasu; Owada, Kei; Tatsuzawa, Kazunori; Mineura, Katsuyoshi

    2014-02-01

    The lateral positioning used for the lateral suboccipital surgical approach is associated with various pathophysiologic complications. Strategies to avoid complications including an excessive load on the cervical vertebra and countermeasures against pressure ulcer development are needed. We retrospectively investigated positioning-related complications in 71 patients with cerebellopontine angle lesions undergoing surgery in our department between January 2003 and December 2010 using the lateral suboccipital approach. One patient postoperatively developed rhabdomyolysis, and another presented with transient peroneal nerve palsy on the unaffected side. Stage I and II pressure ulcers were noted in 22 and 12 patients, respectively, although neither stage III nor more severe pressure ulcers occurred. No patients experienced cervical vertebra and spinal cord impairments, brachial plexus palsy, or ulnar nerve palsy associated with rotation and flexion of the neck. Strategies to prevent positioning-related complications, associated with lateral positioning for the lateral suboccipital surgical approach, include the following: atraumatic fixation of the neck focusing on jugular venous perfusion and airway pressure, trunk rotation, and sufficient relief of weightbearing and protection of nerves including the peripheral nerves of all four extremities.

  1. Evaluation of a Tailored Direct-Mail Marketing Strategy for Recruiting the 19- to 23-Year-Old Market.

    Science.gov (United States)

    1983-05-01

    17AD-A12.9 860 EVALUATION OF A TAILORED DIRECT-MAIL MARKETING STRATEGY 1/ FOR RECRUITNG TH.U) WESAT INC ROCKVILLE MD K FERNANDES ET AL MAY 83 NPRDC...STANDARDS-1963-A EVALUATION OF A TAILORED DIRECT-MAIL MARKETING STRATEGY FOR RECRUITING THE 19- TO 23-YEAR-OLD MARKET APPRVEDFORPUBLIC RELE AnE [B...EVALUATION OF A TAILORED DIRECT-MAIL MARKETING STRATEGY FOR RECRUITING THE 19- TO 23-YEAR-OLD MARKET Kathleen Fernandes Navy Personnel Research and

  2. Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city.

    Science.gov (United States)

    Lavôr, Débora Cristina Brasil da Silva; Pinheiro, Jair Dos Santos; Gonçalves, Maria Jacirema Ferreira

    2016-04-01

    To assess the degree of implementation of the Directly Observed Treatment, Short-course - DOTS for tuberculosis (TB) in a large city. Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program. Avaliar o grau de implantação da estratégia de tratamento diretamente observado (Directly Observed Treatment, Short-course - DOTS) para tuberculose (TB) em um município de grande porte. Avaliação de implantação por meio de modelo lógico, cujos casos novos de TB pulmonar bacilífera foram recrutados em ambulatórios especializados e acompanhados nas unidades básicas de saúde. Utilizou-se matriz de julgamento que abrange os cinco componentes da estratégia DOTS. O resultado do modelo lógico indica DOTS implantada parcialmente. Nos contextos externo, organizacional e de implantação, a estratégia DOTS está implantada parcialmente; e, na efetividade não está implantada. A implantação parcial da estratégia DOTS, na cidade de Manaus, reflete na não conformidade do controle da TB, levando à baixa efetividade do programa.

  3. Attitudes of serodiscordant couples towards antiretroviral-based HIV prevention strategies in Kenya: a qualitative study.

    Science.gov (United States)

    Fowler, Nikola; Arkell, Paul; Abouyannis, Michael; James, Catherine; Roberts, Lesley

    2014-01-01

    Transmission in serodiscordant couples (SDCs) accounts for approximately half of all new HIV infections, both in Kenya and the wider sub-Saharan region (1). With evidence to suggest inconsistent condom use within this population (2), the World Health Organization has recommended two new methods of HIV prevention for SDCs: Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP). However, there has been little research about the attitudes of SDCs towards these strategies (3, 4); knowledge that is paramount for successfully predicting the acceptability and efficacy of each method, as well as for informing decisions regarding HIV policy changes in Kenya. An exploratory, qualitative study was conducted in the Muhoroni constituency of Nyando district, Kenya from January to March 2013. Purposive sampling was predominately used to recruit 21 HIV-positive and 17 HIV-negative individuals in a serodiscordant relationship from four hospitals and health centres. During face-to-face semi-structured interviews, topic guides were used to elicit information about participants' attitudes and preferences towards TasP and PrEP. Collected data underwent framework analysis, allowing the development of overarching categories, sub-themes and inductive interpretation. The majority of participants, irrespective of gender and HIV status, found TasP more acceptable than PrEP. A key factor influencing this decision was HIV-negative participants' limited motivation to take and adhere to antiretrovirals (ARVs), primarily due to a predominantly external health locus of control, a lack of cultural acceptance of prophylactic medication and concerns about side effects. In addition to this, the likely health improvements TasP offers HIV-positive partners, as well as the attitude that the sick individual should be the first to receive HIV medication, also contributed to this conclusion. Issues of risk compensation were raised, with some HIV-negative partners indicating a desire to stop

  4. Global evidence directing regional preventive strategies in Southeast Asia for fighting TB/HIV.

    Science.gov (United States)

    Aung, Myo Nyein; Moolphate, Saiyud; Paudel, Damodar; Jayathunge Ph, Mangalasiri; Duangrithi, Duangjai; Wangdi, Kinley; Aung, Thin Nyein Nyein; Lorga, Thaworn; Higuchi, Kazue

    2013-03-14

    Tuberculosis (TB) and human immunodeficiency virus (HIV) co-epidemics form a huge burden of disease in the Southeast Asia region. Five out of eleven nations in this region are high TB/HIV burden countries: Myanmar, Thailand, India, Indonesia and Nepal. The trends of TB incidence in these countries have been rising in recent years, in contrast to a falling global trend. Experts in the field of TB control and health service providers have been perplexed by the association of TB and HIV infections which causes a mosaic clinical presentation, a unique course with poor treatment outcomes including death. We conducted a review of contemporary evidence relating to TB/HIV control with the aims of assisting integrated health system responses in Southeast Asia and demystifying current evidence to facilitate translating it into practice.

  5. Legionella pneumophila: risk assessment and strategy for the prevention and control of nosocomial infections

    Directory of Open Access Journals (Sweden)

    Salvo Torrisi

    2012-06-01

    Full Text Available The term “Legionellosis” includes all forms of disease caused by microorganisms of the genus Legionella; it may manifest as a flu-like shape (Pontiac fever, or with severe pneumonia with high mortality (Legionnaires Disease. The causative agent was Legionella pneumophila in the literature although other strains of the genus Legionella are classified as pathogens, mode of transmission is through inhalation of aerosol particles produced by hot water or air conditioning systems: for this reason in community settings and nosocomial L. pneumophila represents a serious public health problem. In the light of epidemiological data since the year 2000 the Italian State has issued a series of provisions laws concerning the prevention and control of nosocomial Legionellosis environment and community.The present work aims to evaluate the presence of Legionella species and L. pneumophila comparing the different approaches proposed by the Guidelines of the regions of Lombardy and Piedmont in terms of assessment and prevention of risk “Legionellosis” in the field of nosocomial infection. The analytical methods used are those provided by the Regional Guidelines: the official method in the second CSR April 4 Method 2000 and UNI EN ISO 11731-1: 2008. Checks have been performed on equipment for the comparison of cold water, hot water and air conditioning in nursing homes, retirement homes and hospitals.The results obtained show that the method CSR April 4, 2000 restricts the search to L. pneumophila permitting, than the method EN ISO 11731-1: 2008, to carry out a risk assessment well targeted to the actual pathogen.The culture method for the detection of L. pneumophila allows you to not only prevention, but also to implement a series of targeted interventions following the directions of the legislation.

  6. Household waste compositional analysis variation from insular communities in the framework of waste prevention strategy plans

    International Nuclear Information System (INIS)

    Zorpas, Antonis A.; Lasaridi, Katia; Voukkali, Irene; Loizia, Pantelitsa; Chroni, Christina

    2015-01-01

    Highlights: • Waste framework directive has set clear waste prevention procedures. • Household Compositional analysis. • Waste management plans. • Zero waste approach. • Waste generation. - Abstract: Waste management planning requires reliable data regarding waste generation, affecting factors on waste generation and forecasts of waste quantities based on facts. In order to decrease the environmental impacts of waste management the choice of prevention plan as well as the treatment method must be based on the features of the waste that are produced in a specific area. Factors such as culture, economic development, climate, and energy sources have an impact on waste composition; composition influences the need of collecting waste more or less frequently of waste collection and disposition. The research question was to discover the main barriers concerning the compositional analysis in Insular Communities under warm climate conditions and the findings from this study enabled the main contents of a waste management plan to be established. These included advice to residents on waste minimisation, liaison with stakeholders and the expansion of kerbside recycling schemes

  7. Household waste compositional analysis variation from insular communities in the framework of waste prevention strategy plans

    Energy Technology Data Exchange (ETDEWEB)

    Zorpas, Antonis A., E-mail: antonis.zorpas@ouc.ac.cy [Cyprus Open University, Faculty of Pure and Applied Science, Environmental Conservation and Management, P.O. Box 12794, 2252 Latsia, Nicosia (Cyprus); Lasaridi, Katia, E-mail: klasaridi@hua.gr [Harokopio University, Department of Geography, 70 El. Venizelou, 176 71 Athens, Kallithea (Greece); Voukkali, Irene [Institute of Environmental Technology and Sustainable Development, ENVITECH LTD, Department of Research and Development, P.O. Box 34073, 5309 (Cyprus); Loizia, Pantelitsa, E-mail: irenevoukkali@envitech.org [Institute of Environmental Technology and Sustainable Development, ENVITECH LTD, Department of Research and Development, P.O. Box 34073, 5309 (Cyprus); Chroni, Christina [Harokopio University, Department of Geography, 70 El. Venizelou, 176 71 Athens, Kallithea (Greece)

    2015-04-15

    Highlights: • Waste framework directive has set clear waste prevention procedures. • Household Compositional analysis. • Waste management plans. • Zero waste approach. • Waste generation. - Abstract: Waste management planning requires reliable data regarding waste generation, affecting factors on waste generation and forecasts of waste quantities based on facts. In order to decrease the environmental impacts of waste management the choice of prevention plan as well as the treatment method must be based on the features of the waste that are produced in a specific area. Factors such as culture, economic development, climate, and energy sources have an impact on waste composition; composition influences the need of collecting waste more or less frequently of waste collection and disposition. The research question was to discover the main barriers concerning the compositional analysis in Insular Communities under warm climate conditions and the findings from this study enabled the main contents of a waste management plan to be established. These included advice to residents on waste minimisation, liaison with stakeholders and the expansion of kerbside recycling schemes.

  8. Strategy and technology to prevent hospital-acquired infections: Lessons from SARS, Ebola, and MERS in Asia and West Africa

    OpenAIRE

    Rajakaruna, Sanjeewa Jayachandra; Liu, Wen-Bin; Ding, Yi-Bo; Cao, Guang-Wen

    2017-01-01

    Hospital-acquired infections (HAIs) are serious problems for healthcare systems, especially in developing countries where public health infrastructure and technology for infection preventions remain undeveloped. Here, we characterized how strategy and technology could be mobilized to improve the effectiveness of infection prevention and control in hospitals during the outbreaks of Ebola, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS) in Asia and West Afr...

  9. An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students.

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Flores-Peña, Yolanda; De León-Leal, Silvia; Vázquez-Martínez, Carlos Alberto; Farías-Calderón, Ana Gabriela; Melo-Santiesteban, Guadalupe; Elizondo-Zapién, Rosa María; Hernandez-Hernandez, Dulce María; Garza-Moya, Rubén; Cerda-Flores, Ricardo Martín

    2015-01-01

    Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

  10. Social supports and prevention strategies as adjuncts and alternatives to sedation and anesthesia for people with special needs.

    Science.gov (United States)

    Glassman, Paul; Miller, Christine

    2009-01-01

    People with special needs are assuming a more prominent place in our society. The number of people living in communities with medical, physical, and psychological conditions is increasing dramatically. In spite of the advances that people with special needs have made in recognition of their right to live in society and access services open to other people, their oral health is still significantly poorer than that of other groups. There are a number of modalities that can complement or replace pharmacological interventions and allow individuals to have dental treatment in a dental office or clinic. These include behavioral or psychological interventions and social support and prevention strategies. Social supports include care management and integration of oral health services with general health and social service systems. Preventive programs using modern "medical model" oral health prevention strategies also have the potential to reduce the burden of disease among people with special needs and therefore reduce the need for dental procedures. A social support system using community-based Dental Hygienists acting as Dental Coordinators, is described along with outcomes demonstrating improved oral health for people with special needs living in community residential care facilities. Combined social support systems and community prevention strategies have the potential to reduce the need for pharmacological interventions in order to maintain oral health in populations of people with special needs. Social supports and modern preventive strategies must be included in the range of options available in communities in order to improve and maintain oral health for people with special needs.

  11. Pre- and postharvest preventive measures and intervention strategies to control microbial food safety hazards of fresh leafy vegetables.

    Science.gov (United States)

    Gil, Maria I; Selma, Maria V; Suslow, Trevor; Jacxsens, Liesbeth; Uyttendaele, Mieke; Allende, Ana

    2015-01-01

    This review includes an overview of the most important preventive measures along the farm to fork chain to prevent microbial contamination of leafy greens. It also includes the technological and managerial interventions related to primary production, postharvest handling, processing practices, distribution, and consumer handling to eliminate pathogens in leafy greens. When the microbiological risk is already present, preventive measures to limit actual contamination events or pathogen survival are considered intervention strategies. In codes of practice the focus is mainly put on explaining preventive measures. However, it is also important to establish more focused intervention strategies. This review is centered mainly on leafy vegetables as the commodity identified as the highest priority in terms of fresh produce microbial safety from a global perspective. There is no unique preventive measure or intervention strategy that could be applied at one point of the food chain. We should encourage growers of leafy greens to establish procedures based on the HACCP principles at the level of primary production. The traceability of leafy vegetables along the chain is an essential element in ensuring food safety. Thus, in dealing with the food safety issues associated with fresh produce it is clear that a multidisciplinary farm to fork strategy is required.

  12. Common pathways toward informing policy and environmental strategies to promote health: a study of CDC's Prevention Research Centers.

