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Disease Prevention (disease + prevention)
Kinds of Disease Prevention Selected AbstractsReview article: influenza A (H1N1) virus in patients with inflammatory bowel diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010J.-F. RAHIER Summary Background, Infection with influenza A (H1N1)v (swine flu) has caused widespread anxiety, among patients who are potentially immunocompromised, such as those being treated for inflammatory bowel disease. Aim, To provide guidance for physicians and their patients on the risk, prevention and management of influenza A (H1N1)v infection. Methods, Medline was searched using the following key words: ,swine flu', ,immunosuppression', inflammatory bowel disease', ,recommendations', ,immunization', ,vaccination'. Organizations such as European Centre for Disease Prevention and Control, the Centers for Disease Control and Prevention and the World Health Organization were consulted for recent papers and recommendations regarding immunocompromised patients and influenza A (H1N1)v infection. Results, Pandemic influenza A (H1N1) virus predominantly affects young patients. Those who are immunocompromised because of underlying disease or treatment are considered at higher risk of complications from influenza A (H1N1). They should be offered prevention (vaccination, postexposure prophylaxis) or treatment with antiviral drugs, if affected. Pneumococcal infection is a complication of influenza infection; therefore, pneumococcal vaccination appears advisable. Seasonal influenza vaccination is also recommended. Withdrawal of immunosuppressive treatment appears advisable during severe active infection if possible. Conclusions, Pragmatic advice is the best that can be offered in the current circumstances because of paucity of evidence. Investigation into the impact of influenza A (H1N1)v infection in young people with chronic conditions is needed. [source] Book review: Beer in Health and Disease PreventionAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009Arthur L. KlatskyArticle first published online: 30 APR 200 No abstract is available for this article. [source] Women and Compliance: The Forgotten Issues in Heart Disease PreventionPREVENTIVE CARDIOLOGY, Issue 1 2000Nieca Goldberg MD No abstract is available for this article. [source] Behavioral Medicine Strategies for Heart Disease Prevention: The Example of Smoking CessationPREVENTIVE CARDIOLOGY, Issue 1 2000Barrie J Guise PhD Health related behavior change is one of the most important challenges in the prevention of cardiovascular disease. Lifestyle patterns, such as high fat diet, lack of exercise, persistent smoking, and poor compliance with prescribed medications present the core of this challenge. Conventional wisdom and considerable scientific evidence establish that the barriers to health related behavior change are many and varied. However, much is also known about methods of improving behavioral outcomes. Behavioral medicine strategies incorporate fundamental principles of behavior change together with biomedical and interpersonal approaches to facilitate successful cardiac risk factor modification. Physicians have the most potent opportunity to assist patients with health behavior change. Unfortunately, physicians are least familiar with behavior change technology and the contemporary physician-patient relationship lacks the partnership needed to succeed in these difficult areas. The good news is that medical education has begun to incorporate training in behavior change and interpersonal effectiveness. A description of the behavioral medicine approach to smoking cessation provides an excellent model for a thoughtful and practical approach to heart disease prevention in every day practice. [source] The practice of travel medicine in EuropeCLINICAL MICROBIOLOGY AND INFECTION, Issue 3 2010P. Schlagenhauf Clin Microbiol Infect 2010; 16: 203,208 Abstract Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist ,travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching. [source] Strategies to prevent type 1 diabetesDIABETES OBESITY & METABOLISM, Issue 10 2009S. L. Thrower Type 1 diabetes is a chronic autoimmune condition resulting from T cell,mediated destruction of the insulin-producing cells in the islets of Langerhans. Its primary cause remains unknown, but it has been established that the clinical presentation is preceded by a long prodrome. This enables individuals at high risk of disease to be identified and offers the possibility of intervention to prevent clinical disease. Many groups are working in this field, concentrating on manipulation of environmental exposures that are potential triggers of autoimmunity and on immunomodulation strategies that aim to prevent destruction of ,-cells. Some interventions have shown promising results in early trials, but effective disease prevention remains elusive. This article reviews current progress in the field. [source] Glycaemic status and cardiovascular disease in type 2 diabetes mellitus: re-visiting glycated haemoglobin targets for cardiovascular disease preventionDIABETES OBESITY & METABOLISM, Issue 6 2007Sherita H. Golden Cardiovascular disease (CVD) is the leading cause of death among people with type 2 diabetes. Recent attention has focused on chronic hyperglycaemia as an additional risk factor in people with diabetes since their excess CVD risk is not entirely explained by traditional cardiovascular risk factors. Clinical trials of intensive glucose control to reduce CVD events have been equivocal, but recent epidemiological studies have shown that HbAlc, a measure of chronic hyperglycaemia, predicts incident cardiovascular events. This review, which focuses on type 2 diabetes, summarizes (i) the epidemiological literature examining the relation between glycaemic status, as assessed by glycated haemoglobin (HbAlc) and CVD, (ii) the controversy regarding treatment goals for HbAlc in terms of preventing microvascular