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Journal of UOEH 2023We investigated whether a combined program for heat disorder prevention can improve the behaviors and knowledge of heat disorder prevention in older adults participating... (Comparative Study)
Comparative Study
We investigated whether a combined program for heat disorder prevention can improve the behaviors and knowledge of heat disorder prevention in older adults participating in salons. This non-randomized parallel-group comparison study includes 59 participants from two salons. The intervention group met on alternate weeks on a salon day to watch an educational DVD and conduct hands-on education (Wet-Bulb Globe Temperature (WBGT) measurements inside and outside the meeting place). The intervention group conducted calls every other week except salon week to prevent action for heat disorder prevention information based on a leaflet and monitored WBGT in their bedrooms daily at bedtime. We assessed changes in recognition of heat disorders and prevention behavior between baseline, one and a half months after intervention, and post-season (approximately two months after baseline), using the Wilcoxon signed rank test. Recognition of heat disorder scores and preventive behavior improved from pre- to post-season in the intervention group. It was suggested that the approach toward older adults participating in salons could improve their recognition and behavior in preventing heat disorders.
Topics: Aged; Humans; Hot Temperature; Knowledge; Seasons; Heat Stress Disorders; Health Promotion; Patient Education as Topic
PubMed: 37661386
DOI: 10.7888/juoeh.45.143 -
Australian Critical Care : Official... Mar 2021Since coronavirus disease 2019 was first discovered, at the time of writing this article, the number of people infected globally has exceeded 1 million. Its high... (Review)
Review
BACKGROUND
Since coronavirus disease 2019 was first discovered, at the time of writing this article, the number of people infected globally has exceeded 1 million. Its high transmission rate has resulted in nosocomial infections in healthcare facilities all over the world. Nursing personnel account for nearly 50% of the global health workforce and are the primary provider of direct care in hospitals and long-term care facilities. Nurses stand on the front line against the spread of this pandemic, and proper protection procedures are vital.
OBJECTIVES
The present study aims to share the procedures and measures used by Taiwan nursing personnel to help reduce global transmission.
REVIEW METHODS
Compared with other regions, where large-scale epidemics have overwhelmed the health systems, Taiwan has maintained the number of confirmed cases within a manageable scope. A review of various national and international policies and guidelines was carried out to present proper procedures and preventions for nursing personnel in healthcare settings.
RESULTS
This study shows how Taiwan's health system rapidly identified suspected cases as well as the prevention policies and strategies, key protection points for nursing personnel in implementing high-risk nursing tasks, and lessons from a nursing perspective.
CONCLUSIONS
Various world media have affirmed the rapid response and effective epidemic prevention strategies of Taiwan's health system. Educating nurses on procedures for infection control, reporting cases, and implementing protective measures to prevent nosocomial infections are critical to prevent further outbreaks.
Topics: COVID-19; Cross Infection; Humans; Infection Control; Nurse's Role; Pandemics; SARS-CoV-2; Taiwan
PubMed: 33246864
DOI: 10.1016/j.aucc.2020.10.006 -
British Journal of Clinical Pharmacology Feb 2020Our objective was to identify preventable adverse drug events and factors contributing to their development.
AIM
Our objective was to identify preventable adverse drug events and factors contributing to their development.
METHODS
We performed a retrospective chart review combining data from three prospective multicentre observational studies that assessed emergency department patients for adverse drug events. A clinical pharmacist and physician independently reviewed the charts, extracted data and rated the preventability of each adverse drug event. A third reviewer adjudicated all discordant or uncertain cases. We calculated the proportion of adverse drug events that were deemed preventable, performed multivariable logistic regression to explore the characteristics of patients with preventable events, and identified contributing factors.
RESULTS
We reviewed the records of 1 356 adverse drug events in 1 234 patients. Raters considered 869 (64.1%) of adverse drug events probably or definitely preventable. Patients with mental health diagnoses (OR 1.8; 95% CI 1.3-2.5) and diabetes (OR 1.7; 95% CI 1.2-2.4) were more likely to present with preventable events. The medications most commonly implicated in preventable events were warfarin (9.4%), hydrochlorothiazide (4.5%), furosemide (4.0%), insulin (3.9%) and acetylsalicylic acid (2.7%). Common contributing factors included inadequate patient instructions, monitoring and follow-up, and reassessments after medication changes had been made.