    Science.gov (United States)

    Neri, Elizabeth M; Stringer, Kate J; Spadaro, Antonia J; Ballman, Marie R; Grunbaum, Jo Anne

    2015-03-01

    This study examined the roles academic researchers can play to inform policy and environmental strategies that promote health and prevent disease. Prevention Research Centers (PRCs) engage in academic-community partnerships to conduct applied public health research. Interviews were used to collect data on the roles played by 32 PRCs to inform policy and environmental strategies that were implemented between September 2009 and September 2010. Descriptive statistics were calculated in SAS 9.2. A difference in roles played was observed depending on whether strategies were policy or environmental. Of the policy initiatives, the most common roles were education, research, and partnership. In contrast, the most prevalent roles the PRCs played in environmental approaches were research and providing health promotion resources. Academic research centers play various roles to help inform policy and environmental strategies. © 2014 Society for Public Health Education.

  13. RELAP5/MOD3.3 Analyses of Core Heatup Prevention Strategy During Extended Station Blackout in PWR

    International Nuclear Information System (INIS)

    Prosek, A.

    2016-01-01

    The accident at the Fukushima Dai-ichi nuclear power plant demonstrated the vulnerability of the plants on the loss of electrical power for several days, so called extended station blackout (SBO). A set of measures have been proposed and implemented in response of the accident at the Fukushima Dai-ichi nuclear power plant. The purpose of the study was to investigate the application of the deterministic safety analysis for core heatup prevention strategy of the extended SBO in pressurized water reactor, lasting 72 h. The prevention strategy selected was water injection into steam generators using turbine driven auxiliary feedwater pump (TD-AFW) or portable water injection pump. Method for assessment of the necessary pump injection flowrate is developed and presented. The necessary injection flowrate to the steam generators is determined from the calculated cumulative water mass injected by the turbine driven auxiliary feedwater pump in the analysed scenarios, when desired normal level is maintained automatically. The developed method allows assessment of the necessary injection flowrates of pump, TD-AFW or portable, for different plant configurations and number of flowrate changes. The RELAP5/MOD3.3 Patch04 computer code and input model of a two-loop pressurized water reactor is used for analyses, assuming different injection start times, flowrates and reactor coolant system losses. Three different reactor coolant system (RCS) coolant loss pathways, with corresponding leakage rate, can be expected in the pressurized water reactor (PWR) during the extended SBO: normal system leakage, reactor coolant pump seal leakage, and RCS coolant loss through letdown relief valve unless automatically isolated or until isolation is procedurally directed. Depressurization of RCS was also considered. In total, six types of RCS coolant loss scenarios were considered. Two cases were defined regarding the operation of the emergency diesel generators. Different delays of the pump

  14. Effects of Embedded and Direct Language Strategies on Prekindergarten Students' Cognitive and Social Emotional Development

    Science.gov (United States)

    Dominy, Matthew L.

    2012-01-01

    The purpose of this study is to measure the effect of a standard of care embedded language strategies program utilized in combination with direct language strategy instruction on the measured expressive language, cognitive development, social emotional development, and language development of prekindergarten students attending three neighborhood…

  15. Family communication as strategy in diabetes prevention: an observational study in families with Dutch and Surinamese South-Asian ancestry.

    Science.gov (United States)

    van Esch, Suzanne C M; Cornel, Martina C; Geelhoed-Duijvestijn, Petronella H L M; Snoek, Frank J

    2012-04-01

    To explore the possibility of utilizing family communication as a diabetes prevention strategy, specifically targeting high-risk families with South-Asian ancestry in The Netherlands. In a cross-sectional study, type 2 diabetes patients from Dutch (n=311) and Surinamese South-Asian (n=157) origin filled in a questionnaire assessing socio-demographic characteristics, beliefs and concerns about familial diabetes risk, primary prevention, and diabetes-related family communication. Discussing diabetes is regarded acceptable in most families. Especially Surinamese South-Asian patients (68%) seemed motivated to convey risk messages to their relatives; they reported a higher risk perception and expressed more concern than Dutch patients. While 40% in both groups thought relatives are able to prevent developing diabetes, 46% in Dutch and 33% in Surinamese South-Asian patients were unsure. Promoting family communication appears a feasible strategy in diabetes prevention in high-risk (Surinamese South-Asian) families. Health care providers should address patients' concern and emphasize opportunities for prevention. Findings favor training of clinicians in utilizing a family approach as prevention strategy. Patients (particularly Surinamese South-Asians) are in need of professional help in the process of family risk disclosure. (Online) Educational tools should be made available at which patients can refer their relatives. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Microplastics in seawater: Recommendations from the Marine Strategy Framework Directive implementation process

    Directory of Open Access Journals (Sweden)

    Jesus Gago

    2016-11-01

    Full Text Available Microplastic litter is a pervasive pollutant present in marine systems across the globe. The legacy of microplastics pollution in the marine environment today may remain for years to come due to the persistence of these materials. Microplastics are emerging contaminants of potential concern and as yet there are few recognised approaches for monitoring. In 2008, the EU Marine Strategy Framework Directive (MSFD, 2008/56/EC included microplastics as an aspect to be measured. Here we outline the approach as discussed by the European Union expert group on marine litter, the technical Subgroup on Marine litter (TSG-ML, with a focus on the implementation of monitoring microplastics in seawater in European seas. It is concluded that harmonization and coherence is needed to achieve reliable monitoring.

  17. Redox cofactor engineering in industrial microorganisms: strategies, recent applications and future directions.

    Science.gov (United States)

    Liu, Jiaheng; Li, Huiling; Zhao, Guangrong; Caiyin, Qinggele; Qiao, Jianjun

    2018-05-01

    NAD and NADP, a pivotal class of cofactors, which function as essential electron donors or acceptors in all biological organisms, drive considerable catabolic and anabolic reactions. Furthermore, they play critical roles in maintaining intracellular redox homeostasis. However, many metabolic engineering efforts in industrial microorganisms towards modification or introduction of metabolic pathways, especially those involving consumption, generation or transformation of NAD/NADP, often induce fluctuations in redox state, which dramatically impede cellular metabolism, resulting in decreased growth performance and biosynthetic capacity. Here, we comprehensively review the cofactor engineering strategies for solving the problematic redox imbalance in metabolism modification, as well as their features, suitabilities and recent applications. Some representative examples of in vitro biocatalysis are also described. In addition, we briefly discuss how tools and methods from the field of synthetic biology can be applied for cofactor engineering. Finally, future directions and challenges for development of cofactor redox engineering are presented.

  18. Whole of Systems Trial of Prevention Strategies for Childhood Obesity: WHO STOPS Childhood Obesity

    Directory of Open Access Journals (Sweden)

    Steven Allender

    2016-11-01

    Full Text Available Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1 strengthen community action for childhood obesity prevention, and (2 measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1 to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7–8 y, grade four (9–10 y and grade six (11–12 y students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools. An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.

  19. Childhood drowning in South Africa: local data should inform prevention strategies.

    Science.gov (United States)

    Joanknecht, L; Argent, A C; van Dijk, M; van As, A B

    2015-02-01

    Drowning is an important cause of childhood injury, however, little is known about drowning in Africa. The aim of this study is to investigate submersion incidents in Cape Town, South Africa and provide specific prognostic factors as well as to develop age-appropriate prevention strategies. A retrospective chart review performed at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa. Patients admitted because of 'drowning' or 'near-drowning' between January 2007 and April 2013 were included. 75 children were included. 63 (84 %) survived without complications, 8 (10.7 %) died and 4 (5.3 %) had permanent neurological sequelae. The median age was 2.2 years (range 0.1-12.4). 46 (60.5 %) incidents happened in or around the home, only 14 (18.7 %) were witnessed. 42 (56 %) took place in a pool (29 private, 13 public). Significant predictors of the outcome were: estimated submersion time, duration of apnea, unresponsive and dilated pupils, intubation and use of inotropes. On arrival at the ER we found these significant predictors of the outcome: CPR, a GCS drowning in the home environment. While bathing in baths or buckets, children should never be left alone and parents should be made aware of the dangers. In our study, the majority of incidents occurred in swimming pools and limiting access to these could prevent many incidents of drowning among older children. Although children of all language groups are at risk for drowning, English- or Afrikaans-speaking children were particularly at risk for drowning in private pools while Xhosa-speaking children mostly drowned in baths or buckets. We also report multiple prognostic factors for the outcome, but none of them were absolute predictive of the outcome, indicating that each victim of submersion deserves full resuscitative treatment.

  20. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

    Science.gov (United States)

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

    2013-01-01

    Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

  1. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  2. Strategically Timed Preventive Education and Media Strategies Reduce Seasonal Trends in Adolescent Conception.

    Science.gov (United States)

    Gauster, A; Waddington, A; Jamieson, M A

    2015-08-01

    This study sought to analyze the effect of strategically timed local preventive education on reducing teen conception rates during known seasonal peaks in March and April. All teen conceptions (age ≤ 19) from March and April 2010, 2011, and 2012 were identified using medical records data. Teen conceptions occurring in January 2010, 2011, and 2012 were also identified to control for any new trends in the community. A city of 160,000 with 1 tertiary care centre. Pregnant adolescents (age ≤ 19). During the month of February 2012, preventive education and media awareness strategies were aimed at parents, teachers, and teens. Adolescent conceptions in March and April 2012. Conception rates in teens ≤18 years old were significantly reduced in March and April 2012 compared to March and April 2010 and 2011 (RR = 0.53, 95% CI = 0.32 - 0.88, P = .0132). There was an increase in conceptions in March and April 2012 compared to 2010 and 2011 among 19-year-olds (RR = 1.57, 95% CI = 0.84-2.9, P = .1500). Effect modification revealed our ≤18-year-old group and our 19-year-old group were distinct groups with different risk estimates (P = .0075). Educational sessions were poorly attended and contraception clinic volume was static. We propose increased parental supervision in response to media reminders as a possible explanation for the reduction in adolescent conceptions (≤18 years old) seen in March 2012. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  3. Sudden cardiac death in athletes and its preventive strategies: review article

    Directory of Open Access Journals (Sweden)

    Farzin Halabchi

    2017-12-01

    Full Text Available Sudden cardiac death in sport, although rare, but is a tragic event, attracting the media and public attention. Sport and exercise may act as a trigger for sudden cardiac death. Risk of sudden death in young athletes with cardiovascular disease is 2.5 times more frequent than non-athlete individuals. More than 90% of cases of sudden death occur during or immediately after training or competition. Incidence of sudden cardiac death in any population, including athletes, is related to multiple factors such as gender, age, race, nationality, diagnostic screening methods and preventive measures for sudden cardiac death. Otherwise, incidence rate of sudden cardiac death is linked to the used definition and method of diagnosis. Different cardiovascular disorders may result in death of young athletes and hypertrophic cardiomyopathy, congenital coronary anomalies, arrhythmogenic right ventricular dysplasia and aortic rupture are among the most common causes. Marfan syndrome, dilated cardiomyopathy, viral myocarditis, Wolff-Parkinson-White (WPW syndrome, congenital long QT syndrome, Brugada syndrome and commotio cordis are reported as other etiologies. In older athletes (more than 35 years, ischemic coronary heart disease is responsible for majority of the cases similar to the general population. Because the outcome of sudden cardiac arrest in sports is very poor except in few cases, proper national strategies are needed to diminish the burden of sudden death in young athletes. It seems that there are two main strategies to achieve this goal: A Primary prevention with use of purposeful pre-participation evaluation programs. This evaluation should focuss on the proper history and physical examination. Nevertheless, there is significant debate between American and European countries regarding the use of paraclinical investigations (especially ECG. American heart association does not recommend ECG as an essential part of evaluation. In contrast, European

  4. Methicillin-resistant Staphylococcus aureus prevention strategies in the ICU: a clinical decision analysis*.

    Science.gov (United States)

    Ziakas, Panayiotis D; Zacharioudakis, Ioannis M; Zervou, Fainareti N; Mylonakis, Eleftherios

    2015-02-01

    ICUs are a major reservoir of methicillin-resistant Staphylococcus aureus. Our aim was to estimate costs and effectiveness of methicillin-resistant Staphylococcus aureus prevention policies. We evaluated three up-to-date methicillin-resistant Staphylococcus aureus prevention policies, namely, 1) nasal screening and contact precautions of methicillin-resistant Staphylococcus aureus-positive patients; 2) nasal screening, contact precautions, and decolonization (targeted decolonization) of methicillin-resistant Staphylococcus aureus carriers; and 3) universal decolonization without screening. We implemented a decision-analytic model with deterministic and probabilistic analyses. Methicillin-resistant Staphylococcus aureus infections averted, quality-adjusted life years gained, and incremental cost-effectiveness ratios were calculated. Cost-effectiveness planes and acceptability curves were plotted for various willingness-to-pay thresholds to address uncertainty. At base-case scenario, universal decolonization was the dominant strategy; it averted 1.31% and 1.59% of methicillin-resistant Staphylococcus aureus infections over targeted decolonization and screening and contact precautions, respectively, and saved $16,203/quality-adjusted life year over targeted decolonization and 14,562/quality-adjusted life year over screening and contact precautions. Results were robust in sensitivity analysis for a wide range of input variables. In probabilistic analysis, universal decolonization increased quality-adjusted life years by 1.06% (95% CI, 1.02-1.09) over targeted decolonization and by 1.29% (95% CI, 1.24-1.33) over screening and contact precautions; universal decolonization resulted in average savings of $172 (95% CI, $168-$175) and $189 (95% CI, $185-$193) over targeted decolonization and screening and contact precautions, respectively. With willingness-to-pay threshold per quality-adjusted life year gained ranging from $0 to $50,000, universal decolonization was dominant

  5. Routing Protocols for Underwater Wireless Sensor Networks: Taxonomy, Research Challenges, Routing Strategies and Future Directions.

