Major Public Health Concern (major + public_health_concern)

Distribution by Scientific Domains

Selected Abstracts

Tanning and Cutaneous Malignancy

BACKGROUND Exposure to ultraviolet radiation (UVR) results in a darkening of the skin known as tanning. Recently, it has been shown that tanning is a response to UVR-induced DNA damage and represents the skin's efforts to protect itself against further injury. Despite the link between UVR and cutaneous malignancy, people continue to pursue tanning from natural and artificial sources. This trend is reflected in the exponential rise in skin cancer incidence. OBJECTIVE The objective of this study was to review our current understanding of the factors controlling the tanning response and the relationship to cutaneous carcinogenesis, as well as the impact that the multibillion dollar tanning industry has had on the practice of dermatology. MATERIALS AND METHODS Extensive literature review was conducted in subjects related to tanning and the relationship to cutaneous malignancy. RESULTS Our knowledge of tanning and its effects on the skin has increased tremendously. It is clear that tanning contributes to the development of skin cancer. Despite this information, the incidence of skin cancer continues to increase exponentially. CONCLUSIONS Skin cancer poses a major public health concern and tanning remains the most modifiable risk factor in its etiology. Social, economic, and legislative issues have become tightly intertwined with the complex nature of human behavior in the continued pursuit of an activity that clearly has detrimental effects on one's health. [source]

Inadequacies of absolute threshold levels for diagnosing prediabetes

Michael Bergman
Abstract Prediabetes comprising Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) represents an intermediate stage of altered glucose metabolism between normal glucose levels and type 2 diabetes mellitus and is associated with an increased risk for the development of diabetes and cardiovascular disease. There is considerable evidence that glucose levels lower than those meeting the current definition of prediabetes may also be associated with similar risks particularly in high-risk individuals. Prediabetes is often unrecognized and therefore constitutes a major public health concern suggesting the need for earlier intervention than is currently recommended. Copyright © 2010 John Wiley & Sons, Ltd. [source]

The feasibility of providing community pharmacy-based services for alcohol misuse: A literature review

Dr Margaret C. Watson
Abstract Objectives Excessive consumption of alcohol is a major public health concern. The use of community pharmacies and pharmacists as sources of public health information and services is gaining greater recognition. The objective of this review was to provide an overview of the evidence on the feasibility, effectiveness and acceptability of providing community pharmacy-based services to address the excessive consumption of alcohol. Methods Electronic databases were searched for the period 1996,2007 to identify relevant evidence. Searches were also conducted of relevant pharmacy and addiction journals. Information was sought from key contacts in pharmacy and alcohol research. Studies were included if they were conducted in a community pharmacy setting. Key findings The review comprised three feasibility studies which included 14 pharmacies and 500 customers. Non-significant reductions in alcohol consumption were reported with two studies following brief interventions by pharmacists. Between 30% and 53% of pharmacy customers were identified as having hazardous or harmful drinking behaviour. Customer opinion of the pharmacy-based alcohol services was not reported. Conclusions There has been little empirical evaluation of the effectiveness of community pharmacy-based services for alcohol misuse. The evidence presented in this review suggests that community pharmacy-based screening is feasible. Organisations and individuals involved with tackling excessive alcohol consumption should consider the inclusion of community pharmacies and pharmacists as part of their strategies to address this problem. Large-scale studies are needed to evaluate the short- and long-term effects and cost-effectiveness of community pharmacy-based interventions to reduce excessive alcohol consumption, as well as to explore the acceptability of the service to users. [source]

