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Preventative Measures (preventative + measure)
Selected AbstractsBrain Protection During Pediatric Cardiopulmonary BypassARTIFICIAL ORGANS, Issue 4 2010Xiaowei W. Su Abstract Improvements in peri- and postoperative surgical techniques have greatly improved outcomes for pediatric patients undergoing cardiopulmonary bypass (CPB) in the treatment of congenital heart defects (CHDs). With decreased mortality rates, the incidence of adverse neurological outcomes, comprising cognitive and speech impairments, motor deficits, and behavioral abnormalities, has increased in those patients surviving bypass. A number of mechanisms, including ischemia, reperfusion injury, hypothermia, inflammation, and hemodilution, contribute to brain insult, which is further confounded by unique challenges presented in the pediatric population. However, a number of brain monitoring and preventative techniques have been developed or are being currently evaluated in the practice of pediatric CPB. Monitoring techniques include electroencephalography, near-infrared as well as visible light spectroscopy, transcranial Doppler ultrasound, and emboli detection and classification quantitation. Preventative measures include hypothermic perfusion techniques such as deep hypothermic circulatory arrest, low-flow CPB, blood gas management, and pharmacologic prophylaxes, among others. The present review summarizes the principles of brain insult, neurodevelopmental abnormalities, monitoring techniques, methods of prevention, as well as preexisting morbidities and risk factors in pediatric CPB, with a focus on brain protection. Clinical and translational research is presented with the aim of determining methods that may optimize neurological outcomes post CPB and guiding further study. [source] Obstetric-induced incontinence: A black hole of preventable morbidityAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2006Michelle J. THORNTON Abstract There is a detailed literature comprising clinical and anorectal physiological studies linking faecal incontinence to vaginal delivery. Specific risk factors are high infant birthweight, forceps delivery and prolonged second stage of labour. The onset of symptoms may be delayed for many years. Faecal incontinence occurs in more than 10% of adult females and urinary incontinence in about a third of multiparous women. This places a very large economic burden on the Australian health system. A conservative estimate for overall management of incontinence would be in excess of $A700 million but the actual amount is unknown. Preventative measures for avoiding pelvic floor injuries need to be established, and safe obstetric practice needs to be redefined in the light of current knowledge about incontinence. Outcome measures for safe birthing should not only include infant and maternal mortality and infant morbidity, but should also include the long-term effects of vaginal delivery on the pelvic floor, particularly urinary and faecal incontinence. Several state reports and one federal senate report on safe birthing have been lacking in this area. The safety of birthing centres and home birthing needs to be examined to provide birthing mothers with complete and appropriate information about safety in order that they may consider their options. Appropriate Caesarean section rates for optimal birthing safety are unknown and need to be re-examined. Calls for overall reduction in Caesarean section rates in Australia are inappropriate and cannot be justified until the effects of pelvic floor injury are added to the overall assessment. [source] Ecology and management of exotic and endemic Asian longhorned beetle Anoplophora glabripennisAGRICULTURAL AND FOREST ENTOMOLOGY, Issue 4 2009Jiafu Hu Abstract 1The Asian longhorned beetle is native to China and Korea, and was found for the first time outside its native habitat in the U.S.A. in 1996, with subsequent detections being made in Canada and several European countries. 2We review the taxonomy, distribution, basic biology, behaviour, ecology and management of endemic and exotic Anoplophora glabripennis, including information that is available in the extensive Chinese literature. 3This species has caused massive mortality of Populus species in China and models have demonstrated that it could become established in many locations worldwide. 4Anoplophora glabripennis is polyphagous but prefers Acer, Salix and Populus, section Aigeiros. 5Although A. glabripennis adults do not disperse far when surrounded by host trees, they have the potential to fly more than 2000 m in a season. 6Volatile organic compounds from preferred host trees are attractive to A. glabripennis and this attraction is heightened by drought stress. Males and females orientate to a volatile released by female A. glabripennis and males attempt to copulate after contacting a sex pheromone on the female cuticle. 7At present, A. glabripennis is being (or has been) eradicated from areas where it has been introduced. After detection, extensive surveys are conducted and, if breeding populations are detected, at the very least, infested trees are removed and destroyed. Close attention is paid to imported solid wood packaging material to prevent new introductions. 