CONCLUSIONS
Our study suggests that patients with mental health conditions and diabetes require close monitoring. Efforts to address the identified contributing factors are needed.
Topics: Drug-Related Side Effects and Adverse Reactions; Emergency Service, Hospital; Humans; Pharmacists; Prospective Studies; Retrospective Studies
PubMed: 31633827
DOI: 10.1111/bcp.14139 -
Annals of Internal Medicine Jul 2003Antioxidant vitamins are thought to play a role in atherosclerosis. Supplementation of these nutrients has been explored as a means of reducing cardiovascular morbidity... (Review)
Review
BACKGROUND
Antioxidant vitamins are thought to play a role in atherosclerosis. Supplementation of these nutrients has been explored as a means of reducing cardiovascular morbidity and mortality.
PURPOSE
To assess the evidence of the effectiveness of vitamin supplementation, specifically vitamins A, C, and E; beta-carotene; folic acid; antioxidant combinations; and multivitamin supplements, in preventing cardiovascular disease.
DATA SOURCES
Cochrane Controlled Trials Registry and MEDLINE (1966 to September 2001), reference lists, and experts.
STUDY SELECTION
The researchers selected English-language reports of randomized trials and cohort studies that assessed vitamin supplementation in western populations and reported incidence of or death from cardiovascular events. They also included reports of good- or fair-quality clinical trials of primary and secondary prevention and good- or fair-quality prospective cohort studies. Studies that examined only dietary nutrients or did not provide separate estimates for supplements were not included.
DATA EXTRACTION
Two reviewers abstracted descriptive information and data on cardiovascular outcomes and mortality from included studies. The researchers assessed study quality using predetermined criteria.
DATA SYNTHESIS
Evidence tables were constructed to summarize data from included studies. The researchers summarized the strength, level, and quality of the overall evidence for the effectiveness of each of the vitamin supplements in preventing or treating cardiovascular disease.
CONCLUSIONS
Some good-quality cohort studies have reported an association between the use of vitamin supplements and lower risk for cardiovascular disease. Randomized, controlled trials of specific supplements, however, have failed to demonstrate a consistent or significant effect of any single vitamin or combination of vitamins on incidence of or death from cardiovascular disease. Understanding the sources of these differences will permit researchers to better analyze the cohort study data and to better design long-term clinical trials.
Topics: Cardiovascular Diseases; Dietary Supplements; Evidence-Based Medicine; Humans; Neoplasms; Vitamins
PubMed: 12834320
DOI: 10.7326/0003-4819-139-1-200307010-00014 -
Nutrition and Cancer 2006Our aim was to review the epidemiological literature on possible cancer-preventive effects of the consumption of fruits and vegetables in humans, to quantify the effect... (Review)
Review
Our aim was to review the epidemiological literature on possible cancer-preventive effects of the consumption of fruits and vegetables in humans, to quantify the effect of high versus low consumption of fruits and vegetables, and to give an overall assessment of the existing evidence. We based our work on an expert meeting conducted by the International Agency for Research on Cancer in 2003. A qualitative reading and evaluation of relevant articles on the cancer-preventive effect of the consumption of fruits and vegetables was made followed by the calculation of the mean relative risk and range for cohort and case-control studies separately. The possible population-preventable fraction for modifying diet in relation to fruit and vegetable consumption was calculated as well as an overall statement about the degree of evidence for the cancer-preventive effect of fruit and vegetable consumption for each cancer site. There is limited evidence for a cancer-preventive effect of the consumption of fruits and vegetables for cancer of the mouth and pharynx, esophagus, stomach, colon-rectum, larynx, lung, ovary (vegetables only), bladder (fruit only), and kidney. There is inadequate evidence for a cancer-preventive effect of the consumption of fruits and vegetables for all other sites. Applying this range of risk difference to the range of prevalence of low intake, the preventable fraction for low fruit and vegetable intake would fall into the range of 5-12%. It is important to recognize that this is only a crude range of estimates and that the proportion of cancers that might be preventable by increasing fruit and vegetable intake may vary beyond this range for specific cancer sites and across different regions of the world.