Nurses' attitudes towards adult patients who are obese: literature review

Aims., This paper presents a review of all empirical studies focusing on nurses' attitudes towards adult overweight or obese patients, with the aim of clarifying the dimensions and patterns of these attitudes and the methods by which they have been studied. Background., Obesity has become a common condition and a major public health concern, but it is often associated with negative attitudes and discrimination. Nurses play a key role in providing support and care to patients who are obese. Methods., Electronic searches were carried out on seven databases from inception to December 2004, along with hand-searching of references in relevant studies. The search terms were built around obesity (and related terms), nursing (and its branches) and attitudes (and related terms). Eleven studies met the inclusion criteria. Data were extracted and summarized in tabular form and analysed in relation to the aims of this review during January 2005. Findings., There is relatively little research about nurses' attitudes towards obese patients, and the studies reviewed mostly have weaknesses of sampling and measurement. However, they do consistently suggest that a proportion of nurses have negative attitudes and beliefs, reflecting wider stereotypes within Western cultures. There is also a hint of a more complex mix of attitudes among nurses, some of which may counter the consequences of negative attitudes, but these have not been adequately investigated. A number of variables that influence attitudes of nurses can be identified, including age, gender, experience and the weight/body mass index of the nurse. Conclusion., Further research (both qualitative and quantitative) is needed with more rigorous sampling and, where appropriate, more consistency of measurement. A shift in focus towards the sets of attitudes (positive as well as negative) and behaviours that influence health service quality and outcomes for obese persons would be useful. [source]

How Many Women Have Osteoporosis?

L. Joseph Melton III
Osteoporosis is widely viewed as a major public health concern, but the exact magnitude of the problem is uncertain and likely to depend on how the condition is defined. Noninvasive bone mineral measurements can be used to define a state of heightened fracture risk (osteopenia), or the ultimate clinical manifestation of fracture can be assessed (established osteoporosis). If bone mineral measurements more than 2 standard deviations below the mean of young normal women represent osteopenia, then 45% of white women aged 50 years and over have the condition at one or more sites in the hip, spine, or forearm on the basis of population-based data from Rochester, Minnesota. A smaller proportion is affected at each specific skeletal site: 32% have bone mineral values this low in the lumbar spine, 29% in either of two regions in the proximal femur, and 26% in the midradius. Although this overall estimate is substantial, some other serious chronic diseases are almost as common. More importantly, low bone mass is associated with adverse health outcomes, especially fractures. The lifetime risk of any fracture of the hip, spine, or distal forearm is almost 40% in white women and 13% in white men from age 50 years onward. If the enormous costs associated with these fractures are to be reduced, increased attention must be given to the design and implementation of control programs directed at this major health problem. [source]

Invasiveness and Intracellular Growth of Multidrug-Resistant Salmonella and Other Pathogens in Caco-2 Cells

S.-H. Kim
ABSTRACT:, The increase of multidrug-resistant pathogens of human and animal origins is a major public health concern. For a better understanding of the health consequences of multidrug-resistant bacteria transmitted from animal products to humans, the host interaction of zoonotic Salmonella isolates along with other pathogenic and commensal bacteria was evaluated using a human intestinal Caco-2 cell system. Multidrug-resistant S. Agona, S. Heidelberg, and S. Typhimurium possessed plasmid-mediated class 1 integrons. The S. Typhimurium DT104 isolate from ground beef showed the well-known genotypic and phenotypic resistance characteristics of the species, and contained the chromosomally located class 1 integron. Among the multidrug-resistant Salmonella isolates, the S. Heidelberg 219 had the highest invasion number at 1.0 × 104 CFU/mL, followed by the S. Typhimurium DT104 isolate at 7.7 × 103 CFU/mL. Listeria monocytogenes was the best performer among the tested species in invading the Caco-2 cell. Multidrug-resistant opportunistic pathogens Klebsiella pneumoniae and Pseudomonas aeruginosa were also able to invade the cells. The invasion of S. Heidelberg 219, S. Typhimurium DT104, L. monocytogenes, K. pneumoniae, and P. aeruginosa into the Caco-2 cells was not affected even in the presence of commensal E. coli. During the intracellular growth of S. Heidelberg 219, S. Typhimurium DT104, and L. monocytogenes, the bacterial counts increased 2 log cycles in 9 h in the Caco-2 cells. Therefore, these strains could rapidly proliferate after their invasion into the cells. [source]