    Science.gov (United States)

    Khan, Anwar; Ali, Ihsan; Ghani, Abdullah; Khan, Nawsher; Alsaqer, Mohammed; Rahman, Atiq Ur; Mahmood, Hasan

    2018-05-18

    Recent research in underwater wireless sensor networks (UWSNs) has gained the attention of researchers in academia and industry for a number of applications. They include disaster and earthquake prediction, water quality and environment monitoring, leakage and mine detection, military surveillance and underwater navigation. However, the aquatic medium is associated with a number of limitations and challenges: long multipath delay, high interference and noise, harsh environment, low bandwidth and limited battery life of the sensor nodes. These challenges demand research techniques and strategies to be overcome in an efficient and effective fashion. The design of routing protocols for UWSNs is one of the promising solutions to cope with these challenges. This paper presents a survey of the routing protocols for UWSNs. For the ease of description, the addressed routing protocols are classified into two groups: localization-based and localization-free protocols. These groups are further subdivided according to the problems they address or the major parameters they consider during routing. Unlike the existing surveys, this survey considers only the latest and state-of-the-art routing protocols. In addition, every protocol is described in terms of its routing strategy and the problem it addresses and solves. The merit(s) of each protocol is (are) highlighted along with the cost. A description of the protocols in this fashion has a number of advantages for researchers, as compared to the existing surveys. Firstly, the description of the routing strategy of each protocol makes its routing operation easily understandable. Secondly, the demerit(s) of a protocol provides (provide) insight into overcoming its flaw(s) in future investigation. This, in turn, leads to the foundation of new protocols that are more intelligent, robust and efficient with respect to the desired parameters. Thirdly, a protocol can be selected for the appropriate application based on its described

  6. [A community education strategy to promote participation in dengue prevention in Cuba].

    Science.gov (United States)

    Sánchez, Lizet; Pérez, Dennis; Alfonso, Lázara; Castro, Marta; Sánchez, Luis Manuel; Van der Stuyft, Patrick; Kourí, Gustavo

    2008-07-01

    To document the process and analyze the results of implementing a strategy aimed at increasing community participation in the fight against the dengue mosquito vector. From May 2002 to May 2004, an intervention was implemented to advance social action against dengue in three districts of the municipality of Playa, La Habana, Cuba. A learning group and community working groups (CWG) were organized in each location. A community education model was followed that combines putting the plan of action into practice, with sessions to reflect and learn from the results, and then reworking of the actions for subsequent stages. Diagnostic tools were developed for communities, preventative actions, communication, surveillance, and evaluation. Changes in participation were identified by applying the content analysis technique to the documents and through interviews with key informants. The community work advanced at a pace relative to the abilities and interests of each community with different areas of focus: healthy community, environmental risk, and entomological risk. Positive changes in the concept of participation were obtained, according to the five areas evaluated: leadership, needs assessment, organization, management, and mobilization of resources. At the end of two years of intervention, the rate of Aedes aegypti larvae and pupae deposits found per 100 households had declined 79% and cases of dengue were not detected in any of the districts. This strategy reduced mosquito vector infestation levels by increasing community participation in decision-making and strengthening the competencies of the medical teams and CWGs so that they lead participative processes in the community and raised confidence in their ability to achieve change with the appropriate resources and intersectoral support.

  7. National strategy for suicide prevention in Japan: impact of a national fund on progress of developing systems for suicide prevention and implementing initiatives among local authorities.

    Science.gov (United States)

    Nakanishi, Miharu; Yamauchi, Takashi; Takeshima, Tadashi

    2015-01-01

    In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  8. Main-chain-directed strategy for the assignment of 1H NMR spectra of proteins

    International Nuclear Information System (INIS)

    Englander, S.W.; Wand, A.J.

    1987-01-01

    A strategy for assigning the resonances in two-dimensional (2D) NMR spectra of proteins is described. The method emphasizes the analysis of through-space relationships between protons by use of the two-dimensional nuclear Overhauser effect (NOE) experiment. NOE patterns used in the algorithm were derived from a statistical analysis of the combinations of short proton-proton distances observed in the high-resolution crystal structures of 21 proteins. One starts with a search for authentic main-chain NH-C/sub α/H-C/sub β/H J-coupled units, which can be found with high reliability. The many main-chain units of a protein are then placed in their proper juxtaposition by recognition of predefined NOE connectivity patterns. To discover these connectivities, the 2D NOE spectrum is examined, in a prescribed order, for the distinct NOE patterns characteristic of helices, sheets, turns, and extended chain. Finally, the recognition of a few amino acid side-chain types places the discovered secondary structure elements within the polypeptide sequences. Unlike the sequential assignment approach, the main-chain-directed strategy does not rely on the difficult task of recognizing many side-chain spin systems in J-correlated spectra, the assignment process is not in general sequential with the polypeptide chain, and the prescribed connectivity patterns are cyclic rather than linear. The latter characteristic avoids ambiguous branch points in the analysis and imposed an internally confirmatory property on each forward step

  9. An empirical strategy to detect bacterial transcript structure from directional RNA-seq transcriptome data.

    Science.gov (United States)

    Wang, Yejun; MacKenzie, Keith D; White, Aaron P

    2015-05-07

    As sequencing costs are being lowered continuously, RNA-seq has gradually been adopted as the first choice for comparative transcriptome studies with bacteria. Unlike microarrays, RNA-seq can directly detect cDNA derived from mRNA transcripts at a single nucleotide resolution. Not only does this allow researchers to determine the absolute expression level of genes, but it also conveys information about transcript structure. Few automatic software tools have yet been established to investigate large-scale RNA-seq data for bacterial transcript structure analysis. In this study, 54 directional RNA-seq libraries from Salmonella serovar Typhimurium (S. Typhimurium) 14028s were examined for potential relationships between read mapping patterns and transcript structure. We developed an empirical method, combined with statistical tests, to automatically detect key transcript features, including transcriptional start sites (TSSs), transcriptional termination sites (TTSs) and operon organization. Using our method, we obtained 2,764 TSSs and 1,467 TTSs for 1331 and 844 different genes, respectively. Identification of TSSs facilitated further discrimination of 215 putative sigma 38 regulons and 863 potential sigma 70 regulons. Combining the TSSs and TTSs with intergenic distance and co-expression information, we comprehensively annotated the operon organization in S. Typhimurium 14028s. Our results show that directional RNA-seq can be used to detect transcriptional borders at an acceptable resolution of ±10-20 nucleotides. Technical limitations of the RNA-seq procedure may prevent single nucleotide resolution. The automatic transcript border detection methods, statistical models and operon organization pipeline that we have described could be widely applied to RNA-seq studies in other bacteria. Furthermore, the TSSs, TTSs, operons, promoters and unstranslated regions that we have defined for S. Typhimurium 14028s may constitute valuable resources that can be used for

  10. How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations

    Directory of Open Access Journals (Sweden)

    Jenine R. Leal

    2017-06-01

    Full Text Available Abstract Background The rates of antimicrobial-resistant organisms (ARO continue to increase for both hospitalized and community patients. Few resources have been allocated to reduce the spread of resistance on global, national and local levels, in part because the broader economic impact of antimicrobial resistance (i.e. the externality is not fully considered when determining how much to invest to prevent AROs, including strategies to contain antimicrobial resistance, such as antimicrobial stewardship programs. To determine how best to measure and incorporate the impact of externalities associated with the antimicrobial resistance when making resource allocation decisions aimed to reduce antimicrobial resistance within healthcare facilities, we reviewed the literature to identify publications which 1 described the externalities of antimicrobial resistance, 2 described approaches to quantifying the externalities associated with antimicrobial resistance or 3 described macro-level policy options to consider the impact of externalities. Medline was reviewed to identify published studies up to September 2016. Main body An externality is a cost or a benefit associated with one person’s activity that impacts others who did not choose to incur that cost or benefit. We did not identify a well-accepted method of accurately quantifying the externality associated with antimicrobial resistance. We did identify three main methods that have gained popularity to try to take into account the externalities of antimicrobial resistance, including regulation, charges or taxes on the use of antimicrobials, and the right to trade permits or licenses for antimicrobial use. To our knowledge, regulating use of antimicrobials is the only strategy currently being used by health care systems to reduce antimicrobial use, and thereby reduce AROs. To justify expenditures on programs that reduce AROs (i.e. to formally incorporate the impact of the negative externality of

  11. Direct oral anticoagulants and digestive bleeding: therapeutic management and preventive measures.

    Science.gov (United States)

    Deutsch, David; Boustière, Christian; Ferrari, Emile; Albaladejo, Pierre; Morange, Pierre-Emmanuel; Benamouzig, Robert

    2017-06-01

    The use of direct oral anticoagulants (DOACs) was an important step forward in the management of atrial fibrillation and venous thromboembolism (VTE). The DOACs, anti-IIa for dabigatran and anti-Xa for rivaroxaban, apixaban and edoxaban, all have a rapid onset of action and a short half life. There is no need for routine hemostasis testing for treatment monitoring of a DOAC. Compared with vitamin K antagonists (VKAs), DOACs may increase the risk of gastrointestinal bleeding (relative risk 1.25). Withholding the DOAC treatment, evaluating the time of the last intake and estimating the patient's renal function are the first steps in the management of gastrointestinal bleeding. For patients without impaired renal function, achieving low coagulation takes around 24 h after the last intake of a DOAC. The use of DOAC antagonists will be helpful in controlling bleeding in the most severe and urgent situations. Idarucizumab is available for clinical use for dabigatran and andexanet is currently being reviewed by drug agencies for rivaroxaban, apixaban and edoxaban. It is important to assess the bleeding risk associated with the planned procedure, and the patient's renal function before withholding DOAC therapy for a scheduled intervention. It is mandatory to strengthen the local hemostasis strategies in DOAC-treated patients undergoing a therapeutic endoscopic procedure. Resuming or not resuming anticoagulation with a DOAC after bleeding or a risky procedure depends on the thrombotic and bleeding risk as well as the procedure involved. This discussion should always involve the cardiologist and decisions should be taken by a pluridisciplinary team.

  12. Library Learning: Undergraduate Students’ Informal, Self-directed, and Information Sharing Strategies

    Directory of Open Access Journals (Sweden)

    Jo Ann Murphy

    2014-04-01

    Full Text Available A focus group study of fourteen University of Saskatchewan second to fourth year humanities and social science undergraduate students was conducted in the fall of 2011. The purpose of the research was to determine how students learn about library resources and services. Findings indicate that the participants often use a variety of informal, self-directed and information sharing strategies. Seeking help from professors, peers, friends, and family members is a common practice. Convenience, familiarity, and perceived knowledge are key factors that determine who and how these students learn about the library. Formal instruction and seeking assistance from librarians did not resonate for participants as a typical approach for learning about the library. The author suggests that undergraduate students engage in informal learning and information sharing as many ‘adult learners’ do, similar to an employment setting. The library, within the formal educational structure, lends itself to a more informal learning context. The study concludes that libraries must continue to develop resources, services, and innovative programs that support students’ informal learning styles, while also providing formal instruction as part of the undergraduate curriculum ensuring students are exposed early on to core foundational skills that contribute to their success as informal and self-directed learners.

  13. The implementation of the EU renewable directive in Spain. Strategies and challenges

    International Nuclear Information System (INIS)

    Labriet, Maryse; Cabal, Helena; Lechon, Yolanda; Giannakidis, George; Kanudia, Amit

    2010-01-01

    Based on the European project RES2020, the analysis evaluates the energy strategies to be implemented in Spain in order to satisfy the EU Renewable Directive. The modelling framework relies on the technico-economic model TIMES-Spain, part of the Pan-European TIMES model used in the project. TIMES is a bottom-up technology rich optimisation model representing the whole energy systems of the countries. Among the results, it appears that the gap regarding the renewable deployment in Spain between the Business-as-Usual case (including the existing policies) and the EU Directive should be compensated mainly by the penetration of bioenergy in transport and industry, and by the implementation of conservation measures, which contribute to reduce the total energy demand and thus makes useless additional investments in renewable power plants compared to the Business-as-Usual case. Only higher climate mitigation ambitions result in an absolute increase in the renewable-based electricity generation compared to the Business-as-Usual case. Moreover, when allowed, Spain is offering renewable energy credits under the statistical transfer mechanism to other European countries. The cost increase of the modelled renewable and climate policies compared to the Business-as-Usual remains relatively minor.

  14. Novel Naphthalene Based Lariat-Type Crown Ethers Using Direct Single Electron Transfer Photochemical Strategy

    International Nuclear Information System (INIS)

    Park, Hea Jung; Sung, Nam Kyung; Kim, Su Rhan; Kim, Su Rhan; Ahn, So Hyun; Yoon, Ung Chan; Cho, Dae Won; Mariano, Patrick S.

    2013-01-01

    This study explored a direct SET-photochemical strategy to construct a new family of thioene conjugated-naphthalamide fluorophore based lariat-crown ethers which show strong binding properties towards heavy metal ions. Irradiations of designed nitrogen branched (trimethylsilyl)methylthio-terminated polyethylenoxy-tethered naphthalimides in acidic methanol solutions have led to highly efficient photocyclization reactions to generate naphthalamide based lariat type thiadiazacrown ethers directly in chemo- and regio-selective manners which undergo very facile secondary dehydration reactions during separation processes to produce their corresponding amidoenethio ether cyclic products tethered with electron donating diethyleneoxy- and diethyenethio-side arm chains. Fluorescence and metal cation binding properties of the lariat type enamidothio products were examined. The photocyclized amidoenethio products, thioene conjugated naphthalamide fluorophore containing lariat-thiadiazacrowns exhibited strong fluorescence emissions in region of 330-450 nm along with intramolecular exciplex emissions in region of 450-560 nm with their maxima at 508 nm. Divalent cation Hg 2+ and Pb 2+ showed strong binding to sulfur atom(s) in side arm chain and atoms in enethiadiazacrown ether rings which led to significant enhancement of fluorescence from its chromophore singlet excited state and concomitant quenching of exciplex emission. The dual fluorescence emission responses towards divalent cations might provide a new guide for design and development of fluorescence sensors for detecting those metals

  15. Novel Naphthalene Based Lariat-Type Crown Ethers Using Direct Single Electron Transfer Photochemical Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hea Jung; Sung, Nam Kyung; Kim, Su Rhan; Kim, Su Rhan; Ahn, So Hyun; Yoon, Ung Chan [Pusan National Univ., Busan (Korea, Republic of); Cho, Dae Won [Yeungnam Univ., Geoungsan (Korea, Republic of); Mariano, Patrick S. [Univ. of New Mexico, Albuquerque (United States)

    2013-12-15

    This study explored a direct SET-photochemical strategy to construct a new family of thioene conjugated-naphthalamide fluorophore based lariat-crown ethers which show strong binding properties towards heavy metal ions. Irradiations of designed nitrogen branched (trimethylsilyl)methylthio-terminated polyethylenoxy-tethered naphthalimides in acidic methanol solutions have led to highly efficient photocyclization reactions to generate naphthalamide based lariat type thiadiazacrown ethers directly in chemo- and regio-selective manners which undergo very facile secondary dehydration reactions during separation processes to produce their corresponding amidoenethio ether cyclic products tethered with electron donating diethyleneoxy- and diethyenethio-side arm chains. Fluorescence and metal cation binding properties of the lariat type enamidothio products were examined. The photocyclized amidoenethio products, thioene conjugated naphthalamide fluorophore containing lariat-thiadiazacrowns exhibited strong fluorescence emissions in region of 330-450 nm along with intramolecular exciplex emissions in region of 450-560 nm with their maxima at 508 nm. Divalent cation Hg{sup 2+} and Pb{sup 2+} showed strong binding to sulfur atom(s) in side arm chain and atoms in enethiadiazacrown ether rings which led to significant enhancement of fluorescence from its chromophore singlet excited state and concomitant quenching of exciplex emission. The dual fluorescence emission responses towards divalent cations might provide a new guide for design and development of fluorescence sensors for detecting those metals.