disease vs. macrovascular disease and (iii) on-going clinical trials of intensive glycaemic control for CVD prevention. [source] The relevance of the glycaemic index to our understanding of dietary carbohydratesDIABETIC MEDICINE, Issue 5 2000G. Frost Summary Aims To review the evidence for the importance of glycaemic index of dietary carbohydrate in disease prevention and control Methods A critical appraisal of the literature published in English between and cited on Medline between January 1966 and October 1999. Results Using basic, intervention and epidemiological studies from experienced teams, evidence that the glycaemic index of diet may influence outcome in terms of cardiovascular risk, risk of metabolic syndrome diseases and pregnancy was found Conclusions Consideration of glycaemic indices in making dietary recommendations may be expected to produce additional health benefit. [source] Genetic and environmental interactions on oral cancer in Southern ThailandENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 2 2001Suparp Kietthubthew Abstract Many countries are interested in understanding the relationship between genetic susceptibility and their prevalent environmental cancers for disease prevention. In Thailand we conducted a population-based case-control study of 53 matched pairs to assess the risk of oral cancer in relation to genetic polymorphism of the glutathione-S-transferase genes (GSTM1 and GSTT1) in cigarette smokers, alcohol drinkers, and betel quid chewers. Interaction of the genes with other potential risk factors such as local bean consumption were also elucidated. Homozygous deletion of GSTM1 has a frequency of 56.6% (n = 30 over 53) among the patients and 30.2% (16/53) among the controls. This gene is associated with a 2.6-fold higher risk for development of oral cancer (95% CI 1.04,6.5). Among the null GSTM1 individuals, those who smoke, consume alcohol, and/or chew betel quid have a significantly increased risk for oral cancer with an odd ratio (OR) = 4.0 (95% CI = 1.2,13.7), OR = 7.2 (95% CI = 1.5,33.8), and OR = 4.4 (95% CI = 1.1,17.8), respectively. Interactions between any two of the lifestyle habits for oral cancer risk, however, are not found. The frequency of the GSTT1 null genotype is 34.0% (18/53) among the patients and 47.2% (25/53) among our controls. There is no association between the GSTT1 null allele and oral cancer risk. In conclusion, our study provides data to indicate that individuals who have homozygous deletion of the GSTM1 gene have increased risk for oral cancer. The risk increases further when these individuals are exposed to environmental toxicants such as chemicals in cigarette smoke, alcohol, and betel quid. These baseline data can be applied to a larger population-based study, both to verify the observation and to conduct mechanistic investigations. Environ. Mol. Mutagen. 37:111,116, 2001 © 2001 Wiley-Liss, Inc. [source] Magnetic resonance imaging evaluation of 264 horses with foot pain: The podotrochlear apparatus, deep digital flexor tendon and collateral ligaments of the distal interphalangeal jointEQUINE VETERINARY JOURNAL, Issue 4 2007S. DYSON Summary Reasons for performing study: To improve understanding of the interrelationships between injuries of the podotrochlear apparatus and deep digital flexor tendon (DDFT). Hypotheses: There is a difference in frequency of different types of lesions at different anatomical sites of the DDFT. Lesions of the collateral sesamoidean ligament (CSL), distal sesamoidean impar ligament (DSIL), distal interphalangeal (DIP) joint and navicular bursa are seen in association with lesions of the navicular bone. Methods: The magnetic resonance (MR) images of 264 horses with unilateral or bilateral foot pain were analysed and graded. Descriptive statistics were performed to establish the frequency of occurrence of DDFT lesion types at different anatomical levels, and lesions of the CSL, DSIL, navicular bursa, DIP joint and collateral ligaments (CLs) of the DIP joint. A Chi-square test was used to test for a difference in the proportion of navicular bone grades between limbs with and without DDFT lesions at each level, and to compare navicular bone grades for limbs with and without each of DSIL, CSL, navicular bursa or DIP joint lesions. Results: Lesions of the DDFT occurred in 82.6% of limbs, occurring most commonly at the level of the CSL (59.4%) and the navicular bone (59.0%). Core lesions predominated at the level of the proximal phalanx (90.3%), whereas at the level of the CSL and navicular bone core lesions, sagittal splits and dorsal abrasions were most common. There was a positive association between DDFT lesions and navicular bone pathology involving all aspects of the bone. Lesions of the DSIL (38.2% limbs) were more common than those of the CSL (10.5%), but the presence of either was associated with abnormalities of the navicular bone, especially involving the proximal or distal borders and the medulla. Conclusions and clinical relevance: There are close interactions between injuries of the components of the podotrochlear apparatus, the DDFT, the navicular bursa and the DIP joint. Further knowledge about the biomechanical risk factors for injury may have importance for both disease prevention and management. [source] Inhibition of lipid peroxidation by anthocyanins, anthocyanidins and their phenolic degradation productsEUROPEAN JOURNAL OF LIPID SCIENCE AND TECHNOLOGY, Issue 1 2007Jonathan E. Brown Abstract Food components that delay or prevent biomolecule oxidation may be relevant in shelf life extension as well as disease prevention. Anthocyanins are a potentially important group of compounds, but they are prone to degradation both in vitro and in vivo, producing simple phenols. In this study, eight structurally related (poly)phenols [anthocyan(id)ins and phenolic acids] were examined for their ability to inhibit lipid oxidation at physiologically relevant concentrations (100,1000,nM) using the Cu2+ -mediated low-density lipoprotein oxidation model. Interaction between each (poly)phenol and Cu2+ ions was also investigated. (Poly)phenols with an ortho -dihydroxy group arrangement, i.e. cyanidin-3-glucoside, cyanidin and protocatechuic acid, were the most effective within their class, extending the lag phase to oxidation by 137, 255 and 402%, respectively (at 1000,nM). At the same concentration, trihydroxy-substituted compounds (delphinidin and gallic acid) were of intermediate efficacy, extending the lag phase by 175 and 38%, respectively. Compounds with the 4'-hydroxy-3',5'-methoxy arrangement (i.e. malvidin-3-glucoside and malvidin) were the least effective (3 and 58% extension, respectively), while syringic acid (4-hydroxy-3,5-dihydroxy benzoic acid) was pro-oxidant (lag phase shortened by 31%). (Poly)phenols with the ortho -dihydroxy arrangement chelated Cu2+ ions, which in part explains their greater efficacy over the other (poly)phenols in this model oxidation system. However, differences in their hydrogen-donating properties and their partitioning between lipid and hydrophilic phases are also relevant in explaining these structure-activity relationships. [source] A review on the interactions between gut microbiota and innate immunity of fishFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 2 2008Geovanny D. Gómez Abstract Although fish immunology has progressed in the last few years, the contribution of the normal endogenous microbiota to the overall health status has been so far underestimated. In this context, the establishment of a normal or protective microbiota constitutes a key component to maintain good health, through competitive exclusion mechanisms, and has implications for the development and maturation of the immune system. The normal microbiota influences the innate immune system, which is of vital importance for the disease resistance of fish and is divided into physical barriers, humoral and cellular components. Innate humoral parameters include antimicrobial peptides, lysozyme, complement components, transferrin, pentraxins, lectins, antiproteases and natural antibodies, whereas nonspecific cytotoxic cells and phagocytes (monocytes/macrophages and neutrophils) constitute innate cellular immune effectors. Cytokines are an integral component of the adaptive and innate immune response, particularly IL-1,, interferon, tumor necrosis factor-,, transforming growth factor-, and several chemokines regulate innate immunity. This review covers the innate immune mechanisms of protection against pathogens, in relation with the installation and composition of the normal endogenous microbiota in fish and its role on health. Knowledge of such interaction may offer novel and useful means designing adequate therapeutic strategies for disease prevention and treatment. [source] Efficacy of four insect repellents against mosquito bites: a double-blind randomized placebo-controlled field study in SenegalFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2009Bernard Uzzan Abstract Insect-borne diseases represent a worldwide threat. In addition to fight against vectors (insecticides) and disease prevention (vaccination against yellow fever, chemoprophylaxis against malaria), insect repellents applied on the skin could help reduce the heavy burden related to these diseases. In a field study performed in Senegal, we compared the efficacy of one skin application between 3 and 4 p.m. of four spray repellents [icaridine 20%, para-menthane-diol (PMD) 20% and 50% and DEET 50%] against placebo, among 100 healthy male and female volunteers experienced with mosquito capture. Double-blind randomized cross-over placebo-controlled study (Latin-square design) during five consecutive nights (7 p.m. to midnight) in two villages was conducted. To avoid residual effect, right or left leg was alternately exposed during consecutive nights and the exposed leg was washed before next night. The statistical model was random and mixed effects anova. All four active repellents provided a significant and similar protection compared with placebo, lasting 8 h. However, there was a non-significant trend for a higher protection by DEET 50% than by PMD 20% (P = 0.07). Duration of protection was similar for all repellents. Their effects were similar among men and women, and against Anopheles or other species. No serious adverse drug reaction was noticed. Using a rigorous methodology and a large number of volunteers, our well-controlled study demonstrated an important and similar protective effect of all four repellents compared with placebo. Such field studies should be required before approval of any newly developed repellent. [source] Preventive medicine beyond 65GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2006Lionel S. Lim Preventive health care in adults aged 65 and older is essential to ensure that quality of life is maintained with longevity. The first half of this article will focus on the two major causes of mortality in the US adult population: cancer and cardiovascular disease. We will address current screening and chemoprevention issues pertaining to breast, cervical, colorectal, prostate and skin cancer. For cardiovascular disease prevention, we will discuss the importance of screening for and treating hypertension, hyperlipidemia, diabetes mellitus, and the use of aspirin chemoprophylaxis and angiotensin-converting enzyme inhibition. In the latter half, we will discuss other aspects of preventive health care including fall prevention, motor vehicle safety, immunizations and screening issues. Health screening can help detect conditions like osteoporosis, subclinical thyroid disease, hearing impairment, nutritional status, and oral and dental problems. Finally, we will also address psychosocial health issues that affect older people including dementia, depression, elder abuse, lifestyle habits and advanced directives. Our recommendations are based on the latest available evidence and include the US Preventive