Violence education in nursing: critical reflection on victims' stories

Angela Frederick Amar PhD
Abstract Violence against women is a major public health concern. This paper describes an educational strategy to increase nursing students' understanding of the experience of violence and to foster recognition and intervention with victims of violence. Students in an elective course were asked to critically reflect on the personal stories of victims/survivors of violence. The assignment provided four learning opportunities that include examination of societal myths on sexual victimization, understanding the lived experience of the victim, exploration of personal beliefs and values, and the relationship of the individual's experience to theoretical content of the course. Students gave permission for the use of quotes from papers to illustrate the learning opportunities. [source]

Prevalence of Pervasive Developmental Disorders in Two Canadian Provinces

Hélène Ouellette-Kuntz
Abstract, Although it is generally accepted that the proportion of children diagnosed with pervasive developmental disorders (PDDs) has increased in the past two decades, there is no consensus on the prevalence of these conditions. The accompanying large rise in demand for services, together with uncertainty regarding the extent to which the observed increases are due to a true change in risk, has made PDDs a major public health concern. As few data exist on the prevalence of PDDs in Canada, the aim of this study was to estimate the prevalence of diagnosed PDDs in two Canadian provinces (Manitoba and Prince Edward Island (PEI)) and compare characteristics of diagnosed cases between the two regions. To obtain the estimates, children under the age of 15 years with a PDD diagnosis who lived in either province in 2002 were identified by workers at Children's Special Services, a provincial government program that supports children with special needs in Manitoba, and by the PEI provincial early intervention coordinator (Department of Social Services and Seniors) and special education autism coordinator (Department of Education). The findings show that the prevalence among children 1,14 years of age was 28.4 per 10,000 (95% confidence interval: 26.1,30.8) in Manitoba and 35.2 per 10,000 (95% confidence interval: 28.2,43.4) in PEI. In Manitoba, children of aboriginal identity with PDDs (8.3%) were significantly underrepresented compared with the general population of aboriginal children living off native reserves (15.6%). Sex ratio, sibling risk, and age at initial diagnosis were similar in the two provinces. These findings can serve as a baseline from which to monitor the prevalence of these conditions over time, providing valuable data for researchers, planners, and service providers. [source]

Integrating the transtheoretical model into the management of overweight and obese adults

Judy Gainey Seals NP, MSN (Cardiovascular Nurse Practitioner)
Abstract Purpose: To show how the nurse practitioner (NP) can incorporate stage-specific interventions from the transtheoretical model in the management of overweight and obese adults. Data sources: Research articles, clinical articles, and government guidelines pertaining to the management of overweight and obesity in adults. Conclusions: Overweight and obesity are complex and chronic conditions that require lifelong management. The NP can help clients to safely and successfully lose weight by developing stage-specific interventions, by using an expert multidisciplinary team, and by providing ongoing monitoring and motivation. Implications for practice: The prevalence of overweight and obesity continues to increase at an alarming rate and is a major public health concern. The NP has an important role in the assessment and management of clients with this condition. [source]

Under the Microscope: Arcobacter

W.J. Snelling
Abstract This review describes characteristics of the genus Arcobacter. Unlike its close phenotypically related neighbour Campylobacter, Arcobacter is not currently a major public health concern, but is considered as an emerging human pathogen, and is of significance towards animal health. This review focuses on the public health significance, culturing and typing, reservoirs, and antimicrobial studies of Arcobacter. Collectively, increasing knowledge in these areas will help to develop measures, which can be used to control this emerging pathogen. [source]

Neurocognitive and behavioral impact of sleep disordered breathing in children,

Judith A. Owens MD
Abstract The consequences of poor quality and/or inadequate sleep in children and adolescents have become a major public health concern, and one in which pediatric health care professionals have become increasingly involved. In particular, insufficient and/or fragmented sleep resulting from primary sleep disorders such as obstructive sleep apnea (OSA), often compounded by the presence of comorbid sleep disorders as well as by voluntary sleep curtailment related to lifestyle and environmental factors, has been implicated in a host of negative consequences. These range from metabolic dysfunction and increased cardiovascular morbidity to impairments in mood and academic performance. The following review will focus on what is currently known about the effects of sleep disordered breathing (SDB) specifically on neurobehavioral and neurocognitive function in children. Because of the scarcity of literature on the cognitive and behavioral impact of sleep disorders in infants and very young children, this review will target largely the preschool/school-aged child and adolescent populations. In addition, the focus will be on a review of the most recent literature, as a supplement to several excellent previous reviews on the topic.1,4 Pediatr Pulmonol. 2009; 44:417,422. © 2009 Wiley-Liss, Inc. [source]