  16. Strategies for specifically directing metal functionalization of protein nanotubes: constructing protein coated silver nanowires

    International Nuclear Information System (INIS)

    Carreño-Fuentes, Liliana; Palomares, Laura A; Ramírez, Octavio T; Ascencio, Jorge A; Medina, Ariosto; Aguila, Sergio

    2013-01-01

    Biological molecules that self-assemble in the nanoscale range are useful multifunctional materials. Rotavirus VP6 protein self-assembles into tubular structures in the absence of other rotavirus proteins. Here, we present strategies for selectively directing metal functionalization to the lumen of VP6 nanotubes. The specific in situ metal reduction in the inner surface of nanotube walls was achieved by the simple modification of a method previously reported to functionalize the nanotube outer surface. Silver nanorods and nanowires as long as 1.5 μm were formed inside the nanotubes by coalescence of nanoparticles. Such one-dimensional structures were longer than others previously obtained using bioscaffolds. The interactions between silver ions and the nanotube were simulated to understand the conditions that allowed nanowire formation. Molecular docking showed that a naturally occurring arrangement of aspartate residues enabled the stabilization of silver ions on the internal surface of the VP6 nanotubes. This is the first time that such a spatial arrangement has been proposed for the nucleation of silver nanoparticles, opening the possibility of using such an array to direct functionalization of other biomolecules. These results demonstrate the natural capabilities of VP6 nanotubes to function as a versatile biotemplate for nanomaterials. (paper)

  17. A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking.

    Science.gov (United States)

    Storr, Carla L; Ialongo, Nicholas S; Kellam, Sheppard G; Anthony, James C

    2002-03-01

    In this article, we examine the impact of two universal, grade 1 preventive interventions on the onset of tobacco smoking as assessed in early adolescence. The classroom-centered (CC) intervention was designed to reduce the risk for tobacco smoking by enhancing teachers' behavior management skills in first grade and, thereby, reducing child attention problems and aggressive and shy behavior-known risk behaviors for later substance use. The family-school partnership (FSP) intervention targeted these early risk behaviors via improvements in parent-teacher communication and parents' child behavior management strategies. A cohort of 678 urban, predominately African-American, public school students were randomly assigned to one of three Grade 1 classrooms at entrance to primary school (age 6). One classroom featured the CC intervention, a second the FSP intervention, and the third served as a control classroom. Six years later, 81% of the students completed audio computer-assisted self-interviews. Relative to controls, a modest attenuation in the risk of smoking initiation was found for students who had been assigned to either the CC or FSP intervention classrooms (26% versus 33%) (adjusted relative risk for CC/control contrast=0.57, 95% confidence interval (CI), 0.34-0.96; adjusted relative risk for FSP/control contrast=0.69, 95% CI, 0.50-0.97). Results lend support to targeting the early antecedent risk behaviors for tobacco smoking.

  18. Risk Prevention Strategies and the SWOT Analysis for the Implementation of the SMEs’ Business Plan

    Directory of Open Access Journals (Sweden)

    Ionica Oncioiu

    2014-10-01

    Full Text Available This theme is targeting the importance of implementing the business plan of a small and medium company that has as aim the creation of the added value through research and innovation in the management of human resources performance based on information technology domain. The objective is to increase the economic competitiveness and development of knowledge-based economy whereas by the implementation of the project, it increases the company‟s profitability, creating a competitive advantage resulting in innovative products, as well as the effectiveness of companies that use human resources evaluation platform. The need identified on the market to which the SMEs wish to answer by implementing the plan is represented by the nationwide lack of a complex solution covering both the evaluation and the management of human resources performances. The used methodology can be found in the analysis, developing a strategy for preventing financial, human, market, marketing - image risks and also the physical ones. With the SWOT analysis it was observed one of the strengths i.e. the existence of a single management system of employee performance that includes assessment specific features. In conclusion, there are no software solutions at national level, which would assess the human resources of an organization, following specific indicators of that organization, which could combine the assessment methods in order to achieve more a more efficient and versatile assessment.

  19. Is traditional male circumcision effective as an HIV prevention strategy? Evidence from Lesotho.

    Directory of Open Access Journals (Sweden)

    Elisa M Maffioli

    Full Text Available In many developing countries, male circumcision has been promoted as an effective HIV prevention strategy, and medical randomized controlled trials have indeed shown a causal link. However, there is limited empirical evidence to support this conclusion in countries where individuals can voluntary opt for different types of circumcision. The present study considers male circumcision in Lesotho, where HIV prevalence is among the highest in the world (23%. Here, men can opt for one of two types of circumcision: traditional male circumcision in initiation schools, or the medical option in health clinics. This paper investigates whether the former has medical effects on individual HIV status that are as beneficial as those shown for the latter. Controlling for the potential individual behavioral response after the operation, it was found that circumcision performed in initiation schools wholly offset the medical benefits of the surgical procedure. This supports anecdotal evidence that the operation performed by traditional circumcisers does not have the same protective effect against HIV transmission as the medical operation. No evidence of "disinhibition" behavior among circumcised men was found, nor differential risky sexual behavior among men circumcised, traditionally or medically. Considering that, in Lesotho, traditional male circumcision is undertaken by more than 90% of circumcised men, the findings highlight the need for further research into how the operation in initiation schools is performed and its medical benefits.

  20. Fouling on ion-exchange membranes: Classification, characterization and strategies of prevention and control.

    Science.gov (United States)

    Mikhaylin, Sergey; Bazinet, Laurent

    2016-03-01

    The environmentally friendly ion-exchange membrane (IEM) processes find more and more applications in the modern industries in order to demineralize, concentrate and modify products. Moreover, these processes may be applied for the energy conversion and storage. However, the main drawback of the IEM processes is a formation of fouling, which significantly decreases the process efficiency and increases the process cost. The present review is dedicated to the problematic of IEM fouling phenomena. Firstly, the major types of IEM fouling such as colloidal fouling, organic fouling, scaling and biofouling are discussed along with consideration of the main factors affecting fouling formation and development. Secondly, the review of the possible methods of IEM fouling characterization is provided. This section includes the methods of fouling visualization and characterization as well as methods allowing investigations of characteristics of the fouled IEMs. Eventually, the reader will find the conventional and modern strategies of prevention and control of different fouling types. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Communication strategies in acute health care: evaluation within the context of infection prevention and control.

    Science.gov (United States)

    Edwards, R; Sevdalis, N; Vincent, C; Holmes, A

    2012-09-01

    Communication in healthcare settings has recently received significant attention in the literature. However, there continues to be a large gap in current understanding of the effectiveness of different communication channels used in acute healthcare settings, particularly in the context of infection prevention and control (IPC). To explore and evaluate the main communication channels used within hospitals to communicate with healthcare workers (HCWs) and to propose practical recommendations. Critical review of the main communication channels used within acute health care to communicate information to HCWs, and analysis of their impact on practice. The analysis covers verbal communications, standardization via guidelines, education and training, electronic communications and marketing strategies. Traditional communication channels have not been successful in changing and sustaining best practice in IPC, but newer approaches (electronic messages and marketing) also have pitfalls. A few simple recommendations are made in relation to the development, implementation and evaluation of communications to HCWs; top-down vs bottom-up communications; and the involvement of HCWs, particularly ward personnel. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. Young people in Bogota, Colombia develop their own strategies to prevent risky sexual behavior.

    Science.gov (United States)

    Saavedra, M

    1996-01-01

    Although the government of Colombia moved in 1993 to mandate sexuality education in primary and secondary schools, nongovernmental organizations have worked in this area for more than two decades. Notable has been the work of one such organization, the Colombian Human and Social Development Foundation, among youth from a marginal, underserved area of Bogota that houses approximately 27,000 adolescents. The project uses a peer approach to relate the values of responsibility, tolerance, and self-determination to the prevention of risky sexual behaviors. At the onset, 15 youth leaders from the local school identified strategies for raising the topic of sexuality to their peers: suggestion boxes, school radio programs, educational materials such as murals and pamphlets, workshops, board games with sexuality-related themes, and community involvement. Suggestion box submissions revealed that sixth and seventh graders wanted to know about puberty-related events, while older students were interested in the effects of masturbation on health and appearance and the association between premarital sexual activity and one's reputation. In an 18-month period, close to 9000 community residents were reached with program materials and 1798 adolescents participated in group meetings. Among the gains observed have been correction of misinformation, a broader view of sexuality, the capacity for independent thought, and self-pride.

  3. Impact of antiepileptic drugs on bone health: Need for monitoring, treatment, and prevention strategies

    Directory of Open Access Journals (Sweden)

    Ekta Arora

    2016-01-01

    Full Text Available Epilepsy is the most common neurological disorder affecting approximately 50 million people worldwide. In India, overall prevalence of epilepsy is reported to be 5.59/1000 population. Antiepileptic drugs (AEDs constitute the main-stay of treatment with a large number of AEDs available in the market. High incidence of adverse effects is a major limitation with AEDs. One of the major concerns is significant metabolic effects on the bone. However, little attention has been paid to this issue because most of the bone effects remain subclinical for a long time and may take years to manifest clinically. The main effects include hypocalcemia, hypophosphatemia, reduced serum levels of Vitamin D, increase in parathormone (PTH levels, and alterations in bone turnover markers. The CYP450 enzyme-inducing AEDs such as phenytoin, phenobarbital, carbamazepine, and primidone are the most common AEDs associated with bone disorders while the data regarding the effect of valproate and newer AEDs such as lamotrigine, gabapentin, vigabatrin, levetiracetam, and topiramate on bone metabolism and bone density are scanty and controversial. Deficiency of Vitamin D is commonly described as a cause for the bone loss in epileptic patients while others being decreased absorption of calcium, increased PTH levels, and inhibition of calcitonin secretion, etc. However, there are no formal practical guidelines for the management of bone disease among those taking AEDs. Evidence-based strategies regarding monitoring, prevention, and treatment of bone diseases in patients on AED therapy are needed.

  4. Molecular Mechanisms of Diabetic Retinopathy, General Preventive Strategies, and Novel Therapeutic Targets

    Science.gov (United States)

    Safi, Sher Zaman; Kumar, Selva; Ismail, Ikram Shah Bin

    2014-01-01

    The growing number of people with diabetes worldwide suggests that diabetic retinopathy (DR) and diabetic macular edema (DME) will continue to be sight threatening factors. The pathogenesis of diabetic retinopathy is a widespread cause of visual impairment in the world and a range of hyperglycemia-linked pathways have been implicated in the initiation and progression of this condition. Despite understanding the polyol pathway flux, activation of protein kinase C (KPC) isoforms, increased hexosamine pathway flux, and increased advanced glycation end-product (AGE) formation, pathogenic mechanisms underlying diabetes induced vision loss are not fully understood. The purpose of this paper is to review molecular mechanisms that regulate cell survival and apoptosis of retinal cells and discuss new and exciting therapeutic targets with comparison to the old and inefficient preventive strategies. This review highlights the recent advancements in understanding hyperglycemia-induced biochemical and molecular alterations, systemic metabolic factors, and aberrant activation of signaling cascades that ultimately lead to activation of a number of transcription factors causing functional and structural damage to retinal cells. It also reviews the established interventions and emerging molecular targets to avert diabetic retinopathy and its associated risk factors. PMID:25105142

  5. Patterns of intimate partner homicide suicide in later life: Strategies for prevention

    Directory of Open Access Journals (Sweden)

    Sonia Salari

    2007-10-01

    Full Text Available Sonia SalariDepartment Family and Consumer Studies, University of Utah, Salt Lake City, UT, USAAbstract: Intimate partner homicide suicide (IPHS constitutes the most violent domestic abuse outcome, devastating individuals, families, neighborhoods and communities. This research used content analysis to analyze 225 murder suicide events (444 deaths among dyads with at least one member 60 or older. Data were collected from newspaper articles, television news transcripts, police reports and obituaries published between 1999 and 2005. Findings suggest the most dangerous setting was the home and the majority of perpetrators were men. Firearms were most often employed in the violence. Relationship strife was present in some cases, but only slightly higher than the divorce rate for that age group. Illness was cited in just over half of the cases, but 30% of sick elderly couples had only a perpetrator who was ill. Evidence of suicide pacts and mercy killings were very rare and practitioners are encouraged to properly investigate these events. Suicidal men in this age range must be recognized as a potential threat to others, primarily their partner. Homicide was sometimes the primary motive, and the perpetrators in those cases resembled the “intimate terrorist.” Victims in those cases were often terrorized before the murder. Clinicians are educated about the patterns of fatal violence in later life dyads and provided with strategies for prevention.Keywords: murder-suicide, domestic violence, elder abuse, self abuse

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

    Directory of Open Access Journals (Sweden)

    Hidemasa Torii

    2017-02-01

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

  7. School-Based and Community-Based Gun Safety Educational Strategies for Injury Prevention.

    Science.gov (United States)

    Holly, Cheryl; Porter, Sallie; Kamienski, Mary; Lim, Aubrianne

    2018-05-01

    Nearly 1,300 children in the United States die because of firearm-related injury each year and another 5,790 survive gunshot wounds, making the prevention of firearm-related unintentional injury to children of vital importance to families, health professionals, and policy makers. To systematically review the evidence on school-based and community-based gun safety programs for children aged 3 to 18 years. Systematic review. Twelve databases were searched from their earliest records to December 2016. Interventional and analytic studies were sought, including randomized controlled trials, quasi-experimental studies, as well as before-and-after studies or cohort studies with or without a control that involved an intervention. The low level of evidence, heterogeneity of studies, and lack of consistent outcome measures precluded a pooled estimate of results. A best evidence synthesis was performed. Results support the premise that programs using either knowledge-based or active learning strategies or a combination of these may be insufficient for teaching gun safety skills to children. Gun safety programs do not improve the likelihood that children will not handle firearms in an unsupervised situation. Stronger research designs with larger samples are needed to determine the most effective way to transfer the use of the gun safety skills outside the training session and enable stronger conclusions to be drawn.