Services Task Force and other leading health professional organizations. [source] Aldehyde oxidase is coamplified with the World's most common Culex mosquito insecticide resistance-associated esterasesINSECT MOLECULAR BIOLOGY, Issue 1 2000J. Hemingway Abstract The evolution and spread of insecticide resistance is an important factor in human disease prevention and crop protection. The mosquito Culex quinquefasciatus is the main vector of the disease filariasis and a member of a species complex which is a common biting nuisance worldwide. The common insecticide resistance mechanism in this species involves germline amplification of the esterases est,21 and est,21. This amplification has arisen once and rapidly spread worldwide. Less common and more variable resistance phenotypes involve coamplification of est,3 and est,1, or individual amplification of a single est,1, different alleles of the same est, and est, gene loci. Est,21 and est,21 are on the same large fragment of amplified DNA (amplicon) 2.7 kb apart. We have now shown that this amplicon contains another full-length gene immediately 5, of est,21 which codes for a molybdenum-containing hydroxylase, with highest homology to aldehyde oxidase (AO) from other organisms. The full-length putative AO gene is not present on the est,3/est,1 or est,1 amplicons, but multiple truncated 5, ends of this gene are present around the presumed est,3/est,1 amplicon breakpoint. Polymerase chain reaction (PCR) analysis of insecticide-susceptible genomic DNA demonstrated that a different allele of the putative AO gene in its non-amplified form is immediately 5, of est,. The ,AO' gene on the est,21/est,21 amplicon is expressed and resistant insects have greater AO activity. This AO activity is sensitive to inhibition by an aldehyde-containing herbicide and pesticide. This enzyme may confer a selective advantage to these insects in the presence of insecticide, as AO in mammals is believed to be important in the detoxification process of several environmental pollutants. [source] Revaccination of bone marrow transplant recipients: a review of current practices in AustraliaINTERNAL MEDICINE JOURNAL, Issue 4 2009Adrienne Torda Abstract Background: Vaccination following bone marrow transplant (BMT) is an important part of ongoing care and disease prevention. The aim of the study was to investigate vaccination procedures in BMT recipients and identify what systems are in place throughout Australia to remind and alert patients concerning their need for vaccination. Methods: Questionnaires were sent to haematologists managing BMT recipients in Australia to examine post-BMT vaccination practices in hospitals and outpatient clinics. Questionnaires were also sent to BMT recipients in New South Wales, who had their transplants (either allogeneic or autologous) in the past 5 years to determine what vaccinations they had received and what vaccination reminder systems had been used. Results: Vaccine recommendations and practices by BMT physicians showed little consensus. They also differed greatly between autologous and allogeneic transplant recipients. Only just more than half of the physicians had an effective reminder system in place and only 12 of 34 patients had received vaccination reminders. One-third of all patients were not aware of any need for revaccination. Conclusion: The disparity in physician practice regarding revaccination is significant and may reflect the lack of data available regarding efficacy of revaccination in this setting and/or a lack of knowledge about recommendations. Because of this, a national immunization schedule for post-BMT patients founded on evidence-based studies is required to provide optimal patient care. The lack of effective follow up and reminder systems ensuring patient completion of vaccination schedules is also an area needing improvement. [source] Use of Nursing Diagnoses and Interventions in Public Health Nursing PracticeINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2002Jennifer C. Rivera MSN PURPOSE. To determine the frequency of use of NANDA diagnoses and the Nursing Interventions Classification in care plans written by public health nurses (PHNs) in Orange County, CA. METHODS.Retrospective chart review. FINDINGS. The frequency pattern of nursing diagnoses and nursing interventions used in care plans is consistent with the scope of practice of the PHN, whose emphasis is on health promotion and disease prevention. CONCLUSIONS. The most commonly used diagnoses and interventions provide evidence of a core set of interventions useful for PHN practice. IMPLICATIONS FOR PRACTICE.Linking diagnoses and interventions allow PHNs to build a body of knowledge based on patient care and improve clinical decision-making process. Search terms:Interventions, nursing diagnosis, public health nursing Utilisation des diagnostics infirmiers et interventions en santé publique BUT.Déterminer la fréquence des diagnostics infirmiers (ANADI) et des interventions (NIC) dans les plans de soins rédigés par les infirmières de santé publique dans le Comté d'Orange, CA. METHODE.