Topics: Case-Control Studies; Cohort Studies; Fruit; Humans; Neoplasms; Risk; Vegetables
PubMed: 16800779
DOI: 10.1207/s15327914nc5401_13 -
JAMA Network Open Aug 2021Delayed diagnosis of appendicitis is associated with worse outcomes than timely diagnosis, but clinical features associated with diagnostic delay are uncertain, and the... (Comparative Study)
Comparative Study
IMPORTANCE
Delayed diagnosis of appendicitis is associated with worse outcomes than timely diagnosis, but clinical features associated with diagnostic delay are uncertain, and the extent to which delays are preventable is unclear.
OBJECTIVE
To determine clinical features associated with delayed diagnosis of pediatric appendicitis, assess the frequency of preventable delay, and compare delay outcomes.
DESIGN, SETTING, AND PARTICIPANTS
This case-control study included 748 children treated at 5 pediatric emergency departments in the US between January 1, 2010, and December 31, 2019. Participants were younger than 21 years and had a diagnosis of appendicitis.
EXPOSURES
Individual features of appendicitis and pretest likelihood of appendicitis were measured by the Pediatric Appendicitis Risk Calculator (pARC).
MAIN OUTCOMES AND MEASURES
Case patients had a delayed diagnosis of appendicitis, defined as 2 emergency department visits leading to diagnosis and a case review showing the patient likely had appendicitis at the first visit. Control patients had a single emergency department visit yielding a diagnosis. Clinical features and pARC scores were compared by case-control status. Preventability of delay was assessed as unlikely, possible, or likely. The proportion of children with indicated imaging based on an evidence-based cost-effectiveness threshold was determined. Outcomes of delayed diagnosis were compared by case-control status, including hospital length of stay, perforation, and multiple surgical procedures.
RESULTS
A total of 748 children (mean [SD] age, 10.2 [4.3] years; 392 boys [52.4%]; 427 White children [57.1%]) were included in the study; 471 (63.0%) had a delayed diagnosis of appendicitis, and 277 (37.0%) had no delay in diagnosis. Children with a delayed diagnosis were less likely to have pain with walking (adjusted odds ratio [aOR], 0.16; 95% CI, 0.10-0.25), maximal pain in the right lower quadrant (aOR, 0.12; 95% CI, 0.07-0.19), and abdominal guarding (aOR, 0.33; 95% CI, 0.21-0.51), and were more likely to have a complex chronic condition (aOR, 2.34; 95% CI, 1.05-5.23). The pretest likelihood of appendicitis was 39% to 52% lower in children with a delayed vs timely diagnosis. Among children with a delayed diagnosis, 109 cases (23.1%) were likely to be preventable, and 247 (52.4%) were possibly preventable. Indicated imaging was performed in 104 (22.0%) to 289 (61.3%) children with delayed diagnosis, depending on the imputation method for missing data on white blood cell count. Patients with delayed diagnosis had longer hospital length of stay (mean difference between the groups, 2.8 days; 95% CI, 2.3-3.4 days) and higher perforation rates (OR, 7.8; 95% CI, 5.5-11.3) and were more likely to undergo 2 or more surgical procedures (OR, 8.0; 95% CI, 2.0-70.4).
CONCLUSIONS AND RELEVANCE
In this case-control study, delayed appendicitis was associated with initially milder symptoms but worse outcomes. These findings suggest that a majority of delayed diagnoses were at least possibly preventable and that many of these patients did not undergo indicated imaging, suggesting an opportunity to prevent delayed diagnosis of appendicitis in some children.