  8. Raising awareness of upper airway diseases: Overview of management and prevention strategies

    Directory of Open Access Journals (Sweden)

    De-yun WANG

    2017-11-01

    Full Text Available The nose together with the paranasal sinuses is the main part of the upper airway, which is lined with pseudostratified columnar ciliated epithelium. There are several important physiological functions such as conditioning and filtration of the inspired air and the provision of end organ for the sense of smell. Besides the nose also fulfills a physical and immunological barrier as the nasal epithelium is the first site of interaction between the host tissue and foreign invaders, such as viruses, bacteria, fungi, allergens, and harmful particulates. Hence, nasal diseases such as rhinitis (allergic and infectious and rhinosinusitis are the most common health problems worldwide, affecting millions of people of all ages. In the past 10 to 20 years, our understanding of the immuno-pathophysiological mechanisms underlying the common nasal diseases has been significantly enhanced by in vivo and in vitro studies. This allows the development of novel therapeutic strategies designed to improve the physiological and immune defense functions of the nose, as well as for other common airway diseases. Since the dynamically external changes of atmosphere, environment (pollution and susceptible population, we are now facing some of new features on epidemiology and the types of upper airway diseases that require us to in-deep study the diseases through basic and clinical researches, so as to further understand the prevention, diagnosis and treatment of the diseases. DOI: 10.118555/j.issn.0577-7402.2017.10.01

  9. Deliberate Establishment of Asymptomatic Bacteriuria-A Novel Strategy to Prevent Recurrent UTI.

    Science.gov (United States)

    Wullt, Björn; Svanborg, Catharina

    2016-07-29

    We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.

  10. Gynecologic Cancer Prevention and Control in the National Comprehensive Cancer Control Program: Progress, Current Activities, and Future Directions

    OpenAIRE

    Stewart, Sherri L.; Lakhani, Naheed; Brown, Phaeydra M.; Larkin, O. Ann; Moore, Angela R.; Hayes, Nikki S.

    2013-01-01

    Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer.

  11. Gynecologic cancer prevention and control in the National Comprehensive Cancer Control Program: progress, current activities, and future directions.

    Science.gov (United States)

    Stewart, Sherri L; Lakhani, Naheed; Brown, Phaeydra M; Larkin, O Ann; Moore, Angela R; Hayes, Nikki S

    2013-08-01

    Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer.

  12. Global development and diffusion of outcome evaluation research for interpersonal and self-directed violence prevention from 2007 to 2013: A systematic review

    Science.gov (United States)

    Hughes, Karen; Bellis, Mark A.; Hardcastle, Katherine A.; Butchart, Alexander; Dahlberg, Linda L.; Mercy, James A.; Mikton, Christopher

    2018-01-01

    Through a global review, we identified gaps in the geographical distribution of violence prevention evidence outcome evaluation studies and the types of violence addressed. Systematic literature searches identified 355 articles published between 2007 and 2013 that evaluated programs to prevent interpersonal or self-directed violence; focused on universal or selected populations; and reported outcomes measuring violence or closely related risk factors. The number of studies identified increased annually from 2008 (n = 37), reaching 64 in 2013. Over half (n = 203) of all studies focused on youth violence yet only one on elder maltreatment. Study characteristics varied by year and violence type. Only 9.3% of all studies had been conducted in LMICs. These studies were less likely than those in high income countries (HICs) to have tested established interventions yet more likely to involve international collaboration. Evaluation studies successfully established in LMIC had often capitalized on other major regional priorities (e.g. HIV). Relationships between violence and social determinants, communicable and non-communicable diseases, and even economic prosperity should be explored as mechanisms to increase the global reach of violence prevention research. Results should inform future research strategies and provide a baseline for measuring progress in developing the violence prevention evidence-base, especially in LMICs. PMID:29725241

  13. Global development and diffusion of outcome evaluation research for interpersonal and self-directed violence prevention from 2007 to 2013: A systematic review.

    Science.gov (United States)

    Hughes, Karen; Bellis, Mark A; Hardcastle, Katherine A; Butchart, Alexander; Dahlberg, Linda L; Mercy, James A; Mikton, Christopher

    2014-01-01

    Through a global review, we identified gaps in the geographical distribution of violence prevention evidence outcome evaluation studies and the types of violence addressed. Systematic literature searches identified 355 articles published between 2007 and 2013 that evaluated programs to prevent interpersonal or self-directed violence; focused on universal or selected populations; and reported outcomes measuring violence or closely related risk factors. The number of studies identified increased annually from 2008 (n = 37), reaching 64 in 2013. Over half (n = 203) of all studies focused on youth violence yet only one on elder maltreatment. Study characteristics varied by year and violence type. Only 9.3% of all studies had been conducted in LMICs. These studies were less likely than those in high income countries (HICs) to have tested established interventions yet more likely to involve international collaboration. Evaluation studies successfully established in LMIC had often capitalized on other major regional priorities (e.g. HIV). Relationships between violence and social determinants, communicable and non-communicable diseases, and even economic prosperity should be explored as mechanisms to increase the global reach of violence prevention research. Results should inform future research strategies and provide a baseline for measuring progress in developing the violence prevention evidence-base, especially in LMICs.

  14. Changes in motor unit recruitment strategy during pain alters force direction.

    Science.gov (United States)

    Tucker, Kylie J; Hodges, Paul W

    2010-10-01

    Motor unit (MU) recruitment is altered (decreased discharge rate and cessation of discharge in some units, and recruitment of new units) in force-matched contractions during pain compared to contractions performed before pain. As MU's within a motoneurone pool have different force direction properties we hypothesised that altered MU recruitment during experimental knee pain would change the force vector (total force (F(T)): amplitude and angle) generated by the quadriceps. Force was produced at two levels during 1 × 60-s and 3 × 10-s isometric contractions of knee extensors, and recorded by two force transducers at right angles. This enabled calculation of both F(E) (extension force) and F(T). MU recruitment was recorded from the medial and lateral vastii with four fine-wire electrodes. Pain was induced by hypertonic saline injection in the infra-patella fat pad. Nine subjects matched F(E) and six subjects also matched both medial and lateral forces (F(T)) before and during pain. Changes in MU discharge pattern (decreased discharge rate (Precruitment of new units) during pain were associated with a ∼5° change in absolute force angle. As force angle changed in both directions (left/right) for individual subjects with pain there was no change in average F(T) amplitude between conditions. When both medial and lateral forces were matched MU discharge rate decreased (Punits ceased firing or were newly recruited during pain. Change in motoneurone recruitment during pain alters direction of muscle force. This may be a strategy to avoid pain or protect the painful part. Copyright © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  15. Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

    Directory of Open Access Journals (Sweden)

    Rianne J. A. Hoek

    2017-07-01

    Full Text Available Abstract Background Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1 the effects of the strategy on perceived stress and work-related outcomes, and 2 the barriers and facilitators for implementation of the strategy. Methods The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees’ perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21. Secondary outcome measures

  16. Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial.

    Science.gov (United States)

    Hoek, Rianne J A; Havermans, Bo M; Houtman, Irene L D; Brouwers, Evelien P M; Heerkens, Yvonne F; Zijlstra-Vlasveld, Moniek C; Anema, Johannes R; van der Beek, Allard J; Boot, Cécile R L

    2017-07-17

    Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1) the effects of the strategy on perceived stress and work-related outcomes, and 2) the barriers and facilitators for implementation of the strategy. The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees' perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). Secondary outcome measures are job demands, job resources and the number

  17. Encountering Gender: Resisting a Neo-Liberal Political Rationality for Sexuality Education as an HIV Prevention Strategy

    Science.gov (United States)

    Gacoin, Andrée E.

    2017-01-01

    Globally, sexuality education is framed as a key programmatic strategy for achieving HIV prevention among youth. In particular, sexuality education is positioned as a way to address gender inequalities and promote youth empowerment in relation to gendered identities. In this paper, I argue that the focus on what content should be taught and…

  18. From kids, through kids, to kids: examining the social influence strategies used by adolescents to promote prevention among peers.

    Science.gov (United States)

    Krieger, Janice L; Coveleski, Samantha; Hecht, Michael L; Miller-Day, Michelle; Graham, John W; Pettigrew, Jonathan; Kootsikas, Allison

    2013-01-01

    Recent technological advances have increased the interest and ability of lay audiences to create messages; however, the feasibility of incorporating lay multimedia messages into health campaigns has seldom been examined. Drawing on the principle of cultural grounding and narrative engagement theory, this article seeks to examine what types of messages adolescents believe are most effective in persuading their peers to resist substance use and to provide empirical data on the extent to which audience-generated intervention messages are consistent with the associated campaign philosophy and branding. Data for the current study are prevention messages created by students as part of a four-lesson substance use prevention "booster" program delivered to eighth-grade students in 20 rural schools in Pennsylvania and Ohio during 2010-2011. Content analysis results indicate that didactic message strategies were more common in audience-generated messages than narrative strategies, although strategy was somewhat dependent on the medium used. Two of the most common strategies that adolescents used to persuade peers not to use substances were negative consequences and identity appeals, and messages varied in the degree to which they were consistent with the theoretical underpinnings and program philosophy of the prevention campaign. Implications of the current study for understanding the social construction of substance use prevention messages among adolescents and incorporating audience-generated messages in health communication campaigns are discussed.

  19. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance

    OpenAIRE

    Alonso, Juan-Manuel; Edouard, Pascal; Fischetto, Giuseppe; Adams, Bob; Depiesse, Frédéric; Mountjoy, Margo

    2012-01-01

    Objective To determine the incidence and characteristics of newly incurred injuries and illnesses during international Athletics Championships, by improving the medical surveillance coverage, in order to determine future prevention strategies. Design Prospective recording of newly occurred injuries and illnesses. Setting 13th International Association of Athletics Federations World Championships in Athletics 2011 in Daegu, Korea. Participants National team and Local Organising Committee physi...

  20. Evaluating the implementation of "managing the risk of suicide: a suicide prevention strategy for the ACT 2009-2014".

    Science.gov (United States)

    Sheehan, Johann; Griffiths, Kathleen; Rickwood, Debra; Carron-Arthur, Bradley

    2015-01-01

    Over the past two decades, governments have invested significantly in policies and strategies to prevent the tragic loss of life to suicide. However, there has been little focus on evaluating the implementation of such policies. This paper reports on the evaluation of the implementation of "Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009-2014," the Australian Capital Territory's (ACT) suicide prevention strategy. We sought to answer two questions: (1) Could agencies provide data reporting on their progress in implementing the activities for which they were responsible?; and (2) Could a judgment about implementation progress be made and, if so, to what extent was the activity implemented? Individually tailored electronic surveys were sent to 18 ACT agencies annually over 4 years to measure their progress in implementing activities for which they had responsibility. By year four, full data were provided for 64% of activities, maximal partial data for 9%, and minimal partial data for 27%. Forty-two per cent of activities were fully implemented, 20% were partially implemented, and 38% were not implemented or could not be measured. It is possible to measure implementation of suicide prevention strategies, but appropriate processes and dedicated resources must be in place at the outset.

  1. Mobilizing Communities around HIV Prevention for Youth: How Three Coalitions Applied Key Strategies to Bring about Structural Changes

    Science.gov (United States)

    Chutuape, Kate S.; Willard, Nancy; Sanchez, Kenia; Straub, Diane M.; Ochoa, Tara N.; Howell, Kourtney; Rivera, Carmen; Ramos, Ibrahim; Ellen, Jonathan M.

    2010-01-01

    Increasingly, HIV prevention efforts must focus on altering features of the social and physical environment to reduce risks associated with HIV acquisition and transmission. Community coalitions provide a vehicle for bringing about sustainable structural changes. This article shares lessons and key strategies regarding how three community…

  2. Development of the Environmental Strategies Instrument to Measure Adolescent Alcohol Prevention-Related Outcomes in Community Settings

    Science.gov (United States)

    Cervantes, Richard C.; Goldbach, Jeremy; Yeung, Albert; Rey, Antonio

    2012-01-01

    Recently, evidence-based community policy approaches to preventing substance use and alcohol abuse, called environmental strategies, have gained in popularity. The environmental survey instrument (ESI) was developed to evaluate perceptions around drinking and related problems. Specifically, the authors were interested in assessing community…

  3. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.

    Science.gov (United States)

    Meddings, Jennifer; Rogers, Mary A M; Krein, Sarah L; Fakih, Mohamad G; Olmsted, Russell N; Saint, Sanjay

    2014-04-01

    Catheter-associated urinary tract infections (CAUTI) are costly, common and often preventable by reducing unnecessary urinary catheter (UC) use. To summarise interventions to reduce UC use and CAUTIs, we updated a prior systematic review (through October 2012), and a meta-analysis regarding interventions prompting UC removal by reminders or stop orders. A narrative review summarises other CAUTI prevention strategies including aseptic insertion, catheter maintenance, antimicrobial UCs, and bladder bundle implementation. 30 studies were identified and summarised with interventions to prompt removal of UCs, with potential for inclusion in the meta-analyses. By meta-analysis (11 studies), the rate of CAUTI (episodes per 1000 catheter-days) was reduced by 53% (rate ratio 0.47; 95% CI 0.30 to 0.64, pSMD) in catheterisation duration (days) was -1.06 overall (p=0.065) including a statistically significant decrease in stop-order studies (SMD -0.37; pSMD, -1.54; p=0.071). No significant harm from catheter removal strategies is supported. Limited research is available regarding the impact of UC insertion and maintenance technique. A recent randomised controlled trial indicates antimicrobial catheters provide no significant benefit in preventing symptomatic CAUTIs. UC reminders and stop orders appear to reduce CAUTI rates and should be used to improve patient safety. Several evidence-based guidelines have evaluated CAUTI preventive strategies as well as emerging evidence regarding intervention bundles. Implementation strategies are important because reducing UC use involves changing well-established habits.

  4. Evaluation of methicillin-resistant Staphylococcus aureus skin and soft-tissue infection prevention strategies at a military training center.