Étude rétrospective des dossiers. RÉSULTATS.La répartition des diagnostics infirmiers et des interventions utilisés dans les plans de soin est cohérente avec la pratique des infirmières en santé publique, c'est-à-dire qu'elle souligne l'importance de la promotion de la santé et la prévention de la maladie. CONCLUSIONS.Les diagnostics et interventions les plus fréquemment utilisés permettent d'identifier le groupe d'interventions au centre de la pratique des soins en santé publique. IMPLICATIONS POUR LA PRATIQUE.L'articulation des diagnostics et interventions de soins permet de construire un corpus de connaissances en santé publique basée sur le soin des patients et d'améliorer le processus de décision clinique. Mots-clés:Diagnostics infirmiers, interventions, soins infirmiers en santé publique Utilización de los diagnósticos e intervenciones de enfermería en la práctica de enfermería de salud pública PROPÓSITO.Determinar la frecuencia del uso de los diagnósticos de la NANDA y de la clasificación de las intervenciones enfermeras (NIC), en planes del cuidados escritos por enfermeras de salud pública en el Condado de Orange, California. MÉTODOS.Revisión retrospectiva de gráficos. RESULTADOS. El patrón de frecuencia de diagnósticos de enfermería y de intervenciones enfermeras utilizados en los planes del cuidados, es consistente con el ámbito asistencial de las enfermeras de salud pública, cuyo énfasis está en la promoción de salud y la prevención de la enfermedad. CONCLUSIÓN.Los diagnósticos e intervenciones más comúnmente utilizados, proporcionan evidencia de un grupo nuclear de intervenciones útiles a la práctica de enfermería de salud pública. IMPLICACIONES PARA LA PRÁCTICA.Conectar los diagnósticos y las intervenciones permite a las Enfermeras de Salud Pública construir un cuerpo de conocimientos basado en el cuidado de los pacientes y mejorar el proceso de toma de decisiones en la práctica clínica. Términos de búsqueda:Diagnóstico enfermero, enfermería de salud pública, intervenciones Uso de diagnósticos e intervenções de enfermagem na prótica de enfermagem em Saúde Pública OBJETIVO.Determinar a freqüência de uso dos diagnósticos da NANDA e da Classificação de Intervenções de Enfermagem (NIC) em planos de cuidados escritos por enfermeiras da área de Saúde Pública no Condado de Orange, Califórnia. MÉTODO.Revisão retrospectiva de fichas. ACHADOS.O padrão de freqüência de diagnósticos de enfermagem e intervenções de enfermagem utilizados em planos de cuidados é compatível com o escopo da prática das enfermeiras da área de Saúde Pública, cuja ênfase está na promoção da saúde e prevenção de doenças. CONCLUSãO.Os diagnósticos e intervenções mais comumente utilizados evidenciam a existência de um conjunto de intervenções principais, que éútil para a prática destas enfermeiras. IMPLICAÇõES PARA A PRÁTICA. A ligação entre diagnósticos e intervenções permite às enfermeiras da área de saúde pública construírem um corpo de conhecimentos baseado no cuidado do paciente e melhora o processo de tomada de decisão. Palavras para busca:Diagnóstico de enfermagem, enfermagem em saúde publica, intervenções [source] Probiotics and their fermented food products are beneficial for healthJOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2006S. Parvez Abstract Probiotics are usually defined as microbial food supplements with beneficial effects on the consumers. Most probiotics fall into the group of organisms' known as lactic acid-producing bacteria and are normally consumed in the form of yogurt, fermented milks or other fermented foods. Some of the beneficial effect of lactic acid bacteria consumption include: (i) improving intestinal tract health; (ii) enhancing the immune system, synthesizing and enhancing the bioavailability of nutrients; (iii) reducing symptoms of lactose intolerance, decreasing the prevalence of allergy in susceptible individuals; and (iv) reducing risk of certain cancers. The mechanisms by which probiotics exert their effects are largely unknown, but may involve modifying gut pH, antagonizing pathogens through production of antimicrobial compounds, competing for pathogen binding and receptor sites as well as for available nutrients and growth factors, stimulating immunomodulatory cells, and producing lactase. Selection criteria, efficacy, food and supplement sources and safety issues around probiotics are reviewed. Recent scientific investigation has supported the important role of probiotics as a part of a healthy diet for human as well as for animals and may be an avenue to provide a safe, cost effective, and ,natural' approach that adds a barrier against microbial infection. This paper presents a review of probiotics in health maintenance and disease prevention. [source] Periodontal disease in the oldest-old living in Kungsholmen, Sweden: findings from the KEOHS projectJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2006Poul Holm-Pedersen Abstract Aims: The Kungsholmen Elders Oral Health Study evaluated the oral health status of generally healthy, community-dwelling persons aged 80 years and over living in Stockholm, Sweden. This paper reports periodontal disease findings and evaluates the distribution by sociodemographic factors. Methods: Eligible persons were identified through the Kungsholmen Project, an ongoing, longitudinal, population-based study of older adults. A total of 121 study subjects received a periodontal examination. Results: The mean pocket probing depth was 2.6 mm and the mean clinical attachment loss was 3.7 mm. Gingival bleeding was common. Over half of all study participants met the criteria used for "serious periodontitis" (SP). In the best fit adjusted odds ratio (OR) model, males were 3.1 times more likely than females to have "SP" (OR=3.1, 95% CI 1.2, 8.0), a statistically significant observation. A sub-analysis of the differences in proportion of participants with SP revealed that the difference by sex also increased by age. Conclusions: These findings document the substantial and ongoing impact of periodontal disease in a sample of generally healthy, community dwelling older adults and underscore the importance of continued periodontal disease prevention and treatment in the oldest-old. [source] A systematic review and meta-analysis on the therapeutic equivalence of statinsJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2010T.