Severe ,0 thalassemia/hemoglobin E disease caused by de novo 22-base pair duplication in the paternal allele of , globin gene

Ponlapat Rojnuckarin
Abstract , Thalassemia is a major public health concern in Southeast Asia. A prevention program has been implemented in Thailand comprising mass carrier screening and genetic testing. In this study, a Thai girl with severe , thalassemia/hemoglobin (Hb) E disease was born from the mother with Hb E trait and the genotypically normal father. DNA sequencing revealed novel 22-bp tandem duplication in the paternal allele of , globin gene, producing a severely truncated product. A short recurring nucleotide at the insertion site suggested a predisposition to this mutation. Therefore, spontaneous , globin mutations occasionally occur in normal population. Its clinical significance is noteworthy in countries with high prevalence of , thalassemia. Am. J. Hematol 2007. © 2006 Wiley-Liss, Inc. [source]

The experiences of staff concerning the introduction and impact of a fall prevention intervention in aged care facilities: a qualitative study

Meg Butler
Objective: Falls in aged care facilities are a major public health concern. A pilot study tested the acceptability of a falls risk management intervention. Method: Focus group discussions with care giving staff and falls coordinators and individual interviews with principal nurse managers were taped and transcribed and thematic analysis identified main issues for staff in utilising the intervention. Results: Acceptance of the intervention was high for principal nurse managers and falls coordinators, although the paper work was found to be time consuming. While most caregivers found undertaking fall prevention strategies worthwhile, others found such strategies were irrelevant to them as they "knew" their residents. Conclusions: Among all levels of staff, falls among residents were regarded as stressful events. While the general acceptunce of the intervention programme was high, resistance to changing practices of care by some staff could limit the wider implementation of such a programme. Further research is needed to examine appropriate delivery of educational messages for caregivers, which include multiple cultural understandings. [source]

The Sydney Medically Supervised Injecting Centre: a controversial public health measure

Cate Kelly
Background: Injecting drug use remains a major public health concern, particularly because of opiate overdose and transmission of blood-borne viruses. Sydney's Medically Supervised Injecting Centre (MSIC) opened on a trial basis in May 2001 in an effort to reduce the harms of drug use. In this report, we provide a brief overview of the reported public health impact of supervising injecting facilities (SIFs) and review the history and early process evaluations of the Sydney Centre. Methods Medline, Internet searches and perusal of bibliographies of articles were used to identify key English language publications on SIFs. These were supplemented by interview with the Medical Director of Sydney MSIC, Dr Ingrid van Beek. Discussion and conclusions: It is difficult to be certain of the public health impact of SIFs but evidence from overseas and Sydney's early process evaluations provide promise that they may make a positive contribution to health. [source]

Structure of Staphylococcus aureus cytidine monophosphate kinase in complex with cytidine 5,-monophosphate

Jingshan Ren
The crystal structure of Staphylococcus aureus cytidine monophosphate kinase (CMK) in complex with cytidine 5,-monophosphate (CMP) has been determined at 2.3,Å resolution. The active site reveals novel features when compared with two orthologues of known structure. Compared with the Streptococcus pneumoniae CMK solution structure of the enzyme alone, S. aureus CMK adopts a more closed conformation, with the NMP-binding domain rotating by ,16° towards the central pocket of the molecule, thereby assembling the active site. Comparing Escherichia coli and S. aureus CMK,CMP complex structures reveals differences within the active site, including a previously unreported indirect interaction of CMP with Asp33, the replacement of a serine residue involved in the binding of CDP by Ala12 in S. aureus CMK and an additional sulfate ion in the E. coli CMK active site. The detailed understanding of the stereochemistry of CMP binding to CMK will assist in the design of novel inhibitors of the enzyme. Inhibitors are required to treat the widespread hospital infection methicillin-resistant S. aureus (MRSA), currently a major public health concern. [source]