Topics: Abdominal Pain; Adolescent; Appendicitis; Case-Control Studies; Child; Child, Preschool; Delayed Diagnosis; Emergency Medical Services; Female; Humans; Infant; Infant, Newborn; Male; Practice Guidelines as Topic; United States; Young Adult
PubMed: 34463745
DOI: 10.1001/jamanetworkopen.2021.22248 -
The Cochrane Database of Systematic... Oct 2009Ocular injury is a preventable cause of blindness, yet it remains a significant disabling health problem that affects all age groups. Injuries may occur in the home, in... (Review)
Review
BACKGROUND
Ocular injury is a preventable cause of blindness, yet it remains a significant disabling health problem that affects all age groups. Injuries may occur in the home, in the workplace, during recreational activities or as a result of road crashes. Types of injuries vary from closed globe (contusion or lamellar laceration) to an open globe injury, which includes penetration and even perforation of the globe. To date, the main strategy to prevent these injuries has been to educate people to identify high-risk situations and to take correct action to avoid danger.
OBJECTIVES
To assess the evidence for the effectiveness of educational interventions for the prevention of eye injuries.
SEARCH STRATEGY
We searched the Cochrane Injuries and the Cochrane Eyes & Vision Group Specialised Registers, CENTRAL (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, Current Controlled Trials metaRegister (now includes National Research Register), AgeInfo, HMIC Health Management Information Consortium, WHOLIS (World Health Organization Library Information System), LILACS (Latin American and Caribbean Health Sciences), MEDCARIB (Caribbean Health Sciences Literature), ISI Web of Science: (Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI) Conference Proceedings Citation Index-Science (CPCI-S)), ERIC, ZETOC and SPORTdiscus. We also checked reference lists of relevant papers and contacted study authors in an effort to identify published, unpublished and ongoing trials. Searches were last updated in August 2008.
SELECTION CRITERIA
We included any randomised controlled trials (RCTs) and controlled before-and-after studies which evaluated any educational intervention aimed at preventing eye injuries.
DATA COLLECTION AND ANALYSIS
Four authors independently screened the electronic search results and data extracted. Three authors entered data into RevMan 5. As we judged there to be substantial heterogeneity between participants and interventions, we did not pool the studies' results, but have reviewed the results narratively.
MAIN RESULTS
We included two RCTs and three controlled before-and-after studies in this review. One study reported eye injuries as an outcome and four studies reported change in behaviour or knowledge.
AUTHORS' CONCLUSIONS
The included studies do not provide reliable evidence that educational interventions are effective in preventing eye injuries. There is a need for well-conducted RCTs with adequate allocation concealment and masking (blinding). Studies should have a longer follow-up time and more studies need to be conducted in low and middle-income countries.
Topics: Accidents, Occupational; Athletic Injuries; Eye Injuries; Eye Injuries, Penetrating; Health Behavior; Health Education; Humans; Wounds, Nonpenetrating
PubMed: 19821372
DOI: 10.1002/14651858.CD006527.pub3 -
BMC Complementary Medicine and Therapies Nov 2023The increasing incidence of cognitive impairment has become a health problem in the aging society. Owing to its antioxidant and anti-inflammatory properties, Brazilian...
BACKGROUND
The increasing incidence of cognitive impairment has become a health problem in the aging society. Owing to its antioxidant and anti-inflammatory properties, Brazilian green propolis-derived from Baccharis dracunculifolia-is anticipated to possess anticognitive properties. However, the preventive effect of Brazilian green propolis on cognitive impairment remains unexplained. This study aimed to investigate the effect of Brazilian green propolis on cognitive impairment using a mouse model of Alzheimer's disease (AD) induced by intracerebroventricular injection of amyloid beta (Aβ).
METHODS
Five-week-old male Slc:ddY mice were randomly divided into five groups (n = 8). The groups were pretreated with vehicle and propolis at a dose of 100, 300 and 900 mg/kg body weight for 8 days, then AD-like phenotypes were induced by intracerebroventricular (ICV) injection of Aβ. A sham operation group was set as the control. Memory and learning ability were measured at 7 to 8 days after ICV injection. Gene expression and histological studies were performed at the endpoint of the study.
RESULTS
In a passive avoidance test, the administration of Brazilian green propolis prevented the impairment of learning and memory function. Furthermore, comprehensive gene expression analysis in the hippocampus and forebrain cortex revealed that Brazilian green propolis suppressed Aβ-induced inflammatory and immune responses. In particular, Brazilian green propolis prevented alterations in gene expressions of microglial and astrocytic markers such as Trem2 and Lcn2 induced by Aβ injection, suggesting the suppression of excessive activation of glial cells in the brain. In addition, Brazilian green propolis suppressed the elevation of plasma interleukin (IL)-6 levels induced by Aβ injection.