    Science.gov (United States)

    Morrison, Stephanie M; Blaesing, Carl R; Millar, Eugene V; Chukwuma, Uzo; Schlett, Carey D; Wilkins, Kenneth J; Tribble, David R; Ellis, Michael W

    2013-08-01

    Military trainees are at high risk for skin and soft-tissue infections (SSTIs), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA). A multicomponent hygiene-based SSTI prevention strategy was implemented at a military training center. After implementation, we observed 30% and 64% reductions in overall and MRSA-associated SSTI rates, respectively.

  5. Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: Challenges and strategies from England

    Directory of Open Access Journals (Sweden)

    Mathew Nyashanu

    2016-12-01

    Full Text Available Objective: HIV infection is a sensitive issue in black communities [Serrant-Green L. Black Caribbean men, sexual health decisions and silences. Doctoral thesis. Nottingham School of Nursing, University of Nottingham; 2004]. Statistics show black sub-Saharan African (BSSA communities disproportionately constitute two-thirds of people with HIV [Heath Protection Agency. Health protection report: latest infection reports-GOV.UK; 2013]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [Health Protection Agency. HIV in the United Kingdom: 2012 report; 2012], [Department of Health. DVD about FGM. 2012. Available from fgm@dh.gsi.gov.uk.]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Twelve focus group discussions and 24 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs.

  6. Evaluation of a cavity flooding strategy for the prevention of reactor vessel failure in a severe accident

    Energy Technology Data Exchange (ETDEWEB)

    Park, Rae Joon; Je, Moo Sung; Park, Chang Kyoo [Korea Atomic Energy Research Institute, TaeJon (Korea, Republic of)

    1994-10-01

    As a part of the evaluation of accident management strategies for severe accident prevention or mitigation in a station blackout scenario for YGN 3 and 4, an external vessel cooling strategy for the prevention of reactor vessel failure has been estimated using the MAAP4 computer code. The sensitivity studies have been performed such as actuating timings and the number of spray pumps used. To explore external vessel cooling strategies, containment spray pumps were actuated by varying time spanning core uncovery, core melting and relocation of molten core material. It was shown that flooding of the reactor cavity using the containment spray system may prevent reactor vessel failure but may not prevent the failure of the relocation of molten core material during the station blackout sequence of YGN 3 and 4. Reactor vessel failure can be prevented by external vessel cooling using condensed water from the operation of two containment spray pumps at the time of core melting and using water from the operation of one containment spray pumps at the time of core melting and using water from the operation of one containment spray pump at the time of core uncovery. (Author) 46 refs., 26 figs., 5 tabs.

  7. Direct and indirect effects of screening for Chlamydia trachomatis on the prevention of pelvic inflammatory disease: a mathematical modeling study.

    Science.gov (United States)

    Herzog, Sereina A; Heijne, Janneke C M; Scott, Pippa; Althaus, Christian L; Low, Nicola

    2013-11-01

    Pelvic inflammatory disease (PID) results from the ascending spread of microorganisms, including Chlamydia trachomatis, to the upper genital tract. Screening could improve outcomes by identifying and treating chlamydial infections before they progress to PID (direct effect) or by reducing chlamydia transmission (indirect effect). We developed a compartmental model that represents a hypothetical heterosexual population and explicitly incorporates progression from chlamydia to clinical PID. Chlamydia screening was introduced, with coverage increasing each year for 10 years. We estimated the separate contributions of the direct and indirect effects of screening on PID cases prevented per 100,000 women. We explored the influence of varying the time point at which clinical PID could occur and of increasing the risk of PID after repeated chlamydial infections. The probability of PID at baseline was 3.1% by age 25 years. After 5 years, the intervention scenario had prevented 187 PID cases per 100,000 women and after 10 years 956 PID cases per 100,000 women. At the start of screening, most PID cases were prevented by the direct effect. The indirect effect produced a small net increase in PID cases, which was outweighed by the effect of reduced chlamydia transmission after 2.2 years. The later that progression to PID occurs, the greater the contribution of the direct effect. Increasing the risk of PID with repeated chlamydial infection increases the number of PID cases prevented by screening. This study shows the separate roles of direct and indirect PID prevention and potential harms, which cannot be demonstrated in observational studies.

  8. Adolescents’ Perceptions Regarding Effective Tobacco Use Prevention Strategies for their Younger Counterparts: A Qualitative Study in Malaysia

    Science.gov (United States)

    Mohd Zin, Faridah; Hillaluddin, Azlin Hilma; Mustaffa, Jamaludin

    2016-12-01

    Purpose:The present qualitative study explored adolescents’ perceptions regarding effective strategies to prevent adolescents from using tobacco products (TP). Apart from the commercial TPs, there has been emerging use of alternatives such as vapes, e-cigarettes and shisha. This unfortunate phenomenon continues despite the currently available preventive strategies. Thus, understanding of the perceptions of the current generation would be valuable to provide new insights. Methods: Purposive sampling was utilized to recruit 40 adolescents between the age of 15 and 16 years old attending public daily secondary schools. Eight focus group discussions were conducted among the TP users, ex-users and non-users. Data were analyzed using a thematic content analysis procedure with NVivo. Results: Among barriers with the currently available strategies were having teachers who smoke tobacco, addiction to nicotine and self-perceptions of being healthy. The content of any program should include knowledge on negative outcomes of using tobacco products and awareness of the legislation together with ways to overcome peer and family influence including improving self-efficacy and refusal skills. Strategies were suggested to be delivered using information technology which provides interactive learning and visual effects. Conclusions: Adolescents agreed that the content and delivery of tobacco use prevention strategies need to be revised to suit the current generation to ensure sustainability. Creative Commons Attribution License

  9. [Evaluation of the organization of health services as a strategy for the prevention and control of visceral leishmaniasis].

    Science.gov (United States)

    Barbosa, Miriam Nogueira; Guimarães, Eliete Albano de Azevedo; Luz, Zélia Maria Profeta da

    2016-01-01

    to evaluate the organization of health services as a strategy for the prevention and control of visceral leishmaniasis (VL) in Ribeirão das Neves, Minas Gerais, Brazil, from 2010 to 2012. this was a case study evaluation of the degree of implementation of a strategy for the integration of health care services, control of zoonosis and epidemiological surveillance; it consisted of observing the work process, interviewing health professionals and analysing secondary data from information systems. implementation was partially adequate (84%); in terms of structure, the human resources component had the worst evaluation (64%) whilst in terms of work process, evaluation was 80% for reorganization of care and 77% for surveillance; in the period 2010-2012 there was a 20% increase in reported cases of VL and a 20% reduction in the time interval between reporting a case and starting treatment. the strategy contributed to the improvement of the organization of VL prevention and control actions.

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

    Directory of Open Access Journals (Sweden)

    Jonathan M. Platt

    2017-12-01

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

  11. Host-directed strategies using lipid nanoparticles to reduce mycobacteria survival

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, L. [Faculty of Sciences and Technology of the New University of Lisbon (Portugal); Diogo, J.; Mateus, R.; Pimentel, M.; Videira, M., E-mail: mvideira@ff.ul.pt [iMed.UL - Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy of the University of Lisbon, Intracellular Trafficking Modulation for Advanced Drug Delivery InTraCell-ADD Research Group (Portugal)

    2015-02-15

    Antibiotic-resistant infections and the stagnations in the development of new drugs have increased the demand for new therapeutic approaches against Mycobacterium tuberculosis. Innovative systems that are able to target and eradicate the bacteria in the infected host cells may represent a therapeutic breakthrough while avoiding latency. The development of nanosystems aiming a controlled and targeted intracellular drug release, have proved to increase cytosolic therapeutic concentration while reducing undesired side effects. This work’s main goal was to develop a host-directed strategy against mycobacterial infection through the design of a biocompatible nanocarrier for phage-derived protein delivery, using M. smegmatis as model. Since mycobacterial pathogenicity is strongly supported by the presence of lipids in the cell wall, their degradation induces bacterial destruction through cell wall hydrolysis. Phage-based lipolytic enzymes such as, LysB a mycolylarabinogalactan esterase, represent an appealing therapeutic approach. The herein proposed Ms6 LysB-containing lipid nanocarrier (SLN-LysB) explores the known advantages of nanomedicine-based systems for phagocytic cells selectively targeting thus allowing LysB intracellular accumulation and a more pronounced mycobacterial infection eradication. Adsorption efficiency value indicates the potential of this system as a protein nanocarrier. Moreover, promising outcomes were obtained in host-infected macrophages treated with SLN-LysB. The results show that the herein proposed strategy was more effective in inhibiting the growth of M. smegmatis than free LysB, which might be related to the nanocarrier internalization. Acting as effective protein nanocarriers, the protein-guided delivery in the infected phagocytic cells allows it to exert its hydrolytic action on the lipid layer of the Mycobacterium.

  12. Host-directed strategies using lipid nanoparticles to reduce mycobacteria survival

    Science.gov (United States)

    Pereira, L.; Diogo, J.; Mateus, R.; Pimentel, M.; Videira, M.

    2015-02-01

    Antibiotic-resistant infections and the stagnations in the development of new drugs have increased the demand for new therapeutic approaches against Mycobacterium tuberculosis. Innovative systems that are able to target and eradicate the bacteria in the infected host cells may represent a therapeutic breakthrough while avoiding latency. The development of nanosystems aiming a controlled and targeted intracellular drug release, have proved to increase cytosolic therapeutic concentration while reducing undesired side effects. This work's main goal was to develop a host-directed strategy against mycobacterial infection through the design of a biocompatible nanocarrier for phage-derived protein delivery, using M. smegmatis as model. Since mycobacterial pathogenicity is strongly supported by the presence of lipids in the cell wall, their degradation induces bacterial destruction through cell wall hydrolysis. Phage-based lipolytic enzymes such as, LysB a mycolylarabinogalactan esterase, represent an appealing therapeutic approach. The herein proposed Ms6 LysB-containing lipid nanocarrier (SLN_LysB) explores the known advantages of nanomedicine-based systems for phagocytic cells selectively targeting thus allowing LysB intracellular accumulation and a more pronounced mycobacterial infection eradication. Adsorption efficiency value indicates the potential of this system as a protein nanocarrier. Moreover, promising outcomes were obtained in host-infected macrophages treated with SLN_LysB. The results show that the herein proposed strategy was more effective in inhibiting the growth of M. smegmatis than free LysB, which might be related to the nanocarrier internalization. Acting as effective protein nanocarriers, the protein-guided delivery in the infected phagocytic cells allows it to exert its hydrolytic action on the lipid layer of the Mycobacterium.

  13. Host-directed strategies using lipid nanoparticles to reduce mycobacteria survival

    International Nuclear Information System (INIS)

    Pereira, L.; Diogo, J.; Mateus, R.; Pimentel, M.; Videira, M.

    2015-01-01

    Antibiotic-resistant infections and the stagnations in the development of new drugs have increased the demand for new therapeutic approaches against Mycobacterium tuberculosis. Innovative systems that are able to target and eradicate the bacteria in the infected host cells may represent a therapeutic breakthrough while avoiding latency. The development of nanosystems aiming a controlled and targeted intracellular drug release, have proved to increase cytosolic therapeutic concentration while reducing undesired side effects. This work’s main goal was to develop a host-directed strategy against mycobacterial infection through the design of a biocompatible nanocarrier for phage-derived protein delivery, using M. smegmatis as model. Since mycobacterial pathogenicity is strongly supported by the presence of lipids in the cell wall, their degradation induces bacterial destruction through cell wall hydrolysis. Phage-based lipolytic enzymes such as, LysB a mycolylarabinogalactan esterase, represent an appealing therapeutic approach. The herein proposed Ms6 LysB-containing lipid nanocarrier (SLN-LysB) explores the known advantages of nanomedicine-based systems for phagocytic cells selectively targeting thus allowing LysB intracellular accumulation and a more pronounced mycobacterial infection eradication. Adsorption efficiency value indicates the potential of this system as a protein nanocarrier. Moreover, promising outcomes were obtained in host-infected macrophages treated with SLN-LysB. The results show that the herein proposed strategy was more effective in inhibiting the growth of M. smegmatis than free LysB, which might be related to the nanocarrier internalization. Acting as effective protein nanocarriers, the protein-guided delivery in the infected phagocytic cells allows it to exert its hydrolytic action on the lipid layer of the Mycobacterium

  14. Maternal Lipid Provisioning Mirrors Evolution of Reproductive Strategies in Direct-Developing Whelks.

    Science.gov (United States)

    Carrasco, Sergio A; Phillips, Nicole E; Sewell, Mary A

    2016-06-01

    The energetic input that offspring receive from their mothers is a well-studied maternal effect that can influence the evolution of life histories. Using the offspring of three sympatric whelks: Cominella virgata (one embryo per capsule); Cominella maculosa (multiple embryos per capsule); and Haustrum scobina (multiple embryos per capsule and nurse-embryo consumption), we examined how contrasting reproductive strategies mediate inter- and intraspecific differences in hatchling provisioning. Total lipid content (as measured in μg hatchling(-1) ± SE) was unrelated to size among the 3 species; the hatchlings of H. scobina were the smallest but had the highest lipid content (33.8 ± 8.1 μg hatchling(-1)). In offspring of C. maculosa, lipid content was 6.6 ± 0.4 μg hatchling(-1), and in offspring of C. virgata, it was 21.7 ± 3.2 μg hatchling(-1) The multi-encapsulated hatchlings of C. maculosa and H. scobina were the only species that contained the energetic lipids, wax ester (WE) and methyl ester (ME). However, the overall composition of energetic lipid between hatchlings of the two Cominella species reflected strong affinities of taxonomy, suggesting a phylogenetic evolution of the non-adelphophagic development strategy. Inter- and intracapsular variability in sibling provisioning was highest in H. scobina, a finding that implies less control of allocation to individual hatchlings in this adelphophagic developer. We suggest that interspecific variability of lipids offers a useful approach to understanding the evolution of maternal provisioning in direct-developing species. © 2016 Marine Biological Laboratory.