-C. Weng MSc (Clin Pharm) Summary Background:, Statins are the most commonly prescribed agents for hypercholesterolemia because of their efficacy and tolerability. As the number of patients in need of statin therapy continues to increase, information regarding the relative efficacy and safety of statins is required for decision-making. Objective:, This study will use systematic review to compare the efficacy and safety profiles of different statins at different doses and determine the therapeutically equivalent doses of statins to achieve a specific level of low-density lipoprotein cholesterol (LDL-C) lowering effect. Methods:, Publications of head-to-head randomized controlled trials (RCTs) of statins were retrieved from the Oregon state database (1966,2004), MEDLINE (2005-April of 2006), EMBASE (2005-April of 2006), and the Cochrane Controlled Trials Registry (up to the first quarter of 2006). The publications were evaluated with predetermined criteria by a reviewer before they were included in the review. The mean change in cholesterol level of each statin was calculated and weighted by number of subjects involved in each RCT. Where possible, meta-analysis was performed to generate pooled estimates of the cholesterol lowering effect of statins and the difference between statins. Results:, Seventy-five studies reporting RCTs of head-to-head comparisons on statins were included. Most studies had similar baseline characteristics, except the rosuvastatin related studies. A daily dose of atorvastatin 10 mg, fluvastatin 80 mg, lovastatin 40,80 mg, and simvastatin 20 mg could decrease LDL-C by 30,40%, and fluvastatin 40 mg, lovastatin 10,20 mg, pravastatin 20,40 mg, and simvastatin 10 mg could decrease LDL-C by 20,30%. The only two statins that could reduce LDL-C more than 40% were rosuvastatin and atorvastatin at a daily dose of 20 mg or higher. Meta-analysis indicated a statistically significant but clinically minor difference (<7%) between statins in cholesterol lowering effect. Comparisons of coronary heart disease prevention and safety could not be made because of insufficient data. Conclusions:, At comparable doses, statins are therapeutically equivalent in reducing LDL-C. [source] Communication and Uncertainty ManagementJOURNAL OF COMMUNICATION, Issue 3 2001Dale E. Brashers The fundamental challenge for refining theories of communication and uncertainty is to abandon the assumption that uncertainty will produce anxiety. To better explain processes of communication and uncertainty management, we must answer questions about (a) the experience and meaning of uncertainty, (b) the role of appraisal and emotion in uncertainty management, and (c) the range of behavioral and psychological responses to uncertainty. This paper outlines and extends a theory of uncertainty management and reviews current theory and research in this area. In addition to the theoretical advances promised by this perspective, the paper describes applications to health communication practice. The drive in disease prevention to reduce uncertainty about the state of health and illness has led to a "culture of chronic illness." Constant surveillance of people's health, combined with improved methods for screening and monitoring, virtually guarantee finding something wrong with every person, creating a society divided into the chronically ill and the worried well (i.e., those waiting to be diagnosed). [source] Vaccines modulating lipoprotein autoimmunity as a possible future therapy for cardiovascular diseaseJOURNAL OF INTERNAL MEDICINE, Issue 3 2009J. Nilsson Abstract. Current strategies for prevention of cardiovascular disease focus on risk factor intervention. Although these have been proven both safe and effective results from randomized clinical trials suggest that it is difficult to achieve relative risk reductions exceeding 40% with this approach. To further improve efficacy future therapies must aim at targeting the actual disease process in the arterial wall. Emerging evidence have identified an important role of the immune system in atherosclerosis and suggest that modulation of autoimmune responses against oxidized LDL and other antigens in the atherosclerotic plaque represent one possible new approach to disease prevention. Oxidized LDL is targeted by both antibody-mediated and cellular immune responses and as much as 10% of the T cells in atherosclerotic plaques are oxidized LDL-specific. Immune activation in the atherosclerotic plaque is primarily of the pro-inflammatory Th1-type and inhibition Th1 immunity reduces atherosclerosis in experimental animals. Atherosclerosis vaccines based on antigens derived from LDL have been developed to modulate these processes. Their mechanisms of action remain to be full characterized but may involve expression of protective antibodies that facilitate the removal of oxidized LDL and antigen-specific regulatory T cells that counteract Th1 autoimmunity against oxidized LDL. In this review we will discuss the possibilities and challenges encountering the translation of immune-modulatory therapy for atherosclerosis from the experimental stage into the clinic. [source] Globalization, coca-colonization and the chronic disease epidemic: can the Doomsday scenario be averted?JOURNAL OF INTERNAL MEDICINE, Issue 3 2000P. Zimmet Zimmet P (International Diabetes Institute, Melbourne, Australia). Globalization, coca-colonization and the chronic disease epidemic: can the Doomsday scenario be averted? J Intern Med 2000; 247: 301,310. There are at present approximately 110 million people with diabetes in the world but this number will reach over 220 million by the year 2010, the majority of them with type 2 diabetes. Thus there is an urgent need for strategies to prevent the emerging global epidemic of type 2 diabetes to be implemented. Tackling diabetes must be part of an integrated program that addresses lifestyle related disorders. The prevention and control of type 2 diabetes and the other major noncommunicable diseases (NCDs) can be cost- and health-effective through an integrated (i.e. horizontal) approach to noncommunicable diseases disease prevention and control. With the re-emergence of devastating communicable diseases including AIDS, the Ebola virus and tuberculosis, the pressure is on international and regional agencies to see that the noncommunicable disease epidemic is addressed. The international diabetes and public health communities need to adopt a more pragmatic view of the epidemic of type 2 diabetes and