8Standard practice to control A. glabripennis in China is to spray insecticides in tree canopies. In North America, largely as a preventative measure, systemic insecticides are injected into trees. Entomopathogenic fungi have been developed for the control of A. glabripennis, and entomopathogenic nematodes, coleopteran and hymenopteran parasitoids and predatory woodpeckers have been investigated as biocontrol agents. 9Ecological control of A. glabripennis in China involves planting mixtures of preferred and nonpreferred tree species, and this practice can successfully prevent outbreaks. [source] Coconut palm-related injuries in the pacific islandsANZ JOURNAL OF SURGERY, Issue 1 2001J. S. Mulford Introduction: Coconut palms are an integral part of life in the Solomon Islands, given the widespread dependence of subsistence agriculture. Injuries related to the coconut palm are thus inevitable. Hospital records from the Central Referral Hospital were reviewed to identify (i) how commonly the coconut palm is implicated in injuries referred to the surgery department; (ii) which patients are being injured; and (iii) the type of injuries sustained. Methods: The present study reviews all patients referred to the Department of Surgery and Orthopaedics between January 1994 and December 1999 who had a coconut palm-related injury. This was possible due to the trauma epidemiology form, which records the patient details, cause of injury, fracture details and other injury information. Results: A total of 3.4% of all injuries presenting to the surgical department was related to the coconut palm. Eighty-five patients fell from the coconut palm, 16 patients had a coconut fruit fall on them, three patients had a coconut palm fall on them and one patient kicked a coconut palm. The majority of patients who were injured by falling from a coconut palm were young (aged 6,25 years). Eleven of the 16 patients struck by falling fruit were under 25 years of age. The majority of injuries sustained were fractures. Patients falling from coconut palms sustained mainly upper limb fractures (60.1% of all fractures) or spinal fractures (16.3%). Patients injured by falling fruit sustained skull or upper limb fractures. All skull fractures occurred in patients under the age of 10 years. Conclusion: This is the largest review of coconut palm-related injuries. It highlights some epidemiological facts that raise considerations for preventative health measures in the Solomon Islands. Parents and young children must be warned of the dangers of playing beneath coconut trees. Boy and girls should be warned of the dangers of collecting fruit. With an increasing amount of schooling becoming available the Solomon Islands is an ideal place to direct an education programme about the dangers of coconut palms as well as many other primary health issues. Because subsistence farming plays a crucial role in the life of most Solomon Islanders, injuries that result in loss of function are crippling both to the patient and the village. Any preventative measure to reduce the rates of injury will be important. [source] Emergency contraception , knowledge and attitudes in a group of Australian university studentsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Helen Calabretto Abstract Objective: To explore first year Australian university students' knowledge and attitudes about emergency contraception and their understanding of the risk for pregnancy. Method: A self-report questionnaire was completed by a convenience sample of 627 first year on-campus students from both health and non-health disciplines. Results: Knowledge about emergency contraception (EC) was generally poor including misunderstanding that it can only be used the ,morning after', as well as where it may be accessed. Its potential use was, however, more highly accepted as a preventative measure after unprotected sexual intercourse than abortion in the event of unplanned pregnancy. Women had better knowledge than men, and on a number of measures there were significant differences between these groups. Conclusions: Poor knowledge about the timing, accessibility, action and side effects of EC may act as a barrier to its use in the event of unprotected sexual intercourse. Although EC has been available in Australia as a Schedule 3 medication since 2004, its availability from pharmacies is not well known, nor is access from other primary health care providers. Implications: The lack of knowledge about EC may lead to its underutilisation and underlines the need for future educational strategies about EC as well as the need for health professionals who provide contraceptive services to discuss EC with clients. Health promotion campaigns which are both general as well as gender-specific may improve overall community knowledge about this method of contraception. [source] Functional consequences of cartilage degeneration in the equine metacarpophalangeal joint: quantitative assessment of cartilage stiffnessEQUINE VETERINARY JOURNAL, Issue 5 2005H. BROMMER Summary Reasons for performing study: No quantitative data