  15. Strategies to prevent HIV transmission among heterosexual African-American women

    Directory of Open Access Journals (Sweden)

    Peters Ronald J

    2005-03-01

    Full Text Available Abstract Background African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. Methods Twenty five low income African American women, ages 18–29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and

  16. Strategies for the management and prevention of conformation-related respiratory disorders in brachycephalic dogs

    Directory of Open Access Journals (Sweden)

    Packer RMA

    2015-06-01

    Full Text Available Rowena MA Packer,1 Michael S Tivers2 1Department of Clinical Science and Services, Royal Veterinary College, University of London, London, 2School of Veterinary Sciences, University of Bristol, Bristol, UK Abstract: Brachycephalic (short-muzzled dogs are increasingly popular pets worldwide, with marked increases in registrations of breeds such as the Pug and French Bulldog over the past decade in the UK. Despite their popularity, many brachycephalic breeds are affected by an early-onset, lifelong respiratory disorder, brachycephalic obstructive airway syndrome (BOAS. This disorder arises due to a mismatch in the proportions of the skull and the soft tissues held within the nose and pharynx, resulting in obstruction of the airway during respiration. Increased airway resistance encourages secondary changes such as eversion of the laryngeal saccules and collapse of the larynx. Clinical signs of BOAS are often early onset and chronic, including dyspnea, exercise intolerance, heat intolerance, and abnormal and increased respiratory noise. Episodes of severe dyspnea can also occur, leading to cyanosis, syncope, and death. BOAS may have a severe impact upon the welfare of affected dogs, compromising their ability to exercise, play, eat, and sleep. Although a well-described condition, with surgical treatments for the palliation of this disorder published since the 1920s, many dogs still experience airway restrictions postsurgically and a compromised quality of life. In addition, the prevalence of this disorder does not appear to have substantially reduced in this time, and may have increased. Ultimately, strategies to improve the breeding of these dogs to prevent BOAS are required to improve brachycephalic health and welfare. Recent studies have revealed conformational risk factors associated with BOAS, such as short muzzles and thick necks, which should be discouraged to avoid perpetuating this serious disorder. Positive changes to brachycephalic

  17. Recent advancement to prevent the development of allergy and allergic diseases and therapeutic strategy in the perspective of barrier dysfunction

    Directory of Open Access Journals (Sweden)

    Osamu Natsume

    2018-01-01

    Full Text Available Therapeutic strategy in late 20th century to prevent allergic diseases was derived from a conceptual framework of allergens elimination which was as same as that of coping with them after their onset. Manifold trials were implemented; however, most of them failed to verify the effectiveness of their preventive measures. Recent advancement of epidemiological studies and cutaneous biology revealed epidermal barrier dysfunction plays a major role of allergen sensitization and development of atopic dermatitis which ignites the inception of allergy march. For this decade, therapeutic strategy to prevent the development of food allergy has been confronted with a paradigm shift from avoidance and delayed introduction of allergenic foods based on the theoretical concept to early introduction of them based on the clinical and epidemiological evidences. Especially, prevention of peanut allergy and egg allergy has been established with the highest evidence verified by randomized controlled trials, although application in clinical practice should be done with attention. This paradigm shift concerning food allergy was also due to the discovery of cutaneous sensitization risk of food allergens for an infant with eczema revealed by prospective studies. Here we have recognized the increased importance of prevention of eczema/atopic dermatitis in infancy. Two randomized controlled trials using emollients showed successful results in prevention of atopic dermatitis in infancy; however, longer term safety and prognosis including allergy march should be pursued. To establish more fundamental strategy for prevention of the development of allergy, further studies clarifying the mechanisms of interaction between barrier dysfunction and microbial milieu are needed with macroscope to understand the relationship between allergic diseases and a diversity of environmental influences.

  18. HIV treatment as prevention: debate and commentary--will early infection compromise treatment-as-prevention strategies?

    Directory of Open Access Journals (Sweden)

    Myron S Cohen

    Full Text Available Universal HIV testing and immediate antiretroviral therapy for infected individuals has been proposed as a way of reducing the transmission of HIV and thereby bringing the HIV epidemic under control. It is unclear whether transmission during early HIV infection--before individuals are likely to have been diagnosed with HIV and started on antiretroviral therapy--will compromise the effectiveness of treatment as prevention. This article presents two opposing viewpoints by Powers, Miller, and Cohen, and Williams and Dye, followed by a commentary by Fraser.

  19. Minimizing the cancer-promotional activity of cox-2 as a central strategy in cancer prevention.

    Science.gov (United States)

    McCarty, Mark F

    2012-01-01

    factors such as IGF-I increase cox-2 expression by several complementary mechanisms; hence, decreased cox-2 activity may play a role in the remarkably low mortality from "Western" cancers enjoyed by Third World cultures in which systemic growth factor activity was minimized by quasi-vegan diets complemented by leanness and excellent muscle insulin sensitivity. Practical strategies for achieving a modest degree of calorie restriction may also have potential for down-regulating cox-2 expression while decreasing cancer risk. Soy isoflavones, linked to reduced cancer risk in Asian epidemiology, may suppress cox-2 induction by activating ERbeta. In aggregate, these considerations suggest that a comprehensive lifestyle strategy targeting cox-2 expression and bioactivity may have tremendous potential for cancer prevention. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Metal allergens of growing significance: epidemiology, immunotoxicology, strategies for testing and prevention.

    Science.gov (United States)

    Forte, Giovanni; Petrucci, Francesco; Bocca, Beatrice

    2008-09-01

    Metal-induced allergic contact dermatitis (ACD) is expressed in a wide range of cutaneous reactions following dermal and systemic exposure to products such as cosmetics and tattoos, detergents, jewellery and piercing, leather tanning, articular prostheses and dental implants. Apart from the well known significance of nickel in developing ACD, other metals such as aluminium, beryllium, chromium, cobalt, copper, gold, iridium, mercury, palladium, platinum, rhodium and titanium represented emerging causes of skin hypersensitivity. Despite the European Union directives that limit the total nickel content in jewellery alloys, the water soluble chromium (VI) in cement, and metals banned in cosmetics, the diffusion of metal-induced ACD remained quite high. On this basis, a review on the epidemiology of metal allergens, the types of exposure, the skin penetration, the immune response, and the protein interaction is motivated. Moreover, in vivo and in vitro tests for the identification and potency of skin-sensitizing metals are here reviewed in a risk assessment framework for the protection of consumer's health. Avenues for ACD prevention and therapy such as observance of maximum allowable metal levels, optimization of metallurgic characteristics, efficacy of chelating agents and personal protection are also discussed.

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

    Science.gov (United States)

    Trogrlić, Zoran; van der Jagt, Mathieu; Bakker, Jan; Balas, Michele C; Ely, E Wesley; van der Voort, Peter H J; Ista, Erwin

    2015-04-09

    Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strategies have been tested to improve ICU clinicians' ability to effectively assess, prevent and treat delirium and to evaluate the effect of these strategies on clinical outcomes. We searched PubMed, Embase, PsychINFO, Cochrane and CINAHL (January 2000 and April 2014) for studies on implementation strategies that included delirium-oriented interventions in adult ICU patients. Studies were suitable for inclusion if implementation strategies' efficacy, in terms of a clinical outcome, or process outcome was described. We included 21 studies, all including process measures, while 9 reported both process measures and clinical outcomes. Some individual strategies such as "audit and feedback" and "tailored interventions" may be important to establish clinical outcome improvements, but otherwise robust data on effectiveness of specific implementation strategies were scarce. Successful implementation interventions were frequently reported to change process measures, such as improvements in adherence to delirium screening with up to 92%, but relating process measures to outcome changes was generally not possible. In meta-analyses, reduced mortality and ICU length of stay reduction were statistically more likely with implementation programs that employed more (six or more) rather than less implementation strategies and when a framework was used that either integrated current evidence on pain, agitation and delirium management (PAD) or when a strategy of early awakening, breathing, delirium screening and early exercise (ABCDE bundle) was employed. Using implementation strategies aimed at organizational change, next to behavioral change, was also associated with reduced mortality

  2. Shopping for food with children: A strategy for directing their choices toward novel foods containing vegetables.

    Science.gov (United States)

    Allirot, Xavier; Maiz, Edurne; Urdaneta, Elena

    2018-01-01

    Involving children in the different steps of meal preparation has been suggested as a strategy for enhancing dietary habits in childhood. It has previously been shown that involving children in cooking can increase their willingness to taste novel foods and direct their food choices towards foods containing vegetables. The objective of the present study was to assess the effect of involving children in food purchasing on food choices, intake, liking and appetite. A between-subject experiment was conducted with 86 children (from 8 to 10 years old). Forty-three children (PURCHASE group) participated in a workshop dedicated to purchasing the necessary ingredients online for the preparation of three unfamiliar foods containing vegetables: apple and beetroot juice, zucchini tortilla sandwich and spinach cookies. Forty-three children (CONTROL group) participated instead in a creativity workshop. Afterwards, all the children were invited to choose, for an afternoon snack, between three familiar vs. unfamiliar foods: orange vs. apple and beetroot juice, potatoes vs. zucchini tortilla sandwich and chocolate vs. spinach cookie. The mean number of unfamiliar foods chosen per child was higher in the PURCHASE (0.70 ± 0.14) vs. CONTROL (0.19 ± 0.07) group (P = 0.003). The liking for 1 of the 3 unfamiliar foods was higher in the PURCHASE group (P < 0.05). We did not find any difference between the two groups in food intake estimation and in the levels of subjective appetite. This study demonstrates that involving children in purchasing food can help in directing their food choices towards unfamiliar foods containing vegetables. It highlights the importance of involving children in the different steps of meal preparation for decreasing food neophobia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships.

    Science.gov (United States)

    Niolon, Phyllis Holditch; Taylor, Bruce G; Latzman, Natasha E; Vivolo-Kantor, Alana M; Valle, Linda Anne; Tharp, Andra T

    2016-03-01

    This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the "standard of care" strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges.

  4. FTO genotype, dietary protein, and change in appetite: the Preventing Overweight Using Novel Dietary Strategies trial.

    Science.gov (United States)

    Huang, Tao; Qi, Qibin; Li, Yanping; Hu, Frank B; Bray, George A; Sacks, Frank M; Williamson, Donald A; Qi, Lu

    2014-05-01

    A common obesity-risk variant rs9939609 in the fat mass- and obesity-associated (FTO) gene was recently shown to affect appetite, and the gene is sensitive to the regulation of amino acids. We examined the interaction between FTO genotype and protein intake on the long-term changes in appetite in a randomized controlled trial. We genotyped FTO rs9939609 in 737 overweight adults in the 2-y Preventing Overweight Using Novel Dietary Strategies trial and assessed 4 appetite-related traits including cravings, fullness, hunger, and prospective consumption. We showed that dietary protein significantly modified genetic effects on changes in food cravings and appetite scores at 6 mo after adjustment for age, sex, ethnicity, baseline body mass index, weight change, and baseline value for respective outcomes (P-interaction = 0.027 and 0.048, respectively). The A allele was associated with a greater decrease in food cravings and appetite scores in participants with high-protein-diet intake (P = 0.027 and 0.047, respectively) but not in subjects in the low-protein-diet group (P = 0.384 and 0.078, respectively). The weight regain from 6 to 24 mo attenuated gene-protein interactions. Protein intakes did not modify FTO genotype effects on other appetite measures. Our data suggest that individuals with the FTO rs9939609 A allele might obtain more benefits in a reduction of food cravings and appetite by choosing a hypocaloric and higher-protein weight-loss diet. This trial was registered at clinicaltrials.gov as NCT00072995.

  5. Which strategies reduce breast cancer mortality most? Collaborative modeling of optimal screening, treatment, and obesity prevention.

    Science.gov (United States)

    Mandelblatt, Jeanne; van Ravesteyn, Nicolien; Schechter, Clyde; Chang, Yaojen; Huang, An-Tsun; Near, Aimee M; de Koning, Harry; Jemal, Ahmedin

    2013-07-15

    US breast cancer mortality is declining, but thousands of women still die each year. Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI  ≥  30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer. If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels. Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention. © 2013 American Cancer Society.

  6. An Assessment of the Cocooning Strategy for Preventing Infant Pertussis—United States, 2011

    Science.gov (United States)

    Blain, Amy E.; Lewis, Melissa; Banerjee, Emily; Kudish, Kathy; Liko, Juventila; McGuire, Suzanne; Selvage, David; Watt, James; Martin, Stacey W.; Skoff, Tami H.

    2017-01-01

    Background Infants are at greatest risk for severe pertussis. In 2006, the Advisory Committee on Immunization Practices recommended that adolescents and adults, especially those with infant contact, receive a single dose of Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine). To assess the effectiveness of cocooning, we conducted a case-control evaluation of infant close contacts. Methods Pertussis cases aged <2 months with onset between 1 January 2011 and 31 December 2011 were identified in Emerging Infections Program Network sites. For each case, we recruited 3 controls from birth certificates and interviewed identified adult close contacts (CCs) or parents of CCs aged <18 years. Pertussis vaccination was verified through medical providers and/or immunization registries. Results Forty-two cases were enrolled, with 154 matched controls. Around enrolled infants, 859 CCs were identified (600 adult and 259 nonadult). An average of 5.4 CCs was identified per case and 4.1 CCs per control. Five hundred fifty-four (64.5%) CCs were enrolled (371 adult and 183 non-adult CCs); 119 (32.1% of enrolled) adult CCs had received Tdap. The proportion of Tdap-vaccinated adult CCs was similar between cases and controls (P = .89). The 600 identified adult CCs comprised 172 potential cocoons; 71 (41.3%) potential cocoons had all identified adult CCs enrolled. Of these, 9 were fully vaccinated and 43.7% contained no Tdap-vaccinated adults. The proportion of fully vaccinated case (4.8%) and control (10.0%) cocoons was similar (P = .43). Conclusions Low Tdap coverage among adult CCs reinforces the difficulty of implementing the cocooning strategy and the importance of vaccination during pregnancy to prevent infant pertussis. PMID:27838676

  7. Inuit women's attitudes and experiences towards cervical cancer and prevention strategies in Nunavik, Quebec

    Directory of Open Access Journals (Sweden)

    Helen Cerigo

    2012-03-01

    Full Text Available Objectives: To describe the attitudes about and experiences with cervical cancer, Pap smear screenings and the HPV vaccine among a sample of Inuit women from Nunavik, Quebec, Canada. We also evaluated demographic and social predictors of maternal interest in HPV vaccination. Study design: A mixed method design was used with a cross-sectional survey and focus group interviews. Methods: Women were recruited through convenience sampling at 2 recruitment sites in Nunavik from March 2008 to June 2009. Differences in women's responses by age, education, and marital status were assessed. Unconditional logistic regression was used to determine predictors of women's interest in HPV vaccination for their children. Results: Questionnaires were completed by 175 women aged 18–63, and of these women a total of 6 women aged 31–55 participated in 2 focus groups. Almost half the survey participants had heard of cervical cancer. Women often reported feelings of embarrassment and pain during the Pap smear and older women were more likely to feel embarrassed than younger women. Only 27% of women had heard of the HPV vaccine, and 72% of these women were interested in vaccinating their child for HPV. No statistically significant predictors of maternal interest in HPV vaccination were found. Conclusions: Our findings indicate that health service planners and providers in Nunavik should be aware of potential barriers to Pap smear attendance, especially in the older age groups. Given the low awareness of cervical cancer, the Pap smear and the HPV vaccine, education on cervical cancer and prevention strategies may be beneficial.

  8. Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

    Science.gov (United States)

    Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

    2015-01-01

    OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

  9. Cost effectiveness of cryptococcal antigen screening as a strategy to prevent HIV-associated cryptococcal meningitis in South Africa.

    Directory of Open Access Journals (Sweden)

    Joseph N Jarvis

    Full Text Available Cryptococcal meningitis (CM-related mortality may be prevented by screening patients for sub-clinical cryptococcal antigenaemia (CRAG at antiretroviral-therapy (ART initiation and pre-emptively treating those testing positive. Prior to programmatic implementation in South Africa we performed a cost-effectiveness analysis of alternative preventive strategies for CM.Cost-effectiveness analysis.Using South African data we modelled the cost-effectiveness of four strategies for patients with CD4 cell-counts <100 cells/µl starting ART 1 no screening or prophylaxis (standard of care, 2 universal primary fluconazole prophylaxis, 3 CRAG screening with fluconazole treatment if antigen-positive, 4 CRAG screening with lumbar puncture if antigen-positive and either amphotericin-B for those with CNS disease or fluconazole for those without. Analysis was limited to the first year of ART.The least costly strategy was CRAG screening followed by high-dose fluconazole treatment of all CRAG-positive individuals. This strategy dominated the standard of care at CRAG prevalence ≥0.6%. Although CRAG screening followed by lumbar puncture in all antigen-positive individuals was the most effective strategy clinically, the incremental benefit of LPs and amphotericin therapy for those with CNS disease was small and additional costs were large (US$158 versus US$51 per person year; incremental cost effectiveness ratio(ICER US$889,267 per life year gained. Both CRAG screening strategies are less costly and more clinically effective than current practice. Primary prophylaxis is more effective than current practice, but relatively cost-ineffective (ICER US$20,495.CRAG screening would be a cost-effective strategy to prevent CM-related mortality among patients initiating ART in South Africa. These findings provide further justification for programmatic implementation of CRAG screening.

  10. Suicide prevention strategies in Japan: a 15-year review (1998-2013).

    Science.gov (United States)

    Takeshima, Tadashi; Yamauchi, Takashi; Inagaki, Masatoshi; Kodaka, Manami; Matsumoto, Toshihiko; Kawano, Kenji; Katsumata, Yotaro; Fujimori, Maiko; Hisanaga, Ayaka; Takahashi, Yoshitomo

    2015-02-01

    Suicide is a global public health problem and solutions to it can be found only through a global dialog. The suicide rate in Japan has been alarming, but Japan has made substantial efforts to reduce this rate, making prevention a high priority. This report reviews the developmental stages of a comprehensive policy of suicide prevention in Japan from 1998 to 2013. Our review suggests that suicide prevention activities were facilitated by the 2006 Basic Act for Suicide Prevention and the 2007 General Principles of Suicide Prevention Policy. Along with the establishment of a Special Fund program for local governments, the Basic Act and General Principles led to the development of a comprehensive and multi-sector approach to suicide prevention. Suicide rates in Japan, especially among middle-aged men, decreased consistently after 2009, suggesting that the initiatives were effective. Continuous monitoring is needed to evaluate Japan's suicide prevention policy.

  11. Culturally compelling strategies for behaviour change: a social ecology model and case study in malaria prevention.

    Science.gov (United States)

    Panter-Brick, Catherine; Clarke, Sian E; Lomas, Heather; Pinder, Margaret; Lindsay, Steve W

    2006-06-01

    Behaviour change is notoriously difficult to initiate and sustain, and the reasons why efforts to promote healthy behaviours fail are coming under increasing scrutiny. To be successful, health interventions should build on existing practices, skills and priorities, recognise the constraints on human behaviour, and either feature community mobilisation or target those most receptive to change. Furthermore, interventions should strive to be culturally compelling, not merely culturally appropriate: they must engage local communities and nestle within social and ecological landscapes. In this paper, we propose a social ecology perspective to make explicit the links between intention to change, actual behaviour change, and subsequent health impact, as relating to both theory-based models and practical strategies for triggering behaviour change. A social ecology model focuses attention on the contexts of behaviour when designing, implementing or critically evaluating interventions. As a case study, we reflect on a community-directed intervention in rural Gambia designed to reduce malaria by promoting a relatively simple and low-cost behaviour: repairing holes in mosquito bednets. In phase 1, contextual information on bednet usage, transactions and repairs (the 'social lives' of nets) was documented. In phase 2 (intervention), songs were composed and posters displayed by community members to encourage repairs, creating a sense of ownership and a compelling medium for the transmission of health messages. In phase 3 (evaluation), qualitative and quantitative data showed that household responses were particularly rapid and extensive, with significant increase in bednet repairs (psocial ecology-of behaviour practices that are the bedrock of health interventions.

  12. Environmental quality of Italian marine water by means of marine strategy framework directive (MSFD descriptor 9.

    Directory of Open Access Journals (Sweden)

    Chiara Maggi

    Full Text Available ISPRA, on behalf of the Italian Ministry of Environment, carried out the initial assessment of environmental quality status of the 3 Italian subregions (Mediterranean Sea Region on Descriptor 9. The approach adopted to define the GES started to verify that contaminants in fish and other seafood for human consumption did not exceed levels established by Community legislation (Reg. 1881/2006 and further updates. As the Marine Strategy Framework Directive (MSFD requires to use health tools to assess the environment, Italy decided to adopt a statistical range of acceptance of thresholds identified by national (D.Lgs. 152/2006 concerning water quality required for mussel farms and international legislation (Reg. 1881/2006 and further updates, which allowed to use the health results and to employ them for the assessment of environmental quality. Italy proposed that Good Environmental Status (GES is achieved when concentrations are lower than statistical range of acceptance, estimated on samples of fish and fishery products coming from only national waters. GIS-based approach a to perform different integration levels for station, cell's grid and years, was used; the elaborations allowed to judge the environmental quality good.

  13. Systematic review of prevention and management strategies for the consequences of gender-based violence in refugee settings.

    Science.gov (United States)

    Asgary, Ramin; Emery, Eleanor; Wong, Marcia

    2013-06-01

    Uncertainties continue regarding effective strategies to prevent and address the consequences of gender-based violence (GBV) among refugees. The databases of PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, Anthropology Plus, EMBASE, DARE, Google Scholar, MSF Field Research, UNHCR and the regional and global indices of the WHO Global Health Library were searched twice within a 6-month period (April and September 2011) for English-language clinical, public health, basic and social science studies evaluating strategies to prevent and manage health sequelae of GBV among refugees before September 2011. Studies not primarily about prevention and treatment, and not describing population, health outcome and interventions, were excluded. The literature search for the prevention and management arms produced 1212 and 1106 results, respectively. After reviewing the titles and abstracts, 29 and 27 articles were selected for review in their entirety, none of which met the inclusion criteria. Multiple panels of expert recommendations and guidelines were not supported by primary data on actual displaced populations. There is a dire need for research that evaluates the efficacy and effectiveness of various responses to GBV to ultimately allow a transition from largely theoretical and expertise driven to a more evidence-based field. We recommend strategies to improve data collection and to overcome barriers in primary data driven research.

  14. SOFC direct fuelling with high-methane gases: Optimal strategies for fuel dilution and upgrade to avoid quick degradation

    International Nuclear Information System (INIS)

    Baldinelli, A.; Barelli, L.; Bidini, G.; Di Michele, A.; Vivani, R.

    2016-01-01

    Highlights: • SOFCs are operated on natural gas and biogas direct feeding. • Methane partial oxidation and dry reforming are compared. • The optimal oxygen-to-carbon stoichiometry to avoid degradation is determined for both natural gas and biogas. • NiYSZ anodes degradation mechanisms are investigated though SEM-EDX and XRD. - Abstract: In the outlook of the transition to the carbon-free society, low-carbon gases, such as natural gas or biogas, are very promising. The first is commonly used for stationary applications based on Solid Oxide Fuel Cells (SOFCs) equipped with external reformers. Similar installations are required when the SOFC is run on biogas. Yet, high SOFC operative temperature enables internal decomposition of light hydrocarbons, therefore allowing the suppression of external reforming. Evidently, this brings about benefits in terms of system complexity and cost reduction. Nonetheless, unlike reformate fuels, direct exposure to large amount of methane favours SOFC anodes degradation. Implementing a systematic experimental approach, this paper aims at determining a simple operative strategy to carry out direct feeding without meeting with quick degradation issues, producing interesting outcomes with regards to the management of SOFC-based systems. Particularly, the regulation of the oxygen-to-carbon (O/C) relative fraction of the fuel through air addition to natural gas and partial CO_2 separation from biogas is helpful in the prevention of those mechanisms. In this study, NiYSZ anode SOFCs are exposed to air-diluted natural gas and upgraded biogas, featuring O/C between 0.2 and 1.2. Tracing these cases, at 800 °C and 500 mA/cm"2 constant load, cell performances are measured over a time interval of 100 h. Finally, post-mortem analysis is performed on the specimens to investigate material morphological changes after the exposure to high-methane fuels. Results showed that O/C = 0.8 (+63% air) is the best case to employ air-diluted natural gas

  15. 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....

  16. Prevalence of child-directed and general audience marketing strategies on the front of beverage packaging: the case of Chile.

    Science.gov (United States)

    Mediano Stoltze, Fernanda; Barker, Joshua O; Kanter, Rebecca; Corvalán, Camila; Reyes, Marcela; Taillie, Lindsey Smith; Dillman Carpentier, Francesca R

    2018-02-01

    Front-of-package (FOP) marketing strategies of a wide variety of beverages were catalogued to examine the prevalence of each strategy prior to a sweeping Chilean restriction of child-directed marketing aimed at reducing obesity-related disease among Chile's youth. Photographs of 1005 beverage packages were quantitatively content-analysed to code whether a variety of child-directed, health-oriented and other marketing strategies (e.g. sales promotions) were present on each product's FOP. Strategies were then analysed based on beverages' product category, total sugar, energy and tax status (beverages with added sugars are taxed at different rates). Photographs were taken in six urban supermarkets in Santiago, Chile, representing five different supermarket chains. Beverages using child-directed characters or nature/fruit references were higher in total sugar and beverages with child-directed characters or childhood/family references were higher in energy than beverages without these respective strategies. Of the beverages taxed at the highest rate (greatest amount of added sugars), 49 % used nutrition and health appeals and 80 % used nature or fruit appeals. Plain waters and plain milks were less likely than other selected product categories to use health-oriented appeals or multiple FOP strategies in combination. FOP marketing on beverages varied according to the nutritional quality of the product, with heavier use of health-oriented and child-directed strategies in less healthy products. Marketing activities warrant continued observation to evaluate how industry responds to new marketing restrictions as these restrictions are evaluated in the light of existing taxes and other regulatory efforts to improve diets and reduce obesity-related disease.

  17. Blackout risk prevention in a smart grid based flexible optimal strategy using Grey Wolf-pattern search algorithms

    International Nuclear Information System (INIS)

    Mahdad, Belkacem; Srairi, K.

    2015-01-01

    Highlights: • A generalized optimal security power system planning strategy for blackout risk prevention is proposed. • A Grey Wolf Optimizer dynamically coordinated with Pattern Search algorithm is proposed. • A useful optimized database dynamically generated considering margin loading stability under severe faults. • The robustness and feasibility of the proposed strategy is validated in the standard IEEE 30 Bus system. • The proposed planning strategy will be useful for power system protection coordination and control. - Abstract: Developing a flexible and reliable power system planning strategy under critical situations is of great importance to experts and industrials to minimize the probability of blackouts occurrence. This paper introduces the first stage of this practical strategy by the application of Grey Wolf Optimizer coordinated with pattern search algorithm for solving the security smart grid power system management under critical situations. The main objective of this proposed planning strategy is to prevent the practical power system against blackout due to the apparition of faults in generating units or important transmission lines. At the first stage the system is pushed to its margin stability limit, the critical loads shedding are selected using voltage stability index. In the second stage the generator control variables, the reactive power of shunt and dynamic compensators are adjusted in coordination with minimization the active and reactive power at critical loads to maintain the system at security state to ensure service continuity. The feasibility and efficiency of the proposed strategy is applied to IEEE 30-Bus test system. Results are promising and prove the practical efficiency of the proposed strategy to ensure system security under critical situations

  18. Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy

    Science.gov (United States)

    Wagman, Jennifer A.; King, Elizabeth J.; Namatovu, Fredinah; Kiwanuka, Deus; Kairania, Robert; Ssemanda, John Baptist; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.; Gray, Ronald; Brahmbhatt, Heena

    2016-01-01

    Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes And Respect for Everyone (SHARE) Project between 2005–2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence and its model could be adopted as a promising practice in other settings. In this paper we describe how SHARE’s IPV-prevention strategies were integrated into RHSP’s existing HIV programming and provide recommendations for replication of the approach. PMID:26086189

  19. Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

    Science.gov (United States)

    Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

    2016-01-01

    Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

  20. FAM21 directs SNX27–retromer cargoes to the plasma membrane by preventing transport to the Golgi apparatus

    Science.gov (United States)

    Lee, Seongju; Chang, Jaerak; Blackstone, Craig

    2016-01-01

    The endosomal network maintains cellular homeostasis by sorting, recycling and degrading endocytosed cargoes. Retromer organizes the endosomal sorting pathway in conjunction with various sorting nexin (SNX) proteins. The SNX27–retromer complex has recently been identified as a major endosomal hub that regulates endosome-to-plasma membrane recycling by preventing lysosomal entry of cargoes. Here, we show that SNX27 directly interacts with FAM21, which also binds retromer, within the Wiskott–Aldrich syndrome protein and SCAR homologue (WASH) complex. This interaction is required for the precise localization of SNX27 at an endosomal subdomain as well as for recycling of SNX27-retromer cargoes. Furthermore, FAM21 prevents cargo transport to the Golgi apparatus by controlling levels of phosphatidylinositol 4-phosphate, which facilitates cargo dissociation at the Golgi. Together, our results demonstrate that the SNX27–retromer–WASH complex directs cargoes to the plasma membrane by blocking their transport to lysosomes and the Golgi. PMID:26956659