other noncommunicable diseases. The current situation is a symptom of globalization with respect to its social, cultural, economic and political significance. Type 2 diabetes will not be prevented by traditional medical approaches; what is required are major and dramatic changes in the socio-economic and cultural status of people in developing countries and the disadvantaged, minority groups in developed nations. The international diabetes and public health communities must lobby and mobilize politicians, other international agencies such as UNDP, UNICEF, and the World Bank as well as other international nongovernmental agencies dealing with the noncommunicable diseases to address the socio-economic, behavioural, nutritional and public health issues that have led to the type 2 diabetes and noncommunicable diseases epidemic. A multidisciplinary Task Force representing all parties which can contribute to a reversal of the underlying socio-economic causes of the problem is an urgent priority. [source] Physical Activity Research in NursingJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2001Lorraine B. Robbins Purpose: To present exemplars of physical activity research in nursing, illustrate the importance of physical activity research across the lifespan, and recommend directions for theory development and research. Methods: Studies of physical activity and exercise currently being conducted by nurse investigators were reported and critiqued by attendees of the Midwest Nursing Research Society 2000 Preconference session entitled "Promoting Physical Activity Among Diverse Groups Across the Health Continuum." Physical activity and exercise literature during the past decade was reviewed. Databases searched included Medline, CINAHL, Wilson, and ERIC. Findings: Investigators have emphasized the need to evaluate the effects of theory-based physical activity interventions designed to alter key correlates of physical activity identified through descriptive research. Conclusions: Regular physical activity is necessary for health promotion and disease prevention for all populations. Continued research in this important area of health behavior is critical to identify the most effective interventions to increase physical activity among diverse populations. [source] Problem-based Learning in Undergraduate Dental Education: Faculty Development at the University of Southern California School of DentistryJOURNAL OF PROSTHODONTICS, Issue 5 2007Timothy R. Saunders DDS The University of Southern California School of Dentistry (USCSD) seeks to educate oral health professionals with a balanced curriculum covering health promotion, risk assessment and disease prevention, diagnostics, treatments, and therapeutics. Based on critical analyses of a 5-year educational demonstration project, the USCSD proposed to use problem-based learning (PBL) to achieve its goals. Among the many changes required to convert a traditional dental educational curriculum to PBL, none is more important than that of faculty development. To achieve this, the USCSD Curriculum Subcommittee on Faculty Development, Mentoring, and Evaluation has designed and implemented a series of workshops to train its faculty as facilitators. There are four Core Skills Workshops: PBL Process Workshop, Facilitation of Learning Workshop, Student Assessment and Feedback Workshop, and PBL in the Clinical Environment. [source] Attributes of an ideal oral health care systemJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2010DrPH, Scott L. Tomar DMD Abstract Objectives: The sense of urgency concerning the inadequacies of the current U.S. oral health care system in better preventing oral diseases, eliminating oral health disparities, and ensuring access to basic oral health services has increased in recent years. This paper sought to articulate the attributes that an ideal oral health care system would possess, which would be consistent with the principles of the leading authorities on the public's health. Methods: The authors reviewed policy statements and position papers of the World Health Organization, The Institute of Medicine, The American Public Health Association, Healthy People 2010 Objectives for the Nation, and the American Association of Public Health Dentistry. Results: Consistent with leading public health authorities, an ideal oral health care system would be have the following attributes: integration with the rest of the health care system; emphasis on health promotion and disease prevention; monitoring of population oral health status and needs; evidence-based; effective; cost-effective; sustainable; equitable; universal; comprehensive; ethical; includes continuous quality assessment and assurance; culturally competent; and empowers communities and individuals to create conditions conducive to health. Conclusions: Although there are some attributes of an ideal oral health care system on which the United States has made initial strides, it falls far short in many areas. The development of an oral health care delivery system that meets the characteristics described above is possible but would require tremendous commitment and political will on the part of the American public and its elected officials to bring it to fruition. [source] Veterans' perceptions of care by nurse practitioners, physician assistants, and physicians: A comparison from satisfaction surveysJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2010Dorothy Budzi DrPH (Quality Manager/Performance Improvement Coordinator) Purpose: To examine the differences in patient satisfaction with care provided by nurse practitioners (NPs), physician assistants (PAs), and physicians in the Veterans Health Administration (VHA) system. Data source: Secondary data was obtained from the VHA's Survey of Healthcare Experience of Patients (SHEP), a monthly survey designed to measure patient satisfaction. Descriptive statistics were calculated and categorical variables were summarized with frequency counts. Conclusions: Of the 2,164,559 surveys mailed to the veterans, 1,601,828 (response rate 64%) were returned. The study found that satisfaction scores increased by 5% when the number of NPs was increased compared to 1.8% when the number of physicians was increased and slightly increased or remained the same when the number of PAs was increased. Physician to PA/NP ratio was 7:3. Implications for practice: The VHA is the largest healthcare system and the single largest employer of NPs and PAs in the country. This study shows that a majority of the primary care clinic patients prefer to see NPs as compared with PAs and physicians. Besides clinical care, NPs focus on health promotion, disease prevention, health education, attentiveness, and counseling. Physicians and PAs should be educated on these characteristics to promote patient satisfaction and expected outcomes. [source] Health promotion/risk reduction and disease prevention in women's healthJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2010FAANP Associate Professor (Retired), Judith A. Berg PhD, WHNP-BC No abstract is available for this article. [source] Clinical use of physical activity measuresJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2009CRNP (Associate Professor), Lorraine M Reiser PhD Abstract Purpose:, To provide a review of physical activity measures and subjective and objective methods of its measurement. Considerations for the use of these measurements in research and practice will be discussed. Data sources:, The PubMed, CINAHL, and Health and Psychosocial Instruments databases, and the Centers for Disease Control Web site were searched using the search term "Physical Activity Measurement." Conclusions:, Physical activity is a lifestyle factor that is a key focus in chronic disease,related research, prevention, and interventions. Healthy People 2010 set goals of decreasing the prevalence of preventable diseases by encouraging healthier lifestyle patterns. Shifts toward more sedentary lifestyles have resulted in increases in life-limiting disease states, including obesity, diabetes, heart disease, cancer, and osteoporosis. Physical activity measurements have been used widely in research studies but are less commonly used in primary care. Measuring individuals' physical activity levels as part of the health assessment will enhance the provider's ability to engage in health promotion and suggest health protection interventions. The strengths, weaknesses, and potential applications to practice of physical activity measures are summarized in an effort to familiarize nurse practitioners (NPs) with commonly used tools and encourage integration of physical activity assessment into their current practice. Implications for practice:, NPs are in an ideal position to promote health by encouraging appropriate amounts of physical activity. Screening, health promotion, and disease prevention are part of the core competencies of NP practice established by the National Organization of Nurse Practitioner Faculties. Increased knowledge of physical activity measures will enhance the NP's ability to evaluate relevant physical activity research for use in evidence-based practice. Incorporation of simple yet appropriate physical activity measurements into practice will expand the NP's ability to identify and thus address sedentary lifestyles in their clientele. [source] An overview of ethnicity and assessment of family history in primary care settingsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2006Ann Maradiegue PhD(c), FNP-C (Instructor, Family Nurse Practitioner Program) Abstract Purpose: To discuss the importance of and the nurse practitioner's (NP's) role in the assessment of ethnicity/family of origin in conducting a multigenerational family history in primary care settings. Data sources: A review of the literature on past research results addressing racial and ethnic disparities and current articles from scientific journals exploring the relationship between race and genetics. Web sites were from the National Institutes of Health, the Human Genome Research Institute, the National Cancer Institute, and the Health and Human Services Minority Health and Disparities report. Conclusions: The family history has received renewed interest due to the sequencing of the human genome. A multigenerational family history is an important first step in screening for a multitude of disorders impacted by genetic susceptibility, shared environments, and common behaviors. Assessment of the patient's ethnicity/family of origin is an integral part of the multigenerational family history, particularly in the diagnosis of chronic diseases and the assessment of risks for genetic disorders. The multigenerational family history is important in diagnosis, predictive genetic testing, disease prevention, and health promotion. Challenges facing NPs and the utilization of a multigenerational family history in the current U.S. health system include (a) training clinicians on the correct assessment and utilization of a multigenerational family history, (b) assessment of the subtleties of ethnicity and identifying multiple ethnic groups within a family, (c) collection of the family history in a manner that is sensitive to the cultural beliefs of individuals, and (d) avoidance of stereotyping Implications for practice: Significant advances in genetics and genetic testing requires that NPs be well versed in collecting and interpreting a multigenerational family history to include assessment of the patient/family's ethnicity/family of origin. The ability to effectively conduct and evaluate the individual's and family's health risk through a multigenerational family history will be important in diagnosis, health promotion, disease prevention, and the determination for genetic counseling referral and predictive testing when appropriate. Assessment of risk and prevention of disease is also important in reducing health disparities. [source] | |||||||||||||||||||||||||||||||||||||