currently exist on the relationship of the occurrence of cartilage degeneration and changes in site-specific biomechanical properties in the metacarpophalangeal (MCP) joint in the horse. Objectives: To gain insight into the biomechanical consequences of cartilage deterioration at 2 differently loaded sites on the proximal articular surface of the proximal phalanx (P1). Hypothesis: Static and dynamic stiffness of articular cartilage decreases significantly in degenerated cartilage. Methods: Cartilage degeneration index (CDI) values were measured at the lateral dorsal margin (Site 1), lateral central fovea (Site 2) and entire joint surface of P1 (CDIP1) in 30 horses. Group 1 contained joints without (CDIP1 values <25%, n = 22) and Group 2 joints with (CDIP1 values >25%, n = 8) signs of cartilage degeneration. Cartilage thickness at Sites 1 and 2 was measured using ultrasonic and needle-probe techniques. Osteochondral plugs were drilled out from Sites 1 and 2 and subsequently tested biomechanically in indentation geometry. Young's modulus at equilibrium and dynamic modulus were determined. Results: Cartilage thickness values were not significantly different between the 2 groups and sites. Young's modulus at Site 1 was significantly higher in Group 1 than in Group 2; at Site 2, the difference was not significant. Dynamic modulus values were significantly higher in Group 1 than in Group 2 at both sites. Conclusions: Degenerative cartilage changes are clearly related to loss of stiffness of the tissue. Absolute changes in cartilage integrity in terms of CDI are greatest at the joint margin, but concomitant changes are also present at the centre, with a comparable decrease of the biomechanical moduli at the 2 sites. Therefore, significant cartilage degradation at the joint margin not only reflects local deterioration of biomechanical properties, but is also indicative of the functional quality in the centre. Potential relevance: These findings may be important for improving prognostication and developing preventative measures. [source] Hereditary colorectal cancer: keeping it in the family , the bowel cancer storyINTERNAL MEDICINE JOURNAL, Issue 7 2002D. R. McGrath Abstract Up to 20% of colorectal cancers are thought to have a genetic component. Several familial syndromes are known to confer an increased risk for colorectal cancer. Advances in our understanding of these syndromes has impoved the care delivered to, and the overall survival of, these patients. Genetic testing has great potential to further improve detection and direct subsequent preventative measures. The diagnosis, management and surveillance issues relating to some of the more commonly encountered syndromes , in particular Familial Adenomatous Polyposis and Hereditary Non-Polyposis Colorectral Cancer , are reviewed. [source] Common sources of skin care education: a cross-sectional studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2009Tina Bhutani MD Background, The resources used by the public to locate health information are important. Aim, To expose the sources from which the public gains a knowledge of dermatology. Methods, An anonymous, multiple-choice questionnaire was distributed to adults in college campuses, shopping malls, and community parks over a 4-month period. Results, Sixty-six percent of individuals stated that they felt physicians had the most authority for making recommendations regarding the skin. When questioned about the sources of skin care advice, however, there was a discrepancy, with only 35% stating that they actually consulted professionals. Indeed, 37% admitted to using family and friends as their primary source of information, and 28% used the media first. Conclusions, In our opinion, the best method to ensure healthy skin habits and early diagnosis of disease would be to combine the efforts of healthcare and the media. These public resources should make people aware of skin diseases and preventative measures, whilst encouraging regular check-ups with dermatologists and persuading patients to employ open conversation with their physicians regarding care of their skin. [source] Asymptomatic individuals at genetic risk of haemochromatosis take appropriate steps to prevent disease related to iron overloadLIVER INTERNATIONAL, Issue 3 2008Katrina J. Allen Abstract Background/Aims: If community screening for hereditary haemochromatosis is to be considered, compliance with preventative measures and absence of significant psychological morbidity must be demonstrated. Methods: Workplace screening for the HFE C282Y mutation and then clinical care for C282Y homozygotes was instituted. Data were collected on understanding of test results, perceived health status and anxiety for C282Y homozygotes compared with controls. Uptake of clinical care, compliance and response to treatment and changes in diet were monitored for up to 4 years for C282Y homozygotes. Results: After 11 307 individuals were screened, 40/47 (85%) newly identified C282Y homozygotes completed questionnaires 12 months after diagnosis compared with 79/126 (63%) of controls. Significantly more C282Y homozygotes correctly remembered their test result compared with controls (95 vs 51%, P<0.0001). No significant difference in perceived health status was observed within or between the two groups at 12 months compared with baseline. Anxiety levels decreased significantly for C282Y homozygotes at 12 months compared with before testing (P<0.05). Forty-five of the 47 (95.8%) C282Y homozygotes accessed clinical care for at least 12 months. All 22 participants requiring therapeutic venesection complied with treatment for at least 12 months (range 12,47 months). Conclusion: Individuals at a high genetic risk of developing haemochromatosis use clinical services appropriately, maintain their health and are not ,worried well'. Population genetic screening for haemochromatosis can be conducted in the work place in a way that is acceptable and beneficial to participants. [source] Altered levels of insulin-like growth factor binding protein proteases in preeclampsia and intrauterine growth restrictionPRENATAL DIAGNOSIS, Issue 9 2010Julian K. Christians Abstract Intrauterine growth restriction (IUGR) and preeclampsia (PE) are leading causes of perinatal and maternal morbidity and mortality. Many studies have found association between low levels of insulin-like growth factor binding protein (IGFBP) proteases in the first trimester maternal circulation and the risk of subsequent development of PE and/or IUGR. These results are generally interpreted to reflect decreased production of the proteases by the placenta, leading to reduced proteolysis of IGFBPs and lower free levels of insulin-like growth factor (IGF), resulting in diminished feto-placental development. However, the association between low circulating levels of placental proteins early in pregnancy and the subsequent development of IUGR and/or PE could be due to low exchange in the placenta and not due to reduced production. In contrast, late in pregnancy, the circulating levels of these proteins and their expression in the placenta are often elevated in PE, which may reflect upregulation to compensate for abnormal placental development, that is an adaptive mechanism to increase IGFBP proteolysis, increase local IGF levels and promote feto-placental growth. Further research into the biological mechanisms underlying these associations will aid the identification of high-risk pregnancies and the development of therapeutic targets for diseases for which there are presently no preventative measures. Copyright © 2010 John Wiley & Sons, Ltd. [source] Individual Differences in Public Opinion about Youth Crime and Justice in SwanseaTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 4 2007KEVIN HAINES Gender and age differences in estimations of youth crime were compared to official and self-reported youth offending statistics nationally and locally. Attitudes to sentencing and preventative measures were evaluated with reference to Swansea's positive, inclusionary approach to young people. Findings indicate that the Swansea public overestimates the extent of youth crime locally, yet it remains ambivalent about appropriate sentencing responses, favouring both punitive and preventative measures. This suggests that local public opinion is shaped by national media and political rhetoric, rather than the local realities of youth offending. [source] LAWN MOWER INJURIES IN CHILDREN: A 30-YEAR EXPERIENCEANZ JOURNAL OF SURGERY, Issue 9 2008Anh Nguyen Background: Lawn mowers cause severe injuries that are particularly devastating to children. This study analyses the patterns and trends in lawn mower injuries involving children referred to Victoria's principal children's hospital. Methods: A retrospective review of the patient medical records at the Royal Children's Hospital (Melbourne) Victoria, Australia was carried out. The series included all patients admitted for lawn mower injury during the 30-year period spanning 1975,2004. Results: Lawn mower injuries treated at Royal Children's Hospital were severe and included partially amputated limbs. Overall, admissions for lawn mower injury generally decreased over time from n = 26 in the 1975,1979 interval to n = 14 in the 2000,2004 interval. However, the frequency of admission for injuries caused by ride-on mowers contradicted the overall trend and generally increased over time from n = 5 in the 1975,1979 interval to n = 11 in the 2000,2004 interval. This is of particular concern. Ride-on lawn mowers caused significantly more severe injuries requiring longer periods of admission and more operations during admission in comparison to standard mowers. Rural location at the time of injury was a risk factor associated with requiring longer periods of admission and more operations during admission. Children injured while operating mowers were generally older than children injured as bystanders. Conclusion: Lawn mower injuries are a significant cause of morbidity. These injuries are particularly devastating to children. The tragedy is keenly felt in the realization that these devastating injuries to children could all be prevented. Strategic preventative measures should be developed through partnership between the medical profession, the media, industry specialists and the wider community. [source] | ||||||||||