Molecular epidemiology of tuberculosis in the Tula area, Central Russia, before the introduction of the Directly Observed Therapy Strategy

S. Dubiley
Clin Microbiol Infect 2010; 16: 1421,1426 Abstract Tuberculosis remains a major public health concern in Russia and worldwide. Given the great geographical, ethnic, and socio-economic heterogeneities between Russian regions, epidemiological data cannot be generalized from a regional to a country-wide level. We present data on the epidemiology of tuberculosis in Central Russia. We report a high level of resistance to major antitubercular drugs in both new and previously treated patients in the region. The level of drug resistance in new cases was almost twice as high as the estimated average national level. The Mycobacterium tuberculosis strains that circulated in the region were predominantly represented by LAM-RUS and Beijing genotypes. These two lineages were strongly associated with drug resistance and clustering. Using molecular epidemiology techniques, we showed a high interpenetration by M. tuberculosis strains between the prison and civilian populations. A limited number of identical strains were responsible for the majority of drug-resistant tuberculosis cases in both settings. [source]

Antimicrobial resistance in Europe and its potential impact on empirical therapy

G. M. Rossolini
Abstract The problem of microbial drug resistance is a major public health concern, due to its global dimension and alarming magnitude, although the epidemiology of resistance can exhibit remarkable geographical variability and rapid temporal evolution. The major resistance issues overall are those related to methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Enterobacteriaceae producing extended-spectrum ,-lactamases, and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Europe is not free from any of these issues, although their impact may be significantly different in different countries. MRSA rates are high in several European countries, but seem to have levelled off in some settings. Diffusion of VRE is still irregular. The most alarming resistance trends are those observed for Enterobacteriaceae and the Gram-negative non-fermenters, with a generalized increase in rates of resistance to the most important anti-Gram-negative agents (,-lactams and fluoroquinolones) and the circulation of strains showing multidrug resistance phenotypes. [source]

Food groups and the risk of colorectal carcinoma in an Asian population

CANCER, Issue 11 2002
Adeline Seow M.D.
Abstract BACKGROUND Singapore Chinese have experienced a rapid transition toward a pattern of disease in which lifestyle-related, chronic, degenerative diseases are major public health concerns. The rates of colorectal carcinoma have increased 2-fold over the last 3 decades. It has long been known that dietary factors play a role in the risk of this disease, although studies in Asian populations, with their unique dietary intake, have been few. METHODS The authors conducted a population-based case-control study that included 121 Chinese patients with colorectal carcinoma and 222 healthy control participants who provided information on usual intake of major food groups in the preceding 3 years, physical activity, family history of colorectal carcinoma, and demographic variables through an in-person questionnaire. RESULTS High intake of red meat, but not other meats, indicated a predisposition to risk of colorectal carcinoma (adjusted odds ratio [OR] for the highest tertile vs. the lowest tertile, 2.2; 95% confidence interval [95%CI], 1.1,4.2). A low vegetable intake also was associated with a higher risk, and the combined effect appeared to be additive. Those in the highest tertile of meat intake and the lowest quartile of vegetable intake had an OR of 2.6 (95%CI, 1.0,6.7). The authors observed a slight, albeit nonsignificant, positive association with foods high in refined sugars. There was no association observed with fruit or soy-legume intake in this study. Among nondietary variables, a family history of colorectal carcinoma conferred a significant increase in risk (OR, 6.7; 95% CI 2.4,18.7). CONCLUSIONS Meat intake and vegetable intake were associated significantly with risk of colorectal carcinoma in this Asian population, and further studies on the effects of changes in these specific types of food may shed light on how best to reduce the rapid increase in rates in similar populations. Cancer 2002;95:2390,6. © 2002 American Cancer Society. DOI 10.1002/cncr.10971 [source]