CONCLUSIONS
The results suggest that the prophylactic administration of Brazilian green propolis has a preventive effect against AD by suppressing excessive inflammation and immune response in glial cells. To our knowledge, this study is the first to demonstrate that Brazilian green propolis may inhibit the hyperactivation of microglia and astrocytes as a mechanism of action to prevent AD. Thus, it is a promising ingredient for preventing AD-type dementia.
Topics: Male; Humans; Alzheimer Disease; Amyloid beta-Peptides; Propolis; Brazil; Cognitive Dysfunction
PubMed: 37978479
DOI: 10.1186/s12906-023-04247-7 -
Prevention Science : the Official... Jan 2021Never before has the value of prevention science become so apparent to the populace, particularly in simultaneous fashion across all nations. A general understanding of...
Never before has the value of prevention science become so apparent to the populace, particularly in simultaneous fashion across all nations. A general understanding of what prevention represents in true form has lagged well behind the science and, in fact, few outside of the field recognize that there is actually a significant body of research that undergirds preventative practices, programs and policies. The current pandemic and the uneven impacts on underserved and marginalized populations has highlighted the need for proactive approaches to prevent underlying conditions that increase risk for infection, worsen the wide ranging harms from the virus, and significantly exacerbate disparities that characterize many nations. To ensure uptake of the science by end-users (e.g., community stakeholders, practitioners, policymakers), who operate the levers that determine whether resources and services are distributed equitably across societies' sectors, prevention scientists have a unique and powerful role to play. This commentary on the special issue, focused on the "culture of prevention," considers the broader issues covered in the set of original articles in light of the ongoing COVID-19 pandemic. Toward that end, I also outline two interrelated "calls to action" for prevention scientists. The first call is to concertedly apply a race equity lens to all aspects of our research, a need that is particularly critical given that our field is inherently actionable and, as such, evidence amassed has potential to equalize the playing field for disadvantaged and marginalized groups. The second acknowledges the need for prevention scientists to learn how to effectively communicate scientific knowledge to the public and policymakers to compellingly advocate for reforms guided by the science. A powerful, research-backed collective advocacy can effectively sway action of governing bodies in addressing disparities and inequities for constituents who have no voice.
Topics: COVID-19; Humans; Preventive Health Services; Risk Factors; SARS-CoV-2; Social Marginalization; Syndemic
PubMed: 33215309
DOI: 10.1007/s11121-020-01180-w -
Cancer Prevention Research... Apr 2017The pioneering Royal Marsden Tamoxifen Prevention Trial recruited 2,471 eligible high-risk women to be randomized to either placebo or tamoxifen (20 mg daily) for 8...
The pioneering Royal Marsden Tamoxifen Prevention Trial recruited 2,471 eligible high-risk women to be randomized to either placebo or tamoxifen (20 mg daily) for 8 years. Breast cancer incidence was evaluated at a median of 18.4 years from the start of the study. There was a 32% reduction in estrogen/progesterone receptor (ER/PR)-positive breast cancers after tamoxifen treatment finished. Translational research, to study "the good, the bad, and the ugly of tamoxifen" in the 1980s, subsequently ensured women's safety from possible increases in osteoperosis, coronary heart disease, and endometrial cancer. Other tamoxifen chemoprevention trials followed. The result of laboratory research was the unanticipated discovery of raloxifene to prevent osteoporosis and breast cancer at the same time. A new group of medicines, now known as selective ER modulators, was established. Indeed, the ability to prevent or delay multiple diseases with a single cheap medicine has the potential to alleviate pressure on health care systems that are overwhelmed. It is a priority to educate physicians appropriately to apply recommended proven medicines as preventives. .
Topics: Breast Neoplasms; Chemoprevention; Female; Humans; Selective Estrogen Receptor Modulators; Tamoxifen; Translational Research, Biomedical
PubMed: 28246081
DOI: 10.1158/1940-6207